Immune System Diseases Commons^™

Counseling And Testing For Hiv Prevention: Costs, Effects, And Cost-Effectiveness Of More Rapid Screening Tests, P. G. Farnham, Robin D. Gorsky, D. R. Holtgrave, Wanda K. Jones, Mary Guinan

School of Public Health Faculty Research

New rapid human immunodeficiency virus (HIV) antibody tests permit many individuals to receive test results and appropriate counseling at one clinic visit. Because currently used tests require significant time for processing, all individuals must return for a second visit for test results and counseling. Since return rates for the second visit are low, the more rapid tests present an opportunity to improve the efficiency of HIV counseling and testing.

The authors compared the costs and effectiveness of the currently used counseling and testing procedure and a streamlined procedure made possible by the new, more rapid screening tests. When test-positive clients …

Preventing Perinatal Transmission Of Hiv Costs And Effectiveness Of A Recommended Intervention, Robin D. Gorsky, P G. Farnham, Walter L. Straus, Blake Caldwell, D R. Holtgrave, R. J. Simonds, M F. Rogers, Mary Guinan

School of Public Health Faculty Research

In the United States, nearly all new human immunodeficiency virus (HIV) infections in children are acquired through perinatal (mother-to-infant) transmission. Each year, approximately 7000 infants are born to HIV-infected women in the United States.¹ Without intervention, an estimated 15-30% of these infants would become infected.² In 1994, results of the AIDS Clinical Trial Group (ACTG) Protocol 076 showed that treatment of infected pregnant women and their infants with zidovudine (ZDV) reduced the rate of perinatal HIV transmission from 25% to 8%.^3,4 Following these findings, the Public Health Service (PHS) issued recommendations for ZDV therapy to prevent perinatal …

Behavioral Science And Public Health: A Necessary Partnership For Hiv Prevention, Martin Fishbein, Mary Guinan

School of Public Health Faculty Research

We are now in the second decade of the AIDS epidemic in the United States. As of October 31, 1995, a total of 311,381 U.S. citizens had t died from AIDS, another 189,929 had been diagnosed with AIDS (1), and it is estimated that nearly l million persons are infected with HIV, the virus that causes AIDS (CDC). Despite the best efforts of biomedical researchers, we still have neither a cure nor a vaccine to prevent this deadly disease. Yet AIDS is a preventable disease; AIDS is first and foremost a consequence of behavior. It is not who you are, …

An Overview Of The Effectiveness And Efficiency Of Hiv Prevention Programs, D. R. Holtgrave, Noreen L. Qualls, J. W. Curran, Ronald O. Valdiserri, Mary Guinan, William C. Parra

School of Public Health Faculty Research

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly …

Suppressive Effects Of Transforming Factor-Β And Interleukin-10 On The Cytolytic Activity Of Murine Macrophages And Reversal By Cytokines, Chin-Hung Lin

Loma Linda University Electronic Theses, Dissertations & Projects

In this study, the suppressive effects of transforming growth factor-β (TGF-β) and interleukin-10 (IL-10) on peritoneal macrophage killing of H238 target cells and the potential for reversal of the immunosuppressive effect by IL-4 and interferon-γ (IFN-γ) were investigated. The responsiveness of naive and peptone-activated macrophages was compared. The cytolytic activity for tumor cells of these effector cells was measured by percent lysis of ³H-thymidine labeled Herpes simplex virus type 2-transformed tumor cells (H238). After 18-24 hours of incubation with TGF-β or IL-10, the cytolytic activity of macro-medium alone. The immunosuppressive effect of TGF-β or IL-10 on non-activated macrophages was …

Finding Hiv-Infected Women - The Clinician's Role, Mary Guinan

School of Public Health Faculty Research

An estimated 100,000 women are currently infected with the human immunodeficiency virus (HIV) in the United States, and a great majority of them are unaware of their condition. Approximately 20,000 HIV-infected women were identified through publicly funded HIV screening programs in 1989 and 1990, and an unknown number through private screening. Because most HIV-infected women are believed to be in the lower socioeconomic strata, it is unlikely that a significant number were identified in the private sector. Therefore, up to 80% of HIV-positive women may not know they are infected.

