SEARCH · PubMed Health

Results for “Community Programs for Clinical Research on AIDS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources

PubMed1999

Developing an emergency department team for treatment of stroke with recombinant tissue plasminogen activator.

The EMS, ED, neurology, radiology, nursing, laboratory, and pharmacy departments are integral parts of the stroke team system. These are the key departments responsible for the support of the stroke team, or nucleus, which emanates from the departments of neurology and emergency medicine in the author's medical center. In the same way that cardiac victims are treated for "heart attack," so stroke victims should be treated for "brain attack." The emphasis on public awareness to community outreach and senior citizens groups through the aid of the public affairs department of the institution, the American Heart Association, and the National Stroke Association (NSA) has been a tremendous lift in this, the decade of the brain. The Public Broadcasting System and other television channels have helped enormously in publicizing stroke signs and symptoms, new treatment of stroke, and concurrent risk factors. New clinical research for thrombolytics and neuro-protective agents are now in progress to determine the best treatment for the damaged brain. The emphasis is changing: Time is brain. We hope to change the expenditure attributable to rehabilitation and managed care after stroke to the more hopeful prospects of prevention, early treatment, and fast recovery. We can then see that our friends and family members, as victims of stroke, may proceed to independence rather than long-term care facilities or nursing homes. This will be possible only if hospitals and medical centers nationwide adequately gear themselves for the treatment of ischemic stroke through the creation of a core stroke team, finely-honed interdepartmental cooperation, and the development of an efficient ED team that is fully immersed in the ethics and protocol of "brain attack."

Aged↗

PubMed2002

HIV-associated histories, perceptions, and practices among low-income African American women: does rural residence matter?

OBJECTIVES: This study compared HIV-associated sexual health history, risk perceptions, and sexual risk behaviors of low-income rural and nonrural African American women. METHODS: A cross-sectional statewide survey of African American women (n = 571) attending federally funded Special Supplemental Nutrition Program for Women, Infants, and Children clinics was conducted. RESULTS: Adjusted analyses indicated that rural women were more likely to report not being counseled about HIV during pregnancy (P =.001), that a sex partner had not been tested for HIV (P =.005), no preferred method of prevention because they did not worry about sexually transmitted diseases (P =.02), not using condoms (P =.009), and a belief that their partner was HIV negative, despite lack of testing (P =.04). CONCLUSIONS: This study provided initial evidence that low-income rural African American women are an important population for HIV prevention programs.

AIDS Serodiagnosis↗

PubMed2000

Bridging the gap between the science and service of HIV prevention: transferring effective research-based HIV prevention interventions to community AIDS service providers.

OBJECTIVES: AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. METHODS: Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. RESULTS: The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. CONCLUSIONS: Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone.

Diffusion of Innovation↗

PubMedDate not supplied

Six school-based clinics: their reproductive health services and impact on sexual behavior.

An evaluation of the reproductive health programs of six diverse school-based clinics measured the impact of the clinics on sexual behavior and contraceptive use. All six clinics served low-income populations; at five of them, the great majority of the students served were black. An analysis of student visits by type of care given found that these clinics were not primarily family planning facilities; rather, they provided reproductive health care as one component of a comprehensive health program. Student survey data collected in the clinic schools and nearby comparison schools (four sites) or collected both before the clinic opened and two years later (two sites) indicated that the clinics neither hastened the onset of sexual activity nor increased its frequency. The clinics had varying effects on contraceptive use. Providing contraceptives on site was not enough to significantly increase their use; in only one of the three sites that did so were students in the clinic school significantly more likely than students in the comparison school to have used birth control during last intercourse. However, condom use rose sharply at one clinic school that had a strong AIDS education program and was located in a community where AIDS was a salient issue. At another clinic school, where pregnancy prevention was a high priority and staff issued vouchers for contraceptives, the use of condoms and pills was significantly higher than in the comparison school. A third clinic school--which focused on high-risk youth, emphasized pregnancy prevention and dispensed birth control pills--recorded a significantly higher use of pills than its comparison school. Although the data suggest that the clinics probably prevented small numbers of pregnancies at some schools, none of the clinics had a statistically significant effect on school-wide pregnancy rates.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Bridgeport's Teen Outreach and Primary Services (TOPS) project: a model for raising community awareness about adolescent HIV risk.

