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Query: UMLS:C0021051 (immunodeficiency)
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The findings of a national seroprevalence survey conducted in Peru during 1986-90 indicate accelerating rates of human immunodeficiency virus (HIV) among population groups at high risk of sexually transmitted diseases. Two databases were maintained: 1) January 1986-December 1988 and 2) January 1989-December 1990. Of the 140,976 survey participants, 3345 (2.4%) were HIV-positive by Western blot. 2591 participants were selected because of clinical signs suggestive of acquired immunodeficiency syndrome (AIDS); 46.7% were HIV-positive, but the prevalence increased from 19% in the 1986-88 period to 60% during 1989-90. Among the 4300 men who identified themselves as homosexual or bisexual, 26% were seropositive (8% during 1986-88 and 41% during 1989-90). HIV prevalence among 2204 men attending a sexually transmitted diseases clinic was 10.3%, with an increase from 2.0% in the first period to 19.0% in the later period. 10.4% of the 269 hemophiliacs were HIV-infected, with an increase from 8% to 36%. Among the 145 intravenous drug users, the prevalence rose from 1% during 1986-88 to 27% during 1989-90. Among 5827 registered female prostitutes, the prevalence rose from 0.3% to 0.7%; however, a 1990 analysis of 146 unregistered prostitutes revealed a rate of 9.6%. The HIV rates among 285 female and 105 male heterosexual partners of known HIV-positive persons were 50.2% and 40.0%, respectively. HIV prevalence increased from 0.8% during 1986-88 to 8.0% during 1989-90 among 1532 men and 1247 women who requested anonymous HIV testing. The prevalence among 542 male and 615 female medical personnel was 2.3%. Among 78,793 volunteer and 4733 paid blood donors, HIV prevalence was 0.2% (0.3% among paid donors). The period prevalence among 11,101 male military recruits and active duty members increased from 0.009% to 0.5%. Finally, only 0.3% of 21,595 applicants for immigration visas were HIV-positive, and there were no HIV cases among 1234 pregnant women attending antenatal clinics. Although the very low HIV prevalence among military personnel and pregnant women suggests that the virus is not yet widely disseminated within the general population, the finding that 28% of HIV-positive men were married and engaged in bisexual behavior suggests potential for heterosexual transmission in the years ahead.
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PMID:The epidemiology of HIV-1 infection in Peru, 1986-1990. 887 32

Despite emerging consensus that school-based programs have the potential to create an environment that promotes and facilitates adolescent condom use, the availability of such programs has not been documented. Thus, four data sources were utilized in an effort to identify all school-based condom distribution programs in the US: state departments of education, lists from institutions knowledgeable about such programs, networking with professionals in the field, and interviews with staff members at known programs. This process resulted in the identification of 431 schools (92% high schools) in 50 school districts in 21 states with condom availability programs as of January 1995. This represents only 2.2% of all US high schools and 0.3% of high school districts. 24% of these schools had school health centers as well. 81% of programs were implemented in 1991-92 in Los Angeles and New York City as a result of mandates aimed at reducing human immunodeficiency virus transmission among young people. In most schools, the condom distribution program was part of a more comprehensive program aimed at preventing unprotected intercourse and its consequences. Parental consent and counseling are common requirements for condom acquisition. Also common are restrictions on the hours condoms are distributed and the number that can be taken at one time. The median number of condoms obtained per school year was 1.1 per student. Three program variables were highly related to this number: making condoms available in bowls or baskets (4.8 more condoms per student compared to schools lacking this anonymous distribution technique), the presence of a school health clinic (1.5 more condoms per student), and condom vending machines (3.1 fewer condoms per student). Condom acquisition was also greater in smaller schools and alternative schools.
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PMID:Condom availability programs in U.S. schools. 888 62

The objective of this study was to describe the pharmacy needs of a group of males infected with human immunodeficiency virus (HIV) and to determine whether those needs were being met. An anonymous survey was used to determine the perceptions of a group of HIV-positive males. Of 62 usable responses, 53.2% of respondents tested positive for HIV more than five years ago and 58.1% reported a CD4 count below 200/mm3, the mean age was 41 years (SD = 8.6). Respondents indicated a need for a pharmacist knowledgeable in HIV disease/treatment (74.5%), a pharmacy that accepts all insurance (66.6%), and information on alternative therapies (29.4%). Most (72.6%) wanted both written and oral information, and more than half expected the pharmacist to provide information on side effects, how medications interact with other medications and with food and how to take the medication. More than 85% indicated satisfaction with pharmacy services. The study concluded that HIV-positive males have certain expectations for pharmacy services, such as the provision of written and oral information, specific medication information, and personal interaction with the pharmacist. These patients are satisfied to varying degrees with different aspects of pharmaceutical care Pharmacists should provide these expected services to increase satisfaction for all patients, especially those who are HIV positive.
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PMID:HIV-positive males' satisfaction with pharmacy services. 904 Jan 72

