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AIDS knowledge, perception of risk, and behaviors among female sex partners of injection drug users.

Interviews were conducted with 137 female sex partners of male injection drug users to provide quantitative and qualitative information regarding their AIDS knowledge, attitudes, and specific risk behaviors. Levels of knowledge regarding HIV transmission and prevention were high, with an average of 81.8% correct on a 16-item test. Most women (87.5%) believed that there was at least some chance they would become HIV infected. Substance abuse was prevalent; 67.2% used non-injection drugs (44.5% used crack cocaine), and 32.1% reported prior use of injection drugs. One fifth had engaged in prostitution. Although AIDS knowledge was high, almost all (94.9%) reported engaging in unprotected vaginal intercourse during the previous 6 months, and 6.6% reported anal intercourse without a condom. Among women who did not report consistent condom use, the most frequently stated reasons for non-use of condoms were dislike by their male partner (26.9%) and/or personal dislike of condoms (23.1%). A disturbing pattern of increased risk was observed among black interviewees, who were more likely than Latinas or whites to have contracted syphilis, have multiple sex partners, engage in prostitution, use crack cocaine, and drink alcohol daily.

Acquired Immunodeficiency Syndrome↗

Long distance truck drivers. 2: Knowledge and attitudes concerning sexually transmitted diseases and sexual behaviour.

Three hundred and thirty seven truck drivers, in transit from Mombasa to destinations within east and central Africa were interviewed on their knowledge on AIDS and sex practices using a pre-defined questionnaire. Nearly all of them, 99% (3.7/321), had heard of AIDS through mass media and from friends. When asked for a definition of AIDS, 87% (336/485 responses) described it as a sexually transmitted disease (STD) which causes body wasting and death. The majority were aware of the correct risk reducing behaviours: 76% (228/300) knew that use of condoms can prevent the transmission/acquisition of STDs but only 32% (90/295) had ever used them. This was in spite of the fact that 61% (226/309) admitted to visiting prostitutes. Various reasons were given for not using condoms. About 32% (34/188) claimed that they did not sleep with prostitutes while 18% (34/188) did not see the need for using condoms. Condoms were unavailable to another 18% (34/188). The data obtained show a clear lack of correlation between the correct knowledge of AIDS and application in the prevention of acquisition and transmission of STD.

Acquired Immunodeficiency Syndrome↗

[Prevalence of infection by the human immunodeficiency virus (HIV) in a target population in the Republic of Djibouti].

The Prophylaxis Center of the Republic of Djibouti reports a prevalence investigation about AIDS seropositivity from January to May 1991 at risk people: the "street" prostitutes and "bar" prostitutes in Djibouti town. This serological investigation confirmed by WESTERN-BLOT technique shows the quick-growing of AIDS seropositivity in Djibouti.

Blotting, Western↗

[Heterosexual transmission of the type I human inmmunodeficiency virus in a group of couples residing in the Yucatán peninsula].

OBJECTIVE: To ascertain the prevalence of type 1 human immunodeficiency virus (HIV-1) and to examine the factors associated with its transmission in a group of heterosexual couples. DESIGN: Prospective study, descriptive, from September 1985 to December 1989. SITE. A university research center and a private general hospital in the city of Merida, State of Yucatan. PATIENTS: Twenty-one adult patients (17 men and four women) with initial diagnosis of HIV-1 infection and their respective spouses. All the subjects were residents of the Yucatan peninsula. INTERVENTIONS: The diagnosis of HIV-1 infection was made by the detection of antibodies against HIV-1 (by ELISA and Western Blot). Both the HIV-1 infection and the stage of AIDS were defined by the CDC criteria. The following factors were evaluated in order to define whether any were associated with the risk of transmission of HIV-1: marital status, time of marital status, type of sexual practices, average number of episodes of sexual intercourse per month, stage of HIV-1 infection of the case, presence of sexually transmitted diseases, and presence of genital ulcers. RESULTS: Bisexuality was documented in 15 of the 17 males, and in two heterosexual relations with prostitutes was found. The female cases were infected by transfusion (two cases), intravenous drug addiction (one case) and prostitution (one case). Seventeen cases (81%) fulfilled the criteria for AIDS with diagnosis of HIV-1 infection HIV-1 was detected in eight out of 17 female spouses (47%) but not in the four male spouses. No relation was found between the variables and HIV-1 infection. CONCLUSIONS: The presence of heterosexual transmission of HIV-1 in this study was 38%. The absence of associated factors suggests that heterosexual relations with an infected subject is sufficient for the transmission of HIV-1 to occur. The limited number of female cases makes it difficult to evaluate the efficiency of female-male transmission. Bisexual practices were the predominant cause of HIV-1 infection in the male cases, and as a consequence, the indirect cause of HIV infection in the female spouses.

