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Attenuation of benzodiazepine dependence in mice by a tri-substituted benzoflavone moiety of Passiflora incarnata Linneaus: a non-habit forming anxiolytic.

PURPOSE: A tri-substituted benzoflavone moiety (BZF) recently isolated from the methanol extract of aerial parts of the plant Passiflora incarnata Linneaus had exhibited encouraging results in countering the dependence produced by addiction-prone substances like morphine, nicotine, cannabinoids and ethyl alcohol, during the studies performed by the authors. Since the BZF moiety had exhibited significant anxiolytic properties at 10 mg/kg p.o. dose in mice, therefore, it was desirable to evaluate this potential phyto-moiety (BZF) for its own dependence-liabilities It was also deemed viable to evaluate BZF moiety for its possible usefulness in countering the dependence-liabilities associated with the chronic use of benzodiazepines keeping in light their tremendous clinical use in the management of anxiety and insomnia. METHODS: Different groups of mice were administered BZF alone (10, 50 or 100 mg/kg, p.o.), and concomitantly with diazepam (20 mg/kg, p.o.) in a 21-days treatment regimen, followed by no treatments for the next 72-hours. The withdrawal effects in the form of ambulatory behavior of the treated animals were recorded on the 25th day using an Actophotometer. RESULTS: The BZF-alone (three doses) treated mice exhibited a normal ambulatory behavior on 25th day. Mice groups receiving co-treatments, i.e., BZF-diazepam concomitantly, also exhibited a normal ambulatory behavior in a dose-dependent manner, i.e., the higher dose of BZF (100 mg/kg) being more effective in countering the withdrawal effects of chronically administered diazepam than the lower doses (10 or 50 mg/kg). CONCLUSIONS: The studies revealed that the chronic administration of the BZF moiety (three doses), did not exhibit any dependence-liability of its own, even upon an abrupt cessation. Additionally, the BZF co-treatments with diazepam also prevented the incurrence of diazepam-dependence, which might be because of the aromatase enzyme inhibiting properties associated with the BZF moiety.

Animals↗

Impact of HIV testing and counseling on subsequent sexual behavior.

To assess sexual behavior changes after voluntary HIV testing and routine counseling, we interviewed 235 persons at 2 anonymous test sites in North Carolina. Among the 57 (24%) persons returning for follow-up 1 year later, 70% were male; 44% were black, 37% were homosexual, 10% were bisexual; and 16% were HIV positive. Overall, 28% of returnees at the initial visit and 33% on the follow-up visit admitted to having 2 or more sexual partners in the past month. At the initial interview and at follow-up, 21% of returnees reported condom use in the past month. Homosexual men were significantly less likely to use condoms during anal sex over time (58% non-use initially vs. 74% non-use at follow-up, p = 0.04). No significant net change in high-risk sexual behaviors was found at follow-up. Overall findings indicate that the standard HIV testing and counseling provided by health departments anonymously and free of charge does not result in elimination of high-risk sexual behaviors or initiation of safer sex behaviors among those at high risk for HIV infection.

AIDS Serodiagnosis↗

"Nothing about me without me": leading the way to collaborative relationships with families.

This article discusses the National Center on Addiction and Substance Abuse's CASA Safe Haven, an evidence-based, community-driven intervention program for children and families in child welfare whose lives have been adversely affected by substance abuse, and for staff in the agencies that work with them. CASA Safe Haven builds collaborative relationships that feature a blend of multidisciplinary teams that share responsibility for helping families; family group conferencing, in which families are equal and welcome participants in designing and driving a service plan; and the influence of family court to hold families and service providers accountable for progress. CASA Safe Haven is a framework for collaboration.

Child↗

Condom use with regular and casual partners among women attending family planning clinics.

A survey of 16,632 women attending family planning clinics in Pennsylvania found that only 13 percent of the sample used condoms. Moreover, 67 percent of the women with regular partners never used condoms with those partners, and 72 percent of women who had casual partners never used them with those partners. Levels of condom use with both regular and casual partners were higher among women younger than 20, those who were nonwhite, those with multiple partners and those who reported a previous STD infection. However, women who had sex partners who used intravenous drugs were less likely to use condoms with regular or casual partners than were women who did not have drug-using partners.

Acquired Immunodeficiency Syndrome↗

Applying the theory of reasoned action to AIDS risk behavior: condom use among black women.

This study tested hypotheses regarding attitudinal and normative influences on intentions to use condoms, a practice that would reduce women's risk of sexually transmitted HIV infection. Participants were 103 sexually active unmarried black women undergraduates at an inner-city commuter university, in an area with a high rate of reported AIDS cases among women. Consistent with the theory of reasoned action, multiple regression analysis on women's anonymous responses to a mailed survey revealed that those who registered more favorable attitudes toward condoms and those who perceived subjective norms more supportive of condom use reported firmer intentions to use condoms in the next three months. Key behavioral beliefs related to attitudes centered on the adverse effects of condom use on sexual enjoyment. Key normative influences were respondents' sexual partners and mothers. However, women's own attitudes were a stronger determinant of intentions to use condoms than were their perceptions of normative influences, particularly among women with above-average AIDS knowledge. The results suggest that the theory of reasoned action provides a potentially useful conceptual framework for interventions to change a key AIDS risk behavior among women.

