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Biomedical subjects

M Barnard

Publications and source records attributed to M Barnard.

14 recordsLinked to original sources
PubMed1992

Female streetworking prostitution and HIV infection in Glasgow.

OBJECTIVES: To identify the extent of HIV infection and injecting drug use among female streetworking prostitutes in Glasgow; to estimate the size of the female streetworking prostitute population in the city; and to estimate the number of HIV positive women working as prostitutes on the streets in Glasgow. DESIGN: Observation and interviewing of female prostitutes over seven months in red light district; analysis of saliva samples for presence of antibodies to HIV; capture-recapture approach to estimating the size of the female streetworking prostitute population. SETTING: Glasgow. SUBJECTS: 206 female streetworking prostitutes. MAIN OUTCOME MEASURES: Number of women with antibodies to HIV, self reported use of injecting drugs, history of contact with 206 women. RESULTS: Saliva samples were requested from 197 women; 159 (81%) provided samples. Four (2.5%, 95% confidence interval 0.7%-6.3%) of the samples were positive for HIV, all of which had been provided by women who injected drugs. Of the 206 streetworking women contacted 147 (71%) were injecting drug users. About 1150 women are estimated to work on the streets in Glasgow over a 12 month period. CONCLUSIONS: HIV is not as widespread among female prostitutes as many reports in the tabloid press suggest. A greater proportion of female streetworking prostitutes in Glasgow are injecting drugs than has been reported for other British cities.

Female↗
PubMed1992

Selling sex: female street prostitution and HIV risk behaviour in Glasgow.

Female prostitutes have often been seen as a major source of HIV infection. In this paper we report on a study of HIV-related risk behaviour among street prostitutes in Glasgow. This paper is based on street interviews using a standardized schedule with 68 women. We focus on the extent of HIV testing amongst the women, travel, the sexual services provided, the use of condoms with clients and private partners, and the extent of drug injecting and equipment sharing by the women. It is shown that female street prostitution within Glasgow is, at present, unlikely to be associated with significant heterosexual spread of HIV as most commercial sex is with a condom. However, some risk activities are continuing. Additionally, prostitutes report worrying rates of condom failure with clients. It is suggested that attention should switch away from an exclusive focus on women selling sexual services to target the men who purchase sex. These data indicate that much of the pressure for these women to provide unprotected sex comes from their clients.

AIDS Serodiagnosis↗
PubMed1992

Providing drug injectors with easier access to sterile injecting equipment: a description of a pharmacy based scheme.

In this short paper we describe the operation of a pharmacy-based scheme operating in Glasgow to provide injecting drug users with sterile injecting equipment. The operation of the scheme is described under a number of headings: its physical location, the policy of selling injecting equipment, the return of previously used equipment, counselling and referral, and, the style of working of pharmacy staff. It is shown that while retail pharmacies may be an important point of contact with injecting drug users it should not be assumed that pharmacy staff already possess the requisite skills for working in this area. There is a need for pharmacists' and their staff to be able to draw upon the experience of colleagues working in this area in order to benefit from a pool of common experience. In addition there is a need to provide staff with access to appropriate back-up and support services.

HIV Infections↗
PubMed1991

Metabolic response to colonic surgery: extradural vs continuous spinal.

We have examined the effect of intraoperative and postoperative (4 h) continuous spinal anaesthesia for colonic surgery on the postoperative glucose, lactate and cortisol responses. Twenty-one patients were studied; the first group (control) received general anaesthesia, the second group (extradural) an extradural block (T4-S5) and the third group (spinal) a continuous spinal block (T4-S5). Plasma concentration of glucose increased significantly in the control and extradural groups (P less than 0.05) after surgery, with a small change in the spinal group. Plasma concentration of lactate increased significantly (P less than 0.05) in the control group only. The postoperative increase in plasma concentration of cortisol was similar in both control and extradural groups, and significantly greater than that of the spinal group (P less than 0.05). Thus continuous spinal analgesia attenuated, but did not abolish, the increase in plasma concentration of cortisol associated with colonic surgery.

Aged↗
PubMed1991

Estimating hidden populations: a new method of calculating the prevalence of drug-injecting and non-injecting female street prostitution.

This paper outlines a new method we have developed for estimating the prevalence of streetworking prostitution and the proportions of female street-working prostitutes who are injecting drug users. This method is based on the capture/recapture approach and involves distinguishing new fieldwork contacts from repeat field work contacts. The size of the overall population can be modelled from records of the increasing ratio of repeat to new fieldwork contacts. The method may have a relevance beyond a concern with prostitution and drug injecting, and may be of value in estimating other hidden populations.

Female↗
PubMed1990

An ethnographic study of HIV-related risk practices among Glasgow rent boys and their clients: report of a pilot study.

This paper provides an early report of a continuing ethnographic study of male prostitution in Glasgow. Pilot work indicates that rent boy activity may be of considerable importance for the spread of HIV infection. Although there is little evidence of an association between rent boy activity and injecting drug use, rent boys may well be implicated in epidemic spread because many (but not all) of them report unsafe sexual practices. Some boys reported that they engaged in unprotected anal sex both actively (insertor) and passively (insertee). Although the majority of the boys' clients were covert bisexuals--married men seeking occasional, anonymous, male sexual contact--a substantial minority of clients were gay-identified.

Adolescent↗
PubMed1990

Adolescents, sex and injecting drug use: risks for HIV infection.