The Greater Bridgeport Adolescent Pregnancy Program (GBAPP), based on its skills in sex education, pregnancy, and sexually transmitted disease prevention, developed the Teen Outreach and Primary Services (TOPS) project, an innovative teen-focused community outreach model to expand and ensure access to health and support services for primarily underserved minority adolescents and young adults at risk for or living with the human immunodeficiency virus (HIV). TOPS is supported by the Special Projects of National Significance Program, HIV/Acquired Immunodeficiency Syndrome (AIDS) Bureau, Health Resources and Services Administration. The target population for TOPS is inner-city minority youth (ages 15-24 years) at high risk for HIV or HIV positive. Services ranging from outreach to intensive case management were provided to 2173 youth in the project. The number of HIV-positive youth has increased from three in the first year of the project to 17 in 1997. TOPS provides outreach, case management, HIV counseling and testing, risk-reduction activities, and referrals for housing, entitlements, specialty HIV clinics, and substance abuse counseling and treatment. A group of peer educators has been recruited from among the target population and is trained and paired with the staff to provide outreach services, peer counseling, and education, and to assist with recreational opportunities.

Adolescent↗

PubMed1990

A comparison of hospital and community case management programs for persons with AIDS.

To determine whether locus of AIDS case management affects the content of this service, a survey of case managers in 42 major American cities was conducted. One hundred seventy-one case managers working in both public hospitals and community-based organizations (CBOs) responded. Hospital case managers were substantially more likely to report clinical training than CBO case managers. Hospital case managers' case loads were more likely to include drug users and patients with more urgent needs such as housing and drug abuse treatment. While CBO case managers were more likely to work to develop services in the community, hospital case managers reported working more closely with medical staff and discharge planning committees. CBO case managers reported greater difficulty obtaining a number of key services for their clients including home health care, housekeeping, and entitlements; hospital case managers reported greater difficulty obtaining emotional support volunteers. These results indicate that locus of case management strongly affects the structure and content of this service. The importance of these findings for future program planning is discussed.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Variation in health service use among HIV-infected patients.

The effects of sociodemographic factors on health service use among people with human immunodeficiency virus (HIV) infection are assessed. Data are from a survey of 939 clients of the Robert Wood Johnson Foundation's AIDS Health Services Program in nine communities across the country. Dependent variables are the number of outpatient visits, use of the emergency room, and whether the respondent had been admitted as an inpatient. In the 3 months before the interview, the sample averaged 7.46 outpatient physician/clinic visits: 35.9% reported an emergency room visit, and 29.9% had been hospitalized. The data suggested differential patterns of health service use, such that those who are white, male, and non-intravenous drug users have higher rates of outpatient clinic/physician use, whereas those who are nonwhite, female, and intravenous drug users have higher rates of emergency room use. Whether these observed differences are attributable to the system's response to different socioeconomic groups, or to differences in individual orientations toward use of medical care is discussed.

Black or African American↗

PubMed1998

Private business: the uptake of confidential HIV testing in remote aboriginal communities on the Anangu Pitjantjatjara Lands.

BACKGROUND AND METHODS: Despite a concentration of risk factors for HIV transmission, many remote Aboriginal communities in central Australia have a low uptake of HIV testing. We studied the uptake of HIV testing in six clinics in remote Aboriginal communities following the introduction of voluntary confidential testing to assess the impact of the intervention and to determine if the program was reaching people most at risk of HIV infection and transmission. SETTING: The study was conducted by Nganampa Health Council, an Aboriginal-controlled health service on the Anangu Pitjantjatjara Lands in the far north-west of South Australia. RESULTS: Since the introduction of confidential coded testing in August 1994 the number of HIV tests provided through the remote clinics has increased from 83 tests/year to 592 tests/year. In the 12-month audit period (August 1, 1995, to July 31, 1996) 62.7% of women aged 20-24 years, 44.6% of people aged 12-40 years and 24% of the total population had an HIV test. Fifty per cent of tests were accounted for by the 15-25 year age groups and 60% of tests related to an STD consult. DISCUSSION: This study shows that a high uptake of HIV testing in high-risk groups can be achieved in remote Aboriginal communities where a high level of confidentiality is maintained.

AIDS Serodiagnosis↗

PubMed1991

AIDS case management: the client's perspective.

