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Knowledge of AIDS and HIV infection displayed by Tanzanian operating dental staff in 1988 and 1989: a follow-up study.

In many urban areas of Central and Eastern Africa 20-30 per cent of the sexually active population has been infected with HIV. It can be assumed that every member of the operating dental staff in Tanzania frequently treats HIV-positive patients. The knowledge of AIDS and HIV infection was investigated by Tanzanian dental teams in 1988 and 1989. In both years almost one quarter of the dental officers and half the other operating team members chose incorrect information about the methods of transmission of HIV. Several respondents named health care workers as belonging to a high risk group. Fever and loss of weight were known to be early symptoms of AIDS. In 1989, when asked to identify oral manifestations of HIV, one quarter of all the dental staff could not mention any of them. The findings of the study emphasise the need for urgent further education of dental teams in Tanzania.

Acquired Immunodeficiency Syndrome↗

Prevalence of cervical human papillomavirus in Taiwanese women.

PURPOSE: To define the prevalence rate of cervical human papilloma virus (HPV) using DNA oligonucleotide microarray and its correlation with risk factors in Taiwanese women in metropolitan Taipei. METHODS: Thirteen hundred and twenty healthy women, aged 21 - 65 yr without history of cervical intraepithelial neoplasia (CIN) or carcinoma were included in this prospective study. Pap smear and HPV typing using oligonucleotide microarray were performed for each woman. They were given a standardized questionnaire to obtain information about the risk factors of cervical cancer in Taiwan. RESULTS: The overall HPV positivity was 19.85% and multiple infections were found in 35.84% of the infected group, 7.92% of the whole study population. The younger the subject, the higher was the infection rate and multiple infection rates. The most common HPV types were 16, 18, 58, 52, 51 and 56, which is different from the western world. The sensitivity of the HPV DNA chip in detecting CIN and cervical carcinoma is 97.06%, and 100% in detecting CIN 2 or more lesions. Risk factors for HPV infection include earlier coitarche (P < 0.01), multiple sexual partners (P < 0.05), history of sexually transmitted disease (P < 0.05), two or more vaginal deliveries (P < 0.05) and infrequent use of condoms (P < 0.05). The association between oral contraception or cigarette smoking and HPV infection could not be determined because few women smoke or used oral contraception. There was no relationship between induced abortion and HPV infection. CONCLUSIONS: About one-fifth of adult women in metropolitan Taipei were cervical HPV positive. The popular HPV types and the risk factors of HPV infection in metropolitan Taipei are not the same as those in the western world. The sensitivity of the HPV DNA chip in detecting cervical neoplasia is very high.

Adult↗

[Negative regulation of the JAK/STAT: pathway implication in tumorigenesis].

Cytokines, hormones or growth factors induce a variety of biological responses including proliferation, differentiation and apoptosis. After binding to their specific cell surface receptors, these stimuli induce the activation of a number of signaling pathways including the activation of JAK (JAnus Kinase) proteins by auto and transphosphorylation. Activated JAK phosphorylate the receptor chains on tyrosines, creating docking sites for cytoplasmic transcription factors named STAT (Signal Transducers and Activators of Transcription). Furthermore, the JAK phosphorylate the STAT which form dimers and migrate to the nucleus where they bind to specific DNA sequences leading to the activation of transcription. The multiplicity of JAK (4 members) and STAT (7 members) and their associations with multiple possible partners allow the formation of various STAT homo and heterodimers and STAT-containing transcriptional complexes. Each of these complexes lead to the specific regulation of gene transcription. Negative regulation of the JAK/STAT signaling pathway is crucial to switch off the cytokine/growth factors' signal. Three families of proteins : the phosphotyrosine phosphatases (SHPs, CD45, PTP1B/TC-PTP), the SOCS proteins (Suppressors Of Cytokine Signaling) and the PIAS (Protein Inhibitor of Activated STAT) are involved in this process. These proteins act at various levels of the JAK/STAT pathway. Thus, tyrosine-phosphatases dephosphorylate activated JAK, STAT or cytokine receptors. PIAS interact with activated STAT and inhibit their DNA binding or their transactivating capacity, probably in relation with their intrinsic SUMO E3-ligase activity. The tyrosine phosphatases and the PIAS are constitutively present in the cell and represent a first level of regulation. The SOCS, which represent a second level of JAK/STAT negative control, are induced by cytokines and exert a negative feed-back loop. Indeed, they interact with activated JAK or with phosphorylated receptors, inhibiting the recruitment of STAT, the activation of the JAK enzymatic activity, or inducing the proteasome-dependant degradation of activated JAK or receptors.

