Nature Of HIV Infection Research Articles

Chronic ulcerating genital herpes simplex virus infection: A diagnosis mislead by HIV infection

We report a case of chronic herpes simplex in a 27 year old lady presenting with a history of persistent verrucous ulcer in the natal cleft of nine months duration. The patient was diagnosed and treated initially as a case of Tuberculosis Verrucosa Cutis (TVC) based on the chronicity of the ulcer, negative HIV serological tests and histopathological findings. The diagnosis had to be revised as the lesion was increasing in size and the patient was not responding to treatment even after completing antituberculous treatment for six months. Repeat histopathological examination and immunohistochemistry showed DNA of herpes simplex. Based on this finding a repeat HIV serology was sent which was positive. The ulcer healed after a course of acyclovir. The case is being reported to highlight the importance of considering chronic herpes simplex infection in a case of chronic genital ulcer. In addition this case reminds us the nature of HIV infection to mislead the diagnosis by altering the natural course of the disease process.

Social rebirth and social transformation? Rebuilding social lives after ART in rural Uganda

This paper examines how HIV diagnosis, illness and anti-retroviral therapy (ART) have an impact on the social dimensions of people's lives in rural Uganda, focusing on identity, relationships and membership of groups. Using concepts drawn from sociological research on experiences of illness and recovery, “getting back to normal”, “rebirth” and “turning point”, we present findings from qualitative research that explored the social changes brought about by HIV and ART among 70 men and women taking ART since 2003. With a second chance at life, some people's narratives revealed a pursuit of getting “back to normal”, restoring and resuming their place in their families and communities. Others sought to change or transform their new lives, what we term a “social rebirth”, moving away from old social networks and lifestyles. Regaining health was associated with a desire to make the most of life by joining social groups and civil society organisations, establishing new relationships and advising and supporting others. However, earlier losses of family and friends due to AIDS-related deaths made “social rebirth” hard for many people. Our findings also show that the process of responding to ART is not linear and the pursuit of change following diagnosis and treatment may be difficult to sustain, as the months and years on ART progress and the struggles of getting on with life take their toll. Sustaining social rebirth was challenging and complex due to the nature of HIV infection itself (for example, new intimate relationships pose challenges) and the harsh economic environment. Maintaining changed lives for those living with HIV and ART is important because this will contribute to better disease self-management and so demands an understanding by support organisations of the nature of these changes and challenges.

Urologic complications of HIV and AIDS

In recent years the nature of HIV infection has been dramatically transformed from an invariably fatal disease to a chronic disorder with a relatively benign course. Disease progression from HIV to AIDS and HIV-related mortality can be reduced effectively by several years of treatment with highly active antiretroviral therapy (HAART). For patients who do not have access to HAART, HIV infection continues to be a lethal disorder characterized by opportunistic infection with uncommon organisms (e.g. mycobacteria, fungi, parasites and viruses), as well as lethal malignancies such as Kaposi sarcoma, non-Hodgkin lymphoma and squamous cell carcinoma of the penis or cervix. In patients receiving HAART, urologic complications are likely to be caused by adverse effects of antiretroviral medication (e.g. indinavir urolithiasis) or disorders associated with aging, such as benign prostatic hyperplasia and prostate cancer. Prospective clinical trials have shown that adult male circumcision can reduce the rate of female to male HIV transmission by more than 50%; however, the development of preventive or curative modalities with 100% efficacy remains elusive.

Exploring the Concepts of Vulnerability and Resilience in the Context of HIV Infection

Based on the unique physical, psychological, and social nature of HIV infection, clients with HIV infection have been categorized as both vulnerable and resilient in the existing literature. Concept exploration of vulnerability and resilience via an integrative literature review was conducted in order to examine the existing knowledge base of these concepts in the context of HIV infection. Search engines were employed to review the existing data-based sources of vulnerability and resilience with relation to HIV infection. After the integrative literature review, an analysis of vulnerability and resilience in the context of HIV infection emerged. Implications for further concept analysis, theory, research, and practice are presented.

Snapshot of HIV pathogenesis in China

Several reviews have focused on the nature of HIV infection and its spread in various geographical regions of China. In contrast, this review provides a comprehensive update on the prevalence of multiple HIV-1 subtypes, consequent emergence of recombinant and novel forms of HIV-1 in China, and the implications this may have on HIV diversity and the development of effective vaccines. In addition it also examines the dissemination of primary drug resistance in therapy naïve patients, as well as co-infections with two other important viruses-hepatitis B and C. The main purpose of this review is to provide a current snapshot of HIV-1 pathogenesis in China and possibly shed some light on the future of HIV evolution, and potential challenges for future vaccine and anti-retroviral therapeutics against HIV strains in this area.

How HIV infected haemophiliacs in Japan were informed of their HIV-positive status

The purpose of this study is to find out how HIV-infected haemophiliacs were informed and notified of their HIV infection. Self-reporting questionnaires were mailed to approximately 500 patients, about one half of the haemophiliac patients with HIV in Japan. The response rate was about 57% (n=283); and 270 (male=269) patients, apart from secondary and tertiary infected patients, were eligible as subjects for the study. The mean age was 31.2 ± 9.9 years. Of these subjects, approximately 60% did not receive explanation regarding the risk of HIV infection via unheated blood products. More than 60% did not receive notification until 1990, or five years after the test became available in Japan. Contents of the explanations being given at the time of notifications were poor. In this paper, some problems of notifications of medically induced HIV are discussed, and the lack or delay of explanation/notification is concluded to be a consequence of the paternalistic attitudes of Japanese physicians and the iatrogenic nature of HIV infection.

