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

The purpose of this study was to characterize the risk of human immunodeficiency virus (HIV) infection for men who have sex with men and to identify the risk such men pose to their female sex partners. The subjects were 5480 men who were tested for HIV between January 1987 and December 1991 and who reported having had sex with a man since 1977. Men who identified themselves as bisexual or straight were more likely to use injection drugs, had a substantial HIV seroprevalence, and reported many more female partners than men who identified themselves as gay. Men who identify themselves as bisexual pose the greatest risk to their female partners.
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PMID:HIV transmission: Women's risk from bisexual men. 825 12

The Centers for Disease Control reported in October 1991 that many people at risk for human immunodeficiency virus (HIV) infection had not been tested for antibodies to HIV. This study identifies differences among 110 gay and bisexual men in three small cities in Pennsylvania who decided whether to be tested for antibodies to HIV and, if so, whether to return for results. These men were given self-administered questionnaires and were offered free and confidential HIV antibody tests. Fifty percent of the men refused testing. Of those tested, only 35 percent returned to obtain test results. Contrary to other health prevention data, education was significantly and inversely related to being tested and to returning for results. Men who most often participated in the institutionalized gay community were least likely to be tested. The findings suggest that gay men who are most aware of the potential psychosocial problems associated with HIV antibody testing are more likely to avoid testing.
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PMID:Factors associated with participation in HIV antibody screening and results disclosure. 828 48

The authors separately studied the epidemiology (risk and risk factors) of Kaposi's sarcoma occurring as an initial acquired immunodeficiency syndrome (AIDS) outcome (early Kaposi's sarcoma) and later after a different initial AIDS outcome (later Kaposi's sarcoma) in a cohort of 2,591 human immunodeficiency virus type 1-infected gay men of the Multicenter AIDS Cohort Study between 1984 and 1992. Among 844 AIDS cases, 202 presented with early Kaposi's sarcoma, 101 subsequently developed later Kaposi's sarcoma, and 541 were not diagnosed with Kaposi's sarcoma. Overall, 37.4% of AIDS cases were diagnosed with Kaposi's sarcoma prior to death. Kaposi's sarcoma diagnosed on the skin was significantly more common with early Kaposi's sarcoma (77.3%) than with later Kaposi's sarcoma (65.1%). Men presenting with an AIDS outcome other than Kaposi's sarcoma were at high risk for later Kaposi's sarcoma. Later Kaposi's sarcoma onset in men with a previous AIDS outcome was associated with the following characteristics: 1) lower immune status prior to AIDS and 2) longer post-AIDS survival. A Kaposi's sarcoma diagnosis in a man with a previous AIDS illness approximately doubled the risk (hazard) for death. Histories of urethral gonorrhea and scabies prior to study entry were more common in early Kaposi's sarcoma cases than in later Kaposi's sarcoma cases. However, self-reported sexual activity at study entry and prior to AIDS onset was highest in the later Kaposi's sarcoma group. In this cohort, cigarette smoking had a protective association against all Kaposi's sarcoma in univariate and multivariate models. Only 21.0% of the later Kaposi's sarcoma and 25.0% of the early Kaposi's sarcoma men smoked at least one-half pack of cigarettes daily at study entry compared with 33.8% of non-Kaposi's sarcoma and 35.5% of seroprevalent men still AIDS free. The reasons for this surprising association are unclear. However, other evidence which documents that habitual smoking alters the immune system (and possibly cytokine levels) in ways that could perhaps influence Kaposi's sarcoma pathogenesis should be considered.
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PMID:Epidemiologic analysis of Kaposi's sarcoma as an early and later AIDS outcome in homosexual men. 835 67