Apoptosis↗

Safer sex in tourist resorts.

A survey in Torbay, England, indicated substantial sexual interaction of an unsafe kind between young residents and tourists. A pilot programme is described which sought to promote safer sexual behaviour: the attention of both tourists and local people who frequented nightclubs was engaged by peer groups who conveyed educational messages.

Adolescent↗

Hepatitis B seroprevalance and risk factors in urban areas of Malatya.

BACKGROUND/AIMS: To determine the prevalence of hepatitis B viral markers and to assess possible risk factors in urban areas of Malatya. METHODS: This was a sero-epidemiological, community based cross-sectional study and included 646 participants( female 352, male:294) from 192 houses. A face to face questionnaire was carried out and HBsAg, anti-HBc and anti- HBs markers were analyzed from blood samples using Micro ELISA technique. RESULTS: The prevalence of HBsAg, anti-HBc and anti-HBs were found to be 6.0%, 29.3% and 30.3% respectively. In the final logistic regression, HBV infection (=anti HBc+) was independently associated with the age group of 21 years and older (OR=3.7, 95% CI=1.884-7.494), in illiterate subjects (OR=2.1, 95% CI=1.180-3.326), in farmers and labourers (OR=2.8, 95% CI=1.042-7.953) and in these with multiple sexual partners (OR=2.1, 95% CI=1.574-8.168). In addition, HBV infection was significantly higher in circumcised male children compare to uncircumcised ones ( chi2=5.58, P=0.01), in ones who gave birth to child at home compare to in ones who gave birth to a child at hospital ( chi2=13.86, P=0.0001). CONCLUSION: The results of our study indicate that Malatya province has a moderate endemicity with regard to HBV infection.

Journal Article↗

Sexual behaviour, perception of HIV/AIDS and condom use among commercial motorcylists in Benin City.

OBJECTIVE: This study aims to evaluate the perception of HIV/AIDS, condom use and the sexual behaviour of commercial motorcyclists in Benin-city, Edo State. DESIGN: A questionnaire based study involving consecutive 160 male commercial motorcyclists. SETTING: The study was conducted in three randomly selected major motorcycle parks in Benin-city. The three parks were selected using a multi stage random sampling technique. In each of the selected parks, consecutive motorcyclists were interviewed until a total of 160 respondents had been interviewed. RESULTS: One hundred and fifty-two (95%) of the respondents were acquainted with the subject of HIV/AIDS, but only 140(87%) believed that the disease actually existed. Sixty-six per cent of the respondents had multiple sexual partners while 26% of the subjects had been treated for a sexually transmitted infection. Of the 54 (34%) men who believed the disease had a cure, 46% and 32% felt that the cure was herbal and spiritual respectively. Although 106 of the men (66%) acknowledged the preventive function of the condom in the spread of HIV/AIDS and other sexually transmitted infections, only 45% used the condom regularly with sexual partners. Sixty-two per cent of the respondents would submit themselves to voluntary HIV screening though none had gone for voluntary screening. CONCLUSION: The study suggests that the sexual behaviour of the commercial motorcyclist and a scarcity of information expose him to increased risk of HIV/AIDS infection and other sexually transmitted infections.

Acquired Immunodeficiency Syndrome↗

Targeting the audience for AIDS messages by actual and perceived risk.

Since there are many ways to segment an audience into target groups, we suggest that a productive strategy for AIDS education is to divide the audience by their actual and perceived risk. We provide an example in which we segmented an urban U.S. sample and make suggestions as to how messages appropriate for each group can be constructed. In our sample, the "unthreatened" accurately assessed their low risk of AIDS, and showed high knowledge and tolerance rates. The "panicked," who included more women and Hispanics, inaccurately thought themselves at high risk because of misunderstandings about the causes of AIDS, and showed more intolerance of people with AIDS. "Deniers" continued to have multiple sexual partners and take precautions irregularly, despite seeing AIDS as a social problem and having more education and AIDS knowledge. In contrast, "gamblers" recognized their higher risk of AIDS and were most likely to have taken some action, although not enough to prevent sexual transmission of the HIV virus.

