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current issues concerning the epidemiology of acquired immunodeficiency syndrome and human immunodeficiency virus.this discussion was selected from the weekly staff conferences in the department of medicine, university of california, san francisco. taken from a transcription, it has been edited by nathan m. bass, md, phd, associate professor of medicine, under the direction of lloyd h. smith jr, md, professor of medicine and associate dean in the school of medicine.19921734599
age and human immunodeficiency virus infection in persons with hemophilia in california.thirteen hemophilia centers provide comprehensive care to approximately 90 percent of persons with hemophilia in california. for 1987, these centers reported patient human immunodeficiency virus (hiv) antibody status, age group, level of clotting factor deficiency, and hemophilia type on 1,438 persons with hemophilia a and b; hiv serologic status was known for 860 persons (59.8 percent) of whom 537 (62.4 percent) were hiv-antibody-positive. the hiv positivity rate increased with age after taking ...19902114801
acquired immunodeficiency syndrome.a report entitled "kaposi's sarcoma and pneumocytosis carinii pneumonia among homosexual men in new york city and california" in the mmwr in july 1981 alerted the world to the appearance of a completely new disease. the opportunistic infections and cancers occurring in these patients had previously only been seen in patients who were immunosuppressed. homosexual men were the first as a major risk group to be identified. others quickly followed. the pattern of occurrence clearly indicated an infe ...19892599843
per-contact risk of human immunodeficiency virus transmission between male sexual partners.the risk of human immunodeficiency virus (hiv) transmission from various types of homosexual contact, including oral sex, is of biologic, epidemiologic, and public health importance. the per-contact risk of acquiring hiv infection from specific acts was estimated in a prospective cohort study of 2,189 high-risk homosexual and bisexual men, conducted in san francisco, california; denver, colorado; and chicago, illinois, in 1992-1994. during 2,633 person-years of follow-up, 60 seroconversions were ...199910430236
the impact of hiv-related illness on employment.we used structured telephone interviews to determine the extent of work loss following onset of symptoms, the interval between onset of symptoms and cessation of work, and the risk factors for work loss among 193 persons with symptoms of human immunodeficiency virus (hiv)-related illness attending the aids clinic at the university of california, san francisco, between october 1, 1988, and september 30, 1989. estimates of the duration of time between onset of hiv-related symptoms and work loss de ...19911983921
prevalence of hepatitis c virus antibodies among patients infected with human immunodeficiency virus.a study was undertaken to determine the prevalence and risk factors for serological evidence of hepatitis c virus (hcv) infection in patients infected with the human immunodeficiency virus (hiv). tests for anti-hcv antibody were carried out by enzyme-linked immunoassay (eia) on 101 hiv-infected patients from two university-based outpatient clinics. anti-hcv antibody reactive samples were tested by using a recombinant immunoblot assay (riba) for hcv antibodies. fourteen of 101 (13.9%) hiv-infecte ...19911715384
compliance with infection control procedures among california orthodontists.we conducted a survey of a random sample of california orthodontists and of general dentists to compare their infection control procedures. questionnaires were returned by 124 orthodontists (56% response rate) and 126 general dentists (61% response rate). eighteen questions were asked covering practice profile, perception of risk from hepatitis b virus (hbv) and human immunodeficiency virus (hiv), exposure to blood, barrier protection used, and sterilization and disinfection procedures. gloves a ...19921626533
an experiential program to reduce aids risk among female sex partners of injection-drug users.this article describes the development and implementation of an acquired immune deficiency syndrome (aids) intervention program for female sex partners of male injection-drug users. four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. the development of the workshop modules was guided by traditional theories of h ...19921478552
antiretroviral drug resistance in human immunodeficiency virus-infected source patients for occupational exposures to healthcare workers.to assess the prevalence of hiv antiretroviral resistance among source patients for occupational hiv exposures.200314587931
cost-effectiveness of transfusion of platelet components prepared with pathogen inactivation treatment in the united states.the intercept blood system (ibs) for platelets has been developed to reduce pathogen transmission risks during transfusions.200314604745
high-risk sexual behavior and condom use among gay and bisexual african-american men.little is known about the human immunodeficiency virus (hiv) high-risk sexual practices of gay and bisexual african-american men. these data are needed so that better interventions can be developed and implemented in this population.19921443298
forecasts of the costs of medical care for persons with hiv: 1992-1995.this study concludes that the cumulative (national) cost of treating all persons with the human immunodeficiency virus (hiv) rose considerably over the past year and will continue to rise over the next several years. it is forecast that the cumulative cost of treating all persons with hiv will increase 48% from 1992 to 1995 (from $10.3 billion to $15.2 billion). it is estimated that the average yearly cost of treating a person with aids is $38,300 and of treating an infected person without aids ...19921356925
