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Social Science & Medicine (1982) 1991Although relatively few teenagers have been diagnosed with AIDS and the extent of asymptomatic human immunodeficiency virus (HIV) infection among adolescents remains... (Review)
Review
Although relatively few teenagers have been diagnosed with AIDS and the extent of asymptomatic human immunodeficiency virus (HIV) infection among adolescents remains largely unknown, there is cause for concern about teens' risk of contracting HIV disease The incubation period (the time from initial infection to the development of full-blown AIDS) is estimated to average eight years, and therefore it is probable that most of the individuals in their twenties who have AIDS (20% of all the people with AIDS) contracted HIV during their teenage years. The sexual and drug use activities of many teenagers place them at increased risk for HIV transmission. Sexually transmitted diseases (STDs) are pervasive and a major cause of morbidity among sexually active adolescents. The rates of STDs have continued to rise even during the 'age of AIDS'. These rates are of concern since the behaviors associated with the acquisition and transmission of STDs are also the behaviors associated with HIV transmission. In addition, the presence of STDs may increase the likelihood of HIV transmission. Although condoms reduce the risk of HIV transmission, their use remains low among sexually active teenagers. Reducing or eliminating high risk behaviors is the only way to limit further spread of HIV. Effective prevention programs should be based on models and theories of risk behavior so that the programs can be designed to change those factors which lead to the undesirable risky behaviors. The AIDS Risk Reduction Model (ARRM) is presented as an example of such a social-physiological model. The ARRM model characterizes why people persist in engaging in high risk activities or make efforts to alter those activities. The three stages theorized to be necessary to reduce risky sexual activities are: (1) recognizing that one's activities make oneself vulnerable to contracting HIV; (2) making the decision to alter risky sexual behaviors and committing to that decision; (3) overcoming barriers to enacting the decision, including problems in sexual communication and seeking help when necessary to learn strategies to reduce risky behaviors. Each stage includes a number of constructs identified in prior research as important for engaging in 'healthy' or low risk behaviors. Innovative strategies must be developed and implemented to reach all adolescents, ranging from teenagers who attend school and live with their families to those teens who are runaways, live in detention facilities or are otherwise 'disenfranchised'. To be most effective, HIV prevention programs must utilize strategies which combine cognitive and behavioral skills training.(ABSTRACT TRUNCATED AT 400 WORDS)
Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adolescent Behavior; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Prevalence; Risk Factors; Risk-Taking; United States
PubMed: 1882237
DOI: 10.1016/0277-9536(91)90446-j -
La Pediatria Medica E Chirurgica :... 1987Since its first report in 1981, acquired immunodeficiency syndrome (AIDS) has attracted great interest among clinicians. Pediatric cases of AIDS were reported only two... (Review)
Review
Since its first report in 1981, acquired immunodeficiency syndrome (AIDS) has attracted great interest among clinicians. Pediatric cases of AIDS were reported only two years later. Recently a review of the literature revealed about 300 pediatric patients with AIDS who are now tabulated separately by the Centers for Disease Control of Atlanta. The classification of the pediatric AIDS is based on epidemiologic, immunologic and virologic data. Subjects at risk include infants born to intravenous drug-addicted mothers and infants who have received blood transfusions or blood products. The diagnosis of pediatric AIDS may be established in a patient who has a polyclonal hypergammaglobulinemia and T-cell immunodeficiency associated with antibody to human immunodeficiency virus (HIV) or isolation of retrovirus.
Topics: Acquired Immunodeficiency Syndrome; Humans; Risk Factors
PubMed: 3320990
DOI: No ID Found -
AIDS Patient Care and STDs Nov 1999The objective of this study was to describe the AIDS-defining conditions (ADC) and survival experience of pediatric AIDS cases (< 13 years age) reported in Puerto Rico....
