作者：
Weidle, Paul J.Epidemiology Branch
Division of HIV/AIDS Prevention National Center for HIV STD & TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road MS E-45 Atlanta GA 30333
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 c...
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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.
We evaluated stabilized whole blood control materials for their performance as a routine control material for immunophenotyping using flow cytometry. These materials serve as the method control, controlling for both t...
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We evaluated stabilized whole blood control materials for their performance as a routine control material for immunophenotyping using flow cytometry. These materials serve as the method control, controlling for both the binding of monoclonal antibodies to the cells and the efficiency of the red-blood-cell lysing reagent. Three products (FluoroTrol, StatusFlow, and CD-Chex): were tested. The controls performed very well in evaluating both CD4 and CD8 percentages and absolute cell counts using flow cytometry. Light scattering patterns and fluorescence intensity of antibody binding were slightly different from those of normal whole blood. These products are not appropriate for quantitative fluorescence standards. Cytometry (Comm. Clin. Cytometry) 38:268–273, 1999. Published 1999 Wiley-Liss, Inc.
The objectives of this paper are to compare the patterns of condom use at three times for sexually active HIV-infected women and a comparison group of uninfected women and to examine correlates of condom-use patterns....
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The objectives of this paper are to compare the patterns of condom use at three times for sexually active HIV-infected women and a comparison group of uninfected women and to examine correlates of condom-use patterns. Data are reported from the first three visits (first year) of a longitudinal study of the biomedical and behavioral manifestations of HIV infection in women. Analyses were conducted on 386 HIV-infected and 203 uninfected sexually active women. Participants were interviewed at enrollment and at 6- and 12-month follow-up visits. HIV-infected and uninfected women received safer-sex counseling at each study visit and uninfected women were tested for HIV. Consistent condom use at all three times was reported by a higher percentage of HIV-infected than uninfected women (34% vs.13%;p <.01) whereas inconsistent or nonuse was more common among the uninfected than infected women (21% vs.7%;p <.01). Condom use differed by partner serostatus: 25% of the HIV-infected women with infected partners reported consistent condom use compared with 41% of those with partners whose serostatus was negative or unknown. For HIV-infected women with uninfected partners, injecting drugs and crack use were associated with inconsistent condom use. These findings suggest that HIV serostatus of women and their partners affects consistency of condom use. Despite greater condom use by HIV-infected women with partners of negative or unknown serostatus than by those with infected partners, the fact that condom use was far from universal suggests the need for interventions involving uninfected male partners of infected women.
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 pr...
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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.
OBJECTIVE: Violence is highly prevalent among women with HIV. Determining whether HIV is causally related to violence, and whether risk for violence is increased by certain HIV prevention practices, has been difficult...
OBJECTIVE: Violence is highly prevalent among women with HIV. Determining whether HIV is causally related to violence, and whether risk for violence is increased by certain HIV prevention practices, has been difficult. METHODS: We review recent literature concerning (1) violence and HIV serostatus, including the risk for violence associated with disclosure of a positive serostatus, and (2) violence associated with requests that male sex partners use condoms. RESULTS: Studies suggest that women with or at risk for HIV come from populations that are also at risk for violence. Violence is not statistically increased among HIV-infected women compared to demographically and behaviorally similar uninfected women. However, for a small proportion of women, violence may occur around disclosure or in response to condom negotiation. CONCLUSIONS: Integrating violence screening and referral into HIV services could help many women obtain the assistance they need while minimizing the risk for violence that may be associated with partner notification or condom requests.
This paper reviews the (1) literature on substance use among men who have sex with men (MSM), (2) data that test whether connections between substance use and abuse and high-risk sexual behavior exist among MSM, and (...
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This paper reviews the (1) literature on substance use among men who have sex with men (MSM), (2) data that test whether connections between substance use and abuse and high-risk sexual behavior exist among MSM, and (3) ways that HIV interventions might address the effects of substance use on high-risk sexual behavior. We conclude that while alcohol use patterns are not substantially different between gay and heterosexual men, gay men do use more kinds of other drugs. Although there is considerable evidence to support the view that substance use patterns have declined among gay men since the mid-1980s, substance use should still be regarded as a health risk in this population. Although the associations between substance use and sexual risk- taking for HIV are complex, the inclusion of interventions to disentangle substance use and high-risk sexual practices may increase the efficacy of aidsprevention efforts among gay men.
Now in its third decade, the epidemiology of human immunodeficiency virus (HIV) transmission in the United States has changed considerably since the epidemic began. Our increased understanding of the virus has fueled ...
Now in its third decade, the epidemiology of human immunodeficiency virus (HIV) transmission in the United States has changed considerably since the epidemic began. Our increased understanding of the virus has fueled development of new treatments to prolong life, and research into a viable vaccine offers hope to those at risk in developed and less developed countries alike. In this review, we provide information about the current trends in HIV and Acquired Immune Deficiency Syndrome (aids) among those in the United States who are hardest hit by the epidemic. We also offer insights into and explanations of these changes; update the epidemiology of HIV subtypes and antiretroviral resistance; and describe current strategies for HIV surveillance.
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