ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472178

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractThis article summarizes the epidemiology of AIDS and human immunodeficiency virus (HIV) infection among intravenous drug abusers (IVDAs) in the United States and discusses the status of approaches to prevent HIV infection and to treat AIDS patients. Finally, the status of research of selected community-based prevention programs, such as needle-exchange programs and programs distributing bleach to IVDAs for needle and syringe cleaning, will be reviewed.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472179

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractThe prevention and treatment of HIV infection are particularly difficult in certain subpopulations unless consideration is given to their unique characteristics. These characteristics and the strategies to address them are considered with respect to adolescents, rural/low-incidence populations, gay and bisexual men, African-Americans, Latinos, women, and the mentally ill. Alcohol and other drug use must always be addressed in treatment and prevention efforts even if patients do not meet the full criteria for chemical dependence. Health care providers need to consider their own biases as well as the overt and covert messages they project in order to provide the best possible care to these subpopulations.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472180

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractPrevention of adult AIDS cases should begin during childhood and adolescence. taking into account such issues as personal vulnerability, perceived control, and behavioral change. High-risk sexual and drug using behaviors in adolescents should be viewed within a developmental perspective, focusing on cognitive development (Piaget), psychosocial development (Erikson), and moral development in males (Kohlberg), females (Gilligan), and children (Damon). Public health educators have emphasized the high-risk behaviors of unsafe sex and needle sharing, with considerably less attention given to the role of alcohol and other drug intoxicationin the transmission of human immunodeficiency virus. Adolescents are often uncomfortable discussing sexual matters with their partners. Therefore, alcohol or other drugs may be used to reduce sexual anxiety. Such drug use prior to sexual activity may impair judgment, and risks may be taken that might not have been taken in a more sober condition.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472181

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractBecause gay and bisexual men continue to be the largest at-risk group for human immunodeficiency virus (HIV) related conditions, the special role of substance abuse, and not just intravenous drug abuse, must be understood in order to provide adequate services and prevention. Gay men and women appear to have a higher incidence of substance abuse than the general population. Genetic, biochemical, societal, and cultural factors may all contribute to this increase, especially the overwhelming impact of societal homophobia. To address the treatment barriers to gay and bisexual men seeking or needing treatment for HIV related conditions, chemical dependence or both, the gay community should be seen like any other minority community. The social and cultural norms of this widely varied community should be studied: the socialization of being gay in mainstream society, including the awareness of being different; the coming-out process; and dealing with internalized homophobia need to be understood. In addition, the resistance or anxiety health care providers may feel in working with gay or bisexual men or with HIV-related conditions should be addressed.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472182

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractFemale partners of male drug users may not recognize that they are endangered by sexual transmission of human immunodeficiency virus (HIV). However, even when women acknowledge this problem, there are multiple subsequent impediments to behavior change. Chemically dependent women also have specific additional needs. Most chemical dependence outreach and treatment programs are not yet designed to address the issues of contraception, pregnancy, motherhood, childrearing, and prevention of sexually transmitted diseases. Chemically dependent women may not only give birth to drug-affected infants but they may also perpetuate an intergenerational cycle of inadequate parenting. Most women at risk for HIV infection are in their childbearing years. Infection of either or both mother and infant further complicates an already complex problem. Multiple interdisciplinary resources are needed to integrate AIDS prevention and treatment with chemical dependence treatment for women and their children.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472183

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractAIDS has been largely described as a problem of major urban areas. However, states in which there is a low incidence of AIDS are dealing with issues from somewhat different perspectives than high-incidence states. The terms“low incidence”and“high incidence”can be misleading: If one state compares its AIDS cases to another state, the comparison may indeed show a comparatively low incidence of AIDS. However, if the comparison is made with other diseases within the same state, a quite different picture may emerge. In low-incidence states, some individuals infected with human immunodeficiency virus (HIV) may seek medical care from physicians who have more experience in treating AIDS cases, both because of a perception of better medical care and less stigmatization. Although the numbers may be relatively small, the number of HIV/AIDS patients seeking care in large metropolitan areas may add to the health care burden already being seen in some parts of the country.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472184

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractThis article examines the issue of testing for human immunodeficiency virus (HIV) in chemical dependence treatment programs. Three types of treatment programs are considered: 21- to 28-day inpatient, eight-week outpatient, and methadone maintenance. Through discussion by groups of chemical dependence treatment providers, recommendations are made in regard to issues of who to test, when to test, confidential versus anonymous testing, charting policies, informed consent, elements of pre- and posttest counseling, and the duty to warn others.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472185

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractControversy surrounds the issue of human immunodeficiency virus (HIV) antibody testing in chemically dependent patients. However, HIV testing can be clinically and therapeutically useful in chemical dependence treatment programs. Prerequisites for HIV testing include: staff education, high-quality pre- and posttest counseling for patients, assurance of confidentiality of results, and the use of accurate screening and confirmatory tests. Reasons to offer voluntary HIV testing in chemical dependence treatment programs include: appropriate medical evaluation and treatment, prevention of the spread of HIV infection, and support for working through the crisis of a positive diagnosis. Voluntary informed consent should be obtained prior to HIV testing; involuntary testing and mass screening are not justified. Testing decisions should be individualized, with the focus on the patient's participation based on treatment- and health-related decisions.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472186

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor

摘要:

AbstractAs HIV continues to spread among chemically dependent populations, chemical dependence treatment programs are beginning to address the issue of routine HIV-antibody testing. While there are many rationales given for testing, only two are deemed acceptable in chemical dependence treatment programs: to permit medical personnel to institute therapy promptly; and to assist in behavior modification (risk reduction). Early intervention is deemed premature because federal regulations disallow the use of drugs, such as AZT, until T-4 cell counts are lower than 200. In addition, many clients may not stay in treatment long enough to institute therapy and ongoing treatment. Many experimental drug trials exclude drug addicts and women. Chemically dependent individuals have neither the knowledge nor the funds to obtain experimental drugs from other countries. Moreover, current protocols of HIV test-related counseling are insufficient to assist clients in changing their high-risk behaviors. Many chemically dependent clients who receive a positive test result relapse to drug abuse or act out sexually; many who receive a negative test result deny the need to change behaviors to avoid infection. Additionally, test result validity and discrimination are presented as deterrents to testing, In long-term treatment situations, where HIV/AIDS education and counseling are done over time as part of treatment and where support systems are in place, HIV testing can be an aid in behavior change.

ISSN:0279-1072    

DOI:10.1080/02791072.1989.10472187

出版商:Taylor&Francis Group    

年代:1989

数据来源: Taylor