ISSN:1087-2914    

DOI:10.1089/apc.1996.10.1

年代:1996

数据来源: MAL

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.2

年代:1996

数据来源: MAL

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.5

年代:1996

数据来源: MAL

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.7

年代:1996

数据来源: MAL

摘要:

The role of sexually transmitted diseases (STDs) in the spread of human immunodeficiency virus (HIV) infection is reviewed. The rationale for and approach to reducing STD prevalence in high-risk communities are presented. Given the asymptomatic nature of these infections and problems associated with delivering curative therapy, effective interventions will require the use of diagnostic tests for screening and the use of single-dose therapies in appropriate settings: Treatment of individuals with STDs will likely reduce individual risk, while reduction of STD prevalence in high-risk communities may curtail the epidemic spread of HIV.

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.10

年代:1996

数据来源: MAL

摘要:

PurposeAbnormalities of small airways function may have clinical relevance in AIDS patients withPneumocystis cariniipneumonia (PCP) since obstructive dysfunction at alveolar levels may impede delivery of aerosolized medication. This study was designed to determine if small airways dysfunction is present in AIDS patients with PCP despite normal standard spirometric results.PatientsTen AIDS patients with documented PCP and no other identifiable pulmonary infection without respiratory failure and with a normal FEV1/FVC ratio were evaluated.MethodSmall airways function was assessed by the FEF75and the change in maximum expiratory flow while breathing a helium-oxygen mixture compared to room air (ΔVmax50%) with and without bronchodilator administration. Testing was done before and after completion of intravenous therapy for PCP.ResultsDespite absence of cough or wheezing at the time of evaluation and a normal FEV1/FVC ratio, significant obstructive dysfunction of the small airways was demonstrated in 6 of 10 patients, which improved with bronchodilators. Three weeks of intravenous therapy for PCP had no effect on these abnormalities. The degree of small airways dysfunction was greater than could be explained by smoking history alone.ConclusionsSmall airways dysfunction, which can be improved with bronchodilator administration, may be present in AIDS patients with PCP despite normal spirometry and absence of cough or wheezing. Screening for small airways dysfunction may identify patients who might benefit from bronchodilator administration prior to inhalation of aerosolized medications

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.16

年代:1996

数据来源: MAL

摘要:

ObjectiveThe primary objective was to evaluate factors that might influence delayed entry into health care for women with HIV. Implications of time of diagnosis for early medical intervention was a focused aspect.ProcedureStructured clinical interviews were conducted with HIV-positive women (n = 48); these data were supplemented by medical chart reviews.MeasuresDelayed entry into health care was operationalized as a difference of more than 3 months between diagnosis and entry into care. Measures of race, social class, risk behavior circumstances of HIV testing, and health status were included.ResultsOf women, 58% delayed entry into care following an HIV diagnosis. Upon entry into health care, 65% of women were symptomatic and 40% were severely immunocompromised (CD4 cells/mm3<200). Results from the logistic regression indicated that those who learned their HIV status prenatally were four times more likely to delay entry into care compared to those who self-referred for HIV testing, even after controlling for symptom status.ConclusionsHIV diagnosis is not enough to ensure that women with HIV will get adequate and timely health care. Counseling and testing recommendations should highlight the intrinsic value of early diagnosis.

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.21

年代:1996

数据来源: MAL

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.25

年代:1996

数据来源: MAL

摘要:

This study investigates factors associated with the self-reported use of complementary therapies, types of therapies used, and sources of complementary therapy information among HIV-positive patients attending a public, HIV outpatient clinic in New Orleans. A convenience sample of 287 clients (220 men and 67 women) was given a self-administered anonymous questionnaire. Overall, complementary therapy use was 31%. Patients who used complementary therapy were more likely to be white (OR., 2.5), female (OR. 3.3), a high school graduate (O.R. 2.9), and to know another complementary therapy user (O.R. 7.8). Age, sexual orientation, CD4 cell count, injection drug use, living with another HIV-infected person, having pain, and HIV support group membership were not associated. Men were more likely than women, and whites were more likely than nonwhites, to use vitamins/minerals, imagery/meditation, and dietary regimens. Nonwhites were more likely than whites, and women more likely than men, to use spiritual healing. Of those using complementary therapy, men were more likely than women, and whites more likely than nonwhites, to get information about complementary therapy from HIV organizations, friends, and homosexual-oriented media. Doctors and nurses were the most frequently cited source of complementary therapy information for women. Frequency, type of therapies used, and source of information about complementary therapy among HIV-infected persons vary by race and gender. Clinicians should be educated about complementary therapies so that they can provide information to their patients and be aware of self-treatment behavior.

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.32

年代:1996

数据来源: MAL

摘要:

Rural persons living with HIV disease is a patient group rapidly increasing in size and one that will present America's health-care system with daunting challenges. As the HIV epidemic increasingly affects rural America, it is clear there are many significant barriers to providing adequate care for persons with HIV and AIDS in these smaller communities. The study surveyed 57 attendees of the National Rural AIDS Conference held in early 1995, St. Cloud, MN, to assist in the identification of barriers to care and to examine strategies that may improve their quality of life. Health care professionals were more likely to believe the following circumstances made living with HIV/AIDS in a rural community difficult: long distances to medical facilities and personnel, lack of employment opportunities and unsupportive work environments, and a shortage of psychologists, social workers, and mental health counselors. Health care and nonhealth care personnel also showed high levels of agreement regarding ways to improve the quality of life among rural persons with AIDS. Quality of life strategies rated as most promising included ensuring that instrumental support and daily assistance is readily available, teaching HIV-affected persons coping and problem-solving skills, and conducting weekly face-to-face support groups for persons living with HIV/AIDS. These findings provide useful information for strategies to improve the life circumstances of persons living with HIV/AIDS in rural areas.

ISSN:1087-2914    

DOI:10.1089/apc.1996.10.37

年代:1996

数据来源: MAL