Acquired Immunodeficiency Syndrome↗

Clinical inquiries. What are contraindications to IUDs?

Based on limited evidence, use of intrauterine devices (IUDs) is not contraindicated for women with HIV/AIDS (strength of recommendation [SOR]: C), multiple sexual partners (SOR: C), previous actinomyces colonization (SOR: C), most types of fibroids (SOR: C), or previous ectopic pregnancy (SOR: C). The risk to IUD users of pelvic inflammatory disease (PID) is similar to women using no contraception (SOR: B). Nulliparous women may experience increased insertion discomfort and higher rates of expulsion (SOR: B). IUD use of <3.5 years is not associated with decreased fertility (SOR: B).

Bacterial Infections↗

[Analysis of correlation between HPV DNA lymph node presence and pathologic parameters of primary tumour in cervical carcinoma patients treated surgically].

Young-age sexual activity, multiple sexual partners, number of pregnancies, smoking and human papilliomavirus (HPV) infections are factors commonly considered as promoters of cervical tumorogenesis. Cervical carcinoma patients' prognosis correlates significantly with staging (according to FIGO classification). In early stages lymph-node involvement is considered as the most important prognostic factor. Other factors are: initial volume of the lesion, lymphatic and blood vessels involvement, depth of cervical invasion. Also parametrium involvement seems to decrease the rate of 5-year survival. The aim of the research was to estimate correlation between HPV DNA lymph node presence and pathologic parameters of primary tumour in surgically treated cervical carcinoma patients. We analysed DNA isolated from lymph nodes sampled intra-operatively from 134 patients, surgically treated for cervical cancer with PCR. We confirmed the presence of HPV DNA sequences in lymph nodes in 81 (60.5%) cases. Lymph node presence of HPV DNA rate was significantly higher in: advanced tumours, cases with initial lesion volume exceeding 10 cm3, cases with uterus and vaginal involvement and with initial tumour invasion deeper than 10 mm.

DNA Probes, HPV↗

A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults.

Hepatitis B vaccination is the most effective measure to prevent hepatitis B virus (HBV) infection and its consequences, including cirrhosis of the liver, liver cancer, liver failure, and death. In adults, ongoing HBV transmission occurs primarily among unvaccinated persons with behavioral risks for HBV transmission (e.g., heterosexuals with multiple sex partners, injection-drug users [IDUs], and men who have sex with men [MSM]) and among household contacts and sex partners of persons with chronic HBV infection. This report, the second of a two-part statement from the Advisory Committee on Immunization Practices (ACIP), provides updated recommendations to increase hepatitis B vaccination of adults at risk for HBV infection. The first part of the ACIP statement, which provided recommendations for immunization of infants, children, and adolescents, was published previously (CDC. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices [ACIP]. Part 1: immunization of infants, children, and adolescents. MMWR 2005;54[No. RR-16]:1-33). In settings in which a high proportion of adults have risks for HBV infection (e.g., sexually transmitted disease/human immunodeficiency virus testing and treatment facilities, drug-abuse treatment and prevention settings, health-care settings targeting services to IDUs, health-care settings targeting services to MSM, and correctional facilities), ACIP recommends universal hepatitis B vaccination for all unvaccinated adults. In other primary care and specialty medical settings in which adults at risk for HBV infection receive care, health-care providers should inform all patients about the health benefits of vaccination, including risks for HBV infection and persons for whom vaccination is recommended, and vaccinate adults who report risks for HBV infection and any adults requesting protection from HBV infection. To promote vaccination in all settings, health-care providers should implement standing orders to identify adults recommended for hepatitis B vaccination and administer vaccination as part of routine clinical services, not require acknowledgment of an HBV infection risk factor for adults to receive vaccine, and use available reimbursement mechanisms to remove financial barriers to hepatitis B vaccination.

Adult↗

Gender and oral manifestations of HIV infection among adult Nigerians.

