Population In New York Research Articles

Improving adolescent preventive services through state, managed care, and community partnerships

Purpose To develop and evaluate a multipronged, guideline-based initiative to improve quality of adolescent preventive care. Methods Activities included: (a) academic institution-based grand rounds and insurance company-sponsored community rounds continuing education sessions on preventive care for primary care clinicians, (b) academic detailing during chart review visits to practices by nurse reviewers, to encourage adolescent-specific confidentiality policies and use of screener or trigger questionnaires during well visits, and (c) partnerships with community corporate leaders to promote awareness of quality preventive services. Interventions were evaluated by comparing 2000 and 2001 chart reviews for rates of tobacco use, substance use, and human immunodeficiency virus (HIV) prevention screening and counseling. Results A total of 285 clinicians attended continuing education (CE) sessions and 96 offices received detailing visits. Improvements in adolescent preventive health services delivery were noted in both commercial and Medicaid populations. We found the following when comparing 2001 results with those from 2000: Tobacco use screening or counseling increased from 42.5% to 45.5% for the commercial population and from 32.0% to 43.5% for the Medicaid population; substance use screening increased from 42.5% to 44.0% for the commercial population and from 32.0% to 43.5% for the Medicaid population. HIV counseling increased from 26.5% to 35.5% for the commercial population, and from 28.0% to 40.0% for the Medicaid population (all Medicaid and HIV differences are significant at p < .05). Conclusions These activities have been successful in improving adolescent preventive services for Medicaid populations in New York. Academic detailing can assist health plans in promoting preventive care improvements by primary care clinicians. Further measurement is needed to assess the effect on commercially insured populations.

Advocacy and Enumeration

Enumerating or estimating the numbers of homeless people has become an important research activity in the past few decades. The methodologies of almost all efforts to count homeless people have been closely linked to advocacy activities such as providing shelter and food to those in need. Yet the effect of advocacy work on estimating or enumerating homeless populations has not been much examined in the enumeration literature. This work reviews the methodology of enumeration as it has been influenced by the work of advocates both in general terms and through examining the methods used to conduct a study of a suburban homeless population in New York in 1994. Enumeration methods that overtly take local advocacy activities into account can provide an enriched assessment of homelessness as it exists in relation to surrounding structural conditions. In this case, advocacy work actively prevented literal homelessness for most families in the local community.

Prostate Cancer Screening Trends of New York State Men at Least 50 Years of Age, 1994 to 1997

Background. Despite the lack of consensus on prostate cancer screening recommendations, men are being screened at high rates in some states. Our objective was to examine the trends in prostate cancer screening awareness and practices from 1994 through 1997 and the relationship among screening practices and demographic characteristics, perceived risk, and family history of prostate cancer.Methods. Data from the New York State Behavioral Risk Factor Surveillance System surveys and questionnaire modules on prostate cancer screening were used for this study, which excluded men younger than 50 years of age and men with a history of prostate cancer. The questionnaires were administered by random-digit-dialed monthly telephone surveys of the civilian, noninstitutionalized adult population in New York State.Results. A total of 295, 336, 273, and 448 men, the vast majority of whom were white, met the study criteria for 1994, 1995, 1996, and 1997, respectively. Each year the percentage of men who reported having heard of the prostate specific antigen (PSA) test increased (test for trend, P < 0.001). Among those who had heard of the PSA test, the percentage who reported having had a PSA test increased steadily from 1994 to 1997. About 30% of the men in each year's study did not have an impression of their risk of getting prostate cancer.Conclusions. Given the increasing rate at which men are reporting being screened for prostate cancer and given their reported perceived risk levels, perhaps more needs to be done to educate men about screening implications and personal risk for prostate cancer.

Essay: Rediscovering The Social Determinants Of Health

Essay: Rediscovering The Social Determinants Of Health

What works? The Diabetes Care and Information Center.

