Women and AIDS: The Future is Grim

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

Osteoporosis and ERT--The Jury is Still Out

Bone loss in women accelerates immediately after menopause, often leading to osteoporosis and an increased risk of bone fractures. In 1985,247,000 hip fractures occurred in people over 45 years of age. Among those who live to be 90, one-third of women and one-sixth of men will experience hip fractures. Six months after fracture, 25% of victims will not be able to carry out their usual activities, and 50% will need assistance to do so. Hip fractures are not only a serious cause of morbidity but they also increase the risk of mortality in older people. Because the proportion of the population over 65 will increase steadily, from 11% in 1981 to 22% in 2050, the estimated number of hip fractures will triple by the year 2050

National Case-Control Study of Kaposi\u27s Sarcoma and Pneumocystis Carinii Pneumonia in Homosexual Men: Part 1. Epidemiologic Results

To identify risk factors for the occurrence of Kaposi\u27s 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\u27s 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, cases were also more likely to have been exposed to feces during sex, have had syphilis and non-B hepatitis, have been treated for enteric parasites, and have used various illicit substances. Certain aspects of a lifestyle shared by a subgroup of the male homosexual population are associated with an increased risk of Kaposi\u27s sarcoma and pneumocystis pneumonia

Black communities' belief in “AIDS as genocide”☆A barrier to overcome for HIV prevention

The belief that acquired immunodeficiency syndrome (AIDS) is a form of genocide targeted at the black population is prevalent in black communities in the United States. Public health authorities are distrusted, in part because of the legacy of the Tuskegee Study of untreated syphilis, a perceived racist experiment. For effective interventions to prevent the transmission of human immunodeficiency virus in black communities, genocidal fears and beliefs must be addressed and black community leaders should be involved in planning and implementation.http://dx.doi.org/10.1016/1047-2797(93)90136-

National Surveillance for Neonatal Herpes Simplex Virus Infections

To explore the magnitude and descriptive epidemiology of neonatal herpes simplex virus (HSV) infection, the Centers for Disease Control (CDC) conducted an 18-month hospital-based surveillance study in which 184 cases were reported. Only 22% of mothers had a history of genital HSV infection and only 9% had genital lesions at the time of delivery. Cesarean delivery initiated prior to membrane rupture failed to prevent infection in the 15 cases. These data confirm previous observations that most mothers of infected neonates have no history of genital HSV and are asymptomatic at delivery. Furthermore this study suggests that intrauterine infection may be an important route of transmission and underscores the limitations of current prevention strategy

Topical Ether and Herpes Simplex Labialis

In a double-blind, placebo-controlled study, 51 patients with recurrent herpes simplex labialis were treated with topical ether or placebo within 24 hours of onset of a lesion. There was no noteworthy difference between groups given ether and placebo in progression of lesions, healing time, duration or intensity of pain, and duration or quantity of virus excretion. The ether also failed to reduce appreciably lesion virus titer, even when lesions were cultured immediately after topical application. Despite these results, 75% of the patients receiving ether and 77% of those receiving placebo reported effective reduction of the severity and duration of lesions. The marked placebo effect in the treatment of recurrent herpes infection helps to emphasize the need for objective measurements and placebo-controlled studies

The Course of Untreated Recurrent Genital Herpes Simplex Infection in 27 Women

GENITAL herpes simplex infection affects an unknown but ever increasing number of persons in the United States. Because of the lack of a national surveillance system, no reliable data are available to determine either the magnitude or the growth rate of this problem. However, reports from three different parts of the country indicate that genital herpes is diagnosed more frequently than gonorrhea in women visiting private gynecologists.1 2

Effect of Treatment Regimens for Neisseria gonorrhoeae on Simultaneous Infection with Chlamydia trachomatis

We evaluated the effect of treatment for gonorrhea on simultaneous Chlamydia trachomatis infection by randomly assigning 293 heterosexual men and 246 heterosexual women with gonorrhea to receive one of the following treatment regimens: (1) 4.8 million units of aqueous procaine penicillin plus 1 g of probenecid, (2) nine tablets of trimethoprim–sulfamethoxazole daily for three days, or (3) 500 mg of tetracycline four times a day for five days. Among the men, gonococcal infection was cured in 99 per cent given penicillin plus probenecid, 96 per cent given trimethoprim–sulfamethoxazole, and 98 per cent given tetracycline. Among the women, only 90 per cent given tetracycline were cured, in contrast to 97 per cent given penicillin plus probenecid and 99 per cent given trimethoprim–sulfamethoxazole. Chlamydial infection, present in 15 per cent of the men and 26 per cent of the women, was cured in 30 of 32 patients given trimethoprim–sulfamethoxazole and 27 of 29 given tetracycline, but in only 10 of 23 given penicillin plus probenecid. Among chlamydia-positive patients, postgonococcal urethritis in men and cervicitis in women occurred more often in patients given penicillin plus probenecid. Salpingitis developed in 6 of 20 women given penicillin plus probenecid, but in only 1 of 26 given trimethoprim–sulfamethoxazole and in none of 24 given tetracycline. We conclude that the use of penicillin plus probenecid alone for gonorrhea in heterosexual patients carries an unacceptably high risk of postgonococcal chlamydial morbidity. Trimethoprim–sulfamethoxazole and tetracycline were highly effective against both pathogens and were well tolerated in men, but both drugs caused frequent side effects in women. The failure of tetracycline to cure gonorrhea in 10 per cent of women argues against its use alone; treatment with penicillin followed by tetracycline has been recommended for further trial

Herpes simplex virus type 2 antibodies: high prevelence in monogamous women in Costa Rica

Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1989We studied the prevalence of antibody to Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 766 randomly selected Costa Rican women 25-59 years of age in a national household survey in 1984-1985. Overall, 97.1% were seropositive for HSV-I and 39.4% for HSV-2. Only 1.1% of HSV-2 seropositive women gave a history of symptomatic genital herpes. HSV-2 virus antibody increased with age and with the number of lifetime sexual partners. HSV-2 seroprevalence among women who reported only 1 lifetime sexual partner was almost twice as high as the prevalence among women who denied sexual experience (30.5% vs. 17.7%) and reached 79.2% among women with 2-.4 partners. HSV-2 seroprevalence was lower among women whose partners used condoms: 28.9% for those who had used condoms for at least 2 years vs 44.3% for those who never used condomsUniversidad de Costa Rica. Instituto de Investigaciones en Salud.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones en Salud (INISA