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

The CDC Family of Surveys is a national serologic surveillance system set up to characterize the extent of human immunodeficiency virus (HIV) infection in the United States. The now Centers for Disease Control and Prevention (CDC) and participating State and local health departments began the system in 1987. HIV seroprevalence data are collected by unlinked (anonymous) surveys of particular components of the population that include childbearing women; clients of sexually transmitted disease clinics; injecting drug users; tuberculosis patients; and several special populations, such as adolescents, prisoners, and homeless persons. The data obtained have been used extensively on both national and local levels to assist HIV-prevention programs. Data from the surveys have been used to identify specific demographic groups at risk for HIV infection so that health education programs may be planned and made available to them in clinical settings. Local serosurvey results have been used in planning and implementing prevention programs and in planning health services for HIV-positive persons. The completeness, or coverage, of HIV counseling and testing programs has been evaluated by comparing seroprevalences among clients tested voluntarily with those tested in the unlinked survey. Survey data are used in formulating recommendations and standards of care for health practitioners, in allocating resources, and in carrying out long-range planning for HIV prevention and treatment services for at-risk groups. Such data are essential to the decision-making process in forming public health policy and recommending practices involving the HIV epidemic.
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PMID:Applications of data from the CDC Family of Surveys. 815 71

In Sweden, voluntary testing for HIV (human immunodeficiency virus)-antibodies has been given an important place in combating AIDS (acquired immunodeficiency syndrome). To elicit the reasons why people seek voluntary testing on their own initiative outside general screening programmes, during a three-year period (1989-91) applicants at a major urban testing locale were asked to fill in an anonymous questionnaire, which was completed by 68.6 per cent (831/1,212) of those eligible. Of the 831 respondees (both men and women), 88.9 per cent cited recent casual sexual contact as the reason why they might be at risk. Although in most cases no particular risk factors were reported to be associated with the sexual contact, in 17 cases (2.3 per cent) the partner was known to be an HIV-carrier. Of 664 people completing the item on the questionnaire 208 (31.3 per cent) reported the sexual contact to have occurred abroad. When the reason for undergoing the test was not possible recent exposure, the commonest reasons given were persistent anxiety or the establishment of a new sexual relationship. Only one of the 1,212 tests performed was HIV-positive.
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PMID:[Reasons for HIV testing. Casual sexual contacts are the most common reasons for voluntary HIV testing]. 818

Ethical issues arise throughout the conduct of epidemiologic studies, in the processes of determining the study question, designing the protocol, and implementing the study. There also is an ethical dimension when studies are not done, for example, in studies of the effect of drugs and chemicals on male reproductive capacity. Harm as well as risk must be considered in the conduct of epidemiologic studies. The ethical principles that govern research, while independently justifiable, may come into conflict. Principles that govern research also may conflict with those that predominate in clinical practice. An example is the current controversy over unblinding anonymous, newborn human immunodeficiency virus seroprevalence studies to identify potentially infected infants. As women's health becomes more prominent on the research agenda, the resolution of these conflicts will become a complex challenge to epidemiologists, ethicists, clinicians, and the communities they serve.
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PMID:Ethics, epidemiology, and women's health. 820 84

