AIDS patient care and STDs
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AIDS Patient Care STDS · Oct 2010
Elevated HIV prevalence despite lower rates of sexual risk behaviors among black men in the District of Columbia who have sex with men.
The District of Columbia (DC) has among the highest HIV/AIDS rates in the United States, with 3.2% of the population and 7.1% of black men living with HIV/AIDS. The purpose of this study was to examine HIV risk behaviors in a community-based sample of men who have sex with men (MSM) in DC. Data were from the National HIV Behavioral Surveillance system. ⋯ Despite significantly higher HIV/AIDS rates, black MSM in DC reported fewer sexual risks than non-black. These findings suggest that among black MSM, the primary risk of HIV infection results from nontraditional sexual risk factors, and may include barriers to disclosing MSM status and HIV testing. There remains a critical need for more information regarding reasons for elevated HIV among black MSM in order to inform prevention programming.
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Coalescence of infection of the epiglottis, or epiglottic abscess, is a rare manifestation of epiglottitis. We report the case of a 49-year-old Hispanic man with HIV (CD4 count 243 [16.2%]), HIV viral load 175,689 copies per milliliter, antiretroviral-naive) contracted from his wife who presented to the emergency department with a 3-week history of sore throat, odynophagia, left temporal headache, left neck pain, and occasional blood-streaked sputum. This case represents the first reported case of epiglottic abscess in an HIV-positive individual. ⋯ The diagnosis of epiglottic abscess is often difficult. In HIV-infected individuals, a variety of infectious and oncologic sources of respiratory compromise should be considered in addition to epiglottic abscesses. Prompt diagnosis and treatment of this condition is crucial for ensuring optimal outcomes in this rare but often lethal infection.
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AIDS Patient Care STDS · May 2009
Women's opinions about routine HIV testing during pregnancy: implications for the opt-out approach.
The 1995 United States Public Health Service (USPHS) recommendation regarding HIV testing for pregnant women was revised in 2003 calling for routine HIV testing for pregnant women with patient notification. Routine testing (opt-out screening) offers women the opportunity to decline HIV testing but eliminates the requirement of pretest counseling and separate written consent. To assess women's opinions about the opt-out approach to HIV testing during pregnancy, a cross-sectional survey was conducted in May-June 2004 at 14 geographically diverse clinics funded by Ryan White CARE Act (RWCA) Part C and Part D agreements. ⋯ Approximately half of the respondents indicated that HIV tests are different from other tests and that women need more information prior to testing. Results demonstrated clear consensus in support of routine testing. Increased efforts to disseminate resources to providers coupled with providers' effective communication of information to pregnant women can build on the support that women have conveyed for HIV testing during pregnancy.