In this paper we present data on the HIV-related risks for adolescents growing up in an area where injecting drug use is prevalent and HIV infection has been identified among local injecting drug users. We report on young peoples' knowledge, attitudes and perceptions of drug use and injectors; HIV and AIDS; sex, safer sex and condom use. These adolescents had an extensive and practically oriented knowledge of illicit drugs and drug injectors. The majority of adolescents contacted had an unsophisticated but approximate understanding of HIV transmission dynamics and how to guard against infection. Our data suggest that many adolescents find issues relating to sex awkward, embarrassing and difficult subjects for discussion. In a final section we consider some of the policy implications of our work focussing in particular on the prevention of injecting, the promotion of condom use, and the necessity of avoiding a focus upon risk groups.

Adolescent↗
PubMed1990

Injecting drug use and female street-working prostitution in Glasgow.

There are considerable difficulties associated with calculating the prevalence of covert, illegal and stigmatized activities. This paper outlines new methods we have developed for calculating the prevalence of both drug-injecting street prostitution and non-injecting street prostitution in Glasgow. Our data indicate that Glasgow has a much higher level of injecting drug use than has been reported among prostitutes in other British cities.

Female↗
PubMed1989

HIV-related risk behaviour among a non-clinic sample of injecting drug users.

This paper focuses upon HIV-related risk behaviour among a sample of injecting drug users purchasing injecting equipment at a retail pharmacy in Glasgow. It is shown that the majority of the individuals interviewed were concerned about HIV/AIDS and that many were optimistic about their chances of avoiding contracting the virus. However, it is shown that the shared use of injecting equipment was continuing and that many individuals were prepared to provide their own injecting equipment to others, even if they were unprepared to re-use it again themselves. We also consider here the possibility of encouraging drug injectors to switch to non-injecting drug use and the potential basis for any sexual transmission between drug injectors and others. The paper concludes with a consideration of some of the policy implications of this work.

Adolescent↗
PubMed1988

Clonal rearrangement of the T-cell receptor gamma gene associated with a bizarre lymphoproliferative syndrome.

Investigations in an unusual patient with prolonged fever, fat necrosis and haemorrhagic tendency showed widespread histiocytic phagocytosis in fat and liver biopsy specimens. Lymph nodes were also infiltrated by morphologically normal T lymphocytes predominantly expressing the OKT4 antigen. Analysis of lymph node DNA using immunoglobulin and T-cell receptor (TCR) probes showed rearrangement restricted to the gamma TCR gene combined with polyclonal beta TCR gene rearrangements, thus providing evidence of a unique lymphoproliferative disorder of T cells. The patient displayed a striking response to cytotoxic chemotherapy.

DNA↗
PubMed1986

Polysaccharide surface antigens expressed by nonmucoid isolates of Pseudomonas aeruginosa from cystic fibrosis patients.

We tested nonmucoid Pseudomonas aeruginosa isolates obtained from cystic fibrosis (CF) patients for the expression of lipopolysaccharide (LPS) serotype antigens, serum sensitivity, and production of mucoid exopolysaccharide (MEP). When all nonmucoid isolates were compared with a set of random mucoid isolates, 20 of 52 (38%) nonmucoid isolates were typable and serum resistant, compared with 13 of 51 (24%) mucoid isolates (P = 0.16 by chi-square analysis). However, nonmucoid strains from CF patients colonized only with nonmucoid strains were more frequently typable and serum resistant (67%) than were nonmucoid isolates from patients cocolonized with mucoid strains (31%) (P = 0.012, Fisher exact test). An inhibition enzyme-linked immunosorbent assay done with bacterial extracts, a direct-whole-cell enzyme-linked immunosorbent assay done with affinity-purified antibody to MEP, and immune electron microscopy all demonstrated production of MEP by all nonmucoid P. aeruginosa isolates tested, including nonmucoid revertants of mucoid strains. No other bacterial species tested positive in these assays. These findings suggest that MEP is produced by all P. aeruginosa isolates obtained from CF patients, that the initial colonizing nonmucoid strains produce a smooth LPS, and that once LPS-rough, mucoid strains appear in the sputum, the predominant LPS phenotype is rough regardless of colony morphology.

Antigens, Bacterial↗
PubMed1985

Effects of peptidoglycans from periodontal pathogens on selected biological activities of CD-1 murine peritoneal macrophages.

Resident CD-1 murine peritoneal macrophages were exposed to various concentrations of purified peptidoglycan isolated from members of the genera Bacteroides, Eikenella, and Actinomyces. Macrophage viability, the release of lysozyme, acid phosphatase, and prostaglandins E1 and E2 were assayed as a function of peptidoglycan concentration and time. Macrophages responded as a function of peptidoglycan concentration with increased release of acid phosphatase and prostaglandins; all cells remained greater than 90% viable during the course of the experiments. However, concentrations of peptidoglycan greater than 50 micrograms/mL were toxic to the macrophages, while the peptidoglycan from B. capillus strain 925.08 and Actinomyces viscosus strain T14AV consumed complement by both the classical and the alternate pathways. Cellular lysozyme activity and phagocytosis of Saccharomyces cerevisiae were significantly reduced in the presence of peptidoglycan. When viewed by scanning electron microscopy, the activated macrophages were rounded, lacked distinct pseudopod extensions, and possessed an increased number of microvilli and plasma membrane associated vesicles. These morphological alterations occurred as early as 3 h. Transmission electron microscopy revealed the purified peptidoglycan to have been taken up into numerous phagosomes; however, even after 24 h incubation, it was only partially degraded.

Acid Phosphatase↗