Psychological distress and neuropsychological complications of HIV infection and AIDS.

AIDS, whether real or threatened, poses a radical challenge to the psychological, social, and practical adaptation of individuals at various stages of human immunodeficiency virus (HIV) disease. The challenge arises from multiple sources, including disease progression, social discrimination, bereavement, pressure for life-style change, and neurological impairment associated with HIV brain infection. The consequences of this challenge to people with HIV infection, AIDS-related complex, AIDS, and AIDS dementia complex are reviewed. The potential for both personal crisis and personal growth in response to this challenge is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions to prevent HIV infection are urgently needed: New priorities for behavioral research in the second decade of AIDS.

Behavior change remains the only means for primary prevention of HIV disease. Psychology should take a leading role in efforts to curtail the epidemic, but has not contributed to HIV prevention at a level proportionate to the urgency of the crisis. The authors propose an updated agenda for behavioral research on AIDS-HIV prevention implementing accelerated community trials of promising behavior change models, conducting trials of community-level interventions on a large scale and focused on populations most vulnerable to HIV infections, establishing partnerships between HIV research and community service organizations, integrating efforts from across psychology disciplines to advance and refine HIV prevention interventions, and mobilizing interdisciplinary HIV prevention resources and communication mechanisms to rapidly translate research findings to community and public policy arenas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions for terroristic trauma: Symptoms, syndromes, and treatment strategies.

Terrorist attacks combine features of criminal assaults, disasters, and acts of war. Accordingly, much of the clinical knowledge in treating this relatively new kind of traumatic event is adapted from experiences in treating victims of criminal assault, homicidal bereavement, natural and manmade disasters, war and political violence, workplace homicide, and school shootings. This article reviews the pertinent literature on these types of trauma and combines this information with the author's own experience in treating direct and indirect victims and survivors of recent terrorist attacks. The article describes the psychological syndromes resulting from terrorism and discusses crisis intervention, individual therapy, and family therapy modalities for treating victims of terror. Last, the role of mental health clinicians in the larger national and international response to terroristic trauma is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AIDS: new developments. VI. HIV reservoirs during intensive antiretroviral treatment

Treatment of human immunodeficiency virus (HIV) infected persons with potent antiretroviral combination therapy results in a strong decline of the viral load in the blood. Whether this effect is reached in all tissues and different infected cell types is an important question. There are several potential virus reservoirs. Lymphoid tissue constitutes the largest virus compartment. With potent, often protease inhibitor containing combinations the HIV-RNA decline in lymphoid tissue runs parallel to that in the blood. The central nervous tissue is a potentially important reservoir, because of the limited penetration of several antiretrovirals, especially protease inhibitors. A few short studies with different combinations showed a decline of the amount of virus in the cerebrospinal fluid. The risk of local resistance developing is not known. There are only few studies of the effects of potent anti-HIV therapy on semen but prostate and testis tissue do not appear inaccessible to treatment. The reservoir of latently infected cells that cannot be reached by the immune system or by the viral replication inhibiting therapy, can possibly be reached with immune stimulating agents. This will cause HIV replication and cell death, while the anti-HIV therapy will prevent further replication of the produced virions. This approach is still experimental, however.     

Psychological consultation to persons with AIDS.

Consultation to persons concerned about or infected by the human immunodeficiency virus (HIV) or who have developed the acquired immune deficiency syndrome (AIDS) is relatively new to psychologists. This article is an introductory overview to assist psychologists in understanding the infection, to reflect on any personal biases that may impede successful rendering of care, to understand some psychological responses by patients that are common to various stages of the illness, and to recognize potential clashes of complex individual and societal issues, in order to provide more informed consultation and psychological interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analysis of HIV risk-reduction interventions within drug abuse treatment programs.

A meta-analysis was conducted on studies using a treatment-comparison group design to evaluate HIV/AIDS risk-reduction interventions for clients enrolled in drug abuse treatment programs. Overall, the interventions studied were found to have a reliable positive (weighted) effect size (d?=?0.31), and this was unlikely to be due to publication bias. Effect sizes for specific categories of outcome variables were 0.31 for knowledge, attitudes, and beliefs; 0.26 for sexual behavior; 0.62 for risk-reduction skills; and 0.04 for injection practices. A number of potential moderators were examined. Effect sizes were negatively correlated with the presence of predominantly ethnic minority samples and positively correlated with the number of intervention techniques used, the intensity of the intervention, intervention delivery at a later stage of drug treatment or within methadone treatment, and the presence of a number of specific intervention techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions in organizations: An evolutionary perspective.

