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Biomedical subjects

A H Kral

Publications and source records attributed to A H Kral.

23 records · Page 2Linked to original sources
PubMed1995

Concordance of PCR and antibody results from HIV testing of injecting drug users.

Standard HIV-1 testing relies on the enzyme immunoassay (EIA) for detecting antibodies specific to HIV-1. This technique may misclassify persons as HIV-1-negative in instances where testing follows infection but precedes development of antibody to HIV-1. To evaluate the occurrence of HIV infection in the absence of positive antibody, polymerase chain reaction (PCR) for viral DNA in the blood has been applied. Research comparing these two testing techniques has generally focused on populations of homosexual and bisexual men. This study compares PCR and antibody testing of 337 injecting drug users recruited from street settings in San Francisco. Of 286 HIV-1 antibody-negative samples, 3 (1.0%) were PCR-positive. Of 49 HIV-1 antibody-positive samples, 1 (2.0%) was PCR-negative. Two samples were antibody-indeterminate and PCR-negative. This yielded an overall concordance of 331/335 (98.8%), excluding the indeterminate results. These results suggest that current antibody methodology is adequate. However, misclassification among recently infected individuals may occur, which is of concern in high-incidence groups.

Adult↗
PubMed1991

Frequency and thoroughness of STD/HIV risk assessment by physicians in a high-risk metropolitan area.

The US Preventive Services Task Force recommends that all primary care physicians assess the sexually transmitted disease/human immunodeficiency virus (STD/HIV) risk of all adolescent and adult patients. To determine whether factors amenable to change through continuing medical education are associated with frequent and thorough STD/HIV risk assessment, a telephone survey of primary care physicians in the Washington, DC metropolitan area was conducted (n = 961). Thirty-seven percent of physicians reported regularly asking new adult patients about their sexual practices; 60% asked new adolescent patients. STD/HIV risk questioning was associated with physicians' confidence in their ability to help prevent HIV, comfort with discussing patients' sexual practices, and perception of a large STD/HIV problem in their practice. These findings suggest that continuing medical education should target improvement in physicians' sexual practice questioning skills.

Attitude of Health Personnel↗
PubMedDate not supplied

HIV infection among female injection-drug users recruited in community settings.

BACKGROUND AND OBJECTIVES: To identify relationships between sexual behavior, drug use, and HIV infection among female injection-drug users (IDUs) recruited in community settings. STUDY DESIGN: Risk analysis of 407 survey questionnaires and matched HIV serologies (n = 403) from female IDUs recruited from community settings in 3 inner-city neighborhoods in San Francisco during 1991 and 1992. RESULTS: The HIV seroprevalence of our sample was 11.4%. Fifty-four percent reported using crack cocaine in the past 30 days. HIV seroprevalence was 10.5% among crack cocaine smokers and 12.5% among nonsmokers. In multivariate analysis, HIV infection was associated with a history of sex for money exchanges (adjusted odds ratio [AOR] = 3.11; 95% confidence interval [95% CI] = 1.37, 7.02); history of syphilis (AOR = 3.30; 95% CI = 1.36, 7.99); and African American ethnicity (AOR = 5.31; 95% CI = 2.05, 13.73). Crack smoking in the past 30 days (AOR = 0.33; 95% CI = 0.15, 0.71) and having a current steady sexual partner (AOR = 0.48; 95% CI = 0.24, 0.94) were both inversely associated with HIV infection in the multivariate model. None of our injection-related variables were predictive or protective of HIV infection, when controlled for the above factors. CONCLUSIONS: Unprotected heterosexual activity is a principal risk factor for HIV infection among female IDUs in San Francisco. Greater reported sexual risk behavior of crack smokers was not reflected by a higher HIV rate at present, perhaps because of lower prevalence of HIV among their sexual partners.

Adult↗