Acquired Immunodeficiency Syndrome↗

[Prevalence and determinants of HIV infection in 581 drug addicts in the Northeastern Italy, from 1984 to 1988].

Prevalence and determinants for human immunodeficiency (HIV) virus infection was assessed in 581 heterosexual intravenous drug users, recruited from public drug assistance centers in the northeast of Italy between 1984 and 1988. The overall seroprevalence rate for HIV antibody was 39% (95% confidence interval-CI-35-43%). HIV prevalence had risen from 32% in 1984-85 to 47% in 1986-88. Age was not associated with HIV infection risk, whereas gender was, women being at lower risk of infection than men (odds ratio-OR- = 0.7, 95% CI: 0,5-1.0). Seropositivity rates showed a strong east-west geographical gradient: intravenous drug users living in the western part of the study area had a nearly sevenfold higher risk of infection (95% CI = 4.4-13.9) than those living in the eastern part. Sharing of drug injection equipment was by far the most important risk factor. IVDUs who reported to always share injection equipment had a fourfold higher risk of HIV infection, as compared with those who never did (95% CI = 1.6-12.7). The duration of drug addiction (odds ratio = 2.6), the use of heroin in high-incidence cities (odds ratio = 2.3) and of cocaine in addition to heroin (odds ratio = 1.5) and the practice of prostitution (odds ratio = 2.3) were also important determinants of HIV infection. Over the study period, the odds ratios associated with area of residence decreased, whereas those associated with the use of heroin in high-incidence cities and with prostitution increased.

Adult↗

The demographic, social and clinical presentations of one hundred Ethiopian patients with human immunodeficiency virus (HIV) infection.

The demographic, social and clinical presentation of 100 HIV positive patients hospitalized in Tikur Anbessa Hospital, Addis Ababa, Ethiopia, between 1986 and 1989 are described. The mean age is 38.2 years with a range of 16 to 58. Over 75% of the patients are under 40 years. They came from ten different regions of Ethiopia. Only 82% of the patients fulfil the provisional World Health Organization clinical case definition of AIDS (acquired immunodeficiency syndrome). Tuberculosis is the commonest infection, presenting in unusual and aggressive ways. However, response to chemotherapy is similar to that in HIV-negative patients. It is recommended that all patients with unusual and aggressive tuberculosis should be screened for HIV and Mantoux-positive HIV carriers should receive INH prophylaxis. Also, all non-Hodgkin's lymphoma cases should be tested for HIV. Kaposi's sarcoma was not seen (see Addendum). As HIV infection is spreading rapidly and diagnostic facilities are limited, physicians and other health workers must develop a high index of suspicion to test for HIV among high risk groups, such as prostitutes, individuals having contacts with prostitutes, single, divorced and unemployed women living in towns and truck drivers, when they present with significant weight loss, unexplained and prolonged fever and diarrhoea, lymphadenopathy and oral thrush. Also, facilities and expertise for diagnosing opportunistic infections should be available in hospitals to prolong the lives of patients with AIDS.