This report focuses on the contribution of a referral practice that offers specialist diabetes care to a multi-ethnic population in New York, and describes the process and outcome of an intensive management policy that is particularly strong on communication. The Diabetes Care and Information Center (DCIC), which practices shared care with local primary care physicians, has developed a programme of intensive management for Type 1 and Type 2 diabetes based on a detailed initial patient assessment by a physician, nurse-educator and dietician team. The assessment is followed by an individualized programme of patient education that includes a combination of individual and group education, and counselling. Patients are followed up primarily by an educator or a physician, with frequent interdisciplinary communication to optimize self-care procedures. Medication programmes for patients with Type 2 diabetes include monotherapy and combination therapy with oral agents and single or multiple doses of insulin. Metabolic improvement has been demonstrated by significant changes in mean HbA1c. In addition to initial assessment and routine metabolic follow up, the DCIC provides routine screening and treatment for micro- and macrovascular complications of diabetes, which results in early referral to podiatrists, vascular surgeons and ophthalmologists for appropriate preventive care.

Measuring Substance Abuse among the Deaf

This paper presents results from 2 years' experience in attempting to measure the extent of substance abuse within the deaf community, and preliminary findings of substance abuse incidence and prevalence from that effort. It also describes a new technology, the Interactive Video-Questionnaire, developed to interview deaf persons using questionnaires in multi-media format that are manually signed on a computer screen in American Sign Language and Signed English, as well as mouthed in Speechreading—all of which are simultaneously captioned in English text with Touchscreen™ input and automatic data capture. This technology emerged as one product of a Small Business Innovative Research grant from the National Institute on Drug Abuse designed to overcome the difficulties associated with surveying the deaf population and specifically targeted at addressing the extent of substance abuse among the deaf populations in New York and New Jersey.

COMPLEX COLONY STRUCTURE IN SOCIAL INSECTS: II. REPRODUCTION, QUEEN-WORKER CONFLICT, AND LEVELS OF SELECTION.

Differences in colony structure between two populations of the forest ant, Myrmica punctiventris, have had dramatic consequences on allocation to growth and reproduction. A population in Vermont, in which colonies have a single, once-mated queen, shows no evidence of inbreeding or population subdivision and has allocated 25% of sexual reproduction to males in two consecutive years. In contrast, for a population in New York that is facultatively polygynous, we have evidence of microgeographic genetic structure and inbreeding, and the populationwide allocation ratio was extremely male-biased. Additionally, the Vermont population allocated much more energy to sexual reproduction than did the New York population. Detailed analysis of data from the Vermont population, within which colonies undergo a seasonal cycle of expansion to multiple nesting sites (polydomy), gave strong evidence of queen-worker conflict over male allocation and indicated that workers are winning that conflict. Finally, we used contextual analysis to find that fertility selection operates almost exclusively at the level of the individual nest rather than at the higher level of the multinest colony.

The Return of the Alien: Henry James in New York, 1904

The Return of the Alien: Henry James in New York, 1904 Beverly Haviland When Henry James returned to America after his absence of two decades he found to his surprise that he did not return as a native but as an alien. He had expected to feel that he was coming home, and when he got home, he found that there was unexpected company. During his visit and afterwards while he was composing The American Scene, he began a process of redefining his conception of national identity in a way that bears careful consideration for what it suggests about how ethnic and racial identities are formed and transformed over time and under changing circumstances. 1 He suggests a theory of how cultural transformation normally takes place and offers an analysis of how the business culture of America deforms that process. James’s sense of cultural dispossession becomes for him, not a cause for nostalgic bitterness or xenophobia as some have claimed, but a critical resource by means of which he creates a bond of solidarity with all those who have been dispossessed of their heritage, including the people whom we now call Native Americans. Wondering at the process of creating national identity, he asks: Who and what is an alien, when it comes to that, in a country peopled from the first under the jealous eye of history? . . . Which is the American, by these scant measures?—which is not the alien, over a large part of the country at least, and where does one put a finger on the dividing line, or, for that matter, “spot” and identify any particular phase of the conversion, any one of its successive moments? (AS 124) [End Page 257] James rejects the idea that there is a “dividing line” between the native and the alien and that an absolute conversion can take place. He theorizes instead that a kind of hyphenation of cultures is not only possible but highly desirable. James’s greatest fear is not that the already hyphenated Anglo-Saxon cultural dominance would end but that the “‘ethnic’ synthesis” of the new America would not tolerate increasing complexity (139). One consequence of this simplification would be to leave him (as a writer) dispossessed of his native language, just as the “beautiful red man” had been dispossessed of his native land (464). I wonder if we can say that this fear was exaggerated. The work of rethinking his own relation to his national origins, his “supreme relation, . . . one’s relation to one’s country—a conception made up so largely of one’s countrymen and one’s countrywomen,” is provoked, of course, by his being confronted with an enormous change in the population of New York, the city of his birth and his youth (85). In 1904 more than a million immigrants arrived at Ellis Island, and the composition of the population of New York had been under radical revision since James was last in America in the 1880s. James writes that for the native to witness “the visible act of ingurgitation on the part of our body politic and social” performed by Ellis Island is deeply disturbing, as unnerving as seeing “a ghost in his supposedly safe old house” (a metaphor developed in “The Jolly Corner” as the hero of that 1908 story undergoes an identity crisis) (AS 84–5). The native also notices, however, that he is not the only one who feels alienated from his past identity. The alien is also transformed in peculiar ways by the New World, and James is puzzled by the loss of the national characteristics that distinguished, for example, the Italians as he had known them in Italy. Is it possible that the ethnic characteristics that have taken centuries to develop “may really be thus extinguished in an hour. And if they are not extinguished, into what pathless tracts of the native atmosphere do they virtually, do they provisionally, and so all undiscoverably, melt? Do they burrow underground, to await their day again?—or in what strange secret places are they held in deposit and in trust?” (129). This abrupt loss of character in America is not, however, as James sees it, a natural process...