Nonhuman primate (NHP) species used in biomedical research may be infected with a variety of retroviruses including simian immunodeficiency virus (SIV), simian spumaviruses (i.e., simian foamy viruses [SPV]), simian T-lymphotrophic viruses (STLV), and/or simian type D retroviruses. All of these retroviruses cause life-long infections in NHPs, and some are transmissible through sexual contact, blood, or breast-feeding. Following the detection of SIV infection in a worker with occupational exposure to SIV, in 1993 CDC and the National Institutes of Health conducted an anonymous serosurvey using stored specimens collected from U.S. workers with similar exposures. SIV seroreactivity was present in three (0.6%) of 427 stored serum samples. As a result of this finding, in 1993 CDC implemented a voluntary testing and counseling surveillance program to link specific exposures or health outcomes with the SIV serostatus of persons with potential occupational exposure to SIV. In 1995, the linked surveillance program was expanded to include voluntary testing and counseling for exposure to SFV, STLV and simian type D retroviruses. As of November 20, 1996, samples from 231 of the participating volunteer workers had been tested for SFV; infection was documented in three (1.3%). This report presents laboratory findings and case descriptions of these three infections, which indicate that SFV from NHPs can persistently infect exposed humans and may or may not cause disease or be transmitted among humans.
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PMID:Nonhuman primate spumavirus infections among persons with occupational exposure--United States, 1996. 904 42

An understanding of quality of life (QOL) with human immunodeficiency virus (HIV) is important because the merits of prevention and treatment alternatives may depend substantially on how these interventions affect QOL. Physicians' views about QOL are important, because they influence the therapeutic options that physicians consider or offer, the recommendations that physicians make, and because they are important for the analysis of certain policy questions. We assessed physicians' utilities of health states associated with HIV infection, and hepatitis B virus (HBV) infection; assessment of utilities for HBV was induced to provide a comparison with HIV utilities. We surveyed 200 housestaff and staff physicians in an academic medical centre by anonymous paper-based questionnaire and used the time-tradeoff method to assess physicians' utilities of the health states. On a scale in which 0 was equivalent to death, and 1 was equivalent to good health, the median utilities for asymptomatic HIV infection, symptomatic HIV infection, and AIDS were 0.833, 0.417, and 0.167, respectively (p < 0.01 or each two-way comparison). Median utilities for asymptomatic HBV infection, mildly symptomatic HBV infection, and severely symptomatic HBV infection were 0.917, 0.667, and 0.167, respectively (p < 0.01 for each two-way comparison). Although physicians varied substantially in the ratings of health states, they assessed the utility of life with HIV disease, including asymptomatic infection, as severely reduced. Studies of the effectiveness and cost-effectiveness of preventive and therapeutic interventions for HIV should evaluate the effect of the intervention on utility-based assessments of QOL. Studies that do not assess such effects may significantly underestimate or overestimate the value of these interventions, depending on the intervention's effect on QOL.
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PMID:Physicians' assessments of the utility of health states associated with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infection. 906 45

The sexual behaviour and factors which affect such behaviour, source of knowledge and education about sex was assessed by means of an anonymous self-administered questionnaire among 2754 pupils (15-18 years) attending 40 (85%) second level schools in Galway City and County. The purpose of the study was to make recommendations in relation to a school sexual health education programme. Overall 21% of pupils had had sexual intercourse, with boys more than twice as likely as girls to have experienced this. The mean age of first sexual intercourse was 15.5 years, 72% reported having used a condom at first intercourse but of 475 pupils who had sexual intercourse regularly only 67% used condoms all the time with 33% using them sometimes or never. Over half reported that first intercourse was with a 'casual' partner and 35% and 9% respectively claimed that alcohol and non-prescribed drugs were a contributory factor. In relation to sexual risk beliefs, 72% believed that condoms used properly reduced the risk of sexually transmitted diseases (STDs) and 78% knew that the contraceptive pill is not protective against human immunodeficiency virus (HIV) infections. While the level of knowledge regarding sex education was generally high over one-third of sexually active respondents had been involved in high-risk behaviour. A need for health education programmes which focus on behaviour change and assertiveness has been identified.
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PMID:Sexual behaviour and sex education in Irish school-going teenagers. 908 32

To better understand potential barriers to condom use and the sexual behaviour of women infected with human immunodeficiency virus (HIV), an anonymous self-administered survey was performed on a convenience sample of 83 predominantly single HIV+ women. Most women had only one sexual partner who usually knew of the subject's serostatus. Only a minority of partners (26%) were known to also be HIV infected. Subjects were surprisingly more likely to use condoms with their main partner as opposed to other partners. Factors found to be associated with condom non-use included younger age, low education level, partner HIV+, history of a sexually transmitted disease (STD), and use of drugs or alcohol during sex. Although most subjects indicated the decision was mutual when deciding not to use a condom, 20% stated it a was a partner decision. Future intervention efforts should target these identified high-risk individuals and optimally involve the partners of HIV-infected women.
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PMID:Determination of factors associated with condom use among women infected with human immunodeficiency virus. 914 55

