摘要:

ObjectivesHomeless persons have an increased risk of HIV infection because of a high prevalence of HlV-related risk behaviors. These include drug use, sexual contact with persons at risk for HIV infection, and the exchange of sex for drugs. The objectives of this investigation were to describe HIV seroprevalence rates in homeless adults and runaway youth.MethodsIn 1989, the Centers for Disease Control and Prevention began collaboration with state and local health departments to conduct HIV seroprevalence surveys in homeless populations. Unlinked HIV seroprevalence surveys were conducted in 16 sites; 11 provided medical services primarily to homeless adults, and five to runaway youth aged <25 years.ResultsFrom January 1989 through December 1992, annual surveys were conducted in 16 sites in 14 cities. Site-specific seroprevalence rates ranged from 0–21.1% (median, 3.3%). Among homeless adults in three sites, rates were higher among men who had sex with other men and those who injected drugs than among persons with other risk exposures (28.9 versus 5.3%). In general, rates were higher for heterosexual men than for women and higher among African Americans than whites. In sites providing services to homeless youth, HIV seroprevalence rates ranged from 0–7.3% (median, 2.3%).ConclusionsThese data indicate that HIV infection among homeless adults and runaway youth is an important public health problem. HIV prevention and treatment should be integrated into comprehensive health and medical programs serving homeless populations.

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ObjectivesTo obtain information about the prevalence of, reasons for, and adequacy of HIV testing in the general population in Switzerland in 1992.DesignTelephone survey (n = 2800).ResultsSome 47% of the sample underwent one HIV test performed through blood donation (24%), voluntary testing (17%) or both (6%). Of the sample, 46% considered themselves well or very well informed about the HIV test. Patients reported unsystematic pre-test screening by doctors for the main HIV risks. People having been in situations of potential exposure to risk were more likely to have had the test than others. Overall, 85% of those HIV-tested had a relevant, generally risk-related reason for having it performed.ConclusionsHIV testing is widespread in Switzerland. Testing is mostly performed for relevant reasons. Pre-test counselling is poor and an opportunity for prevention is thus lost.

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ObjectiveThe role of gonorrhea in facilitating acquisition of HIV infection has only recently been studied. A previous nested case-control analysis in a cohort of female sex workers in Zaïre found a strong association between HIV seroconversion and prior gonorrheal infection. The objective of this study was to replicate the Zaïre study analysis in a cohort of 273 Cameroonian sex workers to determine whether gonorrhea increased the risk of HIV acquisition, and if the crude association between gonorrheal infection and HIV acquisition was weakened when the level of unprotected coitus was more carefully controlled.MethodsWe conducted a nested case-control study of initially HIV-1-negative women (n = 273) followed prospectively (with monthly sexually transmitted disease check-ups and 3-monthly HIV-1 serology). As in Zaire, cases (seroconverters, n = 17) were compared with controls (women who remained HIV-1-negative, n = 68) for incidence of gonorrhea and sexual exposure during the presumed period of HIV-1 acquisition.ResultsThe association between gonorrheal infection and subsequent HIV acquisition was stronger in Zaire than in Cameroon [crude odds ratios (OR), 6.3 versus 2.2]. In both the Zaïre and Cameroon data the crude OR were reduced (6.3 to 4.8, and 2.2 to 1.7, respectively) by controlling for risk factors including a dichotomous variable indicating irregular or no condom use. When this variable was replaced in the Cameroon data with a more precise continuous variable indicating the percentage of unprotected coital acts, the gonorrhea OR was further reduced to 1.4 (95% confidence interval, 0.4–4.9).ConclusionThese results suggest that in the Cameroon cohort, gonorrheal infection did not facilitate HIV acquisition, but that having gonorrhea was a marker for unprotected coitus that facilitated HIV acquisition. The data demonstrate how OR can be overestimated when imprecise dichotomous measures of unprotected coitus are used. Future studies should plan for better control of self-reported condom use.

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ObjectiveHIV infection attributable to medical injections is suspected to be low, although case-control studies have not provided definite results. This study aims to determine the number of HIV infections caused by the reuse of syringes and needles in the Mbeya Region, Tanzania.MethodsThe direct identification or detection of HIV in syringes and needles under field conditions was not appropriate, therefore a surrogate marker consisting of two components for possible HIV transmission was used: insufficient sterilization, and blood remaining from a previous patient. The assumption was that HIV infection can only occur if both markers are positive. Samples were collected in nine health-care facilities. All syringes and needles prepared for use in these facilities were collected without prior notification. The samples were rinsed and the resulting fluid was cultured for bacteria. Traces of blood were detected by urine stick test for haemoglobin volumes >0.0015 μl.ResultsBacterial contamination was found in 32.8% of the total 1219 syringes and needles; 67% was caused by improper handling of the equipment after sterilization. Blood was detected in 12.5% of the samples. In the following three sampling strata, both contamination criteria were positive either on the syringe or the needle: wards/outpatient departments (OPD), 1.39%; laboratories, 7.45%; expanded programme on immunization (EPI), <0.1%. We calculated that from 1.1 million patients injected in wards/OPD in any 1 year, fewer than 13 become infected, in laboratories fewer than 12 (160 000 blood-taking procedures), and less than one child in the EPI (850 000 vaccinations).ConclusionWith an established AIDS intervention programme supporting the health system, less than 0.4% of the total annual incidence of 4500–8500 is attributable to medical injections in the Mbeya Region.

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

ObjectiveTo compare survival of patients infected with HIV-1 and HIV-2.DesignLongitudinal follow-up of 175 HIV-1-and 294 HIV-2-infected patients identified in, or referred to a hospital in The Gambia.MethodsSurvival analysis methods were used and the death rate ratios for HIV-2 relative to HIV-1 patients were estimated using proportional hazard regression models that allowed for age, sex and clinical or immunological features.ResultsThe overall death rate ratio for HIV-2 relative to HIV-1 was 0.67 [95% confidence interval (Cl), 0.49–0.91] when adjusted for age, sex and World Health Organization Bangui clinical classification. When allowing for age, sex and three strata of CD4+ count, the rate ratio was 0.64 (95% Cl, 0.43–0.94), and for three strata of β2-microglobulin levels 0.60 (95% Cl, 0.42–0.84).ConclusionMortality rate in HIV-2-infected patients is approximately two-thirds of that for HIV-1-infected patients.

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1994

数据来源: OVID