Use of antiretroviral therapy in children and pregnant women.

The pathogenesis and clinical manifestations of HIV infection in children are distinct from the same process in adults, with differences which provide unique opportunities to understand the nature of HIV infection in both categories of patients. Within the pediatric population, the relatively uniform time of infection (close to the time of birth) means that a large group of patients is available for studies of early intervention. In addition, because the disease tends to progress more quickly in children than adults, studies which require clinical endpoints may be able to be completed more quickly or with fewer individuals. Finally, preliminary studies of viral load in infants indicate that their immune system may be unable to control HIV replication well, permitting maintenance of high viral copy numbers at a time when adults have declining amounts of virus. Thus, there may be a particular role for antiviral therapy in the early suppression of virus during infancy, allowing the immune system time to mature in order to respond to the infection.

Changes in public knowledge and attitudes to HIV/AIDS in Wales, 1987 to 1992.

This paper presents information on changes in public knowledge and attitudes to HIV/AIDS in Wales between 1987 and 1992. The results indicate that throughout this period the majority of adults in Wales were aware of the high risk of infection from sexual intercourse and sharing needles with, and coming into contact with the blood of, someone with HIV. Nevertheless, the proportion who said that sexual intercourse with someone with HIV carries a high risk declined, and in 1992 confusion still remained about the nature of HIV infection amongst a substantial minority of respondents. More than one in ten of the adults in the most recent survey were of the opinion that kissing or being near someone with HIV who is coughing or sneezing carries a high risk of infection. The data also indicate that attitudes to those with HIV remained uneven in 1992. Whilst a greater proportion in 1992 than in 1987 held the view that people with HIV should be able to live normally in the community, attitudes appear to have hardened towards those perceived to be practising high risk behaviours, such as injecting drug users and homosexuals. The data also suggest that attitudes appear to be closely related to levels of knowledge. Given the apparent confusion and prejudice highlighted by the surveys, it is suggested that there is a continuing need for general campaigns to maintain public awareness of HIV-related issues, although this must also be complemented by more in-depth targeted education programmes.

Peer Education in the Residential Context

Research on HIV-prevention education with college students has demonstrated that interventions that provide only information do not bring about risk-reducing changes in behavior. Given the chronic nature of HIV infection, as well as data that show that students do not consistently use condoms and practice safer sex, peer education programs dealing with sexually transmitted diseases need to focus on strategies that have demonstrated success in encouraging behavioral changes. A one-on-one program at the State University of New York (SUNY) at Stony Brook has shown how students' understanding of risk reduction can help bring their behavior into accord with their knowledge.

HIV education for youth: The importance of social consensus in behaviour change

Most theories of health education focus on change in the knowledge, beliefs, and skills of individuals as causes of behaviour change. We argue that this neglects the important contribution of the social environment in supporting healthier behaviour, and we describe a model of social consensus that allows alternative routes for educational influence at both individual and social levels. This model assumes that basic knowledge and skills for avoiding health threats may not be sufficient for behaviour change unless socially-mediated influences that can inhibit behaviour change are addressed. This is especially crucial given the nature of HIV infection and the controversy surrounding its discussion. We illustrate the potential for social influences to have played a role in inhibiting the adoption of safer sexual behaviour in young people, and use our model to analyse young people's responses to the epidemic as documented in available research. The analysis also suggests possible educational strategies to overcome social obstacles in the future.

HIV Infection, AIDS and Occupational Therapy

Occupational therapists need to be informed about the nature of HIV infection and AIDS, both as care providers and in terms of occupational health and safety. An overview of the natural history of the HIV and the consequences of infection is given. Safety procedures are outlined and the contribution that occupational therapists can make to the health maintenance of HIV-infected patients is described.

HIV infection and AIDS: A guide for physiotherapists

Physiotherapists need to be informed about the nature of HIV infection and AIDS, both as care providers and in terms of occupational health and safety. An overview of the natural history of the human immunodeficiency virus and the consequences of infection is given. Safety procedures are outlined and the contribution that physiotherapists can make to the health maintenance of HIV infected patients is briefly described.

Public knowledge and attitudes to AIDS

Three independent cross-sectional surveys of public knowledge and attitudes about AIDS were conducted on a representative sample of people aged 15-54 resident in Wales. 1,303 were interviewed in their homes in February 1987, 683 in September 1987 and 676 in March 1988. The results show that most people knew that having sexual intercourse or sharing needles with people with AIDS represented a high risk of catching AIDS. However there appeared to be considerable misunderstanding about the nature of HIV infection such that one in three thought that a man and woman with a single heterosexual partner was at high or moderate risk of catching AIDS. The high level of concern coupled with considerable confusion appears to have contributed to both unnecessary anxiety and prejudice. One in four people thought that kissing or being spat on by a person with AIDS represented a high or moderate risk, and one in six thought that coughing, sneezing and sharing towels, soap, drinking utensils or lavatory seats were routes of transmission. More than 50% of men and 40% of women said that it was their own fault if homosexuals and drug addicts got AIDS and did not feel sorry for them. It is concluded that action to date to limit the spread of AIDS has informed but not yet adequately educated the public. If unwanted anxieties and prejudice are to be diminished, initiatives by government, health services and others must now concentrate on developing understanding about the nature of HIV infection and its spread through more personal education.(ABSTRACT TRUNCATED AT 250 WORDS)