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Investigation of a New Diagnosis of Multidrug-Resistant, Dual-Tropic HIV-1 Infection --- New York City, 2005 This article describes the final results of the investigation of an unusual strain of HIV diagnosed in a New York City man in late 2004. The strain was resistant to multiple drugs in three classes of HIV medications, and the patient experienced rapid progression of his infection to AIDS. Because the patient reported multiple sexual partners prior to his diagnosis, the New York City Health Department immediately initiated efforts to identify and offer testing to his sexual contacts and to assess the prevalence of this strain in the New York City region. The investigation identified three other patients with the same strain of HIV, all of whom engaged in similar high-risk behaviors at many of the same places during the same time periods as the index patient. All four men are currently clinically stable on complex treatment regimens. Researchers were unable to determine if the rapid disease progression in the index patient was the result of the particular strain or other factors, and information was not sufficient to determine the rate of disease progression in the other patients. These cases underscore the importance of HIV prevention. HIV remains incurable and can progress rapidly to life-threatening illness in some individuals. Transmission of virus that is difficult to treat is increasing, and efforts to monitor the rate and types of transmitted resistance are critical to guide HIV treatment strategies.
HIV/AIDS among Women Who Have Sex With Women To date, there are no confirmed cases of female-to-female sexual transmission of HIV in the United States database. However, case reports of female-to-female transmission of HIV and the well-documented risk of female-to-male transmission indicate that vaginal secretions and menstrual blood are potentially infectious and that mucous membrane (for example, oral, vaginal) exposure to these secretions has the potential to lead to HIV infection. This fact sheet contains information on the risk factors and barriers to prevention for HIV among women who have sex with women.
HIV/AIDS among Youth Young people in the United States are at persistent risk for HIV infection. This risk is especially notable for youth of minority races and ethnicities. Continual HIV prevention outreach and education efforts, including programs on abstinence and on delaying the initiation of sex, are required as new generations replace the generations that benefited from earlier prevention strategies. This fact sheet contains information on risk factors and barriers to prevention for HIV among youth. HIV/AIDS Surveillance by Race/Ethnicity (through 2004) This useful series of slides from the CDC details the prevalence of HIV/AIDS in various ethnic minority groups. In addition to prevalence, the slides also look at method of transmission by gender for each ethnicity and rates for each state by ethnicity. To download the slides, visit the link listed above.
HIV Transmission among Male Inmates in a State Prison System --- Georgia, 1992--2005 Between July 1988 and February 2005, testing records confirmed that 88 inmates contracted HIV in Georgia correctional facilities. Analysis of risk factors associated with transmission found that infected inmates were significantly more likely to have engaged in male-to-male sex in prison; to have received a tattoo in prison; to have a low body mass index; and to be black, when compared to uninfected inmates with similar sentence lengths and time served. Study findings suggest that while HIV transmission in Georgia prisons is not likely to be widespread, both HIV infection and risk behavior do occur during incarceration. Similar to other state and federal prisons in the U.S., overall HIV prevalence among Georgia prisoners was higher than in the general population. In Georgia, over 90 percent of HIV-positive prisoners were infected prior to incarceration. Because prisons bring together a population at high risk for HIV infection, they offer a unique opportunity to intervene with programs that can help slow the HIV epidemic. Comprehensive HIV testing and prevention interventions in prisons can help equip inmates with the knowledge and skills to prevent HIV transmission in prison and in their communities, upon release. Primary and Secondary Syphilis --- United States, 2003--2004 The rate of P&S syphilis was up 8%, from 2.5 cases per 100,000 population in 2003 to 2.7 per 100,000 in 2004. The vast majority of the increase is attributable to a resurgence of syphilis among men who have sex with men (MSM). The rate of P&S syphilis increased 81 percent among men overall since the low in 2000. The analysis also points out that 2004 marked the end of a 13 year decline in syphilis rates among women and the first increase in the disparity in syphilis rates between African Americans and Whites since 1993. Prevention interventions addressing African Americans and MSM need to be enhanced, and health departments and providers should be vigilant about the detection and case reporting of syphilis in women to prevent an increase of the epidemic in heterosexuals. CDC is committed to the elimination of syphilis in the United States and is working with public health and community partners for all populations, particularly African Americans, MSM, and women.
Methamphetamine Use and HIV Risk Behaviors Among Heterosexual Men --- Preliminary Results from Five Northern California Counties, December 2001--November 2003 Previous studies have demonstrated a similar association among men who have sex with men (MSM). Using preliminary data collected between December 2001 and November 2003, the HEY-Man analyses, which included 18- to 35-year-old heterosexual men from northern California, found that 15.6 percent of participants reported meth use, with six percent of men reporting use in the past six months (“recent users”). When compared with men who had never used meth, recent users were more likely to have had casual or anonymous sex partners (64.8 percent vs. 44.4 percent), multiple partners (56.9 percent vs. 26.3 percent), or partners who used injection drugs (11.1 percent vs. 1.7 percent) in the past six months; and to report having ever received drugs or money for sex (15.5 percent vs. 3.5 percent). Study authors recommend a greater emphasis on the association between meth use and HIV/STD risk among heterosexuals, in addition to MSM, and write that prevention services should include referrals for drug use prevention and treatment.
Racial/Ethnic Disparities in Diagnoses of HIV/AIDS – 33 States, 2001-2004
Findings published by the CDC underscore that HIV continues exact a devastating toll on blacks in the United States. These findings, which build upon data presented at a scientific conference earlier in the week, offer additional characteristics about the individuals who were diagnosed with HIV from 2001 through 2004 in 33 states with longstanding HIV reporting. Blacks in this analysis accounted for the highest percentage of diagnoses in both sexes. Among males, blacks accounted for 44 percent of HIV diagnoses, and among females, blacks accounted for 68 percent of cases. Blacks, both males and females, also accounted for the highest percentage of diagnoses in every age group. The overwhelming majority of mother-to-child HIV cases in this analysis (69 percent) were among blacks, as well. Authors note that a diverse and comprehensive prevention approach will be necessary to curtail the HIV epidemic among blacks. CDC is working with black communities to reduce disparities and accelerate prevention efforts.
AIDS Surveillance – General Epidemiology (through 2004) This set of slides contains important data about HIV/AIDS prevalence. Through a series of graphs and charts, information is presented about the number of people with HIV/AIDS in thirty-five areas with name-based, confidential reporting over the course of three years. In different charts, data is broken down by race, method of transmission, geographic location, and more. In 2002, among all persons aged 15-44 years, 15.1% (approximately 18.3 million people) had been tested for HIV during the preceding year. The percentage tested was strongly associated with the number of sex partners of the opposite sex; 8.5% of those with no sex partners of the opposite sex were tested, compared with 26.6% of those with three or more sex partners of the opposite sex during the preceding year. QuickStats: Age-Adjusted Death Rates for Human Immunodeficiency Virus (HIV) Infection, by Sex – United States, 1987-2003 Mortality attributable to HIV and AIDS increased rapidly for both men and women during the late 1980s and early 1990s, reaching a peak in the mid-1990s. The rate then decreased sharply until 1997 before leveling off. From 1999 to 2003, men experienced a modest but steady decrease in HIV/AIDS mortality; the death rate for women was unchanged. This chart gives a visual representation of this information. The Role of Public Health in Mental Health Promotion Mental illness is a leading cause of disability and premature death in the United States, affecting persons of all ages, races and ethnicities, and socioeconomic levels. Mental disorders can influence the onset, progression, and outcome of other illnesses and are often associated with health risk behaviors, such as substance abuse, tobacco use, and physical inactivity. This report discusses the role of public health agencies in promoting mental health.
Atypical Reactions Associated with Heroin Use – Five States, January-April, 2005 In January 2005, man aged 21 years in New Jersey was hospitalized with an atypical reaction (e.g., tachycardia and palpitations) after reported heroin use. During the next 3 months, 25 additional persons in five states were reported to poison control centers and local public health agencies with a similar reaction after reported heroin use; in all, 24 of 26 patients were hospitalized. Analysis of drug specimens or testing of urine was performed in certain cases. In eight patients, the veterinary pharmaceutical clenbuterol was detected.
Shigella flexneri Serotype 3 Infections among Men Who Have Sex with Men – Chicago, Illinois, 2003-2004 Shigella is a common bacterial cause of diarrhea in the United States; typical symptoms include bloody or watery diarrhea, fever, and cramping. Because only a few bacteria are needed to cause an infection, Shigella can be transmitted easily from person to person. In the United States, most Shigella infections occur in young children and their care-takers and are due to a species called S. sonnei. An unusual cluster of 39 Shigella infections caused by another species, S. flexneri, occurred in Chicago in 2003 and 2004. 33 of these cases were in adult men, of whom 88 percent reported being sexually active with men (men who have sex with men, MSM). Although these findings suggest the infection may have been transmitted sexually, the risk factors for Shigella transmission among MSM are not well understood. Simple precautions like washing before and after sex and using barrier methods can reduce the risk for MSM and others of contracting a Shigella infection. In this letter to her colleagues, Dr. Julie Louise Gerberding, Director of CDC, lays out CDC recommendations regarding methods of maintaining confidentiality for HIV patients. CDC recommends that all states and territories adopt a standard, confidential, name-based surveillance system to report HIV infections. Rapid implementation of a scientifically accurate and reliable system of national HIV reporting can only occur with the adoption of a standard system of patient identification that will be used by all states. Those who would like to request technical assistance or further information can contact Dr. Matthew McKenna, Acting Deputy Director for Science, Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, CDC, telephone (404)-639-2050.