To determine whether the excess prevalence of human immunodeficiency virus type 1 (HIV-1) infection in US black and Hispanic homosexual men relative to white men can be explained by differences in sociodemographic factors, history of sexually transmitted diseases, or sexual and drug-use behaviors, the authors conducted a cross-sectional analysis of baseline HIV-1 seroprevalence and HIV-1 risk factors among 4,475 non-Hispanic white, 234 Hispanic white, and 194 black homosexual men from four centers in the United States (Baltimore/Washington, DC, Pittsburgh, Chicago, and Los Angeles). HIV-1 seroprevalence was significantly higher in Hispanic men (50%; odds ratio (OR) = 1.83, 95% confidence interval (CI) 1.41-2.39) and black men (47%; OR = 1.62, 95% CI 1.21-2.16) compared with white men (35%). Both Hispanic and black men more frequently reported a history of sexually transmitted diseases. Overall, Hispanics had the highest risk profile and blacks the lowest risk profile with respect to certain high-risk sexual behaviors (e.g., receptive anal intercourse and use of anonymous sexual partners) and recreational drug use. After multivariate adjustment, black race remained a significant independent risk factor for HIV-1 seropositivity (OR = 1.60, 95% CI 1.13-2.26), but Hispanic ethnicity was no longer statistically significant (OR = 1.17, 95% CI 0.82-1.69). Most of the excess HIV-1 prevalent infection among Hispanics was explained by their predominant recruitment from Los Angeles--the study center with the highest HIV-1 seroprevalence--and their greater prevalence of a history of sexually transmitted diseases and certain high-risk sexual practices. By contrast, adjustment for these same risk behaviors failed to explain the observed black-white differences in HIV-1 seroprevalence, and further studies are needed to elucidate the reasons for these unexplained racial differences. HIV-1 educational programs for homosexual men should take into account the behavioral differences that exist between white and minority racial/ethnic groups.
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PMID:Racial and ethnic differences in human immunodeficiency virus type 1 (HIV-1) seroprevalence among homosexual and bisexual men. The Multicenter AIDS Cohort Study. 821 47

The objectives of this study were to assess attitudes, knowledge, and behavior related to human immunodeficiency virus (HIV) antibody testing of adolescents and young adults undergoing treatment for alcohol and drug problems. Setting and subjects were 101 adolescents and young adults enrolled in a New England substance abuse rehabilitation program. All subjects had heard about acquired immunodeficiency syndrome (AIDS) and 84% desired an HIV antibody test if it were anonymous and confidential. If found to be HIV positive, 83% stated that they would be less likely to continue substance-abuse treatment, 64% would be more likely to continue drug use, and 62% would be more likely to continue alcohol use. The likelihood of continuing school would decrease for 60%. Sixty percent would be more likely to increase use of condoms. Males were more likely than females to want to leave treatment and school, return to alcohol and drug use, and increase risk-taking behavior (p < 0.02). These findings suggest that teenagers undergoing treatment for substance-abuse problems require careful and comprehensive pre- and post-test counseling and follow-up when undergoing HIV antibody testing. Deciding when to test for HIV may impact on the success of substance-abuse treatment, as well as ability to control spread of HIV infection.
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PMID:A survey of attitudes, knowledge, and behavior related to HIV testing of adolescents and young adults enrolled in alcohol and drug treatment. 824 Dec

To evaluate human immunodeficiency virus type 1 (HIV-1) infection among patients of primary care physicians, we performed anonymous, unlinked HIV-1 antibody testing on leftover blood specimens submitted to 10 large commercial clinical laboratories for complete blood cell count or hematocrit determination, the most commonly ordered diagnostic tests. From January through August 1990, 55,613 specimens submitted by general internists, pediatricians, and family practitioners were sampled; 1,104 (2.0%) had HIV-1 antibody. Seroprevalence among the laboratories varied 50-fold, from 0.3 to 12.4%. The HIV-1 prevalence at each laboratory was not always consistent with the AIDS incidence in the area served by the laboratory. Overall the seroprevalence was almost eight times higher in men (3.9%) than in women (0.5%). Specimens from seropositive persons, especially from men, were unevenly distributed among the physician practices; only three practices submitted approximately 50% of all specimens from seropositive men. These data indicate that a few physicians treat the majority of HIV-1-infected primary care patients. The HIV-1 prevalence among specimens at a clinical laboratory is thus determined by whether few physicians submit specimens to that laboratory. These results could be of use, for instance, in analyzing proposals to mandate physician reporting of HIV-1 infection. The high HIV-1 prevalence among laboratory specimens underscores the potential for exposure to HIV-1-infected blood by clinical laboratory personnel and emphasizes the need for universal precautions for all blood specimens.
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PMID:Prevalence of antibody to the human immunodeficiency virus among clinical laboratory specimens: findings from a survey of primary care physicians. 830 29