Prostitution And Hiv Infection: Women, Aids, & Activism, Polly Thistlethwaite, Zoe Leonard

Publications and Research

This "Prostitution and HIV Infection" chapter of the ACT UP/NY Women & AIDS Book Group's Women, AIDS & Activism reflects the scientific, feminist, gay, lesbian, HIV-community work that informed ACT UP/NY's activism and analysis on women and HIV infection up to 1990. Book Group members: Marion Banzhaf, Cynthia Chris, Kim Christensen, Alexis Danzig, Risa Denenberg, Zoe Leonard, Deb Levine, Samuel Lurie, Monica Pearl, Catherine Gund, Polly Thistlethwaite, Judith Walker, and Brigitte Weil. Additional members of the original Women and AIDS Handbook Group included Jamie Bauer, Heidi Dorow, Maria Maggenti, Ellen Neipris, Ann Northrop, Sydney Pokorney, Karen Ramspacher, Maxine Wolfe, and …

What Is The Health Impact Of Day Care Attendance On Infants And Preschoolers?, Ruth L. Berkelman, Mary Guinan, Phen B. Thacker

School of Public Health Faculty Research

The impact of various child care arrangements on the health of infants and preschool children is not known in any systematic way, yet by 1990 more than 10 million of these children may be receiving their care in day care facilities (1). Concerns over the health of these children and health practices within day care facilities have already led some States to place regulation of day care facilities under the jurisdiction of the department of health (2,3), and others are presently considering such legislation. In addition, the American Academy of Pediatrics has recently published "Health in Day Care," a manual …

Women And Aids: The Future Is Grim, Mary E. Guinan, Ann Hardy

School of Public Health Faculty Research

Recently, we analyzed the reported cases of acquired immunodeficiency syndrome (AIDS) in women in the United States.1 We found two areas of great concern: first, women are more likely than men to acquire AIDS through heterosexual intercourse, and second, women are the source of disease for about 80% of children with AIDS. In this column we will discuss the source and distribution of AIDS in women, and in a future piece we will discuss women as the source of infection for pediatric AIDS cases.

Women, Children And Aids, Mary Guinan

School of Public Health Faculty Research

More than 500 cases of acquired immune deficiency syndrome (AlDS) in children (ages I3 and under) had been reported to the Centers for Disease Control as of August , 1987. Of these children, 78% were infected perinatally by their mothers. The ratio of AIDS cases among women to AIDS cases among ; i children has remained stable at approximately 5:1 for several years. So, for the foreseeable future, we can expect that for every five reports of women with AIDS, one child with AIDS will be reported. As is the CMe with other sexually transmitted diseases, AIDS causes a disproportionately …

Letter To The Editor (Human Immunodeficiency Virus In Costa Rica), Mark W. Oberle, Charles A. Schable, Mary Guinan, Luis Rosero

School of Public Health Faculty Research

Recent reports of 12 confirmed cases of acquired immunodeficiency syndrome (AIDS) in Costa Rica have generated interest in the extent of spread of human T-lymphotropic virus type III/LAV (HTLV-III) in Latin America (1). To date, all cases of AIDS in Costa Rica have occurred in members of previously identified, high-risk groups, chiefly hemophiliacs. To examine the possibility of heterosexual transmission in Costa Rica, we utilized sera collected in a population-based case-control study of cervical cancer, conducted by the Costa Rican Demographic Association and other institution.

Heterosexual And Homosexual Patients With The Acquired Immunodeficiency Syndrome: A Comparison Of Surveillance, Interview, And Laboratory Data, Mary Guinan, Pauline A. Thomas, Paul F. Pinksy, James T. Goodrich, Richard M. Selik, H W. Jaffe, H W. Haverkos, Gary Noble, J W. Curran

School of Public Health Faculty Research

Homosexual and heterosexual patients with the acquired immunodeficiency syndrome were compared by risk group. Race; diagnoses; history of sexually transmitted diseases, sexual behavior, and drug use; and socioeconomic indicators differed considerably among the risk groups, suggesting different risk factors for acquisition of the syndrome. Patients in the homosexual, intravenous drug user, and Haitian risk groups differed in their serologic response to cytomegalovirus and syphilis testing, presumably due to lifestyle-related exposures. Differences in the rate of recovery of cytomegalovirus, serum levels of IgA and IgG, and antibody titers to Epstein-Barr virus were noted among patients with different diagnoses. We conclude that …

National Case-Control Study Of Kaposi's Sarcoma And Pneumocystis Carinii Pneumonia In Homosexual Men: Part 1. Epidemiologic Results, Harold W. Jaffe, Keewhan Choi, Pauline A. Thomas, Harry W. Haverkos, David M. Auerbach, Mary E. Guinan, Martha F. Rogers, Thomas J. Spira, William W. Darrow, Mark A. Kramer, Stephen M. Friedman, James M. Monroe, Alvin E. Friedman-Kien, Linda J. Laubenstein, Michael Marmor, Bijan Safai, Selma K. Dritz, Salvatore J. Crispi, Shirley L. Fannin, John P. Orkwis, Alexander Kelter, Wilmon R. Rushing, Stephen B. Thacker, James W. Curran

School of Public Health Faculty Research

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, …