G Weissman — Page 2 | PubMed Health

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Women living with substance abuse and HIV disease: medical care access issues.

This paper presents first-year findings from a multi-site, longitudinal study being coordinated by the Health Resources and Services Administration (HRSA) in collaboration with the National Institute on Drug Abuse (NIDA) on access to care for drug abusers with HIV. The sample of 116 women and 187 men in five sites (Denver, Detroit, New Haven, New Orleans, and St. Louis) were interviewed regarding HIV testing history, HIV disease course, and use of health and social services. For both men and women, there were significant gaps between the medical services they reported needing and those they received. Significantly more women needed and received mental health services. Cost and waiting times emerged as the most important barriers to care. The study also found that significantly fewer women than men subjects received pre- and post-test counseling and were advised to get medical services after their first positive HIV test. Overall, first-year study results suggest that multiple barriers in access to service exist for drug-using women, the largest group of women affected by HIV in the United States.

Adolescent↗

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Intestinal microsporidiosis. Report of five cases.

Five cases of intestinal microsporidiosis are reported, including one case of a heterosexual female acquired immunodeficiency syndrome (AIDS) patient, three homosexual males, and one bisexual male AIDS patients with detailed description of their clinical course. These five cases underscore the severity of immunodeficiency in patients with microsporidiosis. All patients had multiple opportunistic infections and a CD4 cell count below 100/microliters long before diarrhea developed. This is the first kinetic study of helper T-lymphocytes in cases of microsporidiosis. Diagnosis was made by duodenal biopsies stained with Brown and Brenn or Gram-Weigert technique (confirmed by electron microscopy) and by stool smears stained with a modified trichrome technique. However, the best preparation was plastic sections stained with toluidine blue, which demonstrated both the spores and plasmodia clearly. In our evaluation, Giemsa stain was also acceptable for identification of microsporidian spores in both intestinal biopsies and stool smears, but there was a failure to identify the organism on hematoxylin and eosin, acid-fast, periodic acid-Schiff, and Gomeri's methenamine silver stained preparations. Therapeutic attempts using albendazole, metronidazole, octreotide, and zidovudine (AZT) failed to eradicate microsporidia in these patients.

Acquired Immunodeficiency Syndrome↗