A pilot study was conducted to identify nurses' attitudes and concerns pertaining to the care of people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Data were collected using an anonymous, voluntary questionnaire, which was made available to all nurses at a Wellington Area Health Board (New Zealand) hospital. Of 562 nursing staff, 286 (51%) responded, of which 74 (25.9%) had previously attended an HIV/AIDS workshop for Area Health Board staff. Of those staff handling blood, 132 (49.4%) always wore gloves, and only half of the respondents (n = 148, 51%) treated all body fluids as potentially HIV positive. The possible attrition rate from nursing positions in the canvassed hospital was 2.8%, with a further 43 (15.0%) undecided about resigning from their post. Only 36 nurses (12.5%) believed the employer did not provide adequate safety measures. The provision of education regarding HIV/AIDS, by the employer, was considered inadequate by 61 (21.3%) respondents. This study demonstrates that further safety and education needs should be attended to or reinforced.
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PMID:Nurses' attitudes and concerns pertaining to HIV and AIDS. 832 Mar 85

We sought to determine the prevalence of human immunodeficiency virus (HIV) infection in a population of women with human papillomavirus (HPV)-related diseases attending a colposcopy clinic who had no other CDC-defined risk factors for HIV. Study patients included all new patients attending our colposcopy clinic who were found to have histologic evidence of condyloma or cervical intraepithelial neoplasia. Those patients not already known to be HIV-positive were offered testing for HIV. Demographic information was obtained on all patients. Results were compared to data from anonymous testing of our own obstetrical population. One hundred forty of 208 women (67.3%) were either previously known to be HIV-positive or agreed to be tested. Sixteen (11.4%) were HIV-positive. Eight of the HIV-positive women were not previously known to be HIV-positive and 6 of the 8 had no definable risk factors for HIV infection. This is 4.6% of the women not already known to have a CDC-defined risk factor for HIV. The rate of HIV infection in our obstetrical population is 1.6%. In women without other definable risks for HIV infection and who had HPV-related disease the relative risk of HIV infection in our population was 2.94 (95% confidence interval 1.21-6.94; P < 0.031). In areas where HIV is endemic there is a high prevalence of HIV infection in women with HPV-related disease. Even in women without another definable risk factor for HIV, HPV-related disease may serve as a marker for an increased risk of HIV infection in this population.
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PMID:Is human papillomavirus-related disease an independent risk factor for human immunodeficiency virus infection? 838 13

In conjunction with the Centers for Disease Control and Prevention's (CDC's) national Sentinel Hospital Surveillance System for HIV (human immunodeficiency virus) Infection, we conducted unlinked (anonymous) testing of a systematically selected sample of blood specimens for HIV-1 antibodies to assess the HIV-1 infection level in an urban hospital's catchment population. We excluded specimens from patients with admitting diagnoses often associated with HIV infection. Of the 5,350 specimens tested between April 1988 and October 1989, 106 (2%) were HIV-1 seropositive. HIV-1 seroprevalence in female patients was 1%, and in male patients, 3%. Those 25-44 years of age showed the highest seroprevalence (3.7% in all patients: 6.6% in male patients, 1.1% in female patients). These results demonstrate a high HIV-1 infection level in this patient population and suggest Baltimore hospitals should evaluate the impact and costs of developing routine HIV counseling and testing programs for their patients.
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PMID:Prevalence of human immunodeficiency virus-1 infection in a Baltimore acute care hospital. 841 38

Safer sex practices intended to reduce the risk for human immunodeficiency virus (HIV) infection have been vigorously promoted among men who are homosexual or bisexual (i.e., men who have sex with men). Such efforts have emphasized personal responsibility and protection of partners, and many of these men appear to have adopted risk-reducing behaviors (1). However, it is unknown whether these safer sex practices and norms have been adopted by men who have sex with men but conceal their sexual orientations or do not self-identify as homosexual or bisexual (2-7). To characterize the relation between the adoption of safer sex practices among men who have sex with men and sexual self-identity, as well as HIV information-seeking, exposure to the homosexual or bisexual community culture, and comfort in disclosing sexual identity, the Dallas County (Texas) Health Department (DCHD) conducted a survey among men who have sex with men. This report summarizes survey findings for men who reported having had sex with men and who visited DCHD clinics for anonymous HIV counseling and testing from January through June 1991.
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PMID:Condom use and sexual identity among men who have sex with men--Dallas, 1991. 841


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