Updated Slide Set: HIV Mortality (Updated through 2002) These slides provide an analysis of trends in rates and distribution of deaths in the U.S., focusing on deaths due to HIV/AIDS. Data were compiled from death certificates from all 50 states and the District of Columbia by the National Center for Health Statistics for the years 1987-2002. The full slide set is available at the website above.
HIV Prevalence, Unrecognized Infection, and HIV Testing Among Men Who Have Sex with Men - Five U.S. Cities, June 2004-April 2005 This report summarizes a study that surveyed men who have sex with men (MSM) in five cities from June 2004 through April 2005. The study found that while prevalence varied by city, black MSM overall were more than twice as likely to be infected with HIV as MSM of other races. Forty-six percent of black MSM in the study were HIV-positive, compared to 21% of white MSM and 17% of Hispanic MSM. Among HIV-infected MSM, roughly half overall, and more than two thirds of black men, were unaware of their infection. Although 84% of all MSM who were unaware of their infection had previously been tested for HIV, 58% had not been tested in the past year, highlighting the importance of testing on at least an annual basis for this population. Use of Social Networks to Identify Persons with Undiagnosed HIV Infection - Seven U.S. Cities, October 2003-September 2004
To help increase knowledge of HIV status, CDC recently funded nine community-based organizations to implement a social network approach to reach high-risk individuals with HIV counseling, testing, and referral services. The program trains HIV-positive and high-risk individuals in communities of color to reach out through their social, sexual, and drug-using networks and encourage their peers who may be at risk to be tested. In the first 12 months of the program, 133 recruiters in seven U.S. cities referred 814 high-risk individuals for counseling and testing. Of those, 46 were newly diagnosed as HIV positive, representing a prevalence of 5.7%, almost six times that typically seen in publicly funded HIV counseling and testing sites. Researchers believe these findings demonstrate the value of a targeted approach, particularly to peer networks of men who have sex with men and transgender individuals, since the highest rates of undiagnosed infection were found in these populations.
FAQ: Men on the Down Low
The generic definition of the term "down low" is "to keep something private," whether that refers to information or activity. This term is often used to describe the behavior of men who have sex with other men as well as women and who do not identify as gay or bisexual. This page discusses the sexual risk factors, the implications for HIV prevention, and the steps CDC is taking in relation to the "down low." Reporting of Chlamydial Infection - Massachusetts, January-June 2003 Chlamydia trachomatis infection is the most commonly reported sexually transmitted disease in the United States. An estimated 2.8 million infections occur annually. This report summarizes an evaluation of chlamydial-infection reporting in Massachusetts during January-June 2003. Since 1996, cases in Massachusetts have increased. There were 7016 estimated total number of cases reported from January-June 2003. It was estimated that the completeness of reporting was 45% for laboratories, 54% for healthcare providers, and only 25% of the cases reported by both sources. The results underscore the need for improvement in both completeness and timeliness of reporting chlamydial infection in Massachusetts. Back to Top
CSAT
Homeless Admissions to Substance Abuse Treatment: 2004 In 2004, more than 175,300 admissions to substance abuse treatment facilities were homeless at time of admission. These homeless admissions comprised 13 percent of all admissions in 2004 for which living arrangements were recorded in the Treatment Episode Data Set (TEDS). This report looks at the characteristics of homeless admissions. Some notable facts include:
SAMHSA Releases a Treatment Improvement Protocol (TIP) on Detoxification and Substance Abuse Treatment SAMHSA has released a new Treatment Improvement Protocol (TIP 45) “Detoxification and Substance Abuse Treatment.” The new TIP provides clinicians with the latest information on detoxification: the physiology of withdrawal, pharmacologic advances in the management of withdrawal, patient placement procedures and managing detoxification services within comprehensive systems of care. The publication emphasizes that by itself, detoxification does not constitute complete substance abuse treatment, and it identifies the necessity for linking patients in detoxification with substance abuse treatment services.
New Co-Occurring Disorders Publications Available at SAMHSA Co-occurring mental and substance abuse disorders affect approximately 4.6 million individuals in the United States. However, only a small percentage of these individuals receive treatment that addresses both disorders; many receive no treatment of any kind. To better educate states, communities and behavioral healthcare providers, SAMHSA has released three publications on the topic of co-occurring disorders. The publications are:
June 8, 2006 SAMHSA SAMHSA has issued an action alert to substance abuse treatment and prevention professionals about a new combination of street drugs with a potentially lethal effect. The addition of fentanyl, a powerful narcotic analgesic, to heroin or cocaine being sold on the streets is believed to be the cause of clusters of drug-related deaths and even greater numbers of overdoses in east coast and midwest cities in the past few months. The alert encourages recipients not only to advise their networks of patients and colleagues, but also to join local health authorities to bring information about the drugs to first responders, emergency room personnel, street substance abuse workers, drug treatment facilities, local health care providers, the recovery community, and the public at large. State Estimates of Substance Use from the 2003-2004 National Surveys on Drug Use and Health This report presents State estimates for 22 measures of substance use or mental health problems based on the 2003 and 2004 National Surveys on Drug Use and Health (NSDUHs). The NSDUH is an ongoing survey of the civilian, noninstitutionalized population of the United States aged 12 years or older. Recently, State estimates have been produced for additional measures by combining 3 (or more) years of NSDUH data and using sampling weights and direct estimation. The advantage of this approach is that it can be used on any variable in the dataset; however, the estimates typically are not as accurate as the SAE measures. These estimates have been included in some reports and in tables on the SAMHSA website. Disposition of Emergency Department Visits for Drug-Related Suicide Attempts by Adolescents: 2004 http://dawninfo.samhsa.gov/files/Suicide_Attempts_%20Adolescents2004_edited.htm March 24, 2006 The DAWN Report Suicide in adolescence is a major public health problem. This report uses 2004 data from the Drug Abuse Warning Network (DAWN) to examine the outcome emergency department (ED) visits caused by drug-related suicide attempts by adolescents (defined as persons aged 12 to 17). Some interesting facts include: • In 2004, there were over 15,000 ED visits by adolescents whose suicide attempts involved drugs. • Almost three quarters of these drug-related suicide attempts were serious enough to merit the patient's admission to the same hospital or transfer to another health care facility. • Pain medications were involved in about half of the suicide attempts. • Antidepressants or other psychotherapeutic medications were involved in over 40 percent of the suicide attempts by adolescents who were admitted to the hospital. DAWN data do not distinguish which of the patients had been prescribed antidepressants to treat a preexisting condition.
Trends in Methamphetamine/Amphetamine Admissions to Treatment: 1993-2003 In 1993, treatment admissions for methamphetamine/amphetamine abuse were relatively rare. These drugs were the primary substance of abuse for only 2 percent of total treatment admissions. Ten years later in 2003, they were 7 percent of the total. Using data from Treatment Episode Data Set (TEDS), this report provides an analysis of treatment data for methamphetamine and other amphetamines. Some interesting findings include:
Retired Admissions: 2003
Substance abuse treatment admissions among retired persons can be examined with data from the Treatment Episode Data Set (TEDS), which collects data on the approximately 1.8 million annual admissions to substance abuse treatment facilities. TEDS compared the 4,400 admissions with the status of “retired” to the remainder of the 675,000 admissions with known employment status in the States that collected this data. Some notable results include:
Primary Alcohol Admissions Aged 21 or Older: Alcohol Only vs. Alcohol Plus a Secondary Drug: 2003 In 2003, 64 percent of all admissions to the Treatment Episode Data Set (TEDS) involved alcohol, and 42 percent involved alcohol as the primary substance of abuse. Among admissions aged 21 or older where alcohol was the primary substance of abuse, nearly 400,000 (57 percent) reported alcohol as the only substance of abuse, and about 301,000 (43 percent) reported alcohol plus a secondary substance of abuse. This report explores differences between primary alcohol admissions aged 21 or older, comparing admissions for alcohol only with admissions for alcohol plus a secondary drug. Notable results include:
Substance Use, Dependence, and Treatment among Veterans This report provides estimates of substance use, dependence, and treatment for the year 2003 derived from a logistic regression model in which 2000-2003 NSDUH data were pooled to provide more precise measures of differences between veterans and a nonveteran comparison group. Some results include:
National Survey of Substance Abuse Treatment Services (N-SSATS): 2004 Data on Substance Abuse Treatment Facilities The National Survey of Substance Abuse Treatment Services (N-SSATS) is part of SAMHSA's Drug and Alcohol Services Information System (DASIS), a cooperative program between the State substance abuse agencies and SAMHSA to collect data on the location, characteristics, and utilization of services at alcohol and drug abuse treatment facilities (both public and private) throughout the 50 States, the District of Columbia, and other U.S. jurisdictions. This report provides data from the 2004 N-SSATS report.
Trends in Admissions for PCP: 1993-2003 Between 1993 and 2003, the number of admissions in the Treatment Episode Data Set (TEDS) reporting PCP as the primary substance of abuse increased from 3,300 to 4,100, but the proportion of PCP admissions remained constant at about 0.2 percent of all admissions. This report provides an analysis of the characteristics of those seeking treatment for PCP either as a primary or secondary substance of abuse. Some interesting facts include:
SAMHSA Releases New Treatment Improvement Protocol on Medication-Assisted Treatment for Drug Abuse A new Treatment Improvement Protocol, TIP 43, released by SAMHSA provides treatment providers, physicians and other medical personnel with the latest information on medication-assisted treatment for people addicted to opiates, largely prescription narcotics or heroin. The TIP emphasizes the importance of supportive services such as counseling, mental health and other medical services, and vocational rehabilitation in facilitating recovery for patients receiving mediation-assisted treatment. The document outlines best practices in the use of methadone, buprenorphine and naltrexone, including appropriate doses of medication, medically supervised withdrawal, medication maintenance, tapering off of treatment medications, associated medical problems, treatment for multiple substance use, and other crucial aspects of treatment for those who are addicted to opiates.
