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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Legal initiatives and treatment policies regarding mandatory human immunodeficiency virus testing and contact tracing often are considered without the input of those groups most affected by the proposed legislation. A survey of attitudes toward the testing and tracing issues was conducted on one such group--intravenous drug users in treatment. Interview and self-report questionnaire data were collected on 196 methadone-maintained patients from two Philadelphia clinics. Data indicate that although most methadone patients supported mandatory testing, their support appears to be influenced by past testing experience. That is, significantly more untested than tested individuals were opposed to the policy. Regarding contact tracing, data indicate that most patients with seronegative results supported tracing, but of the three patients with seropositive results who were surveyed, two were opposed to it. However, most seropositive and seronegative patients reported a willingness to comply with tracing if it were to become law.
J Subst Abuse Treat 1992
PMID:Attitudes toward mandatory human immunodeficiency virus testing and contact tracing. A survey of intravenous drug users in treatment. 159 63

Two hundred Norwegian substance abusers who consecutively applied for treatment in a hierarchical therapeutic community were divided into two different groups according to intake procedures: the intake group (IG) and the nonintake group (No-IG). Using a prospective design, we found that beginners in the program were more often infected with human immunodeficiency virus and that they used amphetamine more frequently and alcohol less frequently than nonbeginners. The type of intake procedure did not influence the percentage of those who started in the program, but it increased the number of clients who completed Phase 1, the 1-year inpatient phase of the program. Twice as many clients in the IG completed Phase 1 compared to those in the No-IG. From a clinical point of view, we conclude that the IG procedure should be offered to all applicants but that the model should be developed more as a role induction strategy, in which learning practical coping skills to adjust to the treatment program is essential.
J Subst Abuse Treat 1992
PMID:Different intake procedures. The influence on treatment start and treatment response--a quasi-experimental study. 159 64

Widespread use of cocaine by methadone clients is undermining the effectiveness of methadone treatment programs in reducing illicit drug use, decreasing criminal behavior, and slowing the spread of the human immunodeficiency virus (HIV). In response, methadone programs are implementing a range of behavioral interventions to manage this growing problem. Many of these interventions, however, have yet to be evaluated for effectiveness for reducing cocaine use among methadone clients. Interventions that are effective for cocaine use in the general population may not be as effective with cocaine users in methadone programs because these clients differ from other cocaine users in ways that are likely to affect how they respond to the interventions. This paper reviews the literature on the significance and scope of the problem of cocaine use by methadone clients and on the behavioral interventions that have been evaluated for these clients.
J Subst Abuse Treat 1991
PMID:Cocaine use by clients in methadone programs: significance, scope, and behavioral interventions. 178 44

As the AIDS epidemic in the United States moves steadily into the IV drug-abusing population, knowledge of factors related to immune suppression and disease progression gain in public health importance. Indicators of nutritional status, consisting of anthropometric and hematologic data as well as demographic data, were obtained from a random sample of 130 clients in a New York City methadone treatment center. Subjects for this study were selected according to the entry criteria established for inclusion in a large-scale study of the role of nutritional factors and cell-mediated immunity in a group at high risk of HIV seropositivity. Our results indicate a larger than U.S. population-average heterogeneity for Body Mass Index, hematocrit, and hemoglobin concentration, parameters which are conventionally thought to be proxies for general nutritional status. The findings indicate that while some methadone treatment clients are at low nutritional risk, others are probably at very high risk of adverse drug-nutrient and drug-body habitus interactions as well as being at high risk of acquiring infections commonly associated with HIV-related immunodeficiency.
J Subst Abuse Treat 1990
PMID:Indicators of nutritional status among clients from a New York City methadone treatment center. 217 65

We surveyed 11 methadone maintenance treatment programs in the Baltimore, Maryland, area to examine cocaine use among their 2414 clients and the methods employed to cope with that use. The percent of clients with at least one urine sample positive for cocaine during the month previous to study was 15.7% (379/2414) and ranged from 5.9% to 33.0% among the 11 programs. We determined the programs' use of monitoring strategies, treatment services, and administrative controls. We discuss the policy implications of our findings for methadone maintenance programs' efforts to address cocaine use with particular regard to the epidemic of human immunodeficiency virus (HIV) among intravenous drug users, their sexual partners, and offspring.
J Subst Abuse Treat 1990
PMID:A treatment crisis: cocaine use by clients in methadone maintenance programs. 238 10

To slow the spread of AIDS, it may be important for substance abuse treatment programs to give priority admission to patients who are HIV-infected and infectious. A new program is described that provides methadone maintenance treatment to opiate addicts who are "AIDS affected"--heroin addicts diagnosed with AIDS, AIDS-related complex (ARC), or other significant symptoms of HIV infection. The program aims to protect the health of patients and to protect the general public by slowing the spread of the human immunodeficiency virus (HIV). This article describes the program's history and goals, its referral and patient admission process, methods of assessment and treatment planning, medical care, counseling procedures, tolerance for misbehavior, philosophy toward eventual detoxification, and procedures that maintain confidentiality.
J Subst Abuse Treat 1989
PMID:Methadone maintenance program for AIDS-affected opiate addicts. 274 16

State agencies have been profoundly impacted by the AIDS epidemic. In the absence of a vaccine that would prevent AIDS or of medicines that would cure it, the primary strategies of such agencies have focused on reducing the spread of AIDS by promoting cessation of high risk behaviors and thus preventing or slowing its transmission. Recent research indicates that the primary route of AIDS transmission into the general heterosexual population is by intravenous (IV) drug abusers, who directly account for about 17% of AIDS cases nationwide. Reducing the spread of AIDS within this group would not only reduce the overall toll of the disease but should limit its spread to the population at large. Infection by the human immunodeficiency virus (HIV) can be minimized by reducing or eliminating certain high-risk activities. In the IV drug using community, the primary intervention strategies include: educating IV drug users about the hazards of AIDS and sharing of needles; enrolling them in treatment programs to reduce drug use; promoting the use of new or sterilized syringes and needles among those who will not abstain from drug use; and discouraging high-risk sexual activity among those who are already infected by HIV. The State of California has already increased the number of treatment slots for IV drug users and, through the Department of Alcohol and Drug Programs, is scaling up its educational, prevention, and intervention activities, particularly those related to safe sex, promoting the cessation of IV drug use, and improving equipment hygiene by those who continue use.
Adv Alcohol Subst Abuse 1987
PMID:The response of state agencies to AIDS, addiction, and alcoholism. 332 46

Human immunodeficiency virus (HIV) infection produces a spectrum of clinical syndromes, progressing in severity from asymptomatic infection through the life-threatening diseases of the acquired immunodeficiency syndrome (AIDS). Current knowledge about the epidemiology, virology, and clinical manifestations of HIV infection and AIDS are reviewed.
Adv Alcohol Subst Abuse 1987
PMID:AIDS update--1987. 332 48

The debate over the provision of sterile injection equipment to intravenous drug users, as a means of preventing the spread of the AIDS epidemic, has a number of political, ethical, and clinical implications. The issue has in some respects been inappropriately dichotomized as a conflict between public health agendas and the traditional priorities of drug treatment. The relevant issues include: (1) the existence of evidence for needle-sharing as a route of transmission of human immunodeficiency virus among intravenous drug users; (2) the role of needle scarcity as a factor promoting needle-sharing behavior, and evidence for the ability of drug users to change such behavior; (3) the possibility of increased needle availability leading to increased prevalence of intravenous drug abuse; (4) the possibility that the provision of sterile needles would compromise treatment efforts among drug abusers currently or potentially engaged in the treatment system. These issues are discussed in light of relevant existing data; a multilevel strategy for AIDS prevention among drug users is suggested, addressing both the availability of sterile injection equipment and the promotion of drug treatment goals.
Adv Alcohol Subst Abuse 1987
PMID:Sterile needles and the epidemic of acquired immunodeficiency syndrome: issues for drug abuse treatment and public health. 344 96

This report describes the current approach to testing for the human immunodeficiency virus (HIV) antibody at Phoenix House, a large therapeutic community (TC) in the northeastern United States, and presents findings on retention of clients who have been tested for HIV antibodies and notified of their HIV serostatus. A total of 240 clients were tested while in treatment at Phoenix House between April 1988 and July 1992. Of these, 51 tested HIV positive. An additional 76 clients had tested positive for HIV antibodies prior to entering treatment. The difference in length of treatment stay between those who tested negative while in treatment and those who tested positive while at Phoenix House was not significant (t = 0.41, df = 238, p > .683). Although clients who tested seronegative during treatment were found to remain in treatment a significantly longer amount of time than the total population of seropositive clients (t = 4.54, df = 314, p < .001), those who learned of their seropositive status while in treatment remained in the program longer than clients who entered treatment aware of their seropositivity (t = 4.08, df = 125, p < .001). These findings suggest that acute reactions to the knowledge of seropositivity did not determine most premature terminations. The use of a small group, a core technical element of the TC, may have provided a favorable context for the task of HIV counseling and testing.
J Subst Abuse Treat
PMID:HIV antibody testing and client retention in the therapeutic community. A preliminary report of Phoenix House. 786 70


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