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Cost-effectiveness of counseling and testing to prevent sexual transmission of HIV in the United States

aids and Behavior 2002年第1期6卷 33-43页

作者： Farnham, Paul G. Pinkerton, Steven D. Holtgrave, David R. Johnson-Masotti, Ana P. Department of Economics Andrew Young School of Policy Studies Georgia State University Atlanta GA United States Division of HIV/AIDS Prevention: Intervention Research and Support National Center for HIV STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Center for AIDS Intervention Research Department of Psychiatry and Behavioral Medicine Medical College of Wisconsin Milwaukee WI United States Department of Behavioral Science and Health Education Rollins School of Public Health Emory University Atlanta GA United States

In this paper we review the cost-effectiveness of HIV counseling and testing in various settings and populations in preventing the sexual transmission of human immunodeficiency virus, and we discuss how multiple and changing goals have influenced economic evaluations of these programs. The literature indicates that these interventions are generally cost-effective if targeted to groups of infected or high-risk individuals, although there is continuing debate over the efficacy of HIV counseling and testing in changing sexual behavior. For these reasons, HIV counseling and testing programs should be part of an overall prevention strategy which also includes more intensive sexual risk-reduction interventions such as individual, small-group, and community-level approaches.

关键词： Cost-effectiveness Economic analysis Human immunodeficiency virus counseling/testing prevention

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Quantitative fluorescence: To count or not to count. Is that the question?

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Cytometry Part A 2002年第4期34卷

作者： Janet K. A. Nicholson Maryalice Stetler-Stevenson Division of AIDS STD and TB Laboratory Research National Center for Infectious Diseases Centers for Disease Control and Prevention Atlanta Georgia Flow Cytometry Unit Department of Pathology Division of Clinical Sciences National Cancer Institute Bethesda Maryland

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A multicenter study of bacterial vaginosis in women with or at risk for human immunodeficiency virus infection

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Infectious Diseases in Obstetrics and Gynecology 2001年第3期9卷 133-141页

作者： Warren, Dora Klein, Robert S. Sobel, Jack Kieke Jr., Burney Brown, William Schuman, Paula Anderson, Jean Cu-Uvin, Susan Mayer, Kenneth Jamieson, Denise J. Holmberg, Scott Duerr, Ann Centers for Disease Control and Prevention Atlanta GA United States Department of Medicine Montefiore Medical Center Albert Einstein College of Medicine Bronx NY United States Division of Infectious Diseasea Wayne State University School of Medicine Department of Medicine Detroit MI United States Department of Pathology Wayne State University School of Medicine Detroit MI United States Division of Obstetrics and Gynecology Johns Hopkins School of Medicine Baltimore MD United States Department of Medicine Miriam and Memorial Hospitals Brown University School of Medicine Providence RI United States Division of HIV/AIDS Prevention National Center for HIV STD TB Prevention Centers for Disease Control and Prevention Atlanta 30333 GA 1600 Clifton Road United States

Background: Bacterial vaginosis is a common gynecologic infection that has been associated with a variety of gynecologic and obstetric complications, including pelvic inflammatory disease, postabortal infection and premature delivery. Recent studies suggest that bacterial vaginosis may increase a woman's risk for human immunodeficiency virus (HIV). We undertook this study to assess whether the prevalence and characteristics of bacterial vaginosis differed according to HIV status in high-risk US women. Methods: Prevalence of bacterial vaginosis was assessed by Gram's stain and clinical criteria for 854 HIV-infected and 434 HIV-uninfected women enrolled in the HIV Epidemiology Research (HER) Study. Multiple logistic regression techniques were used to determine whether HIV infection independently predicted bacterial vaginosis. Results: Almost half (46%) the women had bacterial vaginosis by Gram's stain. The prevalence of bacterial vaginosis was 47% in the HIV-positive women compared with 44% in the HIV-negative women;this difference was not statistically significant (p = 0.36). After adjustment for other covariates, HIV-positive women were more likely than HIV-negative women to have bacterial vaginosis (odds ratio (OR) 1.31;95% confidence interval (CI) 1.01-1.70) by Gram's stain but not by clinical criteria (OR 1.16;CI 0.87-1.55). Among HIV-positive women, use of antiretroviral drugs was associated with a lower prevalence of bacterial vaginosis (adjusted OR 0.54;CI 0.38-0.77). Conclusions: In this cross-sectional analysis of high-risk US women, HIV infection was positively correlated with bacterial vaginosis diagnosed by Gram's stain.