Adolescent↗

[Prevalence of type 1 human immunodeficiency virus (HIV) infection in African patients residing in Catalonia].

278 black patients from West Africa, living in Maresme, a coastal area north of Barcelona were studied in order to determine the prevalence of HIV-1 infection. During the first period (1984-86), 102 patients were studied, 3 of them were positive for HIV-2, but none was positive for HIV-1. In the second period (1987-89), 176 patients were studied and 15 were positive for HIV-1. Sexual intercourse with prostitutes of low social level was the only risk factor in all of them. Nine of these 15 patients had other STD, 4 parasite infections, 5 AIDS related-syndrome and 2 AIDS. These findings alert us to the high prevalence of HIV-1 infection in this group of patients (8.5%) and call for stricter measures to enforce hygiene in the area of prostitution.

Acquired Immunodeficiency Syndrome↗

Prevalence of HIV infection and high-risk activities in Haiti.

The prevalence of antibodies to human immunodeficiency virus (HIV) was determined in the relatives, friends, and sex partners of AIDS patients in Haiti and in other unrelated Haitian population groups. Among contacts of AIDS patients, HIV seroprevalence was highest among sex partners of the opposite sex (55%) and lowest among female relatives and friends (9%) of female AIDS patients. Male relatives and friends of male AIDS patients had a seroprevalence rate of 19% and also had a history of multiple heterosexual partners and frequent contact with prostitutes. The HIV seroprevalence rate among unrelated groups of Haitian adults ranged from 2% in rural healthy adults to 22% among tuberculosis patients to a high of 49% among Haitian prostitutes. This seroprevalence pattern suggests that HIV infection is widespread in Haiti and that heterosexual activity plays a major role in transmission.

Bisexuality↗

AIDS in Haiti.

The first cases of AIDS in Haiti were recognized in 1978-1979, a period that coincides with the earliest reports of AIDS in the United States. Current data are consistent with the hypothesis that AIDS originated in Africa, came to the United States and Europe, and subsequently was introduced into Haiti by either tourists or returning Haitians. The seroprevalence of HIV among healthy sexually active adults in Port-au-Prince, Haiti, is approximately 10%. This rate of HIV infection is threefold that observed in rural areas. The highest prevalence rates were observed in female prostitutes (53%) and in the male and female spouses of AIDS patients (55%). The types of opportunistic infections and the clinical course in Haitians with AIDS were similar in many respects to those in patients with AIDS in the United States. Important differences were noted in the prevalence of specific opportunistic pathogens in Haiti. It resembled observations on these infections in Africa. During the past 4 years, there has been a progressive decrease in the percent of patients reporting bisexuality and blood transfusions, and an increase in those reporting either a spouse with antecedent AIDS, prostitution, or none of the aforementioned activities. In 1986, heterosexual transmission probably accounted for over 70% of AIDS cases.

Acquired Immunodeficiency Syndrome↗

[Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in 3 groups of Ecuadorian women with different sexual behaviors].

In order to examine the relationship between sexual conduct and infection with Chlamydia trachomatis and Neisseria gonorrhoeae (gonococcus), the prevalence of these two microorganisms was studied in three groups of Ecuadorean women with different patterns of sexual behavior: 116 prostitutes, 136 women from Borbón Parish who had numerous sexual partners, and 61 pregnant women who had sexual relations with only one partner. The prevalence of infection from one or both of the agents was 53.4% in the prostitutes (n = 62), 34.5% in the women from Borbón (n = 47), and 1.6% in the pregnant women (n = 1). These results bear out the relationship between sexual behavior and risk of sexually transmitted disease.