Oral manifestations were studied in 305 adult Nigerians with HIV infection. Data collected were demographic (age, sex, marital status, educational status and occupation) and clinical (mode of transmission, general manifestations and oral manifestations of HIV infection). The chi- square test was used in test for significance between variables and p values less than 0.05 were regarded as significant. A total of 47.5% patients had oral manifestations. There were 67.6% females and 32.4% males (p <0.001). The patients ranged in age from 19-70 years. Heterosexual contact with multiple sex partners was the most common mode of transmission of infection (42.9% in females and 74.5% in males, p < 0.05). Candidiasis was the most common oral manifestation (78.6% in females and 78.7% in males p >0.05). The study concluded that similar demographic and clinical characteristics were observed in the occurrence of oral manifestations of HIV infection in both male and female Nigerians.

Adult↗

HIV-risk behaviors of sterilized and nonsterilized women in drug-treatment programs--Philadelphia, 1989-1991.

From June 1981 through December 1991, 34% of all reported cases of acquired immunodeficiency syndrome (AIDS) among women in the United States were attributed to heterosexual transmission, and that proportion has been increasing steadily (1). Factors associated with an increased risk for heterosexual transmission include unprotected sexual intercourse (2), multiple sex partners, and the presence of other sexually transmitted diseases (STDs) (1). Women who have been surgically sterilized and who are sexually active and/or use injecting drugs may need the same prevention services for human immunodeficiency virus (HIV) and other STDs as similar nonsterilized women; however, the specific needs of sterilized women have not been well characterized. This report compares findings from surveys of surgically sterilized and nonsterilized women in drug-treatment programs in Philadelphia on their drug use and HIV/STD-risk behaviors and assesses changes in risk behaviors among these women after a 9-month period during which family-planning counseling and/or gynecologic services were offered.

Acquired Immunodeficiency Syndrome↗

Long distance truck-drivers: 1. Prevalence of sexually transmitted diseases (STDs).

A cross section study was conducted among long distance truck drivers to determine the prevalence of sexually transmitted diseases (STDs) and antibodies to human immunodeficiency virus (HIV). A total of 8 drivers and their assistants en route from port of Mombasa to countries in East and Central Africa were enrolled into the study. Blood was taken for HIV and syphilis serology. Discharges from urethra and genital ulcer disease (GUD) were cultured. Seroprevalence for HIV was 18% and 4.6% for syphilis. Fifty percent of Neisseria Gonorrhea cultured were penicillinase producers. Most of the men with urethral discharge and all the GUD were culture negative, probably due to prior treatment. Lack of circumcision, past history of GUD and urethritis were significantly associated with HIV seroconversion.

Adolescent↗

Behaviour change in HIV infected subjects following health education.

A total of 85 HIV seropositive subjects among consecutive new registrants in the STD Department were given health education measures directed to avoiding high risk behaviours and also the events with a high potential for transmission of infection. The emphasis was on the use of condoms, discontinuing promiscuity, abstaining from homosexual acts and avoidance of pregnancy and advice against marriage for those contemplating it. The Health Education Programme was delivered individually to each subject over two or three sessions, each lasting for 30 to 45 min. At the time of follow up (one to 24 months) 42 per cent of subjects had become non-promiscuous. There was a good compliance on advice against marriage and pregnancy. Seven infants born during the follow up period were seronegative. The use of condom was not found to be acceptable. The prostitutes comprised the most resistant group to education. Among the factors that influenced the behaviour change favourably was the absence of earlier STD or a short duration of the current STD. Literacy, marital status, awareness of AIDS did not influence the outcome of education. The study demonstrated the feasibility of health education at individual level in the clinical setting of an STD Department. A longer follow-up may indicate the sustainability of behaviour change in the subjects.

Adult↗

Epidemiology of Kaposi's sarcoma.

The AIDS epidemic drew attention to KS, a previously rare and little studied condition. The epidemiological evidence summarized here strongly suggests that the disease is caused by a transmissible agent, in addition to HIV. Sexual contact is the most important mode of transmission of the agent, although transmission by blood and perinatally may also occur (Beral et al, 1990).

Acquired Immunodeficiency Syndrome↗

Sexual networking in the Ekiti district of Nigeria.