The objective of this study was to describe the AIDS-defining conditions (ADC) and survival experience of pediatric AIDS cases (< 13 years age) reported in Puerto Rico. A descriptive analysis of the data gathered by the Puerto Rico AIDS Surveillance System was performed. Data for the 377 pediatric AIDS cases reported from January 1981 through June 1998 were reviewed. Survival curves following AIDS diagnosis were estimated using the Kaplan--Meier method and differences between curves were assessed by the Wilcoxon test. The majority (61%) of the cases were diagnosed before 2 years of age, and nearly 94% of them acquired the infection through perinatal transmission. The most common ADC were Pneumocystis carinii pneumonia (PCP) (23%), wasting syndrome (19.4%), and esophageal candidiasis (19.1%). The overall median survival time during the study period was 53.5 (95% CI: 38.0-106.2) months. Children < 1 year of age had a significantly shorter median survival time compared with older ages (p < 0.05). The survival experience in children diagnosed with PCP, pulmonary candidiasis, cytomegalovirus, and lymphocytic interstitial pneumonia (LIP) was significantly different (p < 0.05) to those children not diagnosed with these conditions. Although patients diagnosed after 1990 showed a median survival time longer than those diagnosed prior to 1990, the difference did not reach statistical significance (p > 0.05). The frequency of several ADC and median survival time of Puerto Rican children differed from those reported in the United States. This may reflect differences in diagnostic procedures or reporting practices.
Topics: AIDS-Related Opportunistic Infections; Acquired Immunodeficiency Syndrome; Adolescent; Age Distribution; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Male; Population Surveillance; Proportional Hazards Models; Puerto Rico; Residence Characteristics; Risk Factors; Statistics, Nonparametric; Survival Analysis; Survival Rate
PubMed: 10743510
DOI: 10.1089/apc.1999.13.651 -
Journal of Pediatric Oncology Nursing :... Oct 1990
Topics: Acquired Immunodeficiency Syndrome; Child; Cultural Characteristics; Family; Humans; Stereotyping
PubMed: 2081004
DOI: 10.1177/104345429000700401 -
ASDC Journal of Dentistry For Children 1992
Topics: Acquired Immunodeficiency Syndrome; Child; Child, Preschool; Female; Humans; Male; United States
PubMed: 1537934
DOI: No ID Found -
The Journal of Pediatrics Feb 1985The acquired immunodeficiency syndrome has been observed with increasing frequency in children with associated hemophilia, high-risk environmental backgrounds, and blood... (Review)
Review
The acquired immunodeficiency syndrome has been observed with increasing frequency in children with associated hemophilia, high-risk environmental backgrounds, and blood transfusions. AIDS should be considered in the differential diagnosis of childhood immunodeficiency, and it must be distinguished from congenital disorders. We emphasize the importance of epidemiologic, clinical, and laboratory data in diagnosis and aggressive management of infectious complications. The relationship between human retrovirus infection and AIDS remains to be precisely defined, especially with regard to cofactors that may play a role in the development of severe immunodeficiency following exposure to the agent.
Topics: Acquired Immunodeficiency Syndrome; Antibody Formation; B-Lymphocytes; Child; Deltaretrovirus; Hemophilia A; Humans; Immunity, Cellular; Monocytes; Nutritional Physiological Phenomena; Recurrence; Retroviridae Infections; Risk; T-Lymphocytes; Transfusion Reaction
PubMed: 2982008
DOI: 10.1016/s0022-3476(85)80320-6 -
Development of Pediatric Orodispersible Tablets Based on Efavirenz as a New Therapeutic Alternative.Current HIV Research 2020Efavirenz is the most used medication in the treatment of Acquired Immunodeficiency Syndrome (AIDS). The limited number of pediatric antiretroviral formulations approved...
BACKGROUND
Efavirenz is the most used medication in the treatment of Acquired Immunodeficiency Syndrome (AIDS). The limited number of pediatric antiretroviral formulations approved by regulatory agencies is the most significant obstacle to adequate and efficient pharmacotherapy for this group of patients. The efavirenz has excellent therapeutic potential, but has low aqueous solubility/bioavailability.
METHODS
To minimize these limitations, multicomponent systems with β-cyclodextrin and polyvinylpyrrolidone K-30 were obtained. Due to the limited number of pediatric antiretroviral formulations, the development of a pediatric orodispersible tablet is an alternative that is thought easy to administer, since it disintegrates rapidly in the oral cavity. The multicomponent systems were obtained by the method of kneading and characterized by solubility test, X-ray diffraction, differential scanning calorimetry and infrared absorption spectroscopy by Fourier transform. The orodispersible tablets were prepared by direct compression. The quality control of hardness, friability, disintegration, and dissolution was performed. The influence of the components of the formulation on the characteristics of the tablets was evaluated through a 22 factorial design added with three central points, to compare the effect of the dependent variables on the responses.
RESULTS
An increase in drug solubility was observed, with a decrease in crystallinity. Besides that, an excellent dissolution profile presented with more than 83% of the drug's content dissolved in less than 15 minutes. Satisfactory disintegration time and friability were observed.