Adolescent↗

Prevalence of HTLV-I compared to HIV-1 and HIV-2 antibodies in different groups in the Ivory Coast (West Africa)

Different Ivorian population groups were comparatively tested for antibodies to HTLV-1, HIV-1, and HIV-2. They included 1,334 healthy individuals, 176 unselected medical patients in regional hospitals, 149 female prostitutes, and 65 males with a sexually transmitted disease (STD) collected in 1987 from four regions (east, north, west, and central). The HTLV-1 prevalence averaged 1 to 2.7% in the different regions, without significant increase in sexually overexposed groups. Furthermore, in Dabou Protestant Hospital, 60 km west of Abidjan, 414 blood donors, 109 asymptomatic HIV-positive individuals, and 181 AIDS clinical cases were also tested. While a significant increase in the prevalence of HTLV-1 antibodies was observed only in AIDS patients. HIV-1 and HIV-2 prevalence increased, as expected, from a low rate (2.4%) in the general population to an intermediate rate (13-15%) in blood donors and unselected hospitalized patients and to a high rate (35%) in prostitutes and STD male patients.

Adolescent↗

[Incidence of viral liver diseases in the province of Corrientes in various populations].

The hepatitis incidence of A and B markers is being analyzed in 600 persons with different characteristics. Where tested 276 Sanitary Agents, 56 Convicts, 36 Hemodialyzed persons, 32 Prostitutes and 200 women in childbirth. It's found that more than 90% of the population studied had contact with VHA. Regarding VHB the incidence for the different groups (measure in anti-HBc positivity) is variable according to risk: Sanitary persons 19.20%, Convicts 12.50%, Hemodialyzed persons 86.11%, Prostitutes 53.12% and women in childbirth 2%.

Antibodies, Anti-Idiotypic↗

[HIV infection--a sexually transmitted disease].

In the light of literature reports and own experiences and observations the most important epidemiological aspects of HIV infection acquired through sexual contacts are discussed, including the likelihood of infection during heterosexual or homosexual intercourse, factors increasing the infection risk in homosexuals intercourse and the more or less safe forms of sexual intercourse. The combination of HIV infections with infections with other sexually transmitted diseases is discussed on the basis of own observations which showed that HIV infection was acquired much more frequently by homosexuals treated in outpatient clinics for venereological diseases (19.7%) as compared to other homosexual groups (2.7%), and the risk was even lower in heterosexuals treated in these clinics for sexually transmitted diseases (0.2%). Over half the patients infected with HIV had or had had syphilis. HIV infection was sought for in Warsaw prostitutes, and 0.6% of them were found to be infected, two-thirds of the infected ones were drug addicted prostitutes. The importance of the sexual route of infection in drug addicts and transmission of this infection to the heterosexual population are considered. The principles of prophylaxis, the directions of health education, and the importance of screening for HIV infection prevention are considered. Attention is called to the harmful effects of all types of restriction of the infected people which lead to trials of infection concealment.

Acquired Immunodeficiency Syndrome↗

HTLV-III exposure among drug users.

The Centers for Disease Control hierarchical classification of those at risk for acquired immunodeficiency syndrome (AIDS) underestimates the number of cases in which illicit drug use may play a role in the exposure to human T-cell leukemia virus type III. The immunosuppressive effects of nitrite inhalants are not sufficiently documented to elucidate their role as a cofactor in the development of AIDS. The currently available data on the immunosuppressive effects of self-administered parenteral drugs and their diluents indicate an associated elevation of immunoglobulin M, depressed helper/suppression T-cell ratios, and even damage to DNA. Illicit psychoactive drugs and their diluents may influence the virulence of the virus among parenteral drug users. An association between parenteral drug use and prostitution is not unexpected. Female prostitutes who use parenteral drugs may be at high risk for exposure to the virus and thus may transmit this infectious agent to their clients and their families.

Acquired Immunodeficiency Syndrome↗

[Retroviral infections by HIV-1, HIV-2 and AIDS-related complex in the Ivory Coast].