The confirmation of a significant number of HIV-positive persons and some deaths due to AIDS in Nigeria has rendered more urgent the study of sexual networking, both for an understanding of the risk of HIV transmission and also that of sexually transmitted diseases, which may serve as a vehicle for HIV infection. This article reports on a research project that concentrated initially on developing both small-scale survey and anthropological methodology to a point where reliable information was obtained. The research was carried out in both urban and rural areas of Ekiti, Nigeria, a Yoruba district 150 miles northeast of Lagos. Findings are reported from both the survey of 200 men and 200 women and the supplementary specialized in-depth studies. A high level of premarital and extramarital sexual activity was shown to exist, with higher levels among men than women and in urban than rural areas. Most female extramarital relations in rural areas were occasioned by the need for material or economic assistance and were highest among the younger wives in polygynous marriages. Male extramarital relations were highest in monogamous marriages and were frequently explained by wives' periods of postpartum sexual abstinence. Polygyny and postpartum sexual abstinence were underlying social institutions that explained much of the sexual networking. Reported levels of sexually transmitted disease were high, as were beliefs that these disease could be treated successfully by traditional healers.

Adolescent↗

[Prevalence of HIV1 and HIV2 infection in women living in an area of Lisboa City].

A seroprevalence study of HIV1 and HIV2 infection in women attending a Family Planning and an Antenatal Clinic was done in an area of the city of Lisbon where 7% of the population is of African origin. The protocol of study was of non linked type although with the possibility of collecting a second sample of blood for confirmation of results. Epidemiological, social and clinical data were collected from 1390 women and this was followed by the collection of a blood sample for the seroepidemiological study of HIV1 and HIV2. The population that was submitted to blood tests (75%) was compared to the one that missed the test and it was found that no important differences were present between the two. The criteria for HIV1 or HIV2 positive results were the presence of a positive ELISA test confirmed by an Western Blot revealing antibodies against the three proteins env, core and gag. For a test to be considered positive results by both methods had to be found in a second sample collected later. The prevalences of infection were of 0.29% for HIV1 and 0.29% for HIV2 although the prevalence of HIV2 in the population of African origin was higher (1.45%). The six seropositive cases detected included a drug addict, one prostitute, one case of African origin and two cases with multiple sexual partners. The clinical, epidemiological and immunological features of the seropositive cases are presented and the prevalence found is discussed in the context of other portuguese data.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Predictors of chlamydial infection and gonorrhea among patients seen by private practitioners.

OBJECTIVE: To identify the predictors of chlamydial infection and gonorrhea among patients tested by general practitioners. DESIGN: Prospective study. SETTING: General private practice, family planning and abortion clinic, adolescent clinic, sexually transmitted disease (STD) clinic and community health clinic in downtown Montreal. PATIENTS: The 2856 patients were included because of symptoms compatible with an STD, a history of sexual contact with a person known or suspected to have chlamydial infection, a history of a nonexclusive sexual relationship or presentation for an abortion. MEASURES: Patient information was obtained by the attending physician on a standard form. Enzyme immunoassay (EIA) for Chlamydia trachomatis and culture for Neisseria gonorrhoeae were performed on cervical (female) or urethral (male) samples. Stepwise logistic regression was used to identify the predictors of infection. RESULTS: The EIA results were positive in 11.1% of the cases and the culture results in 2.3%. Among the males chlamydial infection was independently associated with low age (odds ratio [OR] = 0.88 per year), heterosexuality (OR = 4.99), urethral discharge (OR = 3.74) and the absence of a history of gonorrhea (OR = 0.51). Gonorrhea was associated with urethral discharge (OR = 24.3) and homosexuality (OR = 3.68). Among the females chlamydial infection was associated with low age (OR = 0.79 per year), a history of sexual contact with a person known to have chlamydial infection (OR = 2.30), multiple sexual partners in the previous 12 months (OR = 1.60) and a reason for the test other than screening purposes (OR = 0.60). Gonorrhea was associated with a reason other than screening (OR = 0.24) and low age (OR = 0.74 per year). Among the patients tested for screening purposes age was the only significant predictor of chlamydial infection (OR = 0.79 per year), and the prevalence of gonorrhea was 0.4%. The actual rate of chlamydial infection was 11.8% among the patients younger than 25 years, 5.7% among those 25 to 34 years and 0.6% among those over 34. CONCLUSIONS: Age alone can be used as a criterion to screen for chlamydial infection among asymptomatic patients without a history of sexual contact with a person known or suspected to have such infection and with a history of a nonexclusive relationship. The prevalence in our population justifies screening people up to 34 years of age.

Adolescent↗