Acquired Immunodeficiency Syndrome↗

The epidemiology of sexually transmitted diseases in Africa and Latin America.

We review some aspects of the epidemiology of sexually transmitted diseases (STDs) in the developing countries of Africa and Latin America. Apart from their elevated prevalence, they are responsible for important morbidity in mother and child. Stillbirth, premature delivery, conjunctivitis, and respiratory tract morbidity of the neonate are frequently caused by STDs. Sequelae in adult women include pelvic inflammatory disease, ectopic pregnancy, and infertility. The emergence of antimicrobial resistance has complicated the picture in recent times. Genital ulcer disease is very common in developing countries, the most important being chancroid. Both continents are experiencing major epidemics of the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection with different epidemiological characteristics than in the industrialized world. A link might exist between the high prevalence of STDs and the rapid heterosexual spread of HIV infection.

Acquired Immunodeficiency Syndrome↗

Alcohol use as a situational influence on young women's pregnancy risk-taking behaviors.

Recent studies have found that many young women just beginning their sexual lives use alcohol prior to intercourse. A large number appear to drink heavily enough prior to sex to compromise their ability to use contraceptives. The question emerges whether there is a relationship between drinking before intercourse, the nonuse of birth control methods, and unplanned pregnancies. The present research describes 43 instances of intercourse which resulted in unplanned pregnancies in 14- to 21-year-olds. Variables examined included alcohol use prior to sex, amount of alcohol consumed, the use of other drugs, the planning of intercourse, respondents' stated reasons for nonuse of contraceptives, and other general demographic data.

Adolescent↗

[Are children with alcohol embryopathy latent alcoholics? A study of the risk for developing dependence].

Within 3 years 48 caretakers and parents of children with fetal alcohol syndrome were asked about the childrens experience and contact with alcohol. The children were mainly raised in foster and adoptive families (40/48 cases), where usually moderate or restricted consumption of alcohol was common. The children were between 4-18 years (means = 7; 5) of age. In 5 children alcohol consumption was observed once or several times. Some children showed signs of increased desire for drinking alcohol. A substance related addiction was never observed until now. Nevertheless the risk of addiction development has to be considered as dangerous in any case of fetal alcohol syndrome. All conditions and risk factors for addiction development are present: a) Hereditary factors in the family of origin. b) Early use and adaption in the prenatal period by maternal drinking. c) The social surroundings and family. d) The particular structure of personality in these children, characterised by uncritical behavior, mental retardation, emotional instability and easy seduction. The risk of addiction development can be estimated to 30%. In a society of lacking alcohol prohibition it will be impossible to keep alcohol away from the children. As in dry alcoholics the children have to learn "to live in association with alcohol without drinking it". Besides it is important for the parents, that they learn to help their child to cope with the danger of alcohol. This ist possible by means of information, strengthening of a positive self-image and faith in the child's capacity for insight.

Alcoholism↗

Evaluation of needle exchange in central London: behaviour change and anti-HIV status over one year.

From November 1987 to October 1988, numbers of clients, visits made and syringes dispensed and returned were monitored at the needle exchange of the Middlesex Hospital, London, UK. A sample of clients were interviewed 1 month after entry to the scheme and again 3 months later to evaluate changes in injecting and sexual risk behaviours for HIV infection. Clients were asked to donate saliva for anti-HIV immunoglobulin G (IgG) antibody capture radioimmunoassay (GACRIA). The rate of lending and borrowing used injecting equipment fell, both compared with rates prior to entry to the scheme and during the period of study. Frequency of injecting did not increase and there was reduced incidence of abscesses. There was a highly significant correlation between multiple sexual partners and condom use and a reduction in the proportion of clients with multiple partners. On entry to the study, seven out of 121 (6%) clients were anti-HIV positive; after 3 months, a further two clients tested were found to be anti-HIV positive. Anti-HIV positivity prevalence for the year of study was nine out of 121 (7%). The scheme attracts clients, reduces injecting-related risk for HIV infection and has high equipment return rates. Saliva testing is acceptable to clients. Continued monitoring of anti-HIV in saliva is indicated.

Acquired Immunodeficiency Syndrome↗

Designing interventions to prevent HIV-1 infection by promoting use of condoms and spermicides among intravenous drug abusers and their sexual partners.

This paper summarizes the results of a 2-day workshop to identify the most effective educational strategies to promote use of condoms and spermicides for preventing heterosexual transmission of HIV-1 virus from intravenous drug abusers (IVDA) to their steady, nonintravenous drug abusing (NIVDA) sexual partners. Representatives from health departments, drug abuse treatment centers, academic institutions, service organizations, and the community discussed issues relating to population characteristics, educational strategies and recruitment techniques. A consensus document that identifies the most effective recruitment and intervention strategies was developed. Recruitment issues include locations, recruitment targets, anticipated difficulties, and ethical considerations. The majority of workshop participants agreed that an intervention should target the couple (both IVDA and NIVDA). Intervention concerns encompass obtaining trust, maintaining participation, and identifying guidelines to maximize program impact.