case-control study of shigellosis in san francisco: the role of sexual transmission and hiv infection.shigella species infect approximately 450,000 persons annually in the united states. person-to-person transmission of shigella species, which have a low infectious dose, occurs frequently, particularly in areas with poor sanitation and hygiene. sexual transmission of shigella species among men who have sex with men (msm) has been inferred from outbreaks of shigellosis among that population, and limited studies have suggested the importance of human immunodeficiency virus (hiv) infection as a ris ...200717205436
early adoption of hiv-1 resistance testing in the san diego county ryan white care act program: predictors and outcome.this research identifies predictors and outcomes of early use of human immunodeficiency virus type 1 (hiv-1) resistance testing in the san diego county ryan white care act program. between january and november 2000, 98 patients receiving care in 7 clinics participated in the resistance testing program. provider characteristics predictive of participation included number of patients and percent of practice devoted to hiv care and number of hiv-related continuing medical education hours over the p ...200212214573
human immunodeficiency virus type 1 reverse-transcriptase and protease subtypes: classification, amino acid mutation patterns, and prevalence in a northern california clinic-based population.phylogenetic analysis of the reverse transcriptase (rt) and protease of 117 published complete human immunodeficiency virus (hiv) type 1 genome sequences demonstrated that these genes cluster into distinct subtypes. there was a slightly higher proportion of informative sites in the rt (40.4%) than in the protease (34.8%; p= .03). although most variation between subtypes was due to synonymous nucleotide substitutions, several subtype-specific amino acid patterns were observed. in the protease, th ...200111574914
haart adherence in culturally diverse patients with hiv/aids: a study of male patients from a veteran's administration hospital in northern california.the objective of this study was to identify the factors that influence adherence to antiretroviral medication regimens in culturally diverse populations with human immunodeficiency virus/acquired immune deficiency syndrome (hiv/aids) related to age, ethnicity, and intravenous drug use. the critical incident technique was used to identify factors determining adherence. through a series of brief, focused interviews, patients were asked to recall specific incidents that affected their adherence to ...200111313024
the changing economics of hiv care.new advances in human immunodeficiency virus (hiv) monitoring and therapeutics have led to dramatic changes in the course of hiv disease. we evaluated our closed clinic of 425 hiv patients over the period 1995-1998 to determine the cost effectiveness of these changes in care. we found that the costs of antiretroviral therapy tripled over the period of observation, but that these increases were largely offset by major declines in inpatient and home health expenditures. in addition, we found that ...200111177585
quantitative and cost comparison of ultrasensitive human immunodeficiency virus type 1 rna viral load assays: bayer bdna quantiplex versions 3.0 and 2.0 and roche pcr amplicor monitor version 1.5.quantification of human immunodeficiency virus type 1 (hiv-1) rna as a measure of viral load has greatly improved the monitoring of therapies for infected individuals. with the significant reductions in viral load now observed in individuals treated with highly active anti-retroviral therapy (haart), viral load assays have been adapted to achieve greater sensitivity. two commercially available ultrasensitive assays, the bayer quantiplex hiv-1 bdna version 3.0 (bdna 3.0) assay and the roche ampli ...200010699005
risk factors for human immunodeficiency virus infection and unprotected anal intercourse among young men who have sex with men.few studies concerning human immunodeficiency virus (hiv) and its risk behaviors have been conducted among young men who have sex with men (ymsm). these are important because ymsm will have profound influence on the hiv/acquired immunodeficiency syndrome epidemic.19989518378
assessment of quality of life in early stage hiv-infected persons: data from the aids time-oriented health outcome study (athos).the development of new pharmaceutical interventions for persons with human immunodeficiency virus (hiv) infection has resulted in extended survival and a need for valid, reliable and responsive instruments to assess health-related qol (hrqol). this paper reviews the reliability and validity of an hrqol instrument, the aids health assessment questionnaire (aids-haq), among persons participating in an observational database of hiv infection. the aids-haq includes nine subscales: disability, energy ...19979330550
a descriptive survey of pediatric human immunodeficiency virus-infected long-term survivors.to identify the population of human immunodeficiency virus-infected pediatric long- term survivors (lts) followed in major medical institutions in california, florida and new jersey.19979099779
highlights from the university of california san diego center for aids research. 19979007196
unrecognized hiv-1 infection in inner-city hospital emergency department patients.to determine the prevalence of unrecognized human immunodeficiency virus (hiv)-1 infections in patients presenting to an inner-city hospital emergency department, medical records were reviewed from 1,945 patients diagnosed with diseases not related to hiv or acquired immunodeficiency syndrome. the overall seroprevalence was 2.1% (40): 1.8% (11) in nontrauma versus 3.0% (29) in trauma patients. the highest prevalence was found in black, male, uninsured patients.19968708358
