摘要:

Context:Data on the prevalence of HIV risk behavior that are representative of the general population are needed to help evaluate the effectiveness of prevention programs.Objective:To use data from a large national interview survey to make estimates of the prevalence of sexual and drug-related HIV risk behaviors in the adult population of the United States.Design:Nationally representative cross-sectional survey with in-person interviews collecting information on drug use and sexual behavior.Setting and Participants:12,381 U.S. adults aged between 18 and 59 who were respondents to the 1996 National Household Survey on Drug Abuse, as part of sample of the noninstitutionalized population. Interviews took place in respondents homes using face-to-face interviewer-administered and self-administered questionnaires.Results:In total, 2.8% of respondents were classified as having increased risk for HIV through sexual behavior; this represents 3.9 million persons. 1.7% reported some degree of risk through drug-related behaviors, representing 1.2 million persons. 3.5% of adults (5 million persons) were found to have some degree of HIV risk from sexual or drug-related behavior. Persons who were at risk through drug behavior were much more likely than others to be at risk through sexual behavior. Condom use was not related to HIV risk, although having a recent HIV test was found to be. Among those who reported some behaviors that placed them at increased risk for HIV infection, only 22% used a condom the last time they had sex with a regular partner.Conclusions:The high rate of sexual risk behavior on the part of drug users suggests increasing condom use for this group should be a priority goal for programs, especially condom use with main partners. Survey work needs to be continued and improved to make it possible to assess the impact of successful local prevention efforts on national rates of HIV risk behavior.

ISSN:1525-4135    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We compared the immune activation profile of 46 HIV-negative and 75 HIV-positive Israelis infected with HIV-1 subtype B, with 85 HIV-negative and 102 HIV-positive Ethiopian immigrants to Israel, who were infected with HIV subtype C. The HIV-negative Ethiopians had exceedingly high blood levels of eosinophils, immunoglobulin E (IgE), and p75s tumor-necrosis factor receptors (p75sTNFR); secretion of interleukin-4 (IL-4) and IL-10 by peripheral blood mononuclear cells (PBMC); proportion of human leukocyte antigen (HLA)-DR+cells within CD3+, CD4+, and CD8+T-cell subsets; and proportion of CD45RO+CD4+cells; while having significantly lower secretion of interferon-γ (IFN-γ) by PBMC and percentage of CD45RA+CD4+and CD28+CD8+cells. HIV infection in both populations was associated with reduced IL-2, IL-4, IL-10, and IL-12 secretion, number of CD28+and CD45RA+CD8+cells, and increased number of HLA-DR+-CD3+, CD4+, and CD8+cells, and CD45RO+CD8+cells. Thus, infection with HIV-1 subtypes B and C of studied Israelis and Ethiopians, respectively, results in a similar immune activation profile at all stages of the infection when living in the same environment, despite the striking different immune profile observed in the HIV-negative Israeli and Ethiopian populations. Together with our previous observations, this indicates that HIV subtype is not a major determinant in the natural course of HIV infection.

ISSN:1525-4135    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The concomitant presence of five distinct HIV-1 subtypes and of unclassified HIV-1 was reported in Bangui, Central African Republic (C.A.R.) between 1990 and 1991. This previous study was conducted in individuals belonging to the C.A.R. Armed Forces (FACA) Cohort and in patients from the University Hospital of Baugui. To follow the HIV-1 subtype distribution in Bangui over time, we conducted a cross-sectional surveillance of HIV-1 subtypes between 1987 and 1997 in three groups of individuals in Bangui: 47 men belonging to the FACA Cohort, 38 patients from the CNHUB hospital, and 51 individuals consulting the sexually transmitted diseases (STD) clinic. One hundred and ten HIV-1 were subtyped by heteroduplex mobility assay (HMA) and/or sequencing ofenvregions encompassing the V3 domain. By comparing the HIV-1 distribution in two time periods (1987-1991 and 1991-1996) in the FACA cohort, we observed a significant increase of subtype A from 43.7% to 83.9%. This subtype distribution does not seem specific to the FACA cohort, in that subtype A accounted for 46.7% of the HIV-1 infections in CNHUB patients in the first time period studied and for 69.6% in the second time period. In STD patients, subtype A infections were predominant in 1995 (72.7%) and 1997 (89.7%). Subtype E viruses could be identified in the second time period, but represented only between 6.5% and 21.8% of the infections in the three groups of individuals studied. Other subtypes (B, C, H) and non-classified HIV-1 in C2-V3 were detected with only a 3.2% to 9.1% frequency for each in the second time period. Phylogenetic analysis excluded infection by a single source for the individuals included in the study. Our data demonstrate an increase in the proportion of HIV-1 subtype A infections in Bangui that raises the question of a preferential transmissibility of specific HIV-1 variants.

ISSN:1525-4135    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Injection drug users (IDU), crack smokers, and commercial sex workers engage in illegal activities that place them at risk for HIV infection. The marginalized nature of these groups often limits use of customary sampling methods to assess HIV prevalence. We tested urine samples of recent arrestees to evaluate HIV prevalence of at-risk populations that are difficult to access using standard surveillance methods. We tested for HIV-1 antibodies in urine specimens of recent Los Angeles County (California, U.S.A.) arrestees as part of the Drug Use Forecasting (DUF) Program funded by the U. S. National Institute of Justice. Data are presented for 5 years of a serial cross-sectional study of arrestees. Results from 1991 through 1995 indicate a slight HIV prevalence increase among crack smokers (from 4% to 6%). Prevalence estimates were relatively stable for IDU (6%), male (3%) and female arrestees (3%), arrestees who share needles (9%), and commercial sex workers (6%). HIV status was independently associated with injection drug use, crack smoking, and ever having exchanged sex for money or drugs. Prevalence of HIV among arrestee subgroups may reflect prevalence in the community. However the benefit of using the DUF sample must be weighed against bias introduced from using nonrandom samples to estimate prevalence.

ISSN:1525-4135    

出版商:OVID    

年代:1999

数据来源: OVID