AIDS
-
To examine rates of HIV-1 and sexually transmitted disease (STD) among pregnant and postpartum women in urban Malawi, Africa. ⋯ Among urban childbearing women in Malawi, incidence of HIV is highest among young women while, currently, prevalence is highest among older women. Recent declines in STD prevalence suggest that HIV prevention programs are having an impact either through improved STD diagnosis and treatment or reduced risk behaviors. Sequential cross-sectional STD prevalence measures may be useful in monitoring effectiveness of STD and HIV prevention activities.
-
To illustrate the magnitude of the impact of AIDS on projections of mortality, to explain the reasons for the differences in projections by major international organizations and to provide a simple approach to estimating the impact of AIDS on life expectancy. ⋯ It is clear that AIDS has already increased mortality significantly in many countries and will continue to do so in the coming decades. Uncertainty about current and future levels of HIV prevalence among adults leads to differences in the projections of future AIDS-related mortality. As data and projection methodologies improve, the differences in projections may be reduced for sub-Saharan Africa, but the growing epidemic in some of the largest countries of Asia may increase uncertainty about future global impacts.
-
To describe the role of spiritual beliefs in HIV-positive patients' end-of-life decisions. ⋯ In this HIV-positive population, spiritual beliefs and religious practices appeared to play a role in end-of-life decisions. Discussions about end-of-life decisions may be facilitated by a patient's belief in a forgiving God and impeded by a patient's interpretation of HIV infection as punishment. Health-care providers need to recognize patients' spiritual beliefs and incorporate them into discussions about terminal care.