physician attitudes toward human immunodeficiency virus testing in pregnancy.our purpose was to determine physician attitudes regarding voluntary versus mandatory status of human immunodeficiency virus testing in pregnant women.19968678136
physician satisfaction with human immunodeficiency virus type 1 and hepatitis b virus testing in san diego county.physician satisfaction with the laboratory testing process is one indicator of the physician's perception of the quality of laboratory testing and the effectiveness of the communication of the laboratory results. this study compares the level of satisfaction of physicians reporting their experience with human immunodeficiency virus type 1 (hiv-1) testing with the satisfaction levels of those physicians reporting their experience with hepatitis b virus (hbv) testing. by mail, 6,570 licensed san d ...19968551808
are hiv-infected injection drug users taking hiv tests?knowledge of infection is essential for human immunodeficiency virus-type 1 (hiv-1) treatment initiation and epidemic control. this study evaluates infection knowledge among infected injection drug users and acceptance of confidential testing among injection drug users, particularly those infected with hiv-1.19938214230
neuropsychological impairment in human immunodeficiency virus-infection: implications for employment. hnrc group. hiv neurobehavioral research center.individuals infected with the human immunodeficiency virus-type 1 (hiv-1), are at increased risk for neurobehavioral impairment, particularly in later stages of the disease. even patients in the medically asymptomatic or minimally symptomatic stages of infection may show mild deficits on comprehensive neuropsychological (np) test batteries, although the clinical significance of such deficits remains uncertain. the present study used vocational difficulties as markers of clinical significance of ...19948197319
risk factors for aids and hiv seropositivity in homosexual men.the authors compared cases of acquired immunodeficiency syndrome (aids) diagnosed in san francisco, california, during 1983-1984 with human immuno-deficiency virus (hiv) antibody-negative neighborhood and clinic controls, looking for risk factors for clinical aids. they also compared antibody-positive with antibody-negative neighborhood and clinic controls for risk factors for hiv infection. odds ratios were 52.0 for aids and 7.8 for seropositivity for more than 100 sexual partners versus 0-5 pa ...19873646828
the epidemiology of hodgkin's disease.much of the epidemiological heterogeneity of hd incidence reflects the behaviour of the ns subtype, at least in the usa. incidence variation across races (except asians) and time periods is most marked in this subtype. in young adults with hd, there is compelling evidence for social class modification of risk consistent with an infectious aetiology; limited data suggest that this effect occurs within the ns subtype, but considerable evidence indicates that it does not primarily involve ebv infec ...19968922237
neutropenia is a risk factor for gram-negative bacillus bacteremia in human immunodeficiency virus-infected patients: results of a nested case-control study.a previous cohort study demonstrated a relation between neutropenia and bacteremia due to gram-negative bacilli among patients infected with human immunodeficiency virus (hiv). to explore further the relation between neutropenia and bacteremia due to escherichia coli, klebsiella pneumoniae, or pseudomonas aeruginosa among hiv-infected patients, controlling for confounding factors, the authors conducted a nested case-control study with matching and risk-set sampling of controls. the cohort includ ...19989867263
risk of developing aids in hiv-infected cohorts of hemophilic and homosexual men.the latency period and/or incidence of the acquired immunodeficiency syndrome (aids) may differ in persons infected with the human immunodeficiency virus by different routes or having different "cofactors." we compared 79 hemophilic men in pennsylvania and 117 homosexual and bisexual men in california, all having known dates of infection and long postinfection observation periods, to examine these hypotheses. by 1987, twenty-one percent of the hemophilic and 27% of the homosexual men had develop ...19892911167
determinants of longer time from hiv result to enrollment in publicly funded care and treatment in california by race/ethnicity and behavioral risk.the early intervention program (eip) is california's publicly funded human immunodeficiency virus (hiv) care and treatment program with 30 sites throughout the state. our objective for this study was to examine the number of days from first hiv-positive result until enrollment into eip by race/ethnicity, behavioral risk, and other characteristics, with data from clients who enrolled in an eip site after the availability of highly active antiretroviral therapies. for model i, logistic regression ...200212513904
secondary syringe exchange among injection drug users.syringe-exchange programs (seps) have proven to prevent the spread of bloodborne pathogens, primarily human immunodeficiency virus (hiv), among injection drug users (idus). in the united states, only about 7% of idus have access to and use seps. some idus engage in secondary syringe exchange (sse), meaning that one idu (a "provider") obtains syringes at an sep to distribute to other idus ("recipients"). this formative qualitative research was conducted to understand why and how idus engage in ss ...200312791808
a risk profile of street youth in northern california: implications for gender-specific human immunodeficiency virus prevention.to assess human immunodeficiency virus (hiv) risk behaviors of street youth and to determine whether risk behaviors differ by gender or housing status.19979168381
