Articles: disease.
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Two hundred and fourteen young women received acquired immunodeficiency syndrome (AIDS) prevention interventions at an inner-city family health center serving minority patients predominantly. The community in which the health center is located has a high incidence of intravenous (IV) drug abuse. Either a peer or a health care provider delivered the intervention. ⋯ In addition, subjects in both groups who were sexually active stated immediately after the intervention that asking a sexual partner about past sexual experience would now be less difficult, and at one-month follow-up they reported a significant decrease in the frequency of vaginal sex. Our findings suggest that counseling by physicians can achieve more changes in knowledge of sexual risks, whereas peer education can achieve greater changes in knowledge about IV drug use. Results show that both approaches to AIDS prevention used in this study can significantly affect knowledge, attitudes, and sexual behavior.
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Review Case Reports
Misdiagnosis of appendicitis in tubally sterilized women.
Sterilization by tubal occlusive methods has a small but definite incidence of failure which is not well recognized among general surgeons. As a result of the failure to appreciate the possibility of ectopic pregnancy after tubal ligation, right-sided abdominal pain in this patient population is commonly misdiagnosed as appendicitis. One such case is presented, and the literature is reviewed and discussed.
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The heterosexual spread of HIV-1 is occurring at different rates in different parts of the world. The transmission probability of HIV-1 per sexual contact is low, but may be greatly enhanced by several cofactors. Sexually transmitted diseases (STD), especially genital ulcers, may be such factors. So far, epidemiological evidence that other STD facilitate HIV-1 transmission is weak. The objective of this study was to determine whether treatable STD enhanced sexual transmission of HIV-1 in a cohort of female prostitutes in Kinshasa, Zaire. ⋯ Non-ulcerative STD were risk factors for sexual transmission of HIV-1 in women, after controlling for sexual exposure. Because of their high prevalence in some populations, non-ulcerative STD may represent a considerable population-attributable risk in the transmission of HIV-1 worldwide. The identification of treatable STD as risk factors for HIV-1 transmission offers an important additional strategy for the prevention of HIV/AIDS.
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Female sexual partners of injection drug users are at risk for AIDS because of their association with street drug cultures and all their concomitant risks, including their own non-injecting drug use. This study examines a model of the social determinants of HIV-associated sexual risk behaviors. ⋯ The findings show that crack cocaine use is the strongest contributor to the model, which explains fourteen percent of the variance of sexual risk behavior. The findings suggest that the risks associated with sexual practices are much greater for crack cocaine users than among non users of crack.
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Nutrition and health · Jan 1993
ReviewUndernutrition in Nigeria: dimension, causes and remedies for alleviation in a changing socio-economic environment.
Undernutrition in Nigeria is a long standing problem which has persisted since the 1960s and whose magnitude is on the increase. This is because food consumption, both in quality and quantity, has decreased appreciably, especially with the commencement of the structural adjustment programme (SAP) in 1986. ⋯ Since the economic reforms may continue into the next decade and beyond, sustainable remedies for alleviation of the problem are urgently needed. Suggested remedial programmes include increased support for the rural farmers, strengthening of the rural credit schemes that are specifically targeted at the poor, distribution of vitamin A and iron supplements in rural health centres, encouraging production of low cost weaning diets and integrating nutrition education in primary health care schemes and in educational curricula.