The study of 156 male and 46 female injection drug users (IDUs) found that men with a recent HIV infection had an average of 50,766 particles per milliliter. Women with a recent HIV diagnosis averaged 15,103. for the New England Journal of Medicine, treatment guidelines recommended initiating treatment when HIV levels reached 20,000 particles per milliliter of blood plasma. Guidelines issues earlier this year advise postponing antiviral therapy until there are 55,000 particles per milliliter.
Researcher Margaret Kemeny of UCLA reports that behavioral evidence of the disease is indicative of the need for stress and support groups as part of standard treatment therapies. Study leader Jane Leserman of the University of North Carolina at Chapel Hill also reports that the effects of high levels of stress, anger, depression and higher than average blood pressure will also serve to accelerate HIV.
Other studies indicate that when patients with hostile personalities confront illness or distressing events, their level of general dissatisfaction increases and their immune systems weaken more quickly.
Controlling the study for clinical pathology, substance use, and sociological factors, the authors found that depression among HIV-infected women is associated with disease progression. The findings, they note, reinforce the need for diagnosis and treatment of depression among HIV-positive women.
The authors studied more than 500 sexually active African-American females between the ages of 14 and 18 and reported at the National STD Prevention Conference in Milwaukee that girls who had little or no fear of negative reactions from their partners were more than two times as likely to use the prophylactics consistently. In addition, compared to girls with older partners, those with partners of similar age were also more likely to use condoms regularly.
Comparing elective Caesarean section and vaginal delivery, researchers used the HIV transmission rate, maternal death rate, and quality of life as factors during the study. The results showed that elective Caesarean section led to an HIV transmission rate of 34.9 per 1,000 births, compared to 62.3 per 1,000 vaginal deliveries.
The elective C-section was more cost effective, but it also had increased risk of maternal mortality by 2.4 deaths per 100,000 deliveries. Overall, the researchers concluded that "in pregnant women with detectable HIV RNA, elective Caesarean section would reduce total costs and increase overall quality-adjusted life expectancy for the mother-child pair, albeit at a slight loss of quality-adjusted life expectancy to the mother."
|Rebecca Solomon is a Case Manager at AIDS Project Los Angeles. She can be reached by calling (213) 201-1436 or by e-mail at firstname.lastname@example.org.|