College Enrollment Status and Past Year Illicit Drug Use among Young Adults: 2002, 2003, and 2004 Among the estimated 18.4 million young adults aged 18 to 22 in 2002, 2003, and 2004 for whom college enrollment was known, 7.9 million (42.8%) were classified as full-time college students, 1.4 million (7.6%) as part-time college students, and 9.1 million (49.6%) as non-students. This report summarizes data on how drug use habits vary with college enrollment status. Some interesting facts include:
Substance Abuse or Dependence in Metropolitan and Non-Metropolitan Areas: 2004 Update According to the 2004 NSDUH, 200 million persons aged 12 or older (83.1 percent) lived in counties that were in metropolitan areas, and 40.5 million (16.9 percent) lived in counties that were in non-metropolitan areas. Persons who lived in metropolitan areas were more likely to abuse or be dependent on alcohol or illicit drugs during the past year than those living in non-metropolitan areas (9.6 vs. 8.2 percent). Among youths (aged 12 to 17) and young adults (aged 18 to 25), rates of past year abuse or dependence were similar for those who lived in metropolitan areas and those who lived in non-metropolitan areas. However, among adults aged 26 or older, the rate of past year abuse or dependence was higher among those in metropolitan areas (7.6 percent) than in non-metropolitan areas (6.0 percent). For more information on the results of the NSDUH and how it relates to metropolitan vs. non-metropolitan areas, please visit the link above.
Treatment Admissions in Rural Areas: 2003 The urbanicity of substance abuse treatment facilities—the degree to which the counties they are located in contain metropolitan areas or cities—is related to the kinds of admissions those facilities receive. This report compares admissions to facilities located in rural counties with admissions to facilities in urban counties. Rural admissions were more likely than urban admissions to report alcohol (52 vs. 40 percent) or marijuana (18 vs. 15 percent) as the primary substance of abuse. Rural admissions were less likely than urban admissions to report cocaine (7 vs. 14 percent) or heroin (3 vs. 16 percent), and were equally likely to report opiates other than heroin (3 percent each) or stimulants (8 percent each) as the primary substance of abuse.
Arrest for Driving Under the Influence among Adult Drivers The Federal Bureau of Investigation estimated that there were over 1.4 million arrests for driving under the influence (DUI) in the United States in 2003. According to the National Highway Traffic Safety Administration, 10.9 percent of drivers/motorcyclists in fatal motor vehicle crashes in 2003 were under the influence of alcohol, drugs, or medication. This report explains statistics obtained from the National Survey on Drug Use and Health about driving under the influence. Some results included:
Substance Use among Hispanic Youth Research has found mixed results when comparing the extent of substance use among Hispanic youth with use among non-Hispanic youth. This report examines the prevalence of alcohol and illicit drug use among Hispanic youth aged 12 to 17. All findings presented in this report are annual averages based on combined 2002 and 2003 NSDUH data. Findings include:
Hispanic Substance Abuse Treatment Admissions: 2003 The term "Hispanic" describes a population that includes several ethnic subgroups representing different countries of origin. TEDS data permit separate analysis of some of these ethnic subgroups, specifically Mexican, Puerto Rican, Cuban, and Other Hispanic. This report compares the characteristics of Hispanic admissions to those of non-Hispanic admissions of known race/ethnicity and compares subgroups within Hispanic admissions. Findings include:
Binge Alcohol Use among Persons Aged 12 to 20: 2002 and 2003 Update The National Survey on Drug Use and Health asks respondents aged 12 or older to report their frequency and quantity of alcohol use during the month before the survey. This report describes findings from annual averages based on combined 2002 and 2003 NSDUH data. Some of the findings include:
Cocaine Use: 2002 & 2003 Cocaine, including crack cocaine, was responsible for 12.8 percent of admissions to substance abuse treatment services in 2002. This report examines past year cocaine and crack cocaine use among persons aged 12 or older, as well as cocaine abuse or dependence. All findings presented in the report are annual averages based on combined 2002 and 2003 NSDUH data. Some of the findings include:
Differences in Marijuana Admissions Based on Source of Referral: 2002 A recent study found that while the prevalence of marijuana use remained stable between 1991-1992 and 2001-2002, the prevalence of marijuana abuse or dependence diagnoses increased significantly during this time. A recent issue of The DASIS Report examined marijuana treatment admissions between 1992 and 2002 and found that between these years the rate of substance abuse treatment admissions reporting marijuana as their primary substance of abuse per 100,000 population increased 162%. During this time period, the percentage of marijuana treatment admissions that were referred from the criminal justice system increased from 48% of all marijuana admissions in 1992 to 58% of all marijuana admissions in 2002. This report looks at the characteristics of primary marijuana admissions who were referred to treatment by the criminal justice system, compared with referrals from all other sources. It was reported that non-criminal justice referred marijuana admissions were more likely to report daily use of marijuana and secondary substances, including alcohol, cocaine, opiates, stimulants, and other drugs, than criminal justice referred marijuana admissions.
Marijuana Use in Substate Areas This report combines three years of data to estimate drug use in 331 geographic areas within the 50 States and the District of Columbia. The report reveals large variations in past month marijuana use across states. Some of the main findings include:
Substance Abuse Treatment Admissions among Asians and Pacific Islanders: 2002 There were approximately 16,700 Asian and Pacific Islander admissions in 2002 reported by the Treatment Episode Data Set. More than half of these were in California and Hawaii. This report summarizes some findings about Asian and Pacific Islanders and treatment admissions. They include:
CMHSAMA Calls for More Mental Health Services on College Campuses; New Policy to Help Fight Depression, Suicide Linked To Substance Abuse Young adults consume alcohol about 66 days per year and average 3.7 drinks each day. Studies have shown that youth who report alcohol or drug use are more likely to be at risk for suicide. In 2005, 63 percent of college students reported feeling hopeless and 45 percent felt so depressed they could barely function. Unfortunately, college- aged students are the largest uninsured population in the U.S., and most insurance policies have lesser benefits for mental health and substance abuse services. To ameliorate this situation, the American Medical Association (AMA) has voted to take several new actions to help fight substance abuse on college campuses and advocate for increased availability of mental health services for college students at its Annual Meeting. For more information, visit the link listed above. Commercially Available Antibiotic May Help Fight Dementia in HIV Patients Ceftriaxone, an antibiotic commonly used to treat a variety of serious infections, may also help prevent dementia in HIV patients. A study at the John Hopkins University School of Medicine looked at two proteins that are part of the virus that causes HIV infection and that are implicated in the development of HIV dementia, which is a common side effect of long-term HIV infection. In the study, ceftriaxone protected neurons in lab grown human neuronal cell cultures against both HIV proteins. The dose of ceftriaxone needed for protection was well within the range currently used for treatment of bacterial infections. MH Education Should Be Tailored to Minorities' Values This article explains the need for mental health providers to take into account the different attitudes that certain minority groups may have towards mental health treatment. In many cultures, people are reluctant to go to strangers when they are in trouble. Reaching out beyond the extended family for support, or even for information, can be viewed as evidence that the entire family has failed. Natural supports in the environment, such as the family and places of worship, can be more effective than traditional clinic-based treatment.
Attempted Suicide Often a Snap Decision Fuelled by Drugs and Alcohol, New Study New University of Western Sydney research reveals that many suicide attempts are unplanned, with a good portion of suicide survivors reporting they felt the urge to harm themselves less than ten minutes before acting on it. The study focused on 90 people aged between 17 to 65 years, who had attempted suicide. They were interviewed as soon as possible after the event. The study found that over half of the study participants (51%) tried to make a suicide attempt after thinking about it for 10 minutes or less, with an additional 16% contemplating it for less than half an hour. The impulsiveness of this suicidal behavior was often fuelled by drugs and alcohol, with men the group most likely to be under the influence. Of the 29% of participants who harmed themselves while affected by alcohol, the overwhelming majority (93%) said they considered their actions for less than 10 minutes. Shame, Not Guilt, Related to Substance-Abuse Problems Findings from a collaboration between scientists at the University at Buffalo's Research Institute on Addictions (RIA) and George Mason University in Fairfax, VA, have established the importance of distinguishing between feelings of shame and guilt when providing treatment for substance abuse and in developing substance abuse prevention programs. Shame is the tendency to feel bad about yourself following a specific event. It appears that individuals who are prone to shame when dealing with a variety of life problems may also have a tendency to turn toward alcohol and other drugs to cope with this feeling. Guilt, or the tendency to feel bad about a specific behavior or action, was largely unrelated to substance use problems. This is one of the first studies to scientifically validate the importance of shame versus guilt and their relation to alcohol and drugs. Clinically, this study suggests a point of intervention for the treatment of substance use problems. Specifically, counselors and other medical providers might effectively work with clients toward decreasing shame-proneness and enhancing guilt-proneness.
