Epidemiology Commons^™

Neuropsychiatric Complications Of Hiv Infection: Public Policy Implications, Alexandra Beckett, Theo Manschreck

New England Journal of Public Policy

The human immunodeficiency virus (HIV) infects the central nervous system (CNS), causing symptoms in most persons with AIDS-related complex (ARC) and AIDS, and in a significant proportion of those classified as asymptomatic seropositive. The most common clinical syndrome secondary to CNS infection is known as HIV encephalopathy. When sufficiently disabling, HIV encephalopathy is known as AIDS dementia, and must be reported to the Centers for Disease Control as a case of AIDS.

AIDS dementia is a complex of cognitive, affective, behavioral, and motor symptoms which varies widely in its presentation. In some persons, cognitive impairment predominates, manifesting in a loss …

Understanding The Psychological Impact Of Aids: The Other Epidemic, Marshall Forstein

New England Journal of Public Policy

HIV has created two epidemics, one of disease, the other the consequence of the psychological response to that disease. Thus far, behavioral change is the only effective means of interrupting the transmission of HIV. The underlying psychological dimensions of the societal and individual responses to AIDS are discussed, with suggestions for how both rational thinking and irrational fears and anxiety contribute to the development of public policy. Examples are given of how short-term solutions to reduce anxiety may actually create long-term problems, potentially increasing the risk of transmission of HIV. Specific psychological mechanisms that contribute to the epidemic of fear …

Ethical Issues In Aids Research, Michael A. Grodin, Paula V. Kaminow, Raphael Sassower

New England Journal of Public Policy

There is a need for carefully controlled and scientifically rigorous research studies of the acquired immunodeficiency syndrome (AIDS). The morbidity and mortality associated with AIDS patients and the public health concerns for control of this epidemic have distorted the usual process of research. The Institutional Review Board at Boston City Hospital is suggested as an appropriate mechanism for clarifying the distinctions between research and innovative therapies and for assuring the protection of this vulnerable population of research subjects. This article addresses ethical concerns relating to the time frame of research, drug and antibody testing, vaccine trials, and questions of justice …

Minorities And Hiv Infection, Veneita Porter

New England Journal of Public Policy

This article discusses a preliminary comparison of responses to AIDS in ethnic communities and their basis in previously established support systems. The importance of public policy and its connection to racism and cultural insensitivities are discussed as they relate to communities of color at risk. Particular attention is paid to problems of communication and to the ethics involving confidentiality.

Call To Action: A Community Responds, Larry Kessler, Ann M. Silvia, David Aronstein, Cynthia Patton

New England Journal of Public Policy

This article will examine the early formation of the AIDS Action Committee of Massachusetts, and what it has become. It will examine particular philosophical and organizational conflicts, some unique to AIDS organizing, that have influenced the direction the group has taken. It will try to tease out some of the factors that have made the organization successful in delivering services, providing education, and affecting city and state policy. It will also examine some of the unresolved conflicts that threaten the organization.

Aids Public Policy: Implications For Families, Elaine A. Anderson

New England Journal of Public Policy

Much has been written about the AIDS crisis in the past few years. However, relatively little of this discussion has focused on AIDS as it may affect families. This report emerged from the 1987 Groves Conference on Marriage and the Family. It is a version of the chapter on public policy in AIDS and Families (ed. Eleanor Macklin, Hayworth Press, forthcoming, summer 1988), prepared by the conference's Task Force on AIDS and Families. The book details the probable impact of AIDS on individuals, families, and communities and delineates the implications for relevant professionals, organizations, and public policy. Those individuals who …

The Acquired Immunodeficiency Syndrome In New England: An Epidemiological Review Of The First Six Years, Laureen M. Kunches, Jeanne M. Day

New England Journal of Public Policy

Between 1981 and 1987 — the six-year period following initial recognition of the acquired immunodeficiency syndrome (AIDS) — 1,475 cases were reported among residents of the six New England states. Of nearly 40,000 cases nationwide, 3.8 percent occurred among New England residents, though the region 's population represents 5.5 percent ofthe total United States population. The groups most affected include homosexual or bisexual men (65 percent) and intravenous drug users (20 percent). However, in the two southernmost states — Rhode Island and Connecticut — 32 to 40 percent of all cases have used intravenous drugs. In these states, the male:female …

The Hiv Seropositive State And Progression To Aids: An Overview Of Factors Promoting Progression, Paul H. Black, Elinor M. Levy

