International journal of STD & AIDS
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We explored current access to care among HIV-positive people in Australia. In 2006, 270 HIV-positive gay men from a community-based Positive Health cohort in Sydney were asked about their health (including medical and social) service needs and, subsequently, about difficulty in accessing services. We report the prevalence of specific needs, barriers and associated factors. ⋯ In Australia, HIV-related medical service needs outweigh those for social services. Complex health services remain essential to HIV-positive people, but some services are currently not meeting their needs. To remain adequate, services need to understand and constantly adapt to the changing needs of HIV-positive people.
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Case Reports
Is it recurrent cryptococcal meningitis or immune reconstitution inflammatory syndrome?
We report a case of a 45-year-old patient with a history of cryptococcal meningitis who was started on antiretroviral therapy. The patient presented four months later with complaints of fever and memory loss. ⋯ The diagnosis of immune reconstitution was made at this time and steroids were started. The patient showed remarkable improvement.
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A survey of HIV testing practices among registrars of all admitting specialties within Sheffield Teaching Hospitals National Health Service Trust was performed in 2007. Respondents from most specialties tested patients for HIV infrequently and several barriers were identified, which prevented testing even when the diagnosis was considered.
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Multicenter Study Comparative Study
Association of Mycoplasma genitalium with acute non-gonococcal urethritis in Russian men: a comparison with gonococcal and chlamydial urethritis.
Urethral specimens from 172 men who attended sexually transmitted disease clinics in the Moscow Oblast were examined for Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium by nucleic acid amplification tests. N. gonorrhoeae was detected in the urethra of 41 (24%) of the 172 men and C. trachomatis in 57 (33%). The latter occurred in 15 (36%) of the 41 men who were infected by N. gonorrhoeae and in 42 (32%) of 131 uninfected by gonococci. ⋯ Of these 25 men, 24 (96%) had urethral symptoms and signs of inflammation, a proportion significantly more than experienced by the 64 men uninfected by any of the microorganisms. Of the 31 men who apparently had no symptoms or signs of urethritis, only three (10%) were infected by M. genitalium. The data provide evidence for the pathogenicity and frequent occurrence of M. genitalium in men in Moscow and presumably elsewhere in Russia.
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Case Reports
Minimally invasive approach to median arcuate ligament syndrome in a patient with HIV/AIDS.
Mesenteric ischaemia is most commonly caused by atherosclerotic disease, but extrinsic compression on the coeliac axis (CA) can also lead to similar symptoms as mesenteric ischaemia. This is usually created by the pressure of the fibrous diaphragm on the CA, which can cause abdominal pain and weight loss referred to as 'median arcuate ligament syndrome'. This syndrome is not typically associated with any underlying disease process. This is the first case describing median arcuate ligament syndrome in a young man with a history of HIV/AIDS, who successfully underwent minimally invasive procedure as a therapeutic modality for his condition.