The Robert Wood Johnson Foundation's AIDS Health Services Program uses case management to provide community-based care for people with AIDS. This article reports data concerning implementation of case management, based on interviews with program clients in nine communities. Some clients receive case management from a community-based organization (CBO), while others have clinic-based case managers. Clinic clients are more likely to be disadvantaged. Over 25 percent of respondents report having no case manager at either site, and 10 percent report having two case managers. Those who need social services are more likely to have a case manager. Between 18 and 25 percent have had no contact with their case manager in a month, but over 50 percent have had multiple contacts. Frequency of contact is positively related to having needs for social services. Evaluations of case managers are favorable, but there is some dissatisfaction with ease of access. Having a case manager is positively related to having service needs met. Results suggest that (1) efforts to coordinate care through case management must deal with the existence of clinics and CBOs as distinct treatment sites with differing clientele, and (2) explicit policies concerning eligibility for case management and frequency of monitoring must be developed.

Acquired Immunodeficiency Syndrome↗

PubMed1992

AIDS/HIV risk behavior among the chronic mentally ill.

OBJECTIVE: There is growing concern that chronic mentally ill adults living in the community have a high risk for HIV infection. The purpose of this study was to identify risk knowledge, high-risk behaviors, and risk-related encounters of chronic psychiatric outpatients. METHOD: Detailed information on high-risk behaviors and risk-related situations during the past 12 months was collected from 60 outpatients appearing for regular visits at inner-city community mental health clinics. RESULTS: Of the 60 outpatients, 37 (62%) had been sexually active during the past year, and 42% of the men and 19% of the women reported multiple sexual contacts and infrequent use of condoms during intercourse. Assessments of the patients' knowledge of AIDS risks revealed substantial deficits in their practical understanding of AIDS and risk reduction measures. Although use of intravenous drugs was uncommon in this group, many subjects reported histories of 1) trading sex for money, drugs, or a place to stay, 2) coercion to engage in unwanted sex, 3) causal sexual encounters, and 4) sexual activity after use of drugs or intoxicants. Twenty percent of the subjects had met their sexual partners on the streets, in parks, or in other public places. One-third had been treated for sexually transmitted diseases other than AIDS. CONCLUSIONS: These findings underscore the need for AIDS risk assessment, counseling, and prevention programs for the chronic mentally ill.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Childhood blindness and low vision in Uganda.

PURPOSE: To examine the causes and outcome of subnormal vision starting in childhood in Uganda, to aid in planning for its avoidance and for rehabilitation. METHODS: All those seen having subnormal vision with onset from birth to 15 years (total 1135) (schools 1983-97; community 1988-97) were included in the study. Clinical examination was performed and a World Health Organisation (WHO) form completed, with analysis by its computer program. Main outcome measures were visual acuity, signs of eye pathology, outcome of treatment and refraction and low vision assessment. RESULTS: By WHO category 14.8% had visual impairment, 6.5% severe visual impairment, 63.2% were blind and 15.2% were too young to test. The acuities and causes were similar in school and community groups, excepting cortical visual impairment and multiple impairment, which are much commoner in the community. Cataract was the largest cause of visual impairment (30.7%) and surgical outcome was unsatisfactory. Visual loss following corneal ulceration was the second commonest cause of subnormal vision (22.0%). CONCLUSIONS: Cataract and corneal damage cause half of all subnormal vision, which is avoidable for both. Cataract surgery needs to be upgraded. To prevent corneal visual loss, primary health care should continue to be expanded, especially measles immunisation and nutrition care; rubella immunisation should be added. Special education needs to be greatly expanded. Public perceptions need changing if results are to be improved and help offered to more than the present minority.

Adolescent↗

PubMed1997

AIDS education in Tanzania: promoting risk reduction among primary school children.

OBJECTIVES: The purpose of this study was to test the effects of an education program in Tanzania designed to reduce children's risk of human immunodeficiency virus (HIV) infection and to improve their tolerance of and care for people with acquired immunodeficiency syndrome (AIDS). METHODS: A randomized controlled community trial including baseline and 12-month follow-up surveys was employed. Public primary schools in the Arusha and Kilimanjaro regions of Tanzania were stratified according to location and randomly assigned to intervention (n = 6) or comparison (n = 12) conditions. Of the 1063 sixth-grade students (average age: 13.6 years) who participated at baseline, 814 participated in the follow-up survey. RESULTS: At follow-up, statistically significant effects favoring the intervention group were observed for exposure to AIDS information and communication, AIDS knowledge, attitudes toward people with AIDS, and subjective norms and behavioral intentions toward having sexual intercourse. A consistent positive but nonsignificant trend was seen for attitudes toward having sexual intercourse and for initiation of sexual intercourse during the previous year (7% vs 17%). CONCLUSIONS: It is feasible and effective to train local teachers and health workers to provide HIV/AIDS education to Tanzanian primary school children.