New England Journal of Public Policy

We have considered factors that predispose to infection by the human immunodeficiency virus as well as the clinical consequences of infection. We have also reviewed what is known about the virological status of the asymptomatic carrier, particularly the female, and the fact that pregnancy may be a cofactor for progression of HIV disease in seropositive women. Additionally, we have discussed several other cofactors that may promote the progression of HIV infection. These include intercurrent infection, excessive use of recreational drugs and alcohol, malnutrition, and stress. With respect to stress, we have reviewed evidence indicating that certain personality factors, by buffering …

Aids: Prophecy And Present Reality, Victor De Gruttola, William Ira Bennett

New England Journal of Public Policy

Mathematical modeling of the AIDS epidemic can be useful for policymakers even though precise projections are not possible at this time. Models are useful in establishing ranges for current and future prevalence of HIV infection and incidence of AIDS, as well as in predicting the effect of a given intervention strategy. Most decision makers are using models implicitly when they use epidemiological information as a basis for policy; formulating a model explicitly permits examination of the underlying assumptions. By creating and testing a variety of models, an investigator can determine whether the models reflect more the underlying assumptions or the …

The Quest For An Aids Vaccine, Robert T. Schooley

New England Journal of Public Policy

More than fifty thousand cases of AIDS have been reported in the United States since the disease wasfirst described in 1981. Many times this number of people are infected with human immunodeficiency virus (HIV), which has been identified as the agent responsible for the illness. The seriousness of the disease, coupled with the relatively rapid spread of HIV, has fueled the effort for development of an effective vaccine.

Much is now known about the life cycle of the virus, and about its structural components. This information, and information about methods of transmission of the virus, form the basis for a …

Hiv Antibody Screening: An Ethical Framework For Evaluating Proposed Programs, Ronald Bayer, Carol Levine, Susan M. Wolf

New England Journal of Public Policy

The acquired immunodeficiency syndrome (AIDS) poses a compelling ethical challenge to medicine, science, public health, the legal system, and our political democracy. This report focuses on one aspect of that challenge: the use of blood tests to identify individuals who have been infected with the retrovirus human immunodeficiency virus (HIV). In this article, we follow the terminology recently proposed by the International Committee on the Taxonomy of Viruses; that is, we use the term human immunodeficiency virus. This replaces the more cumbersome dual terminology of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV).

The issue is urgent: the tests are …

Aids Initiatives In Massachusetts: Building A Continuum Of Care, Nancy Weiland Carpenter

New England Journal of Public Policy

The Health Resource Office was officially established within the Massachusetts Department of Public Health in August 1985 to coordinate policy, education, research, and service response to the AIDS epidemic, and to focus attention on the social and economic impact of the disease. The actual work of the office was begun earlier, in October 1983. This article reviews the activities of the Health Resource Office from October 1983 through June 1987 in allocating resources for AIDS and ARC programs and services. It then describes the conceptual model that evolved during this period for the continuum of services needed to reduce HIV …

U.S. Women And Hiv Infection, P. Clay Stephens

New England Journal of Public Policy

Women are inadequately provided with HIV services and education and are differentially denied access to these. Divisions of race, ethnicity, economic class, and religion, among others, are compounded by sexual discrimination within each of these categories.

Review of current data on women with AIDS reveals that the reporting methods used convey a false impression that women are not at significant risk. Moreover, the persons indirectly affected by AIDS are predominantly women — mothers, sisters, partners, family members, teachers, and human service workers. Thus, AIDS is more of a women's issue than the statistics imply.

Women, as a gender-defined class, face …

Aids In Children: An Overview Of The Medical, Epidemiological, And Public Health Problems, Ellen R. Cooper

New England Journal of Public Policy

Cases of AIDS in children under thirteen years of age have been described since 1982. Diagnosis is more difficult in children than in adults, owing to the more varied clinical presentation and the difficulty in interpretation of laboratory tests. Current diagnostic criteria of HIV infection are reviewed, as well as symptomatology, natural history, and controversies surrounding management and therapy. Without a full appreciation of the transmissibility of HIV, issues including school and day-care attendance and foster family placement remain emotionally charged. Conflicting public policies contribute to fears on the part of the general public. Because ofthe unique implications for the …

Hiv Antibody Testing: Performance And Counseling Issues, Michael Gross

New England Journal of Public Policy

This article assesses the performance of currently used tests for exposure to human immunodeficiency virus (HIV), the infectious agent associated with acquired immunodeficiency syndrome (AIDS); suggests, in view of that information, guidelines for counseling people seeking HIV antibody testing; and evaluates the claim that because antibody test results will effect behavior change in those who are infected, all members of high-risk groups should be tested.