关键词： Bacterial vaginosis High-risk US women Human immunodeficiency virus

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Lack of evidence of mitochondrial dysfunction in the offspring of HIV-infected women: Retrospective review of perinatal exposure to antiretroviral drugs in the perinatal aids collaborative transmission study

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Annals of the New York Academy of Sciences 2000年第1期918卷 212-221页

作者： Bulterys, Marc Nesheim, Steven Abrams, Elaine J. Palumbo, Paul Farley, John Lampe, Margaret Fowler, Mary Glenn Epidemiology Branch Division of HIV/AIDS Prevention National Center for HIV/STD/TB Prevention Centers for Disease Control and Prevention Atlanta GA 30333 United States Department of Pediatrics Emory University Atlanta GA 30333 United States Harlem Hospital and Columbia University Newyork NY 10037 United States Department of Pediatrics University of Medicine and Dentistry of New Jersey Newark NJ 07103 United States Department of Pediatrics University of Maryland Baltimore MD 21201 United States Department of Pediatrics University of Maryland Baltimore MD 21201 United States

A recent report suggesting mitochondrial dysfunction among eight HIV-exposed but uninfected children exposed perinatally to nucleoside reverse transcriptase inhibitors (NRTIs) prompted a review within the Perinatal aids Collaborative Transmission Study (PACTS). A standardized retrospective review was conducted of 118 deaths at <5 years. Deaths were classified as unrelated to mitochondrial dysfunction (Class 1), unlikely related (Class 2), possibly related (Class 3), or likely related or proven (Class 4). Among 35 deaths recorded in HIV-uninfected or indeterminate children, none were classified in either Class 2, 3, or 4. We also reviewed signs or symptoms consistent with possible mitochondrial dysfunction among 1,954 living uninfected children. Only one child was in Class 3 and two siblings were in Class 2;none had perinatal antiretroviral drug exposure. We found no evidence indicating that uninfected infants exposed to perinatal NRTIs died of mitochondrial disorders or that living exposed children had symptoms of mitochondrial dysfunction.

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Re: "High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: results of a cohort study"

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American journal of epidemiology 1999年第3期150卷 325-6页

作者： R S Garfein R Lyerla T S Jones A K Nakashima E R Monterroso D Vlahov Hepatitis Branch Division of Viral and Rickettsial Diseases National Center for Infectious Diseases Centers for Disease Control and PreventionAtlanta GA 30333 Division of HIV/AIDS Prevention National Center for HIV STD and TB PreventionAtlanta GA 30333 Department of Epidemiology School of Hygiene and Public Health The Johns Hopkins UniversityBaltimore MD 21205

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Book reviews

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Archives of Sexual Behavior 1996年第5期25卷 535-548页

作者： Vanwesenbeeck, Ine Vincke, John Doll, Lynda S. MacQueen, Kate Thompson, C. Swan, Joye Department of Women's Studies Tilburg University Tilburg The Netherlands Department of Sociology University of Ghent Ghent Belgium Division of HIV/AIDS Prevention National Center for HIV STD and TB Prevention Centers for Disease Control and Prevention Atlanta Department of Psychology Pomona College Claremont

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Influence of perceived and assessed risk on std clinic clients' acceptance of HIV testing, return for test results, and HIV serostatus

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Psychology, Health and Medicine 1996年第1期1卷 83-98页

作者： Fichtner, R.R. Wolitski, R.J. Johnson, W.D. Rabins, C.B. Fishbein, M. Behavioral Interventions and Research Branch Division of Sexually Transmitted Disease Prevention Centers for Disease Control and Prevention Champaign IL United States Behavioral Intervention Research Branch Division of HIV and AIDS Prevention Centers for Disease Control and Prevention Champaign IL United States STD Section Division of Infectious Diseases Illinois Department of Public Health Champaign IL United States Department of Psychology University of Illinois Champaign IL United States Behavioral Interventions and Research Branch Division of STD Prevention Centers for Disease Control and Prevention Atlanta GA 30333 1600 Clifton Road United States

The provision of counselling and testing (CT) for human immunodeficiency virus (HIV) is an important component of publicly funded HIV prevention efforts in the US and is routinely provided in sexually transmitted disease (std) clinics. We examined data from 51,359 client visits to Illinois std clinics from 1991 to 1993 to evaluate the relationships of self-perceived and assessed risk for HIV infection with: (1) receiving HIV pretest counselling, (2) having blood drawn for HIV testing, (3) returning for HIV test results and post-test counselling, and (4) HIV serostatus. Overall, 22.7% of clients perceived themselves to be at risk, while 28.7% were assessed at-risk, with more than two-thirds of all clients correctly perceiving their assessed risk for HIV. Individuals who perceived themselves to be at risk were more likely than those without perceived risk to complete each stage of CT. Assessed risk was not, however, significantly associated with returning for test results. Those with either perceived risk or assessed risk were more likely to be seropositive than those with no perceived or assessed risk. African Americans (25%) were much less likely (p < 0.001) to return for test results than either Hispanics (43%) or Whites (56%), yet perceived risk was most strongly associated with return rates for African Americans. Additional significant differences associated with gender, ethnicity, and their interaction with perceived and assessed risk were also observed for CT participation and HIV serostatus. Implications of these findings for HIV prevention efforts are discussed. © Journals Oxford Ltd.

