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Community-acquired, non-occupational needlestick injuries treated in US Emergency Departments

Abstract

BACKGROUND: The escalating number of persons self-injecting medications, predominantly insulin, has generated concerns that the public is at risk of acquiring blood-borne infections from discarded needles/syringes. Communities have developed disposal guidelines but a debate continues over the need for further legislation and/or at-home safety devices.… Read more

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HIV-1 and HCV infections among antibody-negative blood donors

Abstract

Kainer MA, Jarvis WR

N. Engl. J. Med. 2004 Nov;351(21):2232-5; author reply 2232-5

PMID: 15559958

HIV-1 and HCV infections among antibody-negative blood donors was last modified: September 28th, 2015 by Kainer MA, Jarvis WR… Read more
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Clinical predictors of bloodstream infections and mortality in hospitalized Malawian children

Abstract

BACKGROUND: In sub-Saharan Africa, bloodstream infections (BSI) are a major cause of pediatric mortality. Because of limited resources and facilities in these developing countries, treatment often must be based solely on clinical observations and patient history and includes the use of broad spectrum antimicrobials, a factor in the emergence of antibiotic resistance.… Read more

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Epidemiology of bloodstream infections in a bacille Calmette-Guérin-vaccinated pediatric population in Malawi

Abstract

The risk of Mycobacterium bovis bloodstream infection (BSI) in bacille Calmette-Guérin (BCG)-vaccinated children with human immunodeficiency virus (HIV) infection remains uncharacterized. We studied pediatric inpatients during the 1998 dry season in Malawi. After a detailed clinical evaluation, blood was drawn for culture and HIV testing.… Read more

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Detection of bloodstream pathogens in a bacille Calmette-Guérin (BCG)-vaccinated pediatric population in Malawi: a pilot study

Abstract

Children in Malawi receive bacille Calmette-Guérin (BCG) vaccination within the first 3 days of life. Thus, we hypothesized that Malawian children infected with the human immunodeficiency type 1 virus (HIV-1) might be particularly vulnerable to dissemination of the BCG Mycobacterium bovis strain with which they were vaccinated.… Read more

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Peripheral blood cell-specific cytokines in persons with untreated HIV infection in Malawi, Africa

Abstract

Human immunodeficiency virus (HIV) infection is the primary cause of morbidity and mortality in Malawi, Africa, because of its many effects on the immune system. Immune cells communicate through cytokines; therefore, we examined the relationships between HIV serostatus and cell-specific cytokine production for 40 asymptomatic, employed adults and 312 acutely ill, hospitalized patients in Malawi.… Read more

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Demographic and immune correlates of human herpesvirus 8 seropositivity in Malawi, Africa

Abstract

BACKGROUND: In the USA, human herpesvirus 8 (HHV-8) is associated with Kaposi’s sarcoma (KS) and HIV infection. We examined HHV-8 seroprevalence in a Malawian cohort, and assessed its relationship with HIV, KS, demographic characteristics, and immune findings.

METHODS: In 1997 and 1998, blood samples were obtained from 272 hospitalized Malawian patients, for whom demographic information was obtained, and 24 healthy volunteers without demographic data.… Read more

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Clinical and immune impact of Mycobacterium bovis BCG vaccination scarring

Abstract

The World Health Organization recommends Mycobacterium bovis BCG vaccination in areas of high tuberculosis prevalence. BCG’s clinical and immune effects, not necessarily Mycobacterium tuberculosis specific, are unclear. BCG vaccine scarring often is used as a surrogate marker of vaccination or of effective vaccination.… Read more

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Automated Evaluation of AIDS Messages with High‐Risk, Low‐Literacy Audiences

Abstract

A series of televised public service announcements (PSAs) about acquired immune deficiency syndrome (AIDS) was evaluated with 100 black participants attending a Sexually Transmitted Diseases Clinic in Atlanta, Georgia. Since the literacy level of the participants was suspected to be low, questions were administered orally and an electronic data collection technique was used which permitted the participants to push buttons, as opposed to speaking or writing responses.… Read more

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Spontaneous cytokine production and its effect on induced production

Abstract

Cytokines regulate cellular immune activity and are produced by a variety of cells, especially lymphocytes, monocytes, and macrophages. Multiparameter flow cytometry is often used to examine cell-specific cytokine production after in vitro phorbol 12-myristate 13-acetate and ionomycin induction, with brefeldin A or other agents added to inhibit protein secretion.… Read more

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From the Centers for Disease Control and Prevention. Disseminated infection with Simiae-avium group mycobacteria in persons with AIDS–Thailand and Malawi, 1997