HIV testing is likely to yield a high proportion of false-positive results in low-risk populations and infants born to infected mothers. A negative result may not establish freedom from infection in high-risk groups or the …

Human Immunodeficiency Virus In Intravenous Drug Users: Epidemiology, Issues, And Controversies, Donald E. Craven

New England Journal of Public Policy

Intravenous drug users are the second most common risk group for acquired immunodeficiency syndrome (AIDS) in the United States, and they account for approximately 25 percent of the cases. Drug users may spread human immunodeficiency virus (HIV) by sharing contaminated drug injection paraphernalia and through sexual contact; women who use drugs can transmit the virus to their children. The rapid spread of HIV in this risk group and the fact that intravenous drug users are a source for heterosexual and perinatal transmission underscore the need for immediate intervention. In addition, many drug addicts are poor, have limited career possibilities, and …

Case-Control Study Of Vitamin A Intake And Colorectal Cancer In Seventh-Day Adventists, John William Morgan

Loma Linda University Electronic Theses, Dissertations & Projects

Colorectal cancer is the second most common cause of cancer deaths in Americans; producing approximately 60,000 deaths in Americans each year. Studies of high and low risk populations have suggested a dietary etiology for colorectal cancer, although investigations of specific dietary factors have produced inconsistent results.

Population based studies of California Seventh-day Adventists demonstrate dietary variety regarding factors suspected as important in the etiology of colorectal cancer. These studies document a substantially reduced mortality and incidence from colorectal cancer in Seventh-day Adventists when compared to other California Populations. Although specific reasons for this difference remain obscure, the 'Unique lifestyle and …

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.

Ua37/30/2 Wku Research Notecards - F Topics, Lowell Harrison

Faculty/Staff Personal Papers

Notecards created by Lowell Harrison while researching his book Western Kentucky University. The cards transcribed below are for 259 topics beginning with F ranging from Faculty - Hunt to Future of Education.

Ua37/30/2 Wku Research Notecards - H Topics, Lowell Harrison

Faculty/Staff Personal Papers

Notecards created by Lowell Harrison while researching his book Western Kentucky University. The cards transcribed are for 108 topics beginning with H ranging from Hail Storm to Hundred Club.

Chronic Respiratory Disease Symptom Effects Of Long-Term Cumulative Exposure To Passive Tobacco Smoke And To Ambient Levels Of Tsp, Oxidants, So2, And No2 In Southern California, Gary L. Euler

Loma Linda University Electronic Theses, Dissertations & Projects

To assess risk of chronic respiratory disease symptoms due to long-term exposure to the ambient levels of TSP, oxidants, SO2 and NO2 in photochemical air pollution, symptoms were ascertained using NHLBI questions on 8,572 Southern California Seventh-day Adventist, nonsmokers, 25 years and older, who lived eleven years or longer in their 1977 residential area. Tobacco smoke, active and passive, and occupational exposures were measured by questionnaires, as well as lifestyle characteristics relative to pollution exposure such as time spent outside and residence history. A pulmonary function feasibility study was done on a subsample of 86 women 50-64 years of age …

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 …

Sources Of Nosocomial Infections In Immunocompromised Patients (Letter), B. Burt Gerstman

Faculty Publications

No abstract provided.

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, …

Terence E. Hays' Review Of Judith Farquhar And D. Carleton Gajdusek's Kuru: Early Letters And Field Notes From The Collection Of D. Carleton Gajdusek, Terence E. Hays

Pacific Studies

No abstract provided.

Sero-Epidemiology Of Q Fever With Special Reference To Complications In A Hospital Population Of Southern California, Ajit Singh Randhawa

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

Ua11 Remember When? - Pest House, Wku Public Affairs

WKU Administration Documents

Press release regarding the razing of the Guest House which had been used for quarantines during the 1920s and called the Pest House.

Transactions Of The Plague Control Conference Of The United States Public Health Service And Twelve Western States, United States Public Health Service

Elusive Documents

The plague problem is potentially of grave public health importance. The history of this disease over a period of centuries shows that it has several times assumed epidemic proportions, especially in cities. History also shows that when the disease appears in bubonic form contracted from rat fleas, it sooner or later may assume the pneumonic type and be spread from person to person with fatal results.

From the evidence presented to the conference it appears that complete control of plague is not economically feasible without a great increase in Federal, State, and local expenditures. It is recommended that funds are …

Ua3/1/2/1 Correspondence - Jones, Wku President's Office - Cherry

WKU Administration Documents

Letter from Mattie McLean to Ollie [Olive] Jones former mathematics teacher at WKU regarding appropriations, construction, former and current teachers at WKU and the diseases of measles, influenza, scarlet fever and smallpox.

Ua3/1/2/1 Correspondence - Bradner, Wku President's Office - Cherry

WKU Administration Documents

Letter from Mattie McLean to Mrs. G.W. Bradner regarding her son Raymond's bout with smallpox. The letter describes how students are quarantined in a building on the edge of campus for a period of time prescribed by doctors.