Mental Health Must be Integrated into Global Initiatives for HIV/AIDS An editorial in the July issue of the British Journal of Psychiatry stated that a more prominent role is needed for mental health interventions in global HIV/AIDS initiatives. The article reviewed the reasons why mental health matters to HIV/AIDS treatment programs in developing countries. In July 2004, a group of 18 mental health professionals from developed and developing countries met under the auspices of the WHO to consider how mental health should be integrated into the "3 by 5." This editorial presents the key themes arising from the meeting. Some of the distinct mental health-related issues that are relevant to HIV/AIDS include:
Racial Disparities Found in Pinpointing Mental Illness Although schizophrenia has been shown to affect all ethnic groups at the same rate, scientists found that blacks in the United States were more than four times as likely to be diagnosed with the disorder as whites. Hispanics were more than three times as likely to be diagnosed as whites. The data confirm the fears of experts who have warned for years that minorities are more likely to be misdiagnosed as having serious psychiatric problems. Clinicians need to be trained in "cultural competence" to prevent misdiagnosis and harm.
Adult Antisocial Syndromes Common among Substance Abusers Data from a recent epidemiologic survey of more than 43,000 U.S. adults show that antisocial syndromes are more common among people with substance abuse disorders than those without these disorders. The strong and significant association between substance abuse or addiction and conditions such as antisocial personality disorder, conduct disorder, and adult antisocial behavior, suggests that prevention and treatment strategies need to apply an integrated approach. Researchers from NIDA and NIAAA examined data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions. The analysis showed lifetime prevalence of 3.6% of adults diagnosed with antisocial personality disorders, 1.1% with conduct disorder only and more than 12% with adult antisocial behavior only, while the lifetime prevalence for any drug abuse disorder was 10.3%. Lifetime prevalence of alcohol use disorders was 30.3%. They also found that for antisocial personality disorder and adult antisocial behavior, the odds of having a substance abuse disorder were very high overall, and were higher for women than for men.
Men and Depression: Battling Stigma through Public Education This article discusses the successes of a National Institute of Mental Health campaign, "Real Men. Real Depression." To reduce stigma and educate men and those close to them about the symptoms of and treatments for depression, the campaign uses testimonials of a diverse group of men who have battled the disease. Some preliminary research findings show that the "Real Men. Real Depression" material is better received by "macho" populations, or men resistant to mental health services. For more information on the "Real Men. Real Depression." campaign, visit http://www.menanddepression.nimh.nih.gov.
The Rapid "Feminization" of the AIDS Pandemic Must be Confronted
In an article appearing in the journal Science online June 10, a lead physician and scientist from Johns Hopkins issued an urgent call for global strategies and resources to confront the rapid "feminization" of the AIDS pandemic. Thomas C. Quinn, M.D., senior investigator at the National Institute of Allergy and Infectious Disease, reported that women have in the past 20 years moved from those least affected by HIV to those among whom the disease is spreading fastest. Dr. Quinn argues that women deserve a separate strategy in reducing AIDS transmission because of the increasing and disproportionate numbers becoming infected, and the social consequences of so many young mothers dying and leaving behind children who may also be infected as well as orphaned. Some examples he provided for possible services were: cultural programs for reshaping gender roles, use of condoms, lessons on negotiating safe sex, and awareness campaigns about where to seek testing and treatment. For more detail, see the website above. How Adolescents Perceive the Stigma of Mental Illness and Alcohol Abuse This article summarizes a study on adolescents' perception on stigma of mental illness and alcohol abuse. A total of 303 adolescents completed a revised version of the Attribution Questionnaire that presented four vignettes, each describing a different type of peer: a peer with mental illness, with mental illness caused by a brain tumor, with alcohol abuse problems, and with leukemia. As with adults, adolescent stigmatized peers who abuse alcohol most severely. The researchers concluded that adolescents do tend to discriminate among conditions, viewing substance abuse more harshly than the other disorders. For the full articles, see http://ps.psychiatryonline.org/cgi/content/full/ps;56/5/517 Back to Top
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Viral genetic differences are possible key to HIV dementia A study of 18 HIV-positive subjects shows that HIV in the brain and central nervous system is genetically different from HIV that lives in the blood and peripheral tissues. Moreover, serious cognitive impairment among the study subjects was correlated with the presence of a particular mutation in the HIV envelope gene. The results of this study may provide an answer to the mystery of why only some people infected with HIV go on to develop HIV dementia. Colorectal Cancer Screening in HIV-Infected Patients 50 Years of Age and Older: Missed Opportunities for Prevention Although HIV-infected patients are now living longer, there are no published data on colorectal cancer (CRC) screening in this population. This study looked at 538 outpatients being treated for HIV, 302 of which were over fifty years old. Despite significantly more visits with their primary care provider, HIV-infected patients were less likely to have ever had at least one CRC screening test. Public health strategies to improve CRC screening in HIV-infected patients are needed.
D.C. to require HIV names reporting The Washington, D.C. Department of Health will introduce a proposed municipal regulation later this month that replaces the city’s coded “unique identifier” system with a confidential names reporting system for keeping track of people who test positive for HIV. Leaders of public health and gay advocacy organizations, including the Whitman-Walker Clinic and the Gay & Lesbian Activists Alliance, reviewed a draft of the proposed regulatory change and have agreed to support it. The proposed switch to a name-based reporting system in the District comes less than three months before a Sept. 30, 2006, deadline set by the federal government that could result in the loss of millions of dollars in federal AIDS funds if D.C. fails to adopt the new reporting system. Hope for HIV microbicide breakthrough: scientists Researchers are closing in on a breakthrough microbicide gel to help prevent HIV infection in women, but a lack of funding by major pharmaceutical companies is hampering research. Microbicides cover a range of vaginal and rectal creams, gels or suppositories that prevent the transmission of infectious microbes, including HIV, when applied before sex. They could provide a powerful prevention tool for AIDS and one that, unlike condoms, can be directly controlled by women. Five potential microbicide products are in advanced clinical trials and scientists say the first results should be made public within two years.
Drug therapy has changed HIV skin disease patterns A John Hopkins University study of 897 HIV patients at a dermatology clinic has shown that the skin manifestations of HIV infection have changed as a result of highly active antiretroviral therapy (HAART). Sixty-one percent of patients began HAART before their initial visit to the dermatology clinic. Folliculitis, inflammation of the hair follicles, was the most common skin disease, affecting 18 percent of the patients. Among patients on HAART, 6.2 percent were overly sensitive to light compared with 2.9 percent who were not taking the drugs. Molluscum contagiosum, a type of viral disease of the skin, also was more common among patients on HAART.
Bristol, Gilead file for HIV 3-drug combo drug approval Bristol-Myers and a partner Gilead have filed for marketing approval for their combination HIV treatment. The companies filed an application with the U.S. Food and Drug Administration to market a product that combines in a once-daily tablet the HIV drugs Sustiva, which is made by Bristol-Myers, and Truvada, made by Gilead. Truvada is a fixed-dose product that contains two Gilead drugs: Viread and Emtriva. All three drugs work by blocking reverse transcriptase, an enzyme necessary for HIV replication.
HIV Infection and Dementia in Older Adults: should we be concerned? HIV infection in older patients is becoming increasingly common. Simultaneously, the development and expression of dementia among HIV-infected patients is evolving in the era of highly active antiretroviral therapy (HAART) and immune reconstitution. It is not fully understood how long-term HAART interacts with chronic HIV infection and advanced age with regard to cognition. This article provides an overview of HIV cognitive impairment as it relates to aging and presents some emerging issues in the field
Whites fare poorly with HIV and hepatitis C
April 18, 2006 According to a report from the University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, liver disease and death rates for patients with both hepatitis C virus (HCV) and HIV are worse than the rates for those with just HIV or HCV. The report is based on an examination of 743 veterans over three years. Race also played an important role in mortality, with twice as many white patients dying compared to black patients.
Calif. Gov. Signs Bill That Creates Names-Based HIV Reporting System California Gov. Arnold Schwarzenegger signed a bill implementing a confidential names-based reporting system for new HIV cases in the state. This move was praised by several HIV service-providers, such as San Francisco AIDS Foundation, AIDS Healthcare Foundation, and the Los Angeles County Commission on HIV. The new reporting system will ensure that California does not lose about $50 million in federal funds annually for HIV/AIDS treatment. New provisions under the Ryan White CARE Act mean that states reporting new HIV cases using codes will not receive federal funds beginning on Oct. 1, 2006. In addition, this new system will make it easier to get HIV positive people into proper care.
Why isn't HIV testing routine yet? Twenty years after the HIV test was created, many people are still not being tested for the virus. This article argues that HIV tests should become more routine for groups such as those with other STDs who are treated at emergency rooms. Many states have laws that restrict the availability of HIV tests by requiring that those receiving the test get counseling, or provide written consent. These laws were originally created to protect the civil liberties of those with HIV, but now may be having the opposite effect by hindering efforts to create awareness of the epidemic
Health Officials Cast Web at STDs The internet has been used in the past to encourage and enable casual sexual encounters, something that has fueled the spread of sexually transmitted diseases (STDs). Recently, health authorities in Los Angeles, San Francisco and other cities have been trying to use the internet for healthier purposes by hiring counselors to visit sex chat rooms, advertising often provocative prevention messages, arranging testing for STDs, and even helping to notify the partners of people found to be infected. This article details those efforts, as well as some of their implications.