From 1 February 1993 to 1 February 1994 all new patients, known patients with new problems, and prostitutes attending the Outpatient Department of Sexually Transmitted Diseases (STD) of the University Hospital Rotterdam were asked to participate in unlinked anonymous human immunodeficiency virus (HIV) testing and to answer some questions. Data from the medical records of 300 patients refusing to participate were compared with self-reported data obtained from 2701 people accepting, to verify if the HIV seroprevalence among accepters could be representative for all STD department visitors. Men refusing were more often of foreign origin, had more often had more than one partner during the previous 6 months, more often attended the STD department for the first time, and more often had an STD diagnosed than men accepting. Women refusing were more often of foreign origin, had less often had more than one partner during the previous 6 months, and had more often used drugs intravenously than women accepting. Because most findings associated with refusing are also associated with being infected with HIV, the HIV seroprevalence among refusers is likely to be higher than among accepters. We therefore advise unlinked anonymous HIV testing of all patients visiting an STD department.
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PMID:Comparison of patients refusing with patients accepting unlinked anonymous HIV testing in an outpatient STD department in The Netherlands. 917 46

During 1991-1994, anonymous screening of newborn infants for maternal antibody to human immunodeficiency virus (HIV) was carried out in three regions of Spain: Valencia, Galicia and Sevilla. The newborn infants whose heel-stick blood eluates were satisfactory for HIV antibody tests were a consecutive series of 104 876, representing 99.3% of all newborn infants undergoing routine metabolic screening and estimated as comprising at least 98% of all births in the three regions. Enzyme immunoassay (EIA) positives were confirmed by immunoblot, yielding 246 confirmations: a rate of 2.3 per 1000. Seropositivity rates ranged from 1.4 per 1000 in Galicia to 2.1 in Sevilla and 3.1 in Valencia, and remained relatively stable in each region during the years of the study. Within socioeconomically defined subgroups of birth hospitals in Valencia and Galicia, all subgroups contained seropositives, even though there was a twofold to fivefold over-representation in the "inner city" public hospitals. To estimate the proportion of HIV-1-seropositive newborn infants who were positive for HIV-1 DNA, polymerase chain reaction (PCR) assays were performed on 165 dried blood spots that had been retained following positive immunoblot assays. Fifteen (9%) were PCR positive, and when this proportion is adjusted for the age-specific sensitivity of the method, it translates into an estimated HIV-1 transmission rate of 24% (range 18-36%). For 94,906 of the 104,876 newborn infants screened, the EIA used could detect antibodies that react with epitopes of HIV-1 and HIV-2. There were 30 newborn infants whose blood eluate was positive by this combined HIV-1/HIV-2 antibody screen and whose secondary screening with monovalent HIV-2 and HIV-1 EIA indicated that the HIV-2 reactivity was above the cut-off whereas the HIV-1 was not. Ranking these 30 results according to absolute HIV-2 reactivity and relative reactivity with respect to HIV-1 indicated that four infants were probable true HIV-2 seropositives and a total of 12 were possible HIV-2 seropositives, a prevalence of the order of 1:10000 to 1:20000 newborn infants. These anonymous population-based serological studies provide "leading-indicator" data to complement traditional AIDS surveillance for epidemiological and planning purposes.
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PMID:Anonymous testing of newborn infants for HIV antibodies as a basis for estimating prevalence of HIV in childbearing women: the 1991-1994 study in Spain. 924 Aug 62

This paper deals with subjects seeking counselling and testing for human immunodeficiency virus (HIV); it analyses which sociodemographic and behavioral characteristics are related to beliefs concerning HIV infection and to HIV seropositivity. A one month survey among individuals who attended HIV testing in three anonymous and free centers (CIDAGs) was carried out in Paris city, on March 1994. 2059 subjects completed a self-administered questionnaire. Data collected included demographic information, sexual and IVDU behavior, and HIV seropositivity. Subjects also had to evaluate their own risk of getting the acquired immunodeficiency syndrome (AIDS) and the perceived risk of getting AIDS in specific situations such as unprotected anal/vaginal intercourse with a casual partner, with multiple partners, with a seropositive partner, current dental treatment, French kiss, etc.... Multiple linear and logistic regressions have been used to model the dependent variables. Subjects correctly evaluated the risk level of HIV transmission associated with different situations, and women, young men and those engaged in homo/bisexual behavior were in general more conscious of the increased danger resulting from high risk sexual practices. Among males, homo/bisexuals, drug users and the less educated considered themselves to be more at risk. The most important factors related to HIV seropositivity were sexual orientation, intravenous drug use (IVDU), and the perceived risk of getting aids. Despite a good awareness of HIV contamination and an accurate perception of their own risk, many subjects continued to engage in high risk AIDS activities. Better targeted interventions need to be developed to promote and maintain behavior changes.
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PMID:Demographic and behavioral predictors of knowledge and HIV seropositivity: results of a survey conducted in three anonymous and free counselling and testing centers. 925 22


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