Throughout the 20th century, managers and policy makers have relied on psychological interventions to help solve organizational problems. Yet, the results of these interventions rarely meet expectations. One reason may be that some of the perspectives used in thinking about interventions are at odds with how interventions and organizations function. This article argues that applied psychologists may benefit from an evolutionary perspective. Although it holds an important place in basic psychology and organization theory, an evolutionary perspective is nearly absent in applied psychology. It views the development and use of social technologies as part of sociocultural evolution—driven by variation, selection, and retention. This article provides a framework for theory and research on an evolutionary perspective in applied psychology and suggests implications for practice. Key concepts in the design of interventions include uncertainty, variation, and conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV–AIDS.

Recent advances in AIDS treatment have brought renewed optimism for prolonging the lives of those infected with HIV. This article examined beliefs about how new treatments may reduce HIV transmission risk among 298 HIV-negative gay and bisexual men attending a gay pride festival. Results from an anonymous survey showed that men who practiced unprotected anal intercourse as the receptive partner (UAR intercourse) were younger, less well educated, and more likely to believe that it is safe to have UAR intercourse with an HIV-positive man who has an undetectable viral load and that new treatments for HIV relieve their worries about unsafe sex. As HIV treatments continue to advance, new challenges for HIV prevention will likely emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological research and the prevention, etiology, and treatment of AIDS.

An overview of some of the issues and problems related to psychological research on AIDS and human immunodeficiency virus (HIV) infection is presented. Behavioral, cognitive, psychobiological, and neuropsychological issues are examined in relation to the development of a scientific research agenda on AIDS. The role of psychobiological variables in the etiology, treatment, and prevention of infection and disease are reviewed as they pertain to the fight against AIDS. The relation between AIDS and basic scientific processes is bidirectional in that AIDS may provide important insight into various basic processes and these same processes may also yield information useful to efforts to halt the spread of the disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cost analysis and HIV prevention interventions.

Comments on the review by J. A. Kelly et al (see record 1994-10963-001) regarding public health interventions designed to prevent, reduce, or eliminate behavior that put individuals at risk for becoming HIV-infected. D. R. Holtgrave expands on the review by discussing important economic policy issues, including the cost of HIV prevention interventions and the societal economic benefits of prevention programs. Methods for estimating the cost of an HIV prevention intervention are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Feather of Hope Aboriginal AIDS Prevention Society: a community approach to HIV/AIDS prevention

Urine production and weight deviation in a growth-retarded fetus with oligohydramnios was estimated by ultrasound on four occasions between weeks 27 and 33 of gestational age. The fetus demonstrated facial features typical of Potter's syndrome. Although this syndrome is associated with bilateral renal agenesis, the fetus in the present case presented with hypoplastic kidneys. Urine production was reduced when measured on three occasions but was surprisingly normal at week 31. In this report, we describe a way to assess urine production in a fetus.     

Prevention and remediation through group interventions.

Reviews the book, The handbook of group intervention for children and families edited by Karen C. Stroiber and Thomas R. Kratochwill (see record 1998-07256-000). This book addresses current needs of psychologists and other mental health practitioners who are working across ecologies to address problems of children and youth. As such, this text is an excellent resource for school psychologists, school counselors, and others who are attempting to broaden service delivery systems and procedures. Although this handbook is appropriate for practitioners across a variety of mental health disciplines, it also meets the current needs of school psychologists by addressing gaps often found in school psychology service delivery and training models. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Willingness to provide care and treatment for patients with HIV/AIDS

This paper is derived from the findings of a larger study which examines nurses' and doctors' attitudes towards mainstreaming of hospital inpatient services for individuals with HIV/AIDS in general hospital wards. The aim of this paper is to discuss the factors which influence nurses' and doctors' willingness to provide care and treatment for patients with HIV/AIDS. Two methods of study are used in this research--a survey questionnaire and semi-structured interviews. The findings of this study provide several themes about the positive attributes associated with caring for and treating patients with HIV/AIDS. These include: that caring for and treating is personally and professionally rewarding; the need to be non-judgemental and accepting of others; that previous work or social experience is related to willingness to work with patients; the influence of family and colleague support in the work environment; and having a duty of care.     