Abstract

Reller LB, Archibald LK, Jarvis WR, Grohskopf LA

JAMA 2002 Jul;288(2):157, discussion 157-8

PMID: 12113261

From the Centers for Disease Control and Prevention. Disseminated infection with Simiae-avium group mycobacteria in persons with AIDS–Thailand and Malawi, 1997 was last modified: July 10th, 2002 by Reller LB, Archibald LK, Jarvis WR, Grohskopf LA… Read more
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Vitamin A levels and immunity in humans

Abstract

In animal studies, vitamin A deficiency induces a shift from type 2 (humoral, Th2) to type 1 (cellular, Th1) cytokines; there are no similar data for humans. Control of human immunodeficiency virus (HIV) and Mycobacterium tuberculosis infections requires type 1 cytokine (cellular) immunity.… Read more

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Age-related differences in cell-specific cytokine production by acutely ill Malawian patients

Abstract

Age-related changes in human cell-specific cytokine responses to acute illness have not been well examined. We therefore evaluated age-related differences in T, B and natural killer (NK) peripheral blood lymphocyte cytokine responses of 309 acutely ill hospitalized people in Malawi, Africa, < 1 month-61 years of age.… Read more

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The effects of iron deficiency on lymphocyte cytokine production and activation: preservation of hepatic iron but not at all cost

Abstract

Worldwide, over 40% of children have iron deficiency anaemia, frequently associated with infections. Certain cytokines are involved in both immune activation/response to infection and iron transport/metabolism. We therefore assessed the relations among iron deficiency, cytokine production and lymphocyte activation markers in 142 hospitalized Malawian children.… Read more

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Comparison of serum and cell-specific cytokines in humans

Abstract

Cytokines function at the cellular, microenvironmental level, but human cytokine assessment is most commonly done at the macro level, by measuring serum cytokines. The relationships between serum and cellular cytokines, if there are any, are undefined. In a study of hospitalized patients in Malawi, we compared cytometrically assessed, cell-specific cytokine data to serum interleukin 2 (IL-2), IL-4, IL-6, IL-8, IL-10, gamma interferon (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) levels in 16 children and 71 (IL-2, -4, -6, -10) or 159 (IL-8, IFN-gamma, and TNF-alpha) adults, using Wilcoxon rank sum tests and Pearson’s (r(p)) and Spearman’s (r(s)) rank correlations.… Read more

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Intracellular cytokines in the acute response to highly active antiretroviral therapy

Abstract

OBJECTIVES: Successful highly active antiretroviral therapy (HAART) is usually associated with a rapid decline in HIV plasma RNA levels and a gradual increase in CD4 T cells. We examined whether changes in cytokine production and profile precede other immunological changes and whether these might occur in temporal association with plasma HIV RNA changes.… Read more

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Cytokines and malaria parasitemia

Abstract

The balance between pro- and antiinflammatory cytokines may be important in malaria presentation and outcome. Malaria tends to be more severe in children than in adults, presumably because partial immunity develops with age. However, the full nature of, and age-related differences in, anti-malarial immunity are unknown.… Read more

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Modulation of CD8 and CD3 by HIV or HIV antigens

Abstract

To investigate whether human immunodeficiency virus (HIV)-1 and HIV-1 antigens modulate surface and cytoplasmic CD8 or CD3, as well as CD4, we used cell permeabilization reagents, surface/cytoplasmic fluorescent staining, multiparameter flow cytometric techniques and an in vitro culture system in which relatively few lymphocytes are actively infected with HIV.… Read more

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Seasonal variation in the etiology of bloodstream infections in a febrile inpatient population in a developing country

Abstract

OBJECTIVES: Published data suggest that Streptococcus pneumoniae, non-typhi Salmonella species, and Mycobacterium tuberculosis are the predominant causes of bloodstream infection (BSI) in hospitalized populations in sub-Saharan Africa. This study was conducted during the wet season to ascertain the etiology and prevalence of BSI among febrile inpatients in a hospital where the dry season BSI profile in a similar study population had already been documented.… Read more

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Effects of HIV-1 peptides on T-cell receptor variable beta chain families

Abstract

Superantigens (SAGs) selectively stimulate expansion and then deletion of specific T cell antigen receptor (TCR) variable beta chain (Vbeta) families. We investigated six synthetically produced HIV-1-related peptides for evidence of SAG activity: three derived all or in part from the transmembrane gp41 protein and three from the genetic sequence of the tRNA binding region.… Read more

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Natural T, gammadelta, and NK cells in mycobacterial, Salmonella, and human immunodeficiency virus infections