antiretroviral adherence in persons with hiv/aids and severe mental illness.this study identified factors impacting adherence to human immunodeficiency virus (hiv) therapies in a sample of 46 persons diagnosed with hiv/acquired immune deficiency syndrome and severe mental illness who were receiving care through a day care program in northern california. comprehensive descriptions of factors and circumstances that influence adherence behaviors were obtained through critical incident interviews, and a taxonomy of adherence factors was determined. a chi2 analysis that exam ...200415167402
heterosexual anal sex among female drug users: u.s. national compared to local long beach, california data.receptive anal sex is a well-studied human immunodeficiency virus (hiv) high-risk behavior among gay and bisexual men, yet previous research indicates that more women than men may be at risk from heterosexual anal sex (has). 1991-1996 data from the national institute on drug abuse (nida) cooperative agreement (ca) were analyzed to model risk for women who reported having had has in the 30 days prior to interview. this model was then tested on recent data (2001-2006) collected on women in long be ...200817653843
history-adjusted marginal structural models for estimating time-varying effect modification.much of epidemiology and clinical medicine is focused on estimating the effects of treatments or interventions administered over time. in such settings of longitudinal treatment, time-dependent confounding is often an important source of bias. marginal structural models (msms) are a powerful tool for estimating the causal effect of a treatment using observational data, particularly when time-dependent confounding is present. in recent statistical work, van der laan et al. presented a generalized ...200717875580
human immunodeficiency virus infections among civilian applicants for united states military service, october 1985 to march 1986. demographic factors associated with seropositivity.during the six months from october 1985 through march 1986, blood samples from 306,061 civilian applicants for military service from the united states were tested for antibody to the human immunodeficiency virus (hiv). four hundred sixty subjects were positive for the antibody as determined by western (immune) blot reactivity. the mean prevalence of hiv infection in this population of teenagers and young adults was thus 1.50 per 1000. according to multivariate analysis, the following demographic ...19873474519
epidemiology of ulcerative keratitis in northern california.to determine the incidence and associated risk factors for ulcerative keratitis in northern california.201020697003
steady advance of stem cell therapies: report from the 2011 world stem cell summit, pasadena, california, october 3-5.stem cell research and related therapies (including regenerative medicine and cellular therapies) could have a significant near-term impact on worldwide public health and aging. one reason is the industry's strong linkage between policy, science, industry, and patient advocacy, as was clear in the attendance and programming at the 7(th) annual world stem cell summit held in pasadena, california, october 3-5, 2011. a special conference session sponsored by the sens foundation discussed how stem c ...201122175514
isoniazid- and rifampin-resistant tuberculosis in san diego county, california, united states, 1993-2002.a local tuberculosis (tb) control program.200515875920
warning third parties at risk of aids: apa's policy is a reasonable approach.the author argues that the american psychiatric association's aids policy on confidentiality and disclosure provides reasonable guidelines for psychiatrists struggling to balance their obligation to maintain the confidentiality of individual patients infected with human immunodeficiency virus (hiv) with their obligation to protect the community's health. the policy states that notification of third parties who may be exposed to infection through the behavior of an hiv-positive patient is ethical ...19892914668
preventing hiv in injection drug users: choosing the best mix of interventions for the population.injection drug users (idus) transmit the human immunodeficiency virus (hiv) via both needle sharing and sex. this analysis explores the effects of population risk behaviors, intervention effectiveness, intervention costs, and budget and capacity constraints when allocating funds between two prevention programs to maximize effectiveness. the two interventions, methadone maintenance and street outreach, address different types of risk behavior. we developed a model of the spread of hiv and divided ...200312930884
treatment preferences: impact of risk and benefit in decision-making.understanding treatment preferences of seriously ill patients is complex. previous studies have shown a correlation between the burden and outcome of a treatment and the likelihood a patient will accept a given intervention. in this study the willingness to accept life sustaining treatment (walt) survey was used in a predominantly latino population receiving care at a large urban safety net hospital. eligible patients were cared for by one of four clinics: (1) human immunodeficiency virus (hiv); ...201020050792
rapid hiv testing in emergency departments--three u.s. sites, january 2005-march 2006.approximately one fourth of the estimated 1 million persons living with human immunodeficiency virus (hiv) in the united states are unaware that they are infected with hiv and at risk for transmitting the virus to others. in april 2003, cdc announced a new initiative, advancing hiv prevention: new strategies for a changing epidemic, aimed at reducing barriers to early diagnosis of hiv infection and increasing access of persons infected with hiv to medical care and prevention services. a priority ...200717585288
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