HCV Therapy Successful for With Mental illness/substance abuse Hepatitis C virus (HCV) infection is more frequent in veterans than in nonveterans. Up to 85% of HCV-infected veterans have psychiatric and/or substance use (SU) co-morbidities. The objective of this study was to compare the eligibility, completion and response to antiviral therapy in HCV-infected veterans with and without these comorbidities. It was found that patients with co-morbidities were considered ineligible for therapy more frequently and were treated less frequently than controls. However, completion of therapy did not differ significantly between groups. Decrease in new HIV infections smaller than expected
March 31, 2006 New estimates by San Francisco health officials conclude that the actual HIV infection rate among gay men in San Francisco has declined substantially (by about 20 percent since 2001), but that this decrease has been offset by a 25 percent increase in the city’s gay male population during those five years. A previous federal study by the Centers for Disease Control suggested that the rate in San Francisco was substantially lower than previously thought, raising hopes that the city’s rate of new infections may have been lowered by up to 40 percent. Since 2001, the city’s official estimate has been that each year 1,084 residents become infected with HIV. The new estimate is that each year 976 residents become infected, 87 percent of whom are gay men Since AIDS was first detected in 1981, it has taken the lives of 17,917 San Francisco residents.
HIV/AIDS patients to suffer sting of program cuts
This informative article details the terrible toll that HIV/AIDS has taken on South Florida communities. Between July 1, 1997, and March 31 of 2004, 3,747 people have been diagnosed with HIV in Palm Beach County. In 2002, the most recent year available for data on metropolitan areas, the West Palm Beach to Boca Raton area ranked fifth in the nation for its rate of AIDS cases per 100,000 people. Compounding this problem are many economic and cultural factors, as well as a recent decision by the Federal government to cut $1.2 million in HIV/AIDS related funding. To read more about the situation, visit the link listed above.
HIV & Black Women March 10th was National Women and Girls HIV/AIDS Awareness Day. As of 2004, 27% of new AIDS cases in the United States were in women. Women of color, especially African American women, made up the majority of these new cases. Although non-Hispanic blacks constituted only 13% of the population of the 32 states that were monitored during the last four years, they accounted for more than half (51.3%) of the HIV/AIDS diagnoses, including 68.8% of diagnoses among females and 44.5% of those among males. For more information on the disproportionately large toll that AIDS has taken on African-American women, visit the link listed above.
Sources of Payment for Substance Use Treatment Once individuals develop problems with drug or alcohol, their willingness to seek treatment and success in obtaining it often depends on their ability to pay. This report uses data from the National Household Survey on Drug Use and Health to focus on how individuals who received substance use treatment in the past year paid for their last or current treatment and compares sources of payment by gender and family income relative to the Federal poverty threshold. Some interesting results include:
Characteristics of Recent Adolescent Inhalant Initiates Inhalant use (i.e., the deliberate inhalation of volatile substances to induce a psychoactive or mind-altering effect) is a serious problem among adolescents. Research suggests that inhalants are the third most widely used class of illicit drugs among adolescents. This report uses data from the National Household Survey on Drug Use and Health to focus on youths aged 12 to 17 who initiated the use of inhalants in the 12 months prior to the survey. Some interesting results include:
Newer Hepatitis B Drug Bests Standard Treatment In a pair of studies on hepatitis B, researchers from around the world have found the medication entecavir is more effective than the commonly used drug lamivudine in managing the liver disease. Additionally, the researchers found that no one developed resistance to entecavir (brand name Baraclude) after 12 months on the drug. Resistance to lamivudine is a concern when people have to be on it long-term, as is often the case with hepatitis B patients. Throughout the world, as many as 400 million people are infected with hepatitis B, a viral infection that affects the liver. For most adults, the infection is acute and lasts no more than six months, but for about 10 percent of adults, up to half of all children and about 90 percent of babies infected with hepatitis B, the disease becomes chronic and can lead to scarring of the liver, liver cancer and liver failure.
Battling H.I.V. Where Sex Meets Crystal Meth The article features Terry Evans, an outreach worker for Positive Health Project, an advocacy group that strives to reduce the spread of H.I.V. As an outreach worker, he tries to lure internet users into his support group for black and Latino men whose lives have been hijacked by crystal meth, an illegal stimulant known to melt away inhibitions. Mr. Evans, a recovering crystal meth addict, is among a handful of drug abuse counselors trying to stanch the powerful amphetamine's increasing popularity among black and Hispanic gay men, a trend that has alarmed city health officials who link the drug to the spread of H.I.V. and other sexually-transmitted diseases.
Babes benefit when HIV+ moms take a multivitamin According to a study in Tanzania, maternal multivitamin supplements containing vitamins B, C and E reduce the risks of motor developmental delays in infants born to HIV-positive mothers in developing countries. These findings support current recommendations to give multivitamin supplements, in addition to an anti-retroviral treatment, to HIV-1-infected pregnant women in developing countries In the study, a population of HIV-1-infected women received daily doses of either vitamin A alone, a multivitamin regimen of vitamins B1, B2, B6, niacin, B12, C, E and folic acid, both supplements combined, or placebo. The treatment lasted throughout pregnancy and continued for 18 months after delivery. Their results indicate that a multivitamin supplement (B, C and E without A) had significant positive effects on motor scores, as assessed by a validated index. For more information on the study and its results, visit the link listed above.
AIDS Survival Varies With HIV Subtype A study of more than 300 HIV patients in Uganda has found that people infected with a specific subtype of HIV, called subtype D, have shorter survival than those with the A subtype. In the study, 10 percent of the people infected with subtype D died within three years, while none of the people with subtype A died within that period of time. Subtype D may be more virulent than subtype A because D has the ability to bind to key receptors on immune cells. This ability enables subtype D to kill immune cells more quickly. The discovery could improve the care of those with HIV/AIDS.
Early treatment always better for HIV, study finds In order to most effectively fight AIDS, patients are advised to start taking powerful drug cocktails as soon as possible, despite the medications’ side-effects. This is according to researchers at the University of Colorado and the CDC. Deaths, the rate of opportunistic infections and side effects all were the lowest in patients who started treatment early, while their immune systems were still relatively intact. The head researcher said that current guidelines that recommend delaying therapy are based on incorrect assumptions that starting drugs early worsens toxicity, because his study found that early treatment reduces toxic side-effects. For more information about different types of HIV treatment and their side effects, visit the link listed above.
International HIV/AIDS Trial Finds Continuous Antiretroviral Therapy Superior to Episodic Therapy
The National Institute of Allergy and Infectious Diseases (NIAID) has stopped enrollment into a large international HIV/AIDS trial. The trial, known as Strategies for Management of Anti-Retroviral Therapy (SMART), was designed to determine which of two different HIV treatment strategies would result in greater overall clinical benefit. HIV-positive volunteers were assigned at random to either a viral suppression strategy, in which antiretroviral therapy (ART) was taken on an ongoing basis to suppress HIV viral load, or a drug conservation strategy, in which ART was started only when the levels of key immune cells, called CD4+ cells, dropped below 250 cells per cubic millimeter (mm3). Volunteers in the drug conservation group were taken off ART, with the aims of reducing drug side effects and preserving treatment options, whenever their CD4+ cells were above 350 cells/mm3. Enrollment was stopped because those patients receiving episodic therapy had twice the risk of disease progression (the development of clinical AIDS or death) as those in the viral suppression strategy group.
New Prescription Drug Information Format to Improve Patient Safety The FDA unveiled a major revision to the format of prescription drug information, including drugs to treat HIV/AIDS, commonly called the package insert or drug label, to make information for healthcare professionals clear and concise, which will help ensure safe and optimal use of drugs. The insert will provide the most up-to-date information in an easy-to-read format that draws attention to the most important pieces of drug information, thus reducing the complexity of information on prescription drug labels. For more information on these changes, visit the link listed above.
Hepatitis C treatment difficult in older patients According to a study in Japan, patients over the age of 60 with hepatitis C find it more difficult to stick with standard treatments than do their younger counterparts because of side effects. Impaired heart, lung and kidney function can make older patients more susceptible to anemia induced by ribavirin, one of the drugs used for treating hepatitis C. The study analyzed outcomes among 208 patients with chronic hepatitis C who received injections of interferon daily for 2 weeks then three times weekly for 22 weeks, and daily ribavirin. Only 92 (44 percent) continued without dose reductions until the end of treatment. Rates of discontinuation or dose reduction were 38 percent in those younger than 50 years old, 48 percent in those between 50 and 59, and 77 percent in patients 60 or older. Half of Americans use prescription drugs - survey
Early HIV control by drug therapy predicts outcome
Reductions in the amount of HIV in the blood that occur during the initial period of highly active antiretroviral therapy (HAART) predicts the likelihood of survival up to six years later. Researchers came to this conclusion after an observational study of 2,046 patients, who were divided into three groups based on the amount of time they had detectable virus during the first to 6 to 18 months of HAART. Because early episodes of loss of viral suppression "are associated with a bad long-term prognosis," concluded Lohse, "the physicians prescribing antiretroviral therapy should continue to work with patients to keep viral load under tight control." Interim methadone program can help heroin addicts
For heroin addicts waiting to get in to a comprehensive treatment program, an interim methadone maintenance program reduces heroin use and criminal activity. Interim treatment is an alternative to being on a waiting list. Low-threshold services can reduce patients' drug use and increase their likelihood of entering comprehensive treatment. In a recent study, out of 194 participants in interim treatment, only 31 (16.0 percent) dropped out of treatment before day 120, the maxim duration of the interim program. After an average of 117 days of interim treatment, 75.9 percent of the participants entered comprehensive treatment, while only 20.8 percent of waiting list participants did so (after an average of 58.5 days). Less than 60 percent of participants in interim treatment had a positive urine heroin test after entering the program, the researchers note, compared with 79.2 percent of participants on the waiting list. Most interim participants had no or only one positive heroin test after the study began. During the last month of the study, the interim-treatment group reported substantially less money spent on drugs and less illegal income than did the waiting-list group, the investigators say. NIDA Unveils Campaign to Send Teens the Message about the Link Between Drug Abuse and HIV A new public awareness campaign announced by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health, is pushing the message “Drug Abuse and HIV: Learn the Link.” NIDA and partnering organizations are working together to get this important message about the link between drug abuse and HIV to teens and young adults. While research has shown that a large proportion of young people are not concerned about becoming infected with HIV, the reality is that there exists a very real danger for those engaged in risky behaviors. In addition, minority populations are disproportionately affected by the health consequences of drug abuse and HIV. In addition to public service announcements distributed to television stations across the country, NIDA has launched a website, www.hiv.drugabuse.gov that provides the latest scientific findings on the relationship between drug abuse and HIV.