Abstract

NK cells, gammadelta T cell antigen receptor chain-positive cells, and CD3(+)CD16/56(+) (natural T [NT]) cells are involved in innate immunity and immunoregulation; however, their role in clinical infection is not well defined. Cytofluorometric analysis was used to examine peripheral blood from bacteremic, nonbacteremic, and healthy human immunodeficiency virus (HIV)-positive and -negative persons in Malawi, Africa.… Read more

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A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy

Abstract

The etiology of bloodstream infections (BSIs) in febrile (or =37.5 degrees C) adults (or =18 years old) in one Malawi hospital were determined during August and September 1997. After clinical evaluation, blood was drawn for comprehensive culture, human immunodeficiency virus (HIV) type 1 testing, and malaria smear.… Read more

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Nosocomial tuberculosis prevention measures among two groups of US hospitals, 1992 to 1996

Abstract

OBJECTIVE: To compare trends in nosocomial tuberculosis (TB) prevention measures and health-care worker (HCW) tuberculin skin test (TST) conversion of hospitals with HIV-related Pneumocystis carinii pneumonia (PCP) patients and other US hospitals from 1992 through 1996.

DESIGN AND SETTING: Surveys in 1992 and 1996 of 38 hospitals with PCP patients in four high-HIV-incidence cities and 136 other US hospitals from the American Hospital Association membership list.… Read more

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Epidemic transmission of human immunodeficiency virus in renal dialysis centers in Egypt

Abstract

In 1993 an epidemic of human immunodeficiency virus (HIV) infection occurred among 39 patients at 2 renal dialysis centers in Egypt. The centers, private center A (PCA) and university center A (UCA) were visited, HIV-infected patients were interviewed, seroconversion rates at UCA were calculated, and relatedness of HIV strains was determined by sequence analysis; 34 (62%) of 55 patients from UCA and 5 (42%) of 12 patients from PCA were HIV-infected.… Read more

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Unrecognised Mycobacterium tuberculosis bacteraemia among hospital inpatients in less developed countries

Abstract

BACKGROUND: Nosocomial transmission of Mycobacterium tuberculosis is a global public-health concern. Although early clinical recognition of M. tuberculosis in hospital inpatients is critical for effective infection control, such recognition may be difficult in patients with HIV infection. To find out whether M.… Read more

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Prospective evaluation of risk factors for bloodstream infection in patients receiving home infusion therapy

Abstract

BACKGROUND: Intravenous therapy in the outpatient and home settings is commonplace for many diseases and nutritional disorders. Few data are available on the rate of and risk factors for bloodstream infection among patients receiving such therapy.

OBJECTIVE: To determine rates of and risk factors for bloodstream infection among patients receiving home infusion therapy.… Read more

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Fever and human immunodeficiency virus infection as sentinels for emerging mycobacterial and fungal bloodstream infections in hospitalized patients >/=15 years old, Bangkok

Abstract

To determine the etiology of bloodstream infections (BSIs) in hospitalized patients /=15 years old in Thailand, prospectively enrolled, consecutive febrile (/=38 degrees C) patients were admitted to one hospital during February-April 1997. After a patient history was taken and a physical examination was performed, blood was obtained for comprehensive culture and human immunodeficiency virus (HIV) testing.… Read more

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Increased expression of CD80 and CD86 in in vitro-infected CD3+ cells producing cytoplasmic HIV type 1 p24

Abstract

Determining the effects of HIV infection on the expression of cell surface molecules has been limited by an inability to differentiate between productively infected cells and those without productive infection. We inoculated human peripheral blood mononuclear cells from healthy, human immunodeficiency virus type 1 (HIV) antibody-negative donors with HIV; noninoculated cells were also examined.… Read more

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Immune determinants of organism and outcome in febrile hospitalized Thai patients with bloodstream infections

Abstract

Opportunistic infections (OI) and the human immunodeficiency virus (HIV) cause significant morbidity and mortality in developing countries. Immune cell and cytokine profiles may be related to the type and course of OI and to the OI-HIV interaction. Examining cell-specific cytokine production ex vivo has only recently become feasible.… Read more

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Prevention of nosocomial transmission of Mycobacterium tuberculosis

Abstract

The recent resurgence of TB together with the ongoing HIV epidemic has resulted in a larger number of infectious TB patients being admitted to US health care facilities. These patients have become a source for both nosocomial (patient-to-patient) and occupational (patient-to-health care worker) M.… Read more

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Tracing patients exposed to health care workers with tuberculosis

Abstract

OBJECTIVES: Following an outbreak of tuberculosis (TB) among health care workers at a public hospital, the study was undertaken to (a) locate all exposed patients and administer tuberculin skin tests (TSTs) to them, (b) provide clinical treatment or prophylaxis to infected patients, and (c) ascertain the risk of M.… Read more