Acquired Immunodeficiency Syndrome↗

PubMed1990

The safety and pharmacokinetics of GLQ223 in subjects with AIDS and AIDS-related complex: a phase I study.

A phase I dose-escalation study was performed to evaluate the safety and pharmacokinetics of a single intravenous infusion of GLQ223 in subjects with AIDS and AIDS-related complex (ARC). The active ingredient in GLQ223 is trichosanthin. Trichosanthin, imported from China, is the active drug in community-initiated treatment programs for patients with HIV infection. Eighteen subjects were enrolled, 10 with AIDS and eight with ARC. All subjects were monitored for tolerance and toxicity. Immunological and virological parameters were also followed. GLQ223 administration was not associated with notable toxicity with the exception of one subject who experienced a severe neurological adverse reaction. No consistent or sustained changes in CD4+ lymphocyte populations or HIV antigen levels were observed. Serum concentrations of GLQ223 that were comparable to concentrations shown to have antiviral activity in vitro were achieved transiently but may not have been maintained for a sufficient duration to exert antiretroviral effects. Further studies are indicated to determine pharmacodynamic properties of GLQ223, its optimal dosing schedule, and whether GLQ223 or related molecules will be useful in the treatment of HIV infection.

AIDS-Related Complex↗

PubMed1999

Sex in the New World: an empowerment model for HIV prevention in Latina immigrant women.

In 1996, nearly 60% of U.S. AIDS cases among Latinas were attributed to unprotected sex with men. Economic disadvantage, language barriers, and strong cultural gender norms regarding sex exacerbate the risk for HIV infection among Latina immigrant women. Through a collaboration among scientists and providers, this study was designed to evaluate the impact of a multifaceted empowerment program for Latina immigrant women on HIV risk behaviors. Women (N = 74) were followed for the first 6 months of their participation and attended up to nine distinct types of activities (e.g., information meetings, friendship circles, and workshops). Although the program was not developed to specifically target HIV risk behaviors, women showed significant increases in sexual communication comfort, were less likely to maintain traditional sexual gender norms, and reported changes in decision-making power. Targeting broader sociocultural issues may increase the necessary skills for Latina women to prevent HIV infection from their sexual partners. Successful collaborations between scientists and providers are critical in developing effective, community-relevant interventions.

Adult↗

PubMedDate not supplied

Hazardous terrain and over the edge: the survival of HIV-positive heterosexual, minority men.

The purpose of this study was to describe and explore the experience and perceptions of heterosexual minority men living with and surviving HIV infection. This descriptive, exploratory qualitative study used in-depth interviews that were guided by Rosenstock's health belief model and Ajzen's theory of planned behavior. A purposive sample of 18 HIV-positive heterosexual, minority men were accrued from an outpatient HIV/AIDS clinic in upstate New York and a community-based AIDS service organization in New York City. The findings revealed that the experience of surviving HIV infection encompassed several stages. The men of this study described the choices they made in adolescence that led them down a trail of life that may be metaphorically described as "hazardous terrain," as the majority became involved in substance use or other illicit activities. With the diagnosis of HIV infection came a "Falling Off" stage, in which the participants went "over the edge" and initially were afraid to die but realized at this point that they were okay but vulnerable. The next stage was "Hanging On," in which they attempted to gain control, reevaluated priorities, and developed a new perspective on life and health. In the "Pulling Up" stage, participants realized that the rescue team included self, God, family, and friends, with self-rescue occurring on emotional, physical, and spiritual levels. As the participants reached the "Turning Around" stage, they began to accept responsibility for their health, focused on their abilities rather than their limitations, and reframed their perspectives to living with rather than dying from HIV infection. This study has implications for health-education programs, AIDS prevention, health assessment, and interventions for HIV-positive, heterosexual, minority men.

Adaptation, Psychological↗

PubMed2003

Randomised trials in general practice--a New Zealand experience in recruitment.

AIM: To examine general practitioner (GP) and patient recruitment in a randomised clinical trial to determine the usefulness of brain natriuretic peptide (BNP) in the diagnosis of heart failure in the community. METHODS: Different techniques were used to maximise GP recruitment including early consultation with GPs, benefits for participating GPs and patients, and a comprehensive suburb-by-suburb approach to GPs using letters and personal visits. GPs then referred patients. At the conclusion of the study, GPs were given a questionnaire focussing on barriers to referral and reasons for participation. RESULTS: Three hundred and twenty seven GPs from 135