Bone loss in Great Britain and Japan: a comparative longitudinal study

Benzenediazonium sulfate (BD) was given to Swiss mice by 26 subcutaneous injections of 10 micrograms/g body weight at weekly intervals. The treatment gave rise to tumors of the subcutis. The tumor incidences in the treated groups were 42% in females and 26% in males. The corresponding tumor incidences in the untreated controls were 0% in females and 2% in males. Histopathologically, the neoplasms were classified as fibrosarcomas, rhabdomyosarcomas, and osteosarcomas of the subcutaneous tissue. BD is formed during the cytochrome P-450 catalyzed metabolism of the carcinogenic 1-(phenylazo)-2-hydroxynaphthalene (Sudan I, Solvent Yellow 14), which was used as a coloring agent for food and other materials in several countries. Further, BD is a metabolic breakdown product of different classes of nitrogen-nitrogen bond- containing chemicals. BD is the fourth benzenediazonium salt found to be carcinogenic in this laboratory.     

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)     

A comparative analysis of four protocols for maximal treadmill stress testing

The purpose of this investigation was to compare the results from four commonly used maximal treadmill stress tests: Balke, Bruce, Ellestad, and a continuous multistage running protocol. The results compared serial and maximal heart rate, metabolic demands, and ECG determinations. Fifty-one healthy men, 35 to 55 years of age, volunteered for this study and were dichotomized into trained and untrained subjects. Regression analyses showed all the tests to correlate highly. No significant differences were found between tests at maximum for V02, heart rate, and blood pressure, except for V02 for the Balke as compared to the running protocol (39 vs. 41 ml./Kg-min). The Balke protocol showed lower values at maximum in VE and RP than the other three tests as well as the most gradual rate of progression in MET cost (0.5 METS per minute). The increase for the Bruce and Ellestad tests was from 1 to 1.5 METS per minute, and a rapid initial increase (9 METS in the first 3 minutes) made the running test undesirable as a screening method. Although serial plots of heart rate and MET costs were similar to those previously reported for different population samples, the present data further refined these values. Finally, a nomograph comparing treadmill time and V02, max. for the Balke, Bruce, and Ellestad tests was developed from these data.     

Orofacial clefts in Hungary. Epidemiological and genetic data, primary prevention

The occurrences (birth prevalences) of different types of isolated and multiple orofacial clefts are known in Hungary. The empiric risk figures in the first-degree relatives of probands with cleft lip +/- cleft palate, cleft palate, Robin sequence and multiple congenital abnormalities including orofacial clefts as component defects were also determined. Finally the recent controversial data concerning the primary prevention of isolated orofacial clefts by periconceptional folic acid-containing multivitamins are summarized.     

Transgender HIV prevention: a qualitative needs assessment

Although clinical experience and preliminary research suggest that some transgender people are at significant risk for HIV, this stigmatized group has so far been largely ignored in HIV prevention. As part of the development of HIV prevention education targeting the transgender population, focus groups of selected transgender individuals assessed their HIV risks and prevention needs. Data were gathered in the following four areas: (1) the impact of HIV/AIDS on transgender persons; (2) risk factors; (3) information and services needed; and (4) recruitment strategies. Findings indicated that HIV/AIDS compounds stigmatization related to transgender identity, interferes with sexual experimentation during the transgender 'coming out' process, and may interfere with obtaining sex reassignment. Identified transgender-specific risk factors include: sexual identity conflict, shame and isolation, secrecy, search for affirmation, compulsive sexual behaviour, prostitution, and sharing needles while injecting hormones. Community involvement, peer education and affirmation of transgender identity were stressed as integral components of a successful intervention. Education of health professionals about transgender identity and sexuality and support groups for transgender people with HIV/AIDS are urgently needed.     

Experimental component analysis of a behavioral HIV–AIDS prevention intervention for inner-city women.

A component analysis of a behavioral HIV risk reduction intervention was conducted among 87 women recruited from an inner-city community. Women were randomly assigned to an intervention consisting of (a) sexual communication skills training, (b) self-management skills training, (c) a combination of sexual communication and self-management skills, or (d) HIV education and risk sensitization. Results showed that all 4 intervention conditions increased AIDS knowledge and intentions to reduce risk behaviors. Communication skills training resulted in higher rates of risk reduction conversations and risk refusals. However, the combined skills training condition showed the lowest rates of unprotected sexual intercourse at the 3-month follow-up. This study is the first to experimentally control HIV risk reduction elements in an analysis of a skills-based HIV prevention intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV antibody testing in a teaching hospital: policy versus practice

The cost of HIV antibody testing can be phenomenal. Thus many countries, Ghana included, have adopted policies to guide physicians in making judicious test requests. An analysis of compliance with this policy in a teaching hospital in Ghana, shows that 70% of physician requests meet the stated Ministry of Health guidelines. However, while 84.5% of all test requests which turned positive were within stated guidelines, 48.6% of those turning out negative were not indicated by the policy. The cost of HIV antibody testing could be minimised if clinicians operated within the stated guidelines which make considerations for judicious use of health resources. Compliance with policy also needs evaluating.     