CONCLUSION
It was observed that reduced concentrations of mannitol decreased the hardness and disintegration time of the formulations. The orodispersible tablet composed of efavirenz: β- cyclodextrin: polyvinylpyrrolidone, favors greater absorption and bioavailability. It has several advantages for pediatric patients, as the dosage form disintegrates quickly in the mouth and does not require water for administration, thereby improving patient compliance with the treatment.
Topics: Acquired Immunodeficiency Syndrome; Administration, Oral; Alkynes; Benzoxazines; Calorimetry, Differential Scanning; Cyclopropanes; Drug Compounding; Hardness; Humans; Pediatrics; Reverse Transcriptase Inhibitors; Solubility; Tablets; beta-Cyclodextrins
PubMed: 32614748
DOI: 10.2174/1570162X18666200702130449 -
The Pediatric Infectious Disease Journal Jul 2023
Topics: Humans; Child; Acquired Immunodeficiency Syndrome
PubMed: 37200515
DOI: 10.1097/INF.0000000000003964 -
Soins; La Revue de Reference Infirmiere Aug 1987
Topics: Acquired Immunodeficiency Syndrome; Adult; Child; Humans; Nursing Care; Pediatric Nursing; Transfusion Reaction
PubMed: 3672169
DOI: No ID Found -
The Cochrane Database of Systematic... Sep 2012The integration of HIV/AIDS and maternal, neonatal, child health and nutrition services (MNCHN), including family planning (FP) is recognized as a key strategy to reduce... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The integration of HIV/AIDS and maternal, neonatal, child health and nutrition services (MNCHN), including family planning (FP) is recognized as a key strategy to reduce maternal and child mortality and control the HIV/AIDS epidemic. However, limited evidence exists on the effectiveness of service integration.
OBJECTIVES
To evaluate the impact of integrating MNCHN-FP and HIV/AIDS services on health, behavioral, and economic outcomes and to identify research gaps.
SEARCH METHODS
Using the Cochrane Collaboration's validated search strategies for identifying reports of HIV interventions, along with appropriate keywords and MeSH terms, we searched a range of electronic databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, MEDLINE (via PubMed), and Web of Science / Web of Social Science. The date range was from 01 January 1990 to 15 October 2010. There were no limits to language.
SELECTION CRITERIA
Included studies were published in peer-reviewed journals, and provided intervention evaluation data (pre-post or multi-arm study design).The interventions described were organizational strategies or change, process modifications or introductions of technologies aimed at integrating MNCHN-FP and HIV/AIDS service delivery.
DATA COLLECTION AND ANALYSIS
We identified 10,619 citations from the electronic database searches and 101 citations from hand searching, cross-reference searching and interpersonal communication. After initial screenings for relevance by pairs of authors working independently, a total of 121 full-text articles were obtained for closer examination.
MAIN RESULTS
Twenty peer-reviewed articles representing 19 interventions met inclusion criteria. There were no randomized controlled trials. One study utilized a stepped wedge design, while the rest were non-randomized trials, cohort studies, time series studies, cross-sectional studies, serial cross-sectional studies, and before-after studies. It was not possible to perform meta-analysis. Risk of bias was generally high. We found high between-study heterogeneity in terms of intervention types, study objectives, settings and designs, and reported outcomes. Most studies integrated FP with HIV testing (n=7) or HIV care and treatment (n=4). Overall, HIV and MNCHN-FP service integration was found to be feasible across a variety of integration models, settings and target populations. Nearly all studies reported positive post-integration effects on key outcomes including contraceptive use, antiretroviral therapy initiation in pregnancy, HIV testing, and quality of services.
AUTHORS' CONCLUSIONS
This systematic review's findings show that integrated HIV/AIDS and MNCHN-FP services are feasible to implement and show promise towards improving a variety of health and behavioral outcomes. However, significant evidence gaps remain. Rigorous research comparing outcomes of integrated with non-integrated services, including cost, cost-effectiveness, and health outcomes such as HIV and STI incidence, morbidity and mortality are greatly needed to inform programs and policy.
Topics: Acquired Immunodeficiency Syndrome; Child; Child Health Services; Delivery of Health Care, Integrated; Family Planning Services; HIV Infections; Humans; Infant, Newborn; Maternal Health Services; Neonatology; Nutritional Sciences
PubMed: 22972150
DOI: 10.1002/14651858.CD010119