Clinal variation in morphology among eastern populations of the waterstrider,Aquarius remigissay (Hemiptera: Gerridae)

We examined morphological variation among populations of the stream-dwelling waterstrider, Aquarius remigis. A previous analysis of allozyme variation along a transect from southern Quebec to southern North Carolina revealed two distinct ‘types’ of A. remigis, north and south of a transition zone in southern New York and northern Pennsylvania. To assess the concordance of morphological and allozyme differentiation, adults were sampled from 15 populations along the original transect, as well as 11 additional populations in New York, Connecticut and New Jersey. Eight measurements of leg and body size were taken of preserved individuals. Univariate and multivariate analyses (multiple regression, PCA, discriminant analysis) reveal significant differentiation between northern and southern populations with a transition zone between latitudes 39 ∘ and 42 ∘ north. Strong clines within each region and a clear transition between regions support previous suggestions that there are two distinct ‘types’ of this species in eastern North America. The transition zone in morphology coincides with that revealed by the allozyme variation, but extends further south. The covariance of allozyme frequency and morphometric traits suggests that differentiation has occurred through vicariance and secondary contact, and that in this system, cladistic and adaptive differentiation are coupled.

Clinal variation in morphology among eastern populations of the waterstrider, Aquarius remigis Say (Hemiptera: Gerridae)

We examined morphological variation among populations of the stream-dwelling waterstrider,Aquarius remigis.A previous analysis of allozyme variation along a transect from southern Quebec to southern North Carolina revealed two distinct ‘types’ ofA. remigis,north and south of a transition zone in southern New York and northern Pennsylvania. To assess the concordance of morphological and allozyme differentiation, adults were sampled from 15 populations along the original transect, as well as 11 additional populations in New York, Connecticut and New Jersey. Eight measurements of leg and body size were taken of preserved individuals. Univariate and multivariate analyses (multiple regression, PCA, discriminant analysis) reveal significant differentiation between northern and southern populations with a transition zone between latitudes 39∘and 42∘north. Strong clines within each region and a clear transition between regions support previous suggestions that there are two distinct ‘types’ of this species in eastern North America. The transition zone in morphology coincides with that revealed by the allozyme variation, but extends further south. The covariance of allozyme frequency and morphometric traits suggests that differentiation has occurred through vicariance and secondary contact, and that in this system, cladistic and adaptive differentiation are coupled.

Feeding ecology of redside dace,Clinostomus elongatus

Abstract–Redside dace,Clinostomus elongatus(Kirtland), from two populations in New York, USA, consumed adult Diptera; over 85% of the prey taken between April and November was in this order. AdultHilaraspp. (Empididae) were the dipterans consumed most frequently; individuals of this genus represented 70% and 60% of the items consumed by fishes from populations in Allcgheny and Hudson River drainages, respectively. Over 98% of the prey consumed by redside dace was in ten insect orders. Adult and larval chironomids and adult trichopterans were the next most frequently consumed prey. Adult chironomids made up 9% of the diet, by number, in both populations. Adult trichopterans accounted for 2–3% of the items taken. Adult empidids were selected by individuals in both populations. The dominance of flying insects in the diet of redside dace is related to their foraging behavior. These data show that adjacent terrestrial environments may be important to some stream‐dwelling organisms.