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HIV antigens and T-cell receptor variable beta chain families

Abstract

The authors investigated whether the human immunodeficiency virus (HIV) has restrictive effects on the variable region of the beta chain (V beta) of the T-cell antigen receptor (TCR), by in vitro cultivation of non-HIV-infected peripheral blood lymphocytes with one of six HIV antigens or heat-inactivated whole virus (HIV-HI).… Read more

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Evidence for a shift from a type I lymphocyte pattern with HIV disease progression. Hemophilia Growth and Development Study

Abstract

Whether a shift from a type I (cell mediated) immune profile occurs with progressive HIV-related immune dysfunction is a matter of heated debate.

We analyzed data for 333 HIV antibody-positive (HIV+) and -negative (HIV-) hemophilic children/adolescents, to examine whether the relationships among immunologic parameters and vaccine-related serology supported a shift with advancing HIV infection.… Read more

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Tuberculosis infection-control practices in United States emergency departments

Abstract

STUDY OBJECTIVE: To determine the frequency with which patients with suspected tuberculosis (TB) or TB risk factors present to US emergency departments and to describe current ED TB infection-control facilities and practices.

DESIGN: Mailed survey of a sample of EDs in US acute care facilities.… Read more

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Control of nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis among healthcare workers and HIV-infected patients

Abstract

From 1988 to 1990, an outbreak of multidrug-resistant tuberculosis (MDR-TB) among patients, and an increased number of tuberculin-skin-test conversions among healthcare workers, occurred on the HIV ward of Jackson Memorial Hospital, Miami, Florida, USA. Measures similar to those subsequently recommended in the 1990 Centers for Disease Control and Prevention guidelines were implemented on the HIV ward by June, 1990, and in September, 1992, we evaluated the efficacy of these control measures.… Read more

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Immune and serologic profiles of HIV-infected and noninfected hemophilic children and adolescents. Hemophilia Growth and Development Study Group

Abstract

OBJECTIVES: To assess relationships among the effects of HIV on hemophilic children and adolescents’ immunologic parameters and vaccine-related serology.

METHODS: We analyzed data from extensive baseline immunologic evaluations of 207 HIV antibody-positive (HIV+) and 126 HIV antibody-negative (HIV-) hemophilic children and adolescents.… Read more

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Addressing the public’s concerns about human immunodeficiency virus transmission in health-care settings

Abstract

BACKGROUND: The 1990 report of a cluster of patients infected with the human immunodeficiency virus (HIV) associated with a Florida dentist with acquired immunodeficiency syndrome attracted considerable media coverage and legislative attention. A number of polls found that the public favored mandatory HIV-antibody testing of health-care workers.… Read more

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Educating Young Adults About HIV and AIDS: the Impact of Direct Response Television Public Service Advertising

ABSTRACT Limited resources combined with a desire to reach as many people as possible often make direct response public service announcements an important tool in educational campaigns. To understand the impact of direct-response TV PSAs, and find ways to increase their effectiveness, this study examined 1) the effects of a highly targeted HIV prevention message on young adults’ knowledge, perceptions, and intentions; and 2) whether altering two PSA elements, the telephone number used and the length of time it was displayed, would affect viewers’ recall and intention responses.  … Read more

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Potential use of mass media to reach urban intravenous drug users with AIDS prevention messages

Abstract

To access the potential of using the mass media to reach urban intravenous drug users (IVDUs) with AIDS prevention messages,

we: 1) questioned 353 participants in a Baltimore IVDU cohort study on their media use and sources of AIDS information, 2) analyzed data on Baltimore AIDS public service announcement (PSA) airings during a 3-month period, and 3) discussed with media executives their willingness to air a variety of potential AIDS messages.… Read more

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Hemophilia growth and development study. Design, methods, and entry data

Abstract

PURPOSE: The study design, research questions, and baseline data are presented from a multicenter longitudinal epidemiologic investigation of the impact of human immunodeficiency virus (HIV) infection on three areas of functioning in children and adolescents with hemophilia: physical growth and sexual maturation, immune function, and neurological and neuropsychological functioning.… Read more

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Using indices to differentiate dimensions of knowledge regarding modes of HIV transmission in the U.S. population, 1987-1989

Abstract

The number of HIV-infected individuals is increasing, making it important for the public to understand not only how HIV is transmitted but also the lack of transmission risk associated with casual contact. Using CDC’s National Center for Health Statistics National Health Interview Survey, we divided modes of transmission items into two areas of knowledge: “True Transmission” and “False Transmission.” Items were recoded with scores from 3 for the most correct response to 0 for the most incorrect response for each of three items related to true and each of eight items related to false transmission.… Read more

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Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections. Factors in transmission to staff and HIV-infected patients

Abstract

OBJECTIVE: To describe transmission of multidrug-resistant (MDR) Mycobacterium tuberculosis infection among patients and health care workers (HCWs) in a ward and clinic for human immunodeficiency virus (HIV)-infected patients in a hospital, four studies were conducted.