The study of 500 blood donors, of 23 prostitutes, 22 confirmed AIDS cases and 19 ARC patients in Abidjan showed that HIV-2 prevalence in blood donors (3.4%) was somewhat higher than that of HIV-1 (2.4%). Furthermore HIV-2 alone was found associated with 14% of AIDS cases and 21% of ARC, while HIV-1 was associated with 32% of the cases. Antibodies to HIV-1 and HIV-2 were found in 54% of AIDS and ARC cases, as well as in 48% of the prostitutes sera. These preliminary results suggest that HIV-2 is pathogenic, being causally involved in some AIDS cases and does not protect from HIV-1 pathogenic potential.

AIDS-Related Complex↗

Notification of HIV carriers: possible effect on uptake of AIDS testing.

Passing of the AIDS Prevention Bill, which demands the notification of human immunodeficiency virus (HIV) carriers, seems imminent in Japan. Its effect on people's willingness to be tested for the HIV antibody was assessed among heterosexual subjects (students, office workers) and groups at high risk of the acquired immunodeficiency syndrome (AIDS) (prostitutes, homosexual males) by means of a questionnaire. More than 70% of the 811 students and 509 workers replied that, if notification became mandatory, they would agree to be tested but 10% of the males and 17% of the females in these two groups would prefer testing at institutes not complying with the clause; all 198 prostitutes said that they would be prepared to undergo testing but 35% of them would prefer to go to non-complying clinics; 45% (410) of 902 homosexual males replied that they would refuse testing, and 65% of those who would agree to be tested (492) would prefer to go to non-complying clinics. These findings strongly suggest that when the bill is passed the greater the self-perceived risk of HIV infection the poorer will be the uptake of AIDS testing. Hence the bill would be counterproductive in the surveillance of potential HIV carriers.

Acquired Immunodeficiency Syndrome↗

Occurrence of sexual behaviour related to the risk of HIV-infection. A survey among Danish men, 16-55 years of age.

To describe the occurrence of sexual behaviour involving increased risk of HIV-infection in a representative sample of Danish men, 16-55 years of age, a self-administered anonymous questionnaire was distributed in connection with a personal health interview and returned by mail. The response rate was 55% corresponding to 1,155 participants. The sexual behaviour of 33% of the men was potentially risky, with a chance of HIV-infection. Homosexual experience was reported as 3% and sexual contact with female prostitutes as 14%. During the previous twelve months, 1% had had homosexual contact, 2% had had contact with prostitutes, and 22% had more than one female partner; most of these men had "one night stands" and used condoms infrequently. Consequently, a significant minority of the participants engaged in sexual behaviour which might facilitate the dissemination of HIV-infection. Although the prevalence of HIV among heterosexuals in Denmark is low, intense health education will be needed in order to prevent heterosexual spread of HIV in the future.

Acquired Immunodeficiency Syndrome↗

Human immunodeficiency virus transmission among heterosexual couples in Central Africa.

From February to June 1986, 150 heterosexual couples with at least one HIV-seropositive member were recruited in the 'Centre Hospitalier de Kigali', Kigali, Rwanda. Of the 138 HIV-seropositive couples in whom both members were tested, 124 (90%) were sexual unions between two antibody-positive partners, illustrating the high efficiency of the heterosexual transmission of HIV. A comparison of these 124 couples with 150 HIV-seronegative couples showed that, in the husbands, seropositivity is significantly associated with sexual contacts with prostitutes and history of sexually transmitted disease (STD) within the past 2 years. Seropositive wives were less likely to be in their first marriage and reported more episodes of STD than seronegative ones. Seropositive couples were similar to seronegatives in their history of blood transfusion, male circumcision and overall use of contraception but not in their use of oral contraceptive pills, which was more frequent; they were more often in polygamous unions. Discriminant analysis showed that STD, sexual contacts with prostitutes and the number of previous unions are the most powerful independent variables associated with the seropositivity of the couples. Most of the risk factors for the couples were the risk factors for the husband, suggesting that in most cases the husband acquired the HIV infection and passed it to his wife.

Acquired Immunodeficiency Syndrome↗