Treating Depression Boosts Immune Response to HIV According to research conducted at the University of Pennsylvania, there may also be a link between depression and immunity in HIV-infected individuals. Depression in HIV-positive persons not only appears to impair certain immune cells that may be crucial to fighting HIV, but if the depression resolves, the damaged immune cells seem to rebound. The study assessed 57 HIV-positive women at baseline and then a year later for depression. They also evaluated the women at baseline and again after one year for activity of a particular type of immune cell, the natural killer cell, which appears effective in fighting HIV infection. They then looked for associations between changes in depression status and natural killer cell activity over time. For more information on the study, and its results, visit the link listed above.
Drugs Help AIDS Patients Live Well Into Senior Years Over the next decade, medical professionals predict that the ranks of seniors living with AIDS will grow as treatments extend their lives well into their golden years. However, there are many unknowns with the revolutionary treatments that are prolonging the lives of those infected with HIV. Experts say there are indications that some of the newer anti-retroviral drugs used to treat AIDS accelerate heart disease, could cause high cholesterol over prolonged periods and also bring about diabetes and high blood pressure. These are health problems already affiliated with old age and could complicate treatment.
Drugs to Treat HIV so Foul-tasting, Many Kids Refuse to Take Them Many children infected with the AIDS virus find the liquid drugs needed to keep the infection in check so nasty-tasting that they refuse to take them. A study of almost 120 Canadian children being treated for HIV found that more than one-third of them refused to swallow their medication. While medicines for children, such as cough syrups and even some antibiotics, are made more palatable with sugar, sweeteners or other taste-altering ingredients pose a challenge for drug companies because the additions could cause a chemical interaction with the drugs.
Prisons Failing Inmates on HIV A joint report from the National AIDS Trust and Prison Reform Trust has found that Sexual health services in prisons in the UK are inconsistent and substandard, and are failing to meet the needs of prisoners living with, or at risk of contracting, HIV and other blood-borne viruses. Despite high rates of HIV and hepatitis C among prisoners, most still do not have access to condoms, disinfecting tablets, clean needles or basic health care information. For more information, visit the link above. Seroquel Reduces Opioid Withdrawal Symptoms According to a study published in the Journal of Clinical Psychiatry, the use of the antipsychotic drug Seroquel (quetiapine) during opioid cessation appears to help relieve the symptoms of withdrawal. Of the 107 patients who completed a survey, 79 reported that Seroquel helped reduce cravings for opioids and 52 said that it helped reduce withdrawal-associated anxiety. Smaller numbers of patients reported that Seroquel reduced pain, helped alleviate insomnia, and improved appetite.
New Look for Veterans Affairs HIV Site The United States Veterans Affairs HIV/AIDS Program has redesigned its website. With separate sections for patients and providers, this website can serve as a valuable resource on topics such as getting tested, living with HIV/AIDS, conditions associated with HIV/AIDS, and HIV/AIDS epidemiology.
Record New HIV Cases in 2005: UN According the United Nations, almost 5 million people were infected by HIV globally in 2005, the highest jump since the first reported case in 1981, taking the number living with the virus to a record 40.3 million. The new infections were fueled by the epidemic’s continuing rampage in sub-Saharan Africa and a spike in the former Soviet Union and Eastern Europe, Central Asia and East Asia. More than 3.1 million people died this year from AIDS, including 570,000 children. This is far more than the toll from all natural disasters since last December’s tsunami. For more information, visit the link above.
AIDS Project Lets Home PCs Research New HIV Drugs AIDS researchers are asking the world’s computer users to join the fight against the disease by donating the power of their idling PCs to the search for new drugs. The newly expanded FightAIDSHome project, backed by the Scripps Research Institute and IBM Corp., is an example of distributed or grid computing, which can harness thousands of personal desktops and laptops to work together like one of the world’s most powerful supercomputers. The new project on AIDS drugs comes as the HIV virus is evolving to resist current treatments. The effort uses home computers to test thousands of chemical compounds against variations of a protein found in the HIV virus, one combination at a time. For more information, or to learn how to get involved, visit the link above.
High Hepatitis B Rate Found in Asians in NYC A community hepatitis B screening program targeting mainly underserved foreign-born Asian residents of New York City found a higher number of cases of infection than previously reported among Asian populations in the United States. Investigators reported an overall prevalence of 24 percent among the 1,836 people screened as of June 30. Previous hepatitis screening programs in the US have reported prevalence rates of 10 percent to 15 percent. Many of the participants had not had access to medical care because of language, economics or other reasons.
Proposed US Condom Labels Warn Against Spermicide New draft guidelines for male latex condoms call for packaging to include information that they reduce, but do not eliminate, the risk of pregnancy and sexually transmitted diseases. The U.S. Food and Drug Administration guidelines also specifically say condoms that contain the spermicide nonoxynol-9 must specify that they can cause irritation and increase the risk of HIV. They also specify that consistent condom use may help protect against some other sexually transmitted diseases, such as human papilloma virus, or HPV, that are transmitted through skin contact.
China to Build Special Prisons for AIDS Convicts China’s booming southern province of Guangdong will build at least two prisons exclusively for HIV/AIDS-infected convicts to try to halt the disease’s spread. There are currently 20 AIDS sufferers and 518 HIV carriers serving jail terms in Guangdong. China says it has 840,000 HIV-AIDS cases among its 1.3 billion population, but experts say at least a million poor farmers were infected in botched blood-selling schemes in the 1990s in the central province of Henan. The UN has warned that the number of HIV-AIDS cases could reach 10 million in China by 2010 if no effective measures are taken to curb the disease.
Condoms Protect Against Genital Herpes Consistent condom use can lower both women’s and men’s risk of contracting the virus that causes genital herpes. The study, of more than 1,800 adults at high risk of genital herpes, found that those who said they usually used condoms were one-quarter less likely to test positive for herpes simplex virus type 2 (HSV-2). HSV-2 causes most cases of genital herpes, a common STD that causes recurrent outbreaks of sores in and around the genitals. Other possible symptoms include pain and burning in the affected area, fever and difficulty urinating. An earlier study had found that consistent condom use helped prevent genital herpes in women, but the results in men were inconclusive.
US FDA, Biogen, Say Skin Drug Not for HIV Patients Biogen Idec and FDA notified healthcare professionals of revisions to the contraindications section of the prescribing information for Amevive. Amevive should not be administered to patients infected with HIV. Amevive reduces CD4+ T lymphocyte counts, which might accelerate disease progression or increase complications of disease in these patients. In addition, other sections of the product labeling were revised to reflect additional safety information.
Infectious Diseases in Corrections Report (IDCR) (Formerly the HEPP Report) Findings from the largest survey ever conducted on the co-occurrence of psychiatric disorders among U.S. adults indicates a sharper picture than previously reported of major depressive disorder (MDD) in specific population groups. Results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) also indicate a strong relationship of MDD to alcohol use disorders, drug disorders and other mental health conditions. According to researchers at Columbia University's Mailman School of Public Health, middle age, female gender, Native American race, low income, and separation, divorce, or widowhood increase the likelihood of current or lifetime MDD.
Government Mulls Do-It-Yourself AIDS Test The Food and Drug Administration is considering permitting the OraQuick Advance HIV test to be sold over the counter. With a swab of saliva and a vial of test fluid, this test can tell in 20 minutes if a person has HIV. It is already widely available in health clinics and doctors’ offices. Supporters of home kits say they will spur more people to get tested and get treatment sooner if infected. However, concerns have been raised about whether a doctor or counselor should be nearby when people find out they are HIV-positive.
U.N. Campaigns to End AIDS in Kids The United Nations is launching a global campaign to combat the rising threat of AIDS against children, nearly 1,800 of whom are infected with HIV every day. According to a new report from UNICEF and UNAIDS, children under 15 account for 1 in 6 global AIDS-related deaths and 1 in 7 new global HIV infections. An estimated 15 million children have lost one or both parents to AIDS, but less than 10 percent receive any public support. The campaign’s message is that AIDS is a growing threat to children and if serious action isn't taken immediately the world will not achieve the U.N. Millennium Development Goal of halting and reversing the AIDS pandemic by 2015. October 2005 This presentation from the UCSF Center for HIV Information reviews the changes taking place that affect both Arab Americans and HIV prevention strategies. It covers the topics of barriers to prevention and care; the ways in which difficulties vary with region and immigration status; the intracultural pressures that affect HIV prevention and care; and the differing organizational and individual views of HIV/AIDS prevention in Arab American communities. Study Supports Routine HIV Tests for Fever Patients A new study published in The Annals of Family Medicine American suggests that doctors could save hundreds of lives annually by giving HIV tests to patients with fevers and other signs of viral illness. While only a tiny percentage of the sick patients would actually be ill because they are in the early stages of HIV infection, identifying the disease in these individuals could prevent them from infecting others. Currently, the U.S. medical establishment is nowhere near making HIV tests routine for people with routine symptoms. The tests themselves still carry a stigma, and doctors themselves often do not think about the prospect that their patients may be ill with the virus that causes AIDS.