METHODS: Case patients and control patients were persons who had been treated in the HIV ward or clinic, whose clinical course was consistent with tuberculosis and who had at least one positive culture for M tuberculosis between January 1, 1988, and January 31, 1990, resistant to at least isoniazid and rifampin (case patients), or whose isolates were susceptible to all drugs tested (control patients).… Read more

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Tuberculin skin testing of hospital employees during an outbreak of multidrug-resistant tuberculosis in human immunodeficiency virus (HIV)-infected patients

Abstract

Tokars JI, Jarvis WR, Edlin BR, Dooley SW, Grieco MH, Gilligan ME, Schneider N, Montonez M, Williams J

Infect Control Hosp Epidemiol 1992 Sep;13(9):509-10

PMID: 1430996

Tuberculin skin testing of hospital employees during an outbreak of multidrug-resistant tuberculosis in human immunodeficiency virus (HIV)-infected patients was last modified: September 1st, 1992 by Tokars JI, Jarvis WR, Edlin BR, Dooley SW, Grieco MH, Gilligan ME, Schneider N, Montonez M, Williams J… Read more
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Nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis. A risk to patients and health care workers

Abstract

OBJECTIVE: To determine the factors associated with the development of multidrug-resistant tuberculosis among patients at a New York City Hospital and to investigate possible nosocomial transmission.

DESIGN: A retrospective case-control study and tuberculin skin test survey.

PATIENTS: Twenty-three patients with tuberculosis whose isolates were resistant to at least isoniazid and rifampin (case patients) were compared with patients with tuberculosis whose isolates were susceptible to all agents tested (controls).… Read more

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The pediatrician’s role in encouraging parent-child communication about the acquired immunodeficiency syndrome

Abstract

OBJECTIVE: We explored whether communication from pediatrician to parent to child might assist in education about and prevention of human immunodeficiency virus (HIV) infection by comparing parents of children aged 10 through 17 years who did discuss acquired immunodeficiency syndrome (AIDS) with their children with parents of children aged 10 through 17 years who did not discuss AIDS with their children.… Read more

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Recall of AIDS public service announcements and their impact on the ranking of AIDS as a national problem

Abstract

The efficacy of two public service announcements from Phase V of the “America Responds to AIDS” (ARTA) campaign was assessed at two sites. Participants were randomly assigned to view a local news program, one with an ARTA public service announcement appearing six times and the other with no AIDS public service announcements.… Read more

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Nosocomial transmission of tuberculosis in a hospital unit for HIV-infected patients

Abstract

OBJECTIVE: To assess nosocomial transmission of tuberculosis (TB).

DESIGN: A historical cohort study of hospitalized patients with the human immunodeficiency virus (HIV) and a purified protein derivative (PPD) tuberculin skin test survey of health care workers (HCWs).

SETTING: A large public teaching hospital in San Juan, Puerto Rico.… Read more

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Paid advertising for AIDS prevention–would the ends justify the means?

Abstract

An examination by the Centers for Disease Control and the Research Triangle Institute concluded that “hard-to-reach” populations could be reached with AIDS prevention messages through the broadcast and print media and that a study should be undertaken to assess whether paid placement of these messages could have an effect on HIV-related behaviors.… Read more

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A system for evaluating the use of media in CDC’s National AIDS Information and Education Program

Abstract

The National AIDS Information and Education Program (NAIEP) commissioned the National Academy of Sciences to design a prototypical system of research for use in the evaluation of the agency’s media campaign. It consists of four types of evaluation: formative, efficacy, process, and outcome.… Read more

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Human immunodeficiency virus transmission from hemophilic men to their heterosexual partners

Lawrence DN, Jason JM, Holman RC, Murphy JJ. In: Heterosexual transmission of AIDS: Alexander, N.J., Gabelnick, H.L. and Spieler, J.M. (Eds.), xiv + 440 pp., illus. Wiley-Liss, New York, 1990.

ISBN 0-471-562080-4

DOI: 10.1016/0022-1759(91)90137-5 Human immunodeficiency virus transmission from hemophilic men to their heterosexual partners was last modified: October 19th, 2015 by Lawrence DN, Jason JM, Holman RC, Murphy JJ… Read more