Love, sex, and power: Considering women's realities in HIV prevention.

The rates of HIV infection and AIDS cases among women in the United States have increased significantly in the last decade. Thanks in large part to the work of advocacy groups and to action by the U.S. Congress, there has been some progress in making HIV/AIDS research and services more responsive to women's needs (e.g., including women in clinical drug trials and revising the Centers for Disease Control definition of AIDS to include infections typical in women). However, little progress has been made in addressing the need for prevention of HIV infection among women. This article examines how researchers using behavioral approaches to HIV prevention have largely ignored how gender, women's social status, and women's roles affect sexual risk behaviors and the ability to take steps to reduce risk of infection. Additional factors to be considered in theories that guide future HIV/AIDS prevention programs are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV seroprevalence in a London same-day testing clinic

OBJECTIVES: To determine the prevalence of HIV infection among people attending a confidential, non-genitourinary medicine based testing clinic that provides HIV antibody test results on the day of consultation. METHODS: Retrospective analysis of data collected on 2635 individuals attending the Same-Day HIV Testing Clinic at the Royal Free Hospital, London between March 1992 and February 1993. RESULTS: A total of 1612 men and 1023 women were tested for HIV antibody. The primary risk for HIV infection was heterosexual (71.7%; 1889 out of 2635) and homosexual contact (24.5%; 646 out of 2635). Fifty-four individuals were given positive HIV test results (46 men, median age 34 years; eight women, median age 27 years). Overall HIV seroprevalence was 2.0% (95% confidence interval, 1.5-2.5). HIV seroprevalence was highest among homosexual men (6.5%; 41 out of 635) and injecting drug users (5.7%; four out of 70). The rates for heterosexual men and women were 0.2% (two out of 915) and 0.7% (seven out of 974), respectively. Of the 54 individuals who were HIV-antibody-positive, 44 were Centers for Disease Control and Prevention stage II/III, eight stage IV and one was tested at the time of seroconversion (stage I; data were not available for one patient). Of the total numbers attending this clinic 27% (702 out of 2635) had previously been tested and received a negative result. Of a total of 54 HIV-antibody-positive individuals, 40% (21) had previously received a negative test result. CONCLUSIONS: The data suggest that seroprevalence amongst homosexual men attending a designated HIV testing clinic in London is lower than that reported by genitourinary clinic based testing sites. The large number of repeat testers who subsequently became infected with HIV suggests that there is a population requiring specific targetting for HIV risk reduction.     

Attitudes, beliefs, and practices of nursing students concerning HIV/AIDS: implications for prevention in women

Nursing students are a group of predominantly young women who may be sexually active but who are well educated and presumably health conscious. It might be expected, therefore, that they are not a population at risk for sexually acquired HIV infection. Recent studies indicate that heterosexual women constitute the fastest growing population of persons with AIDS in the United States and Canada (Health and Welfare Canada, 1993b; Wofsky, 1992) and that women and adolescents will constitute the next surge of the AIDS epidemic (Novello, 1993). First-year nursing students in a major Canadian city were surveyed regarding HIV-related knowledge, attitudes, beliefs, and behaviors. The women were highly knowledgeable about HIV transmission but 15% to 25% reported high risk sexual behavior. The results reinforce that knowledge is not enough to prevent HIV infection among young women and that interventions must be based on an understanding of the social context of women's lives.     