Urine Test Spots Chlamydia in Male Teens Sexually active male adolescents often have the sexually transmitted infection Chlamydia trachomatis, but do not know it. Investigators in California have found that routine urine screening for chlamydia is an effective means of diagnosing these infections in sexually active young men. In men, chlamydia can lead to inflammation of the urethra and structures of the testes. Men can pass the infection to their female sex partners whose fertility could become compromised. The investigators determined the effectiveness of screening sexually active 14 to 18 year-old males scheduled for routine health maintenance visits at ten clinics of a large HMO between 2001 and 2002. For more information on the study and its results, visit the link above.
Treating Individuals with Substance-abuse Disorders Who Have Attempted Suicide Inpatient treatment is better for substance-related, but not psychiatric, outcomes. Reported rates of suicide attempts by individuals with substance-use disorders (SUDs) range from three percent in the previous 30 days to lifetime rates of 45 percent. Despite this relatively high frequency of suicide attempts by substance users, the effects of treatment following a suicide attempt are not well understood. A study in the September issue of Alcoholism: Clinical & Experimental Research investigates if treatment setting – inpatient or outpatient – has a different impact on outcomes for suicidal and nonsuicidal patients with SUDs. Suicidal patients receiving inpatient, compared to outpatient, SUD treatment were significantly more likely to have better substance-related, but not psychiatric, outcomes following treatment. The study did not show clinically significant differences in outcomes for inpatient vs. outpatient care among individuals with SUDs who had not made a suicide attempt. Early Drinking Increases Later Risky Behaviors in Urban Youth Join Together/Alcohol and Health: Current Evidence Early alcohol use can contribute to later sexual and alcohol-related risk behaviors. A recent study or urban youth found the following statistics:
Number of Older HIV Victims is Increasing HIV is often regarded as a disease of young people, but researchers say the number of people over age 50 infected with HIV is significant and growing. The increasing number of older people diagnosed with HIV may be due to several factors. The development of highly active anti-retroviral therapy has probably contributed to HIV-infected patients' survival into old age. Older patients are more likely to adhere to medication schedules, resulting in good immune responses. Also, HIV infection is slowly starting to become more recognized as a potential diagnosis for older patients, resulting in expanded testing. Areas in which future research into HIV in older people would be helpful include HIV-related bone density loss, cardiovascular disease and dementia. These areas are all well studied in younger patients, but may progress differently in older HIV-infected individuals.
Lab Tests for Herpes Often Give Wrong Results Many labs in the US are using outdated blood tests for genital herpes that often give erroneous results, according to a new report. There are two types of herpes virus -- HSV-1, which is responsible for common 'cold sores,' and HSV-2, which causes genital herpes. The College of American Pathologists recently sent 172 participating laboratories a sample of blood that was positive for HSV-1 antibodies and negative for HSV-2 antibodies. While virtually all of the laboratories accurately detected HSV-1 in the sample, more than half incorrectly reported that the sample was positive for HSV-2 antibodies.
Hurricane Katrina Response and Guidance for Health-Care Providers, Relief Workers, and Shelter Operators CDC/ATSDR, local and state health departments, other federal agencies, and other partners are supporting public health and medical-care functions for persons in affected areas and those displaced as a result of the hurricane. To protect the public health and safety during recovery operations, CDC has provided multiple sets of guidelines. These include guidelines of particular interest to health-care providers, relief workers, and shelter operators.
People with HIV Not Being Tested for Colon Cancer Although people with HIV in developed countries are living longer, they appear to be less likely than other people to undergo routine recommended screening for colorectal cancer. Guidelines recommend colon cancer screening for everyone over 50, or over 40 if they have a family history of the disease. A study showed that compared with similar but uninfected people, HIV patients are significantly less likely to have undergone at least one colorectal cancer screening test, despite having significantly more primary care visits.
Ecstasy User More Prone to Disease Ecstasy users could be setting themselves up for illnesses linked to compromised immune systems, according to Trinity College Dublin researcher Thomas Connor. Connor pointed to anecdotal evidence of ecstasy users developing diseases like shingles and meningitis that could be related to the drug's suppression of the body's immune system. "Ecstasy has potent immunosuppressant qualities which have the ability to increase an individual's susceptibility to disease," Connor said, adding that "people ingest these drugs in crowded nightclubs full of young people with lots of (germs) going around." Connor estimated that a person taking two tablets of ecstasy would see their immune system compromised for up to 48 hours. Some club-drug websites recommend that ecstasy users eat fruit and vegetables before partying in order to boost their immune system, he said. Some studies have shown that ecstasy use makes users more prone to depression and other mental illnesses. Connor said the physical damage caused by the drug could impede the effectiveness of medications designed to treat these disorders. "In ecstasy users the proteins that Prozac works on are greatly diminished in number," he said, citing animal studies.
Hurricane Katrina Information To assist HIV/AIDS organizations and their clients impacted by this disaster, NMAC has assembled answers to the most frequently asked questions (FAQ). This bulletin gives advice on what conditions to look for in HIV positive patients in the wake of Hurricane Katrina. It directs care providers to contact NMAC personnel directly at its headquarters: (202) 483-6622 or technical assistance office: (202) 234-5120 if they have any questions. Condoms Effective for Preventing Chlamydia A new study indicates that consistent use of condoms offers significant protection for people who run the risk of catching Chlamydia from their sex partners. Among 152 clients of an STD clinic who were known to have been exposed to Chlamydia, only 13 percent of consistent condom users were diagnosed with chlamydial infection compared with 34 percent of inconsistent condom users. The researchers calculate that consistent condom use is 90 percent effective in preventing Chlamydia infection for people who are at risk. The findings are reported in the August 2005 issue of Sexually Transmitted Diseases.
Updated Adult/Adolescent ART Guidelines Slides from AETC National Resource Center The AETC National Resource Center has put out a series of four slide sets titled Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents. Two of the sets have recently been updated, and can be found by visiting the links listed above. The first set is a Comprehensive Guide Summary; the second set focuses on Initiation of Therapy. The intended audience for the sets is clinicians involved in the care of patients with HIV. The AAETC cautions that, due to the rapidly changing field of HIV care, this information could become out of date quickly. Update to the "Guidelines for the Use of Antiretroviral Agents in HIV-1- Infected Adults and Adolescents" The Panel on Clinical Practices for Treatment of HIV Infection is providing the readers with the following supplemental recommendations to the April 7, 2005 guidelines: (1) A regimen containing “tenofovir + didanosine + NNRTI” should not be used as an initial regimen in antiretroviral treatment naïve patients; (2) Lopinavir/ritonavir can be dosed as one single daily dose (6 capsules or 10 mL – equivalent to 800mg lopinavir/200mg ritonavir) in treatment-naïve patients. Once daily dosing is not recommended in treatment-experienced patients or in patients receiving concomitant efavirenz, nevirapine, amprenavir (or fosamprenavir), or nelfinavir. NIAID Funds Center for HIV/AIDS Vaccine Immunology (CHAVI) The National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, today announced funding to establish the Center for HIV/AIDS Vaccine Immunology (CHAVI). Barton Haynes, M.D., of Duke University has been selected to lead the CHAVI consortium. The consortium may receive more than $300 million over seven years, $15 million of which is designated for its first year. CHAVI's mission is to address key immunological roadblocks to HIV vaccine development and to design, develop and test novel HIV vaccine candidates. Approximately 40 million people are living with HIV/AIDS globally, and the rate of new HIV infections continues to exceed 13,000 per day, according to the Joint United Nations Program on HIV/AIDS. Although AIDS drugs have extended the lives of many in wealthy nations, an effective HIV vaccine would be an extremely valuable addition to the comprehensive prevention strategies necessary to halt the spread of HIV in both developing and developed countries. More information on CHAVI is provided in an online Q&A at http://www.niaid.nih.gov/daids/chavi/CHAVI_QA_12_22_04.pdf
Farmworker Justice Fund Has Updated its Binational Directory of HIV Services Farmworker Justice Fund has updated its Binational Directory of HIV Services. The tool is designed to be used by health service providers to locate services for migrant workers with HIV/AIDS who travel across the border on a regular basis. If you are aware of HIV/AIDS services in either Mexico or the United States that are not included in the directory please download the New Organization Referral Form (in MS Word format) and send it to sdiaz@nclr.org. June 15, 2005 FDA has given tentative approval to the generic version of the AIDS drug Lamivudine, allowing it to be used to treat patients in poor countries. It is manufactured by Aurobindo Pharma Ltd. of Hyderabad, India. The FDA action does not allow the drug to be sold in the U.S., but the FDA certified that it meets U.S. standards, allowing it to be considered by the President's Emergency Plan for AIDS Relief. High Rates of Sexually Transmitted Infections Found in Young Drug Users http://www.medicalnewstoday.com/medicalnews.php?newsid=26265 June 17, 2005 Medical News Today Researchers at the Johns Hopkins Bloomberg School of Public Health and other institutions found high rates of herpes simplex virus 2 and syphilis among young drug users in Baltimore, MD. The study found that women had significantly higher rates compared to their male counterparts, but did not find significant differences between injection drug users and non-injection drug users. Few of the infected study participants were aware of their sexually transmitted infection. The researchers examined herpes simplex virus 2 and syphilis test results in 543 heroin, cocaine and crack users, aged 18-20 years old. They found that over half (58%) of the female study participants and a little more than 20% of male participants were infected with herpes simplex virus 2. Women were also more likely to have syphilis than men in the study (4% versus less than 1%). The findings are reported in the June issue of Sexually Transmitted Infections.