Acquired Immunodeficiency Syndrome↗

Sexual behavior, drugs, and relationship patterns on a college campus over thirteen years.

Three samples of college students at a small New England liberal arts college received questionnaires regarding their sexual philosophies, behavior, relationship with most recent partner, self-perceived attractiveness, relationship with parents, use of drugs and alcohol, attitudes toward marriage and abortion, and other subjects. The college was sampled in 1974, 1979, and 1986. Sexual behavior increased dramatically from 1974 to 1979 and then decreased in 1986 to approximately where it was in 1974. The reason for this change, and findings regarding the relationships between sexual behavior and many of the variables cited above are discussed.

Adolescent↗

Epidemiological observations in the AIDS clinic at the Hadassah University Hospital in Jerusalem.

Of the first 395 attendees at the AIDS clinic in Jerusalem, 32% were homo/bisexuals, 4% i.v. drug abusers (IVDAs), 24% persons with minimal risk for AIDS and 38% were persons having no risk. Human immunodeficiency virus (HIV) antibody rates were 7% for homosexuals, 29% for IVDAs, 1% for persons with minimal risk and 0% for persons at no risk. Israeli homosexuals had a significantly greater risk for HIV infection (9 of 35) if they had sexual contact with non-Israelis as compared with homosexuals who had contact with local partners only (0/91, P less than 0.001). The mean number of attendees per month increased by 431% during the 4 months following the first prime-time television program on AIDS. The largest mean increases occurred among persons at no risk (1 to 27.2), those with minimal risk (2.5 to 16.5), and among women (1.25 to 20.0). This report indicates that HIV infection among Israeli homosexuals has not yet reached U.S. proportions. It also shows that the TV program raised anxiety concerning AIDS among the general public, and probably encouraged the public to use HIV testing as part of a general health screening program.

Acquired Immunodeficiency Syndrome↗

HIV infection among intravenous drug users: epidemiology and risk reduction.

Research on the epidemiology of HIV infection among IV drug users is still at a relatively early stage. Multilocation studies that would permit better geographic comparisons are greatly needed. Multi-method studies within single geographic areas are also needed to assess possible biases with respect to sample recruitment and data collection procedures. The continuation of the epidemic provides a changing historical context that complicates any comparisons. Despite these problems, there are some consistencies that can be seen across studies. Studies of HIV seroprevalence among IV drug users show wide variation among cities in the United States and Europe. The time that the virus was introduced into the IV drug using group within the city is one factor in explaining these differences; other cross-city factors have yet to be identified. Once HIV has been introduced into the IV drug use group within a particular geographic area, there is the possibility of rapid spread up to seroprevalence levels of 50% or greater. Thus, a currently low seroprevalence rate should not be seen as a stable situation. Frequency of injection and sharing of equipment with multiple other drug users (particularly at shooting galleries) have been frequently associated with HIV exposure. Being female, ethnicity (in the USA) and engaging in prostitution also may be associated with increased risk for HIV exposure, suggesting that prevention programs should include special consideration of sex and ethnic differences. Studies of AIDS risk reduction show that substantial proportions of IV drug users are changing their behavior to avoid exposure to HIV. This risk reduction is probably more advanced in New York, with its high seroprevalence and incidence of cases, but is also occurring in cities with lower seroprevalence and limited numbers of cases. The primary forms of risk reduction are increasing the use of sterile equipment, reducing the number of needle sharing partners, and reducing the frequency of injection. These behavior changes are very similar to the frequently identified behavioral risk factors associated with HIV exposure, suggesting that they should be effective in at least slowing the spread of HIV among IV drug users. No linkage of risk reduction to decreases in seroconversion has yet been shown, however, and greater risk reduction is clearly required. A variety of prevention strategies will probably be needed to reduce the spread of HIV among IV drug users. Prevention of initiation into drug injection is an undeniable long-term goal for the control of HIV infection, but there is very little research being conducted in this area.

Acquired Immunodeficiency Syndrome↗

AIDS prevention: issues and strategies.

Prospects for vaccines to prevent HIV infection and disease have dimmed appreciably in the past year, and drugs for chemoprophylaxis and/or chemical cure are both unlikely and grossly unrealistic as a means of global HIV control. However, the paucity of transmission routes and their susceptibility to strategies of blood screening and of education for behavior modification point in a clear direction for concerted effort. Where they have been applied, blood screening programs have resulted in a dramatic reduction in transfusion-associated infections, and efforts at enhancing donor- and unit-deferral strategies offer promise of further decrease in risk. There is much encouragement in recent reports of education for prevention. While there has been some unevenness in the extent to which successful risk reeducation has occurred, it is nonetheless dramatic compared with prior health educational efforts, and especially so given the exceptional sensitivity of the sexual and illicit drug using behaviors at issue. Finally, clearly articulated public education and particularly correction of misinformation, can contribute significantly to overall prevention efforts by easing fear and enhancing the climate in which persons at behavioral risk of HIV infection can receive and respond to targeted messages.

Acquired Immunodeficiency Syndrome↗