Psychological influences on immunity: Implications for AIDS.

There is considerable variability in the clinical course of individuals infected with the human immunodeficiency virus (HIV), the acquired immune deficiency syndrome (AIDS) virus. Because there is good evidence for psychological mediation of immune function, psychosocial or behavioral variables are among the possible cofactors that may influence HIV infection and disease progression. This article reviews relevant psychoimmunology research and addresses the implications of these data for the lives and medical treatment of HIV-infected people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological and socio-medical aspects of HIV/AIDS: a reflection on publications in AIDS care (1989-1995)

Cardiovascular disease is the leading cause of death in non-insulin dependent diabetes mellitus and first degree relatives of such patients are at increased risk of developing diabetes and cardiovascular disease. The aim of the present study was to determine whether lipid abnormalities occur in normoglycaemic relatives of non-insulin dependent diabetic patients. Cholesterol, triglycerides, apolipoprotein A-I and apolipoprotein B concentrations were measured in serum; the lipoprotein fractions very low density, intermediate density, low density and high density lipoprotein were prepared by sequential flotation ultracentrifugation and their composition investigated. The groups were matched for age, sex and blood glucose concentrations although the relatives (n = 126) were more insulin resistant as determined using the homeostasis model assessment method [1.9 (0.8-9.0) vs 1.6 (0.4-4.9) mmol/mU per l (mean [95% confidence intervals]); p < 0.001] and had greater body mass indices [26.6 (4.1) vs 24.8 (3.9) (mean [S.D.]); p = 0.001] than control subjects (n = 126). Relatives had higher serum apolipoprotein B concentrations than control subjects [0.9 (0.3) vs 0.8 (0.3) g/l, p = 0.02) and lower serum apolipoprotein A-I concentrations (1.4 (0.3) vs 1.5 (0.3), p = 0.02). In multivariate linear regression analysis of all subjects log insulin resistance (p = 0.0001), age (p = 0.002) and waist:hip ratio (p = 0.01) were independent predicators of apolipoprotein B concentrations while waist:hip ratio (p < 0.001) and smoking status (p = 0.002) were independent predictors of apolipoprotein A-I concentrations. Lipoprotein composition (measured in a subgroup of 76 control subjects and 88 relatives), serum cholesterol and serum triglyceride concentrations did not differ between the groups. We conclude that atherogenic apolipoprotein abnormalities occur in normoglycaemic relatives of non-insulin dependent diabetic patients.     

Implications of HIV treatment advances for behavioral research on AIDS: Protease inhibitors and new challenges in HIV secondary prevention.

Protease inhibitor combination therapies can reduce HIV viral load, improve immune system functioning, and decrease mortality from AIDS. These medical developments raise a host of critical new issues for behavioral research on HIV/AIDS. This article reviews developments in HIV combination therapy regimens and behavioral factors involved in these regimens and focuses on four key behavioral research areas: (a) the development of interventions to promote treatment adherence, (b) psychological coping with HIV/AIDS in the context of new treatments for the disease, (c) the possible influence of treatment on continued risk behavior, and (d) behavioral research in HIV prevention and care policy areas. Advances in HIV medical care have created important new opportunities for health psychologists to contribute to the well-being of persons with HIV/AIDS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pediatric AIDS and human immunodeficiency virus infection: Psychological issues.

Pediatric acquired immunodeficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection is a growing medical problem in this country with a broad range of psychological implications. This report from the American Psychological Association's Division of Child, Youth and Family Services Task Force on Pediatric AIDS provides a brief review of what is known about the disease in children and addresses three areas of concern: (a) the delivery of clinical services to infected and ill children and their families, (b) the development of effective AIDS education and prevention programs, and (c) research needs. Recommendations for action are included. (PsycINFO Database Record (c) 2010 APA, all rights reserved)