Immigration to New York City in the Post–1965 Era: Sex Selectivity and the Economic Role of Women

Center for Migration Studies special issuesVolume 11, Issue 1 p. 46-72 Free Access Immigration to New York City in the Post–1965 Era: Sex Selectivity and the Economic Role of Women Joseph J. Salvo, Joseph J. Salvo Population Division, New York City Department of PlanningSearch for more papers by this author Joseph J. Salvo, Joseph J. Salvo Population Division, New York City Department of PlanningSearch for more papers by this author First published: January 1994 https://doi.org/10.1111/j.2050-411X.1994.tb00102.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References Arnold, F., B. V. Carino, J. T. Fawcett, and I. H. Park 1989 Estimating the Immigration Multiplier: An Analysis of Korean and Filipino Immigration to the United States,” International Migration Review 23: 813– 838. Bouvier, L. F., and V. M. Briggs Jr.. 1988 The Population and Labor Force of New York: 1990 to 2050. Washington, DC: The Population Reference Bureau, Inc. Bryce-LaPorte, R. 1979 New York City and the New Caribbean Immigration,” International Migration Review 13: 214– 233. Donato, K. M. 1990 Recent Trends in United States Immigration: Why Some Countries Send Women and Others Send Men?” Paper presented at 1990 Population Association of America meetings. Toronto, Canada. Donato, K. M., and A. Tyree 1986 Family Reunification, Health Professionals and the Sex Composition of Immigrants to the United States,” Sociology and Social Research 70: 226– 230. Garcia, J. A. 1986 Caribbean Migration to the Mainland: A Review of Adaptive Experiences,” ANNALS 487: 114– 126. Gordon, L. W. 1990 Asian Immigration Since World Wat II.” In Immigration and the U.S. Foreign Policy. Eds. R. Tucker, C. B. Keely, and L. Wrigley. Boulder, CO: Westview Press. Herold, J. M. 1979 Female Migration in Chile: Types of Moves and Socioeconomic Characteristics,” Demography 16: 257– 278. Houstoun, M. F., R. G. Kramer, and J. M. Barrett 1984 Female Predominance of Immigration to the United States since 1930: A First Look,” International Migration Review 18: 908– 963. Keely, C. B. 1989 American Immigration: The Continuing Tradition. Washington, DC: The Portfolio Project – The Coordinating Committee for Ellis Island, Inc. Keely, C. B. 1975 Effects of U.S. Immigration Law on Manpower Characteristics of Immigrants,” Demography 12: 179– 192. Keely, C. B. 1971 Effects of the Immigration Act of 1965 on Selected Population Characteristics of Immigrants to the United States,” Demography 8: 157– 170. Khoo, S-E., P. C. Smith, and J. T. Fawcett 1984 Migration of Women to Cities: The Asian Situation in Comparative Perspective,” International Migration Review 18: 1247– 1263. Kraly, E. P. 1987 U.S. Immigration Policy and the Immigrant Populations of New York.” In New Immigrants in New York City. Ed. N. Foner. New York: Columbia University Press. Massey, D. S. 1988 Economic Development and International Migration in Comparative Perspective,” Population and Development Review 14: 383– 410. New York City Department of City Planning 1992 The Newest New Yorkers: An Analysis of Immigration Into New York City During the 1980s. New York: New York City Department of Planning. Pessar, P. R. 1987 The Dominicans: Women in the Household and Garment Industry.” In New Immigrants in New York City. Ed. N. Foner. New York: Columbia University Press. Reimers, D. M. 1985 Still the Golden Door: The Third World Comes to America. New York: Columbia University Press. Stafford, S. B. 1987 The Cultural Meaning of Race and Ethnicity.” In New Immigrants in New York City. Ed. N. Foner. New York: Columbia University Press. Stark, O., and J. E. Taylor 1989 Relative Deprivation and International Migration,” Demography 26: 1– 14. Stepick, A., and A. Portes 1986 Flight into Despair: A Profile of Recent Haitian Refugees in South Florida,” International Migration Review 20: 329– 350. Tyree, A., and K. Donato 1985 The Sex Composition of Immigrants in the United States,” Sociology and Social Research 69 (July). U.S. Bureau of the Census 1975 Historical Statistics of the United States, Colonial Time to 1970. Washington, DC: U.S. Government Printing Office. U.S. Immigration and Naturalization Service (INS) 1990 Statistical Yearbook of the Immigration and Naturalization Service, 1989. Washington, DC: U.S. Government Printing Office. Citing Literature Volume11, Issue1Special Issue: The Immigration Experience in the United States: Policy ImplicationsJanuary 1994Pages 46-72 ReferencesRelatedInformation

Causes of death among elderly Jews in New York City, 1979-1981.

