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S W Perry

Publications and source records attributed to S W Perry.

At least 37 records · Page 2Linked to original sources
PubMed1994

Self-disclosure of HIV infection to sexual partners after repeated counseling.

This study, with the objective of examining voluntary self-disclosure of HIV infection after repeated counseling, was conducted in a private setting, and designed to operate in conjunction with HIV testing. Counseling was provided at entry, and then at 3 months, 6 months, and every six months thereafter. The study was conducted among 129 HIV-positive adults; the primary risk factor was history of: males having sex with males (n = 104); injection drug use (n = 19); or heterosexual contact (n = 6). Results showed that after a mean of 2.3 years since initial HIV-positive notification, 29 percent of subjects had not disclosed the HIV infection to any present partner, and 30 percent to any past sex partner. Casual sex and lower perceived social support were significantly associated with nondisclosure. The authors conclude that even after repeated individual counseling and at least several months to inform others, about one-third of the sexually active subjects did not disclose their HIV infection to any present sex partner. Clinical and public health implications are covered.

Adolescent↗
PubMed1994

HIV-related depression.

While there is still much to be learned about depression in the context of HIV illness, studies over the past decade are generally reassuring. True, low-grade depressive symptoms are frequent among both HIV-positive and at-risk HIV-negative adults, but depressive disorders are the exception and not the rule, occurring in about 1 of 10 individuals. Similar to non-HIV populations, these depressive disorders are more likely to occur among those HIV-infected adults with severe personality problems, with a history of previous depressions, and with limited current social support. Although rates of depression may slightly increase with development of more severe physical symptoms, even then the clinician should not consider the presence of a depressive disorder as understandable, justified, and therefore "normal." Rather, depressive symptoms accompanied by suicidal ideation are signals for further evaluation and treatment. When antidepressant treatment is indicated, the weight of current evidence suggests that standard therapies can be safely and effectively prescribed for HIV-infected adults. For outpatients without severe physical illness, antidepressant medications are generally well tolerated in recommended dosages and do not increase immunosuppression. For those with more severe physical impairment, the adage for geriatric populations is applicable: "Start low and go slow." If lethargy and cognitive slowing is a major component of the depression, especially among those in later stages of disease, then psychostimulants may be helpful. When concerns about drug abuse preclude such a prescription, an activating antidepressant may be just as helpful to improve both mood and energy. For severe or refractory depressions, such as delusional affective disorders. ECT has been safely given to HIV-infected patients. And finally, accumulated clinical experience and a couple of systematic studies suggest that psychotherapy, alone or in combination with antidepressant drug therapy, can be remarkably beneficial. In sum, data support the fact that we have much to offer our depressed HIV-infected patients. Our task is to make sure that we identify their depressions when present and counter their feelings of hopelessness by ensuring that effective antidepressant treatments are provided.

AIDS Dementia Complex↗
PubMed1993

Inconsistent divergence of mitochondrial DNA in the spontaneously hypertensive rat.

We have recently shown that the spontaneously hypertensive rat (SHR) and the Wistar-Kyoto (WKY) rat differ at a frequency of 1 per 62 bases in their nuclear DNA (Hypertension 1992; 19:425-427). Given the origin of these strains this level of divergence was unexpected. To investigate the origin of this nuclear divergence we have examined mitochondrial DNA. Mitochondrial DNA was isolated from SHR and WKY rats, digested with several restriction enzymes, electrophoresed in 1.0% agarose gels, and the fragments visualized with ethidium bromide staining. This approach allowed us to analyze 220 base pairs of mitochondrial DNA. No differences were detected between SHR and WKY rats. Comparison with the King-Holtzman rat strain produced differences at an average of 1 per 52 base pairs. We also examined several SHR and WKY rats from within our colonies and found no differences suggesting intrastrain homogeneity for mitochondrial DNA phenotypes. These data indicate that the SHR and WKY rat share a recent, common maternal ancestor. This result is consistent with the published origins of the SHR and WKY rat strains. Together with the nuclear divergence results, the data suggest that the original Wistar colony from which SHR and WKY rats were derived was probably highly polymorphic for nuclear genes.

Animals↗
PubMed1993

Self-disclosure of HIV infection to dentists and physicians.

We prospectively examined self-disclosure of HIV infection by 129 men and women to dentists and physicians. After an average of 2.3 years since initial HIV-positive notification and repeated individual counseling, only 53 percent of subjects had told their dentists of HIV infection compared to 89 percent who had told their physicians. This high rate of non-disclosure despite extensive counseling raises concern about effectiveness of education alone in promoting voluntary self-disclosure. Our findings further support recommended universal precautions.

Adolescent↗
PubMed1992

Interpersonal psychotherapy of depressed HIV-positive outpatients.