STD/HIV prevention in Turkey: planning a sequence of interventions

This study was initiated to assess which mix of early STD/HIV prevention interventions would potentially be effective, cost-effective and sustainable in Turkey; and to program an intervention sequence to maximize synergy among the interventions. During rapid assessment we: 1) reviewed past issues of 3 leading newspapers; 2) collected information on TV coverage; 3) interviewed key informants including taxicab drivers, hotel employees, grocery store owners, academicians in public health and law, investigators of STD/HIV and reproductive tract infections, and officials in the ministry of health; 4) reviewed available evidence on STD/HIV morbidity, sexual behavior patterns, migration patterns and same/opposite gender sex trade. We found: 1) discrepancies between decision makers' perceptions and social realities with respect to the epidemiology of sexual behavior and STDs, and the state of public health programs; 2) discrepancies between sexual practices and public expression regarding sexual practices; 3) economic, demographic, and political pressures in Turkey and in surrounding countries for the expansion of prostitution; 4) a sexual double standard and gender specific migration patterns which sustain a high demand for commercial sex; 5) patterns of health care seeking behaviors and provision of STD clinical services which indicate other STDs may play a very important role in spread of HIV infection; 6) an important mass media role in opinion formation; 7) consensual denial of risk for the majority based on beliefs embedded in machismo, nationalism and religion, and a resulting marginalization and externalization of STD/HIV risk; 8) high prevalence of syphilis among both Turkish and immigrant female prostitutes in Istanbul (early latent 8 and 13%; late latent 0 and 4%; previous history 9 and 22%) 9) and high rates of syphilis among male prostitutes (early latent 11%, late latent 21% and previous history 58%). We concluded that interventions should initially include, in the following order; 1) awareness raising for decision makers and opinion leaders including members of parliament and mass media; 2) awareness raising for members of the general population; 3) needs assessment and intervention development for sex workers; 4) training in HIV and other STDs for medical personnel; and 5) quality assurance and control for laboratory procedures for STDs/HIV.     

Internalized heterosexism among HIV-positive, gay-identified men: Implications for HIV prevention and care.

Internalized heterosexism (IH), or the internalization of societal antihomosexual attitudes, has been consistently linked to depression and low self-esteem among gay men, and it has been inconclusively associated with substance use and sexual risk in gay and bisexual men. Using structural equation modeling, the authors tested a model framed in social action theory (C. K. Ewart, 1991, 2004) in which IH is associated with HIV transmission risk and poor adherence to HIV antiretroviral therapy (ART) through the mechanisms of negative affect and stimulant use. Data from a sample of 465 gay-identified men interviewed as part of an HIV risk reduction behavioral trial were used to test the fit of the model. Results support the hypothesized model in which IH was associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, and with ART nonadherence indirectly via increased negative affect and more regular stimulant use. The model accounted for 15% of the variance in unprotected receptive anal intercourse and 17% of the variance in ART nonadherence. Findings support the potential utility of addressing IH in HIV prevention and treatment with HIV-positive gay men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational exposure to HIV: considerations for postexposure prophylaxis and prevention

HIV seroconversion as a result of an occupational exposure is a terrifying concern of healthcare workers who deliver care to patients in a variety of health care settings. In this article the most recent CDC guidelines for the management of HIV exposure and postexposure prophylaxis are reviewed. Prevention of bloodborne pathogen exposures, specifically through the selection of safety devices, is recognized as an important issue.     

Priorities for HIV testing in developing countries?

The specificity and sensitivity of human immunodeficiency virus (HIV) antibody tests have increased and their use has expanded in developed and developing countries since 1985. Lately, more expensive rapid (US $3-12/test) and cheaper HIV tests have been proposed. HIV testing by the inexpensive enzyme-linked immunosorbent assays (ELISAs) is often infeasible in developing countries because of the lack of equipment. In 1990, in Kinshasa, Zaire, only about 50% of blood donors were screened for HIV. Counseling before and after testing at centers sponsored by non-governmental organizations is limited in developing countries. HIV testing can lead to discrimination: people have been put in quarantine because they were found to be HIV positive. In regions of high prevalence, high priority testing for blood transfusion is cost beneficial. A positive HIV test would justify the start of treatment for toxoplasmosis in a patient with a focal neurological deficit. In a region of high HIV prevalence, a patient with chronic diarrhea would benefit more from an HIV test than from gastroenterological tests. The absence of facilities for CD4 cell counting makes it impossible to advise symptom-free HIV infected subjects. Prophylactic isoniazid may decrease the incidence of Mycobacterium tuberculosis infection among HIV-infected people but the potential for non-compliance with treatment and the risk that drug resistance will develop exist. Confidential HIV testing plus counseling and condom promotion decreased the incidence of HIV infection and gonorrhea among women living in Kigali, Rwanda. There has been successful counseling of discordant couples with HIV infection in Kigali, Rwanda, and Kinshasa, Zaire. HIV testing in the most cost-beneficial way should be done for both members of a steady couple at the same time. HIV tests should be more available in developing countries, and national guidelines for HIV testing should be set.