Virologic, immunologic, and epidemiologic associations with AIDS among gay males in a low incidence area.
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Biomedical subjects
Publications and source records attributed to L Kingsley.
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Methods are developed to estimate and test for the impact of intervention use on a population's survival function (time to AIDS). Each participant's history is divided into J + 1 components: omega 0 occurring before the intervention is available and omega 1 to omega J occurring later, as the intervention becomes successively more available. Distribution free truncated Kaplan-Meier models based on time since exposure fit separately to the risk sets/outcomes in omega 0 to omega J directly show the changing patterns of survival. Multivariate proportional hazards models can be used to adjust for covariates. Application of these methods indicates that availability of proven anti-AIDS interventions may have delayed time to AIDS by 8 months in an educated HIV-1 infected homosexual cohort with good access to medical care.
Alcohol consumption as a cofactor in the progression of HIV infection was examined in 1,446 homosexual and bisexual HIV + men enrolled in the Multicenter AIDS Cohort Study who had a minimum of three visits. Two measures of drinking were employed: initial level, and pattern during the study period. Outcome measures included AIDS-related symptoms and AIDS diagnosis. Level of drinking at entry to the study was not significantly associated with either AIDS-related symptoms at final visit or with AIDS diagnosis. However, men who decreased drinking were more likely to report thrush, fatigue, weight loss, and diarrhea at their final visit. Most likely, these men decreased drinking as a result of failing health, not because their drinking pattern influenced symptom onset. These data support earlier reports that found no relationship between alcohol consumption and progression to AIDS.