Archive for the ‘HIV’ Category

UNDERSTANDING TESTS FOR HIV: WHO SHOULD GET TESTED-BEHAVIORS THAT RUN THE RISK OF EXPOSURE TO HIV

Tuesday, July 5th, 2011

Some of the following behaviors run a high risk of exposure to HIV, and the people who engage in the behaviors will find it in their best interests to get tested. Other behaviors run a lower risk, and the people who engage in them might want to get tested.     High-risk behaviors. The behaviors that run the highest risk of exposure to HIV are injecting drugs and having sex with gay or bisexual men. Hemophiliacs who received clotting factors before 1986 also have had a high risk of exposure to HIV. Having sex regularly with anyone who injects drugs, has gay sex with men, or has hemophilia also runs a high risk.     Among people with these behaviors, the frequency of HIV infection ranges from 10 percent to 70 percent, meaning that somewhere between 1 out of 10 and 7 out of 10 are infected. People with these levels of risk of infection should be tested.     The risks of HIV infection, and the recommendation for getting tested, differ in different parts of the country. In the Northeast, 20 percent to 70 percent of those who regularly use drugs intravenously are infected. In such areas as Denver, Tampa, and Los Angeles, only 5 percent or fewer of those who regularly use drugs intravenously are infected, a risk of 1 in 20. The risk of infection among men who have gay sex is more consistent throughout the country, ranging from 20 percent to 50 percent. For people with hemophilia, the risk of infection was constant in different parts of the country. The reason is that the clotting factors used for therapy were prepared and distributed throughout the United States from a central location. (It should be emphasized that these clotting factors are now considered safe because the blood is screened and because the factors are treated to eliminate HIV.)     In any case, those who will find it in their best interests to get tested are people who use drugs intravenously; or people who have sex with gay or bisexual men; or hemophiliacs who received clotting factor before 1986; or people who regularly have sex with any of the above or with people known to have HIV infection.     People who have high rates of infection also have different levels of risk. Among people who use injected drugs regularly, the risk is substantially higher than among those who use these drugs only occasionally. The same is true for sexual exposure: no one knows exactly what the risk is with a single sexual episode, although the number of people who have been infected after a single episode appears to be small. Those who have had sex with a lot of people have higher risks of infection than those who have had sex with fewer people. Those who have had sex more frequently with an infected partner have a higher risk of infection than those who have had sex less frequently. The risk is somewhat higher for women exposed to infected men than for men exposed to infected women. The risk of infection is also substantially higher in those who fail to practice “safer sex” or who have genital ulcers. And there may be differences according to the type of sexual practice: anal sex and sex that results in injury may be more likely to risk infection. As above, the probability of HIV infection depends on many interrelated variables. The probability by risk category may be 10 percent or 70 percent, but for the one who is infected, it is 100 percent. It is important for people to know this information so they can protect others and can obtain the best medical care.     Lower-risk behaviors. Other behaviors, though they still risk exposure to HIV, have a substantially lower risk. These include having many sexual partners, having sex with prostitutes (prostitutes have had many sexual partners and are also likely to use drugs), and having had transfusions between 1978 and 1985.     The risk of exposure from these behaviors is relatively small, but it may be large enough to warrant testing, especially if a person is worried about the possibility of exposure.*256\191\2*

HIV: WHAT TO DO WHEN-GET DENTAL CARE AND GET EXERCISE

Monday, May 2nd, 2011

The dental problems common to all adults—diseases of the teeth and of the supporting structures of the teeth—seem to occur more frequently and more severely in people with HIV infection. See your dentist regularly. Floss and brush your teeth assiduously. Tell your dentist about your HIV infection: people who are prone to dental problems should probably see the dentist more frequently, and the dentist may change some of his or her normal recommendations. Some dentists may also wish to take additional precautions while working in your mouth, even though the standard recommendation is that all people receiving any kind of medical and dental care should be treated as though they have HIV infection.     Get Exercise-Aerobic exercise programs are widely advocated as a way of staying healthy and of preventing cardiovascular disease. Whether exercise is similarly helpful to people with HIV infection is unknown. Most people who exercise regularly, however, feel better both physically and emotionally. There is no reason for a person with HIV infection to avoid regular exercise as long as fatigue or other symptoms do not prevent it.
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HIV: MEDICAL TREATMENTS-EXPERIMENTAL DRUGS AND CLINICAL TRIALS: ADVANTAGES OF PARTICIPATING IN A CLINICAL TRIAL