In an open pilot study, 23 depressed adults infected with human immunodeficiency virus were treated using interpersonal therapy. Twenty subjects recovered from depression after a mean of 16 sessions. The authors discuss six aspects of interpersonal therapy that make it useful with depressed HIV-infected persons: psychoeducation about the sick role; a here-and-now framework; formulation of problems from an interpersonal perspective; exploration of options for changing dysfunctional behavior patterns; identification of focused interpersonal problem areas (grief, role transition, interpersonal disputes, and interpersonal deficits); and the confidence therapists gain from a systematic approach to problem formulation and treatment. Results suggest that mental health professionals should consider interpersonal therapy as a treatment for depressed HIV-positive patients.

AIDS-Related Opportunistic Infections↗
PubMed1990

Behavioral and psychological responses to HIV antibody testing.

The development of tests to identify the antibody to human immunodeficiency virus (HIV) has made it possible to diagnose infection with the virus prior to the development of physical symptoms. The introduction of these tests raises questions regarding the effects of informing individuals of their antibody status. These issues include the emotional impact of telling individuals that they have been infected with a fatal virus and the usefulness of antibody testing in promoting behaviors that would reduce the spread of acquired immunodeficiency syndrome (AIDS). Research that has examined changes in psychological distress and in behaviors associated with HIV infection among individuals who have undergone antibody testing is reviewed. Methodological issues encountered in studying behavioral and psychological responses to antibody testing are identified, and directions for future research are offered.

HIV Antibodies↗
PubMed1990

Psychological responses to serological testing for HIV.

To determine the emotional impact of serological testing for HIV, 218 physically asymptomatic adults were evaluated in a confidential clinical setting 2 weeks before HIV test notification, immediately before and after notification, and 2 and 10 weeks later. All received extensive pre- and post-test counseling. The 179 seronegatives reported one or more HIV risk behaviors: homosexual intercourse (n = 111), heterosexual intercourse with possibly infected partners (n = 62), intravenous drug use (n = 20). Immediately after notification, seronegatives had significant decreases in visual analogue scale (VAS) measures of anxiety, depression, fear of getting AIDS, and fear of having infected others. Reductions were sustained at both follow-up assessments and were complemented by significant reductions on standardized self-reported measures of anxiety (Spielberger State Anxiety Inventory, SAI), depression (Beck Depression Inventory, BDI), and psychiatric symptoms (Brief Symptom Inventory, BSI) as well as by clinical ratings of depression (Hamilton Depression Rating Scale, HDRS). Of 39 seropositives, 35 had homosexual risk behaviors, seven had been intravenous drug users (IVDUs; four of whom were homosexual men), and one was a female partner of an IVDU. Immediately after notification, VAS measures of their anxiety were not significantly increased, and at 10 weeks after notification, their VAS measures of distress and mean scores on BDI, SAI and BSI were significantly lower than at entry. Their HDRS ratings were not significantly increased.

AIDS Serodiagnosis↗
PubMed1990

Organic mental disorders caused by HIV: update on early diagnosis and treatment.

HIV directly affects the CNS, primarily causing subcortical neuropathology. Dementia as the initial presentation is rare, but organic mental changes that mimic many functional disorders can occur during the course of infection. The mental status examination is not adequately sensitive to detect noncognitive dysfunction, and subjective complaints, neurological signs, reduced T4 lymphocytes, CSF abnormalities, diffuse slowing on ECG, mild cerebral atrophy on brain CT, and nonspecific hyperdensities on brain magnetic resonance imaging do not correlate reliably with early and subtle HIV-induced neuropsychological impairment. Zidovudine (AZT) can delay or reverse mental deficits, and psychostimulants can reduce apathetic withdrawal, but high-potency neuroleptics can cause neuroleptic malignant syndrome.

AIDS Dementia Complex↗
PubMed1988

Stress and coping in relatives of burn patients: a longitudinal study.

Standardized psychological assessment of 48 close relatives of patients hospitalized for burns revealed that the relatives experienced high levels of distress during the acute phase of the patient's hospitalization. At six-month follow-up, the relatives' general psychological symptomatology had receded to within the normal range, but 25 percent continued to show specific stress syndromes characterized by intrusive and avoidant responses to the past burn trauma. Intrusive-avoidant stress responses could not be predicted by demographic information, severity of the burn, facial disfigurement, or actual responsibility for the burn, but blaming oneself for the injury to the patient was a significant predictor. Evaluating stress responses of close relatives after burn trauma can lead to more successful intervention for those who remain stressed and may enhance patient and family compliance with the treatment and rehabilitation regime.

Adaptation, Psychological↗
PubMed1988

Counseling for HIV testing.

Recommendations are presented for counseling individuals who wish to know if they have been infected by the human immunodeficiency virus (HIV). Pretest counseling includes explaining the sensitivity and meaning of HIV antibody tests and the limits of confidentiality, assessing the patient's potential strengths, vulnerabilities, coping capacity, and supportive resources, and mutually deciding if the test is advisable. Populations that have been identified as at risk for HIV infection are listed, and four case vignettes that illustrate the complexity of the decision to be tested are provided. Posttest counseling includes notification of test results, reducing the immediate distress of seropositive patients, educating about how HIV is and is not spread, explaining methods to prevent transmission, advising the patient about who should be told the test results, and arranging follow-up care.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Homophobia reassessed.

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Acquired Immunodeficiency Syndrome↗