Important differentials in mortality exist among ethnic and religious groups in the US but available statistics frequently preclude their examination. In the absence of mortality data for US Jews researchers have developed various alternatives, including using New York City's unique coding of death certificates according to religious affiliation of cemetery. Based on mortality rates for a sample of Medicare enrollees assumed to be representative of the Jewish population, in combination with New York City death record data, estimated death rates by sex and cause of death are developed for that city's elderly Jewish population. Comparisons made with rates for the white population of New York indicate low death rates for smoking-related diseases (lung cancer, chronic obstructive pulmonary diseases) among Jewish males. Other findings include above-average mortality from breast cancer among 65-74 year old Jewish women and from pancreatic cancer among Jewish women aged > or = 85. Below average mortality for both sexes is estimated for cerebrovascular disease and accidents, and for males from prostate cancer. The estimates produced are consistent with data from previous studies.

US-Based World Medical Relief Group Finds Charity Begins at Home

DOCTORS of the World, an American-based volunteer organization that provides medical and humanitarian relief to desperate populations around the world, is now providing care in its own home town. Doctors of the World, based in New York, NY, was created with the assistance of the French group Medicins du Monde to help American medical professionals find ways to serve the world's neediest people. Since its founding in 1990, the organization has sent physicians and other medical professionals from the United States on missions to Somalia, Ethiopia, South Africa, Tanzania, Cambodia, Iranian Kurdistan, Kenya, El Salvador, Guatemala, Brazil, Russia, and the former Yugoslavia. In August 1992, Doctors of the World set up the first of several programs to provide medical services among drug addicts, political refugees, the homeless, and other disenfranchised populations in New York. These projects currently involve 14 volunteer physicians who are providing health care to drug addicts enrolled

Spatial and temporal variation in the prevalence of growth decline in red spruce populations of the northeastern United States

An analysis of the prevalence of individual-tree growth decline, based on reconstructed annual stemwood volume increment (AVI), was implemented on three data bases that have been used in past dendrochronological analyses of red spruce (Picearubens Sarg.) decline in the northeastern United States. This analysis focused on the proportion of individual trees that exhibited a decrease in periodic mean AVI, a decrease in the linear trend of AVI, and (or) a negative AVI trend during the most recent 20-year period. Various subpopulations within the data bases were identified by site location, elevation, and aspect, and tree size, age, and competitive status, and the proportion of individual trees exhibiting growth decline was compared among these subpopulations. Also, the prevalence of growth decline after 1960 was compared with historical levels of growth decline. Differences in prevalence of growth decline were found among the three data bases and among locations within data bases. The proportion of red spruce that exhibited growth decline after 1960 exceeded historical levels of decline for populations in New York, Vermont, and New Hampshire, but not in the northern Maine population. Weak positive associations were found between prevalence of growth decline and tree size (DBH) and elevation. No consistent relationship was found between growth decline and tree age, competitive status, or stand density. Contrary to a previous report, growth decline was not more common among trees that exhibited evidence of competitive release in the 1940s than among unreleased trees.

The Organization of Song Repertoires in Song Sparrows: Themes and Variations

AbstractAlthough songtypes are generally considered to be important functional units in birdsong, they have not been well‐characterized in terms of within‐ and between‐songtype variation. We analyzed the song repertoires of 12 adult male song sparrows (Melospiza melodia) from a population in New York. We identified minimal units of production (MUPs), and calculated the degree to which song variants within a bird's repertoire were similar to each other based on an analysis of MUP sharing. Using statistical techniques from numerical taxonomy, we assessed how song variants clustered into songtypes, and we derived quantitative measures of within‐songtype and between‐songtype similarity. We found that birds produced a limited number of songtypes, but constantly produced new song variants within the framework of these types. Most song variants were produced very rarely; over 43% of song variants were produced only once. Repertoires differed in the degree of between‐songtype similarity and in the number of songtypes defined, but there was comparatively less variation in within‐songtype similarity. Between‐songtype similarity and repertoire size were positively correlated. We argue that song sparrow songtypes are probabilistic units of song production, and discuss the functional and evolutionary implications of having vocal motor patterns organized in this way.