Substance Use During Pregnancy: 2002 and 2003 Update Substance use by pregnant women is a leading preventable cause of mental, physical, and psychological problems in infants and children. This report examines illicit drug, alcohol, and cigarette use among pregnant and nonpregnant women aged 15 to 44. The findings presented in this report are annual average based on combined 2002 and 2003 NSDUH data. Some of the findings include:
The Dangerous Frontiers of Substance Abuse: A Look at Alcohol and Drug Use Trends http://www.recoverymonth.gov/2005/multimedia/w.aspx?ID=410 Premiering June 1, 2005 Recovery Month 2005 This webcast is part of a series from Recovery Month 2005. It is designed to reveal the most recent developments in substance abuse. This show will look at the emerging trends related to illicit drug use, underage drinking, and non-medical use of prescription and over-the-counter medications. It will also address the challenges and successes of treating individuals who are becoming alcohol or drug dependent while living on the dangerous frontiers of substance abuse.
New National Library of Medicine Special Information Services Website A new website from the National Library of Medicine provides resources for HIV/AIDS diagnosis and testing information. Topics covered on the website include:
Materials are also available in Spanish. Internet Fuels Risky Sex in Gay, Bisexual Men - Study A new U.S. study reported that gay and bisexual men who meet partners over the Internet are more likely to engage in risky sex but have a greater tendency to do so with people who have the same HIV status. According to a study conducted by the Denver Public Health Department, 41% of men who arranged to have sex with other men through the Internet reported having unprotected anal intercourse with their last partner. That compared with 31% of men who met partners in gay bathhouses, 29% who used other public sex venues, and 25% of those who met in bars or at parties. The study also found that 51% of the men who used the Internet to meet had chosen a sex partner with the same HIV status as themselves, compared to 20% of bathhouse patrons. Although choosing partners based on their HIV status or the amount of virus in blood can reduce the risk of acquiring or transmitting HIV, researchers said that there are dangers to doing so. In the Colorado study, the Internet users were also more likely to have been diagnosed with gonorrhea. In the recent years, health experts have warned of a possible resurgence of STDs, especially AIDS, among gay and bisexual men.
AIDS "Tsunami" Threatens Africa's Children - Red Cross The Red Cross issued a warning of "a silent tsunami" wiping out an entire generation as it launched a campaign to help millions of African children orphaned or otherwise affected by HIV/AIDS. It is estimated that 12.3 million African children have lost one or both parents to AIDS and the figure could double by 2010. Others are left caring for sick parents no longer able to provide for their families, slashing children's chances of a decent education and making them more vulnerable to abuse and prostitution. The campaign across 10 southern African countries aims to step up HIV/AIDS prevention measures as well as the Red Cross's programs of support and home-based care for children affected by the pandemic. The Red Cross called for closer coordination with other organizations to improve the care given to AIDS orphans within their own communities. Black Womens' HIV Rates Lopsided, Researcher Says Researchers from University of North Carolina at Chapel Hill stated that while only a quarter of Americans newly diagnosed with HIV are women, a significant majority of them are black, living in the South, and facing entrenched social ills: poverty, racism, segregation and the imprisonment of many black men. In recent years, diagnoses of HIV have decreased slightly in women overall and increased slightly in men. But the racial gap remains much more pronounced in females: black women were 18 times more likely to be diagnosed with HIV in 2003 than white women; Hispanic women were four times more likely to receive such a diagnosis. Researchers said that reasons why women, especially minorities, contract HIV are complicated. Previous studies have shown that HIV-positive women were more like to have no job, be on public assistance, have many sex partners, receive money for sex, and use crack cocaine. Other factors noted were the shortage of black men and childhood sexual abuse. AIDS Pandemic Racing Faster Than Means to Stop It A report prepared for a high-level U.N. forum said that the pandemic is racing faster than the means to stop it, especially among women and girls, despite the money available to fight AIDS soaring to an all-time high of $8 billion. It was reported that only 12% of those who need treatment are receiving it. Effective prevention programs, counseling and testing services are the exception to the rule and drugs still cost too much. It was also noted that the trend is moving toward more young women being infected than young men. Men and women between 15 and 24 years old are the hardest hit by the pandemic.
STD Self-test Uses Internet Researchers have developed a method to use the internet in helping women self-test confidentially for Chlamydia and other sexually transmitted diseases while providing public-health authorities information on the spread of STDs. Researchers from Johns Hopkins Universeity sent participants a kit in an unmarked brown envelope containing a sterile cotton vaginal swab, an informational survey and a sealable vial for the specimen, as well as instructions on how to collect the swab and a pre-addressed postpaid envelope to return the sample. Participants request the kits by going to the website www.iwantthekit.org. The kit's availability was publicized to youth in the Baltimore area, primarily through popular radio. In presenting the study results at the meeting of the American Society for Microbiology, researchers suggested that online accessibility to self-testing kits for STDs is an effective way to tackle "the spread, detection and treatment of this disease."
Science Hopes to Give Women New Tools Against AIDS Researcher reported that a new HIV prevention treatment for women may be available as early as 2009, a sign of hope in fighting AIDS epidemic with an increasingly feminine face. Microbicides, which women might one day be able to use in gel or cream form to shield themselves from HIV infection, hold some of the best promise for fighting AIDS. Researchers noted this may be a prevention technology that is designed for and under the control of women since they can be used surreptitiously and do not need a partner's consent. For more details on the developing of microbicides, see the website above.
Reuse of Supplies to Blame for Hepatitis Outbreak According to a report in the Annals of Internal Medicine, a large outbreak of hepatitis C virus (HCV) that occurred at a cancer clinic a few years ago seems to have resulted from the reuse of contaminated syringes and IV bags. The researchers contacted 613 clinic patients who visited the clinic during the likely exposure period, from March 2000 through December 2001. Of these patients, 494 were tested for HCV infection. Ninety-nine patients were identified with new HCV infection. Genetic tests confirmed that the HCV strain was the same in all cases. The researchers believe the virus came from a patient with chronic hepatitis C who started treatment at the clinic in March 2000. Researchers emphasized that the report is a reminder that all suspected cases of healthcare-associated bloodborne infections deserve vigorous investigations because they might signal a widespread problem. Findings are reported in the June 7 issue of the Annals of Internal Medicine. Diabetes Risk High in Men on Anti-HIV Meds John Hopkins University researchers reported that the prevalence of diabetes in HIV-infected men taking antiretroviral drugs is more than four times higher than in HIV-negative men. To investigate how potent combination antiretroviral therapy might affect the likelihood of developing diabetes, they examined data for 710 men free of HIV, 411 HIV-infected men receiving antiretrovirals, and 157 HIV-infected men not being treated with the drugs. They reported that 57 (14%) of the HIV-infected men on antiretroviral therapy had diabetes compared with 33 (5%) of the HIV-negative men at the beginning of the study. After adjusting the data to take account of age and weight, the diabetes rate was 4.6-times higher in HIV-infected men on antiretrovirals and 2.2-times higher in HIV-infected men not taking drugs. The findings are reported in the May 23, 2005 issue of the Annals of Internal Medicine. Journal ArticlesRisk Perceptions, Condom Use, and Sexually Transmitted Diseases Among Adolescent Females According to Social Network Position Bettinger, J.A., Adler, N.E., Curriero, F.C., & Ellen, J.M. Adolescent females are frequently treated as a homogenous group but could differ on their sexually transmitted disease (STD) risk because of individual attitudes and exposure through sexual networks. GOAL: The goal of this study was to determine if risk perceptions, condom use, and STD prevalence differs within sexual networks. The study demonstrated an inverse relationship between STD risk perceptions and network location. Adolescents with higher risk perceptions were more likely to use condoms, irrespective of network location. Is HIV/Sexually Transmitted Disease Prevention Counseling Effective Among Vulnerable Populations?: A Subset Analysis of Data Collected for a Randomized Controlled Trial Evaluating Counseling Efficacy (Project RESPECT). The researchers conducted a subset analysis of data collected from July 1993 through September 1996 during a randomized, controlled trial (Project RESPECT). Participants from 5 public U.S. sexually transmitted disease (STD) clinics were assigned to enhanced counseling, brief counseling, or educational messages. Nine subgroups (sex, age, city, education, prior HIV test, STD at enrollment, race/ethnicity, injection drug use, exchanging sex for money/drugs) were compared in STD outcomes for those assigned either type of counseling with STD outcomes for those assigned educational messages. After 12 months, all subgroups assigned counseling (brief or enhanced) had fewer STDs than those assigned educational messages. STD incidence was similar for most subgroups assigned enhanced or brief counseling. All subgroups had an appreciable number of STDs prevented per 100 persons counseled, especially adolescents (9.4 per 100) and persons with STD at enrollment (8.4 per 100). Efficacy of an HIV Prevention Intervention for African American Adolescent Girls: A Randomized Controlled Trial The objective of this study was to evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors among African American adolescent girls. All participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition. Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. Back to Top
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