Sunday, March 27th, 2011
The advantages of participating in trials usually include the following:
1. New drugs: Usually, people have access to a new and unlicensed drug only by participating in a clinical trial. The exception is the parallel program, which still makes special demands on the physician and the participant to adhere to protocol requirements.
2. Extraordinary medical care: In clinical trials, the participant is monitored extensively in order to evaluate the drug’s effectiveness and toxicity. The advantage to the participant is the extraordinary medical care that accompanies monitoring. Moreover, the research groups that conduct clinical trials are usually composed of health care providers who are devoted to controlling this disease and who are important sources of new information and new treatment. Participants in clinical trials may find comfort in receiving care from health care providers who have good credentials and clear commitment, and who are working at the cutting edge of the field.
3. Free care: Most participants in clinical trials receive drugs and medical care related to the trial free of charge. The costs are usually covered by the research grant that supports the trial or by the manufacturer, who is interested either in FDA approval or in favorable publicity. However, the participant should not assume that all costs of medical care associated with HIV infection are likely to be included. Most trials provide the drug and the cost of monitoring for safety and effectiveness. They do not provide the cost of care for any complications of HIV infection. Some trials are designed to provide the drug and the cost of monitoring only if the participants are not covered by insurance.
4. Altruism: The advantages listed so far provide direct benefits to the person participating. Participating in a clinical trial also serves a greater need. Medical scientists, people with HIV infection, and people at risk for HIV infection all need more information about new drugs for treating HIV infection. Even the participant who does not benefit directly will nevertheless make a contribution to the welfare of others with or without HIV infection.
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HIV: MEDICAL TREATMENTS-EXPERIMENTAL DRUGS AND CLINICAL TRIALS: ADVANTAGES OF PARTICIPATING IN A CLINICAL TRIALThe advantages of participating in trials usually include the following:1. New drugs: Usually, people have access to a new and unlicensed drug only by participating in a clinical trial. The exception is the parallel program, which still makes special demands on the physician and the participant to adhere to protocol requirements.2. Extraordinary medical care: In clinical trials, the participant is monitored extensively in order to evaluate the drug’s effectiveness and toxicity. The advantage to the participant is the extraordinary medical care that accompanies monitoring. Moreover, the research groups that conduct clinical trials are usually composed of health care providers who are devoted to controlling this disease and who are important sources of new information and new treatment. Participants in clinical trials may find comfort in receiving care from health care providers who have good credentials and clear commitment, and who are working at the cutting edge of the field.3. Free care: Most participants in clinical trials receive drugs and medical care related to the trial free of charge. The costs are usually covered by the research grant that supports the trial or by the manufacturer, who is interested either in FDA approval or in favorable publicity. However, the participant should not assume that all costs of medical care associated with HIV infection are likely to be included. Most trials provide the drug and the cost of monitoring for safety and effectiveness. They do not provide the cost of care for any complications of HIV infection. Some trials are designed to provide the drug and the cost of monitoring only if the participants are not covered by insurance.4. Altruism: The advantages listed so far provide direct benefits to the person participating. Participating in a clinical trial also serves a greater need. Medical scientists, people with HIV infection, and people at risk for HIV infection all need more information about new drugs for treating HIV infection. Even the participant who does not benefit directly will nevertheless make a contribution to the welfare of others with or without HIV infection.*186\191\2*