Fear of AIDS Among Intravenous Drug Users In London and New York

Intravenous drug users in drug treatment centers in London (N = 89) and New York City (N = 100) were given a 31-item, closed-ended questionnaire which asked them to rate levels of fear they experienced and to note fear-related behavior during the previous 8 weeks. Users reported an awareness of AIDS and had changed their behavior to reduce their risk of contracting the disease. The higher rates of AIDS within the study population in New York were associated with (1) higher levels of fear of AIDS on the part of the subjects interviewed and (2) higher rates of behavior change to limit the risk of contracting AIDS.

Winter and Spring Habitat Use by Gray Partridge in New York

We compared winter and spring habitat use and home ranges of radio-tagged gray partridge (Perdix perdix) in established (1982) and translocated (1982 and 1983) populations in New York. Both populations selected grain stubble during winter and spring. Birds in the established range also used farmsteads in winter. By late spring, both populations selected idle uplands, and partridge in the translocated range also used legume hay. Home ranges were variable (x=82-672 ha), and did not differ by season (P>0.05). We suggest that a lack of preferred grain stubble in winter may limit populations in the established range. Populations in the translocated range may be limited by the availability of nesting cover

The Costs of HIV Infections-Reply

In Reply.— We appreciate the thoughtful responses of Drs Cheung and Sacks and Dr Harris and Mr Rattner to our article on the economic and policy implications of early intervention in HIV disease. The study was conceived and researched in the year prior to the release of data from national clinical trials, which now indicate that low-dose zidovudine therapy can be effective in slowing progression from asyptomatic HIV disease to AIDS. This breakthrough significantly enhances the importance and feasibility of providing successful early intervention services. We estimate in our article the economic magnitude of providing care to 25%, 50%, and 100% of the HIV-infected populations in New York, NY, San Francisco, Calif, and the United States. Our cost figures reflect the best available epidemiologic and treatment data, and our midrange estimates fall between those suggested by Drs Cheung and Sacks and Dr Harris and Mr Rattner. This costing model

Clinical and immunological aspects of HIV infection in drug addicts

Intravenous drug users (IVDUs) account for more than 64% of the total AIDS cases in Italy. The IVDUs' seropositivity rate is >70% in Milan and >50% in the main cities of Italy. The first evidence of seropositivity in this population dates back to 1979. In a cohort study performed in Milan the rate of progression to overt AIDS among IVDUs was 6% in 3 years (1984–1987). At presentation, more than 75% of the subjects had CD4+ cell counts higher than 400/mm 3 (mean 631, median 528, mode 465). These values are significantly higher than those observed in the same population in New York, the only American city with HIV-infection spread comparable to that observed in Milan. The probability of having CD4+ cell counts lower than 400, 300, and 200/mm 3 in relation to the length of follow-up was, respectively, 50, 40, and 2% after 36 months from presentation. At the same end point, subjects presenting less than 400 CD4+ cells at entry had 30% probability of falling under 200 cell/mm 3. The pattern of CD4+ cells, as much as the low percentage of yearly progression to overt AIDS, is probably related to the recent, even if rapid, spread of infection among IVDUs in Italy. The clinical features of overt AIDS present some differences between IVDUs and other at-risk groups. Among U.S. IVDUs with AIDS, Kaposi's sarcoma is infrequent (2.9% vs 27.7% in homosexual men) while mycotic infections such as deep candidiasis and cryptococcosis are significantly more frequent. The same pattern has been observed in our case file in Milan: esophageal candidiasis represents the most frequent cause of diagnosis of overt AIDS. Mycotic infections, overall, are more frequent than in U.S. IVDUs. The increased rate of mycotic infections among IVDUs might be justified by altered functions of nonspecific immunity, such as PMNL killing and phagocytosis of Candida albicans spores, impaired in HIV-infected IVDUs, but generally normal in infected subjects belonging to the other at-risk groups.