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Behavioural risk factors and HIV infection of injection drug users at detoxification clinics in puerto rico

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International Journal of Epidemiology 1994年第3期23卷 595-601页

作者： Robles, Rafaela R. Colón, Héctor M. Díaz, Nereida Cancel, Lourdes I. Macgowan, Robin Cole, Galen E. Allen, David M. Research Institute Puerto Rico Department of Anti Addiction Services Rio Piedras Station Rio Piedras PO Box 21414 Puerto Rico Center for Evaluation and Sociomedical Research School of Public Health Medical Sciences Campus University of Puerto Rico San Juan Puerto Rico Behavioral and Prevention Research Branch Division of STD/HIV Prevention National Center for Prevention Servicesm Centers for Disease Control and Prevention Atlanta Georgia HIV Seroepidemiology Branch Division of HIV/AIDS National Centers for Infectious Diseases Centers for Disease Control and Prevention Atlanta Georgia

Background. The ethnic and geographical variations of aids prevalence among Injection drug users (IDU) have highlighted the need to understand the role of the relevant rIsk factors in specific subpopulatlons of IDU. In this study we examine the factors related to seropositivity among IOU entering drug detoxification facilities In metropolitan San Juan, Puerto ***. From October1990 until August1991, 390 IDU were Interviewed. Four groups of risk factors were examined: sexual practices, drug Injection behaviours, risk behaviours while In US Mainland cities, and while incarcerated. A stepwise logistic regression model was used to simultaneously assess the Independent effects of the behavioural risk factors on HIV ***. Of the 342 IDU who were tested for HIV antibodIes, 29.5% were seropositive. The behaviours found to be associated with seropositivity were: having sex with an IOU In the last 6 months;having injected drugs for over 5 years;and Injecting with used needles while ***. Public health programmes will need to establish more effective collaborative links with correctional institutions in order to reduce the spread of HIV among IDU in Puerto Rico. © 1994 International Epidemioloigy Association.

关键词： Americas Behavior Biology Caribbean Comparative Studies Developing Countries Diseases Drug Usage Hiv Infections Iv Drug Users Latin America North America Puerto Rico Research Report Risk Factors Sex Behavior Sexual Partners Studies Viral Diseases

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Tuberculosis 1

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丛书名： Current Topics in Microbiology and Immunology

1000年

作者： Thomas M. Shinnick

ISBN: (数字)9783642801662

ISBN: (纸本)9783642801686

Tuberculosis has plagued mankind since prehistoric times and is still an important source of morbidity and mortality, with particularly devastating effects in developing and tropical countries. Tuberculosis results from an infection with Myeo baeterium tubereu/osis, and the World Health Organization estimates that perhaps as much as one-third of the world's population or approximately 1. 9 billion persons are or have been infected with M. tubereu/osis. Each year, there are 8-10 million new cases of tuberculosis and about 3 million deaths due to it. Indeed, tuberculosis is the leading cause of death in adults due to a single infectious agent and accounts for ap proximately 26% of all preventable adult deaths in the world. In addition, tuberculosis is an enormous social and economic problem because approximately 95% of new cases occur in developing countries and because about 80% of tuberculosis cases affect persons of child-bearing age and du ring their most economically productive years (ages 15-59). Tuberculosis has also re-emerged as an important public health problem in many developed countries. For example, between 1985 and 1992, the number of tuberculosis cases reported to the United States Centers for Disease control and prevention increased by more than 20%. Similarly, Austria experienced a 5% increase in tuberculosis cases from 1987 to 1991, Ireland a 9% increase from 1988 to 1991, Denmark a 20% increase from 1987 to 1992, and Italy a 27% increase from 1988 to 1992.

关键词： Immunology Medical Microbiology Internal Medicine

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HIV/aids in China 1

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1000年

作者： Zunyou Wu Jennifer M. McGoogan Yu Wang Roger Detels Marc Bulterys

ISBN: (数字)9789811385186

ISBN: (纸本)9789811385179;9789811385209

The book includes chapters on the epidemiology, treatment, and prevention of HIV, as well as several chapters that discuss in detail specific provincial- and national-level programs to control and treat HIV. It chronicles the Chinese government’s amazing about-face, as it replaced underfunded, non-evidence based policy decisions with successful, science-based approaches to disease control and prevention, including the adoption of once controversial needle-exchange programs and the establishment of a national HIV/aids data registry. It measures the success of national policy decisions, the implementation of treatment policies, and discusses the difficulty of accessing high-risk communities, including people who inject drugs, sex workers, and men who have sex with men – groups not easy to reach, study, engage in prevention programs, or treatment, for fear of stigmatization and loss of social status. Further, it documents the spread of HIV to other provinces, and the tragedy that befell repeat plasma donors in Henan and other poor provinces, where reused or improperly sterilized lab equipment caused some villages to have epidemic-level incidence rates. This book represents a positive contribution to the field of aids research, making vital, new information available to an interested readership.

关键词： Public Health Epidemiology Infectious Diseases

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