Using data from the San Francisco Men's Health Study and the San Francisco General Hospital Cohort, we derived partially population-based estimates of human immunodeficiency virus (HIV) antiretroviral therapy and Pneumocystis carinii prophylaxis use in HIV-infected men in 1991. Zidovudine, didanosine, and dideoxycytidine were the antiretroviral therapies and aerosolized pentamidine, trimethoprim-sulfamethoxazole, and dapsone were the Pneumocystis prophylaxis evaluated. Among 81 men (29 of whom had AIDS) with < or = 200 CD4 cells, 76 (94%) had ever used and 56 (69%) were currently using an antiretroviral drug; 73 (90%) had ever used and 61 (75%) were currently using Pneumocystis prophylaxis. Among 127 men with 201-499 CD4 cells, 95 (75%) had ever used and 81 (64%) were currently using antiretroviral therapy; 49 (39%) had ever used and 36 (28%) were currently using Pneumocystis prophylaxis. Among 122 men with > or = 500 CD4 cells, 29 (24%) were currently receiving antiretroviral therapy. Forty-three men had discontinued antiretroviral therapy, 29 (67%) because of side effects. Thirty-seven men with < or = 500 CD4 cells had never used antiretroviral drugs: 48% because of feeling well and 28% because of possible side effects. Compared with 1987-1989, there were substantial increases in both antiretroviral therapy and anti-Pneumocystis prophylaxis use.
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PMID:Population-based estimates of antiretroviral therapy and anti-Pneumocystis prophylaxis in San Francisco: 1991. 838 68

A 1991 study of a nationally representative sample of men aged 20-39 finds that 27% of sexually active men had used a condom in the four weeks before interview. Black men are more likely than white men to report condom use (38% vs. 25%), and men younger than 30 are more likely to do so than are those older than 30 (36% vs. 19%). Among white men, condom use increases with years of education; among black men, however, those with 12 years of education are much less likely to report condom use than are those with more or less than 12 years (28% vs. 43-50%). Condom use is positively related to number of partners. Men who have engaged in anal intercourse, those who have had a one-night stand and those who are bisexual or homosexual are also more likely to report condom use. Among those who reported using a condom in the previous four weeks, 55% of whites and 18% of blacks had done so only for birth control and 7% of whites and 9% of blacks had done so only for protection against infection with the human immunodeficiency virus and other sexually transmitted organisms; the remainder had used a condom for both reasons.
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PMID:Condom use among U.S. men, 1991. 840 47

According to a nationally representative sample of 3,321 men aged 20-39 surveyed in 1991, men appear well aware of the severity of AIDS: Nearly all know that AIDS destroys the immune system and that there is no cure for the disease, but a substantial minority do not think that AIDS will necessarily result in pain and death. Men's perceptions of the disease's severity seem to have little impact on their sexual behavior, with no clear relationship between men's knowledge of AIDS and their recent number of sex acts, their condom use or their participation in anal or casual sex. Men's perceptions of the general risk of human immunodeficiency virus (HIV) transmission also appear to have little impact either on their concerns about AIDS or on their behavior, but their perceptions about the AIDS rate in their local community do affect their concerns and behavior. Men know that certain kinds of behavior place them at risk, and their prior behavior significantly influences their perceptions of their own HIV risk. However, speculation about their own HIV status is only moderately related to their recent sexual behavior.
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PMID:Perceptions of AIDS risk and severity and their association with risk-related behavior among U.S. men. 840 47

Traditional sampling methods are unsuitable for determining the levels of human immunodeficiency virus type I infection and related behavioral risk factors among young men who have sex with men. Most surveys of this hard-to-reach population have used nonprobability samples of young men in clinical or public settings. While these studies have revealed high rates of HIV infection and risk behaviors, their findings are not generalizable to broader populations of young men who have sex with men. To better understand the epidemiology of HIV within this population, the Centers for Disease Control and Prevention, in collaboration with state and local health departments, has developed a venue-based probability survey of young men who have sex with men. Conducted in seven metropolitan areas in the United States, the Young Men's Survey combines outreach techniques with standard methods of sample surveys to enumerate, sample, and estimate prevalence outcomes of a population of young men who frequent public venues and who have sex with other men. Venues where young men who have sex with men are sampled include dance clubs, bars, and street locations. At sampled venues, young men are enumerated, consecutively approached, and offered enrollment if they are determined eligible. Young men who agree to participate in the Young Men's Survey are interviewed, counseled, and tested for human immunodeficiency virus, hepatitis B, and syphilis in vans parked near sampled venues. The Young Men's Survey provides data on the locations and times at which demographic and behavioral subgroups of young men who have sex with men may be targeted for prevention activities. Behaviors and psychosocial factors associated with human immunodeficiency virus infection can be used to design culturally relevant and age-specific prevention activities for young men who have sex with men.
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PMID:The Young Men's Survey: methods for estimating HIV seroprevalence and risk factors among young men who have sex with men. 886 70

The course of disease associated with infection with the human immunodeficiency virus varies widely. Some patients deteriorate rapidly, while others live for years, even after an illness that defines the acquired immunodeficiency syndrome (AIDS). In this study, comorbidity, or the presence of concurrent health problems, was investigated prospectively as a possible co-factor for different rates of decline in 395 homosexual/bisexual men in the San Francisco Men's Health Study (SFMHS) who were infected with the human immunodeficiency virus (HIV). Comorbidity data obtained from baseline interviews included both chronic and infectious diseases as well as depression. Smoking, alcohol, and drug use were also examined. The most prevalent comorbid conditions were sexually transmitted diseases (90%) and hepatitis B infection (76%). Most chronic and acute concurrent health conditions were not significant discrete predictors of survival to AIDS or death after controlling for immune status and markers of disease progression. Significantly, other risk factors (e.g., depression and smoking) were found to be associated with more rapid progression. Men with symptoms of depression had a higher risk of progression of AIDS diagnosis; the relative hazard (RH) was 1.4 (95% confidence interval [CI], 1.00-2.08); smoking was associated with higher risk of death (RH, 1.6; 95% CI, 1.20-2.17). Older age was marginally associated with poorer survival to death. No associations were found between survival and alcohol and drug use.
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PMID:Comorbidity and survival in HIV-infected men in the San Francisco Men's Health Survey. 891 73

Cellular entry of human immunodeficiency virus type 1 (HIV-1) requires binding to both CD4 (ref, 1, 2) and to one of the chemokine receptors recently discovered to act as coreceptors. Viruses that infect T-cell lines to form syncytia (syncytium-inducing, SI) are frequently found in late-stage HIV disease and utilize the chemokine receptor CXCR-4; macrophage-tropic viruses are non-syncytium-inducing (NSI), found throughout disease and utilize CCR-5 (ref. 3-11). We postulated that CCR-5 gene defects might reduce infection risk in seronegative subjects and prolong AIDS-free survival in seropositive subjects with NSI but not SI virus. Homozygous (delta ccr5/delta ccr5) and heterozygous (CCR5/delta ccr5) CCR-5 deletions (delta ccr5) were found in 7 (2.7%) and 51 (19.5%), respectively, of 261 seronegative subjects from the San Francisco Men's Health Study. CCR-5/delta ccr5 genotype was identified in 33 of 172 (19.2%) nonprogressors and 25 of 234 (10.7%) progressors from the seropositive arm of this cohort. The delta ccr5 allele conferred a significant protective effect against HIV-1 infection (P = 0.001) and a survival advantage against disease progression (P = 0.02). Although both progressing and nonprogressing CCR5/delta ccr5 subjects were identified, a distinct survival advantage was shown for those with NSI virus (P < 0.0001). Thus, the protective effect of delta ccr5 against disease progression is lost when the infecting virus uses CXCR-4 as a coreceptor.
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PMID:The role of viral phenotype and CCR-5 gene defects in HIV-1 transmission and disease progression. 1050 92

After contradictory findings from a number of previous studies, behavioral risk factors for Kaposi's sarcoma were examined in a case-control study of 202 people diagnosed with acquired immunodeficiency syndrome (AIDS) in 1991-1993 in Sydney, Australia. Cases comprised 67 men who developed Kaposi's sarcoma at or after a diagnosis of acquired immunodeficiency syndrome, and controls were 135 people who did not have Kaposi's sarcoma at the time of diagnosis of acquired immunodeficiency syndrome or during follow-up until 1995. Men who developed Kaposi's sarcoma were more likely to report having a history of sexually transmissible diseases and having engaged more frequently than controls in a number of sexual practices with casual partners in the period before they became aware of their human immunodeficiency virus (HIV) infection. However, the only sexual practice reported significantly more often by cases at the 0.05 significance level was insertive oroanal contact with casual partners (odds ratio = 2.6, 95 percent confidence interval 1.3-5.3). This association was not present for insertive oroanal contact with regular partners or for insertive oroanal contact after subjects became aware of their HIV infection. The relation was present both in men who had Kaposi's sarcoma at the time of interview and in those who developed it later. The relation was not affected by adjustment for time of HIV infection and diagnosis or for other sexual practices. These results can be interpreted as supporting the hypothesis that Kaposi's sarcoma in people with HIV is caused by an infectious agent transmitted by oral contact with feces.
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PMID:Risk of Kaposi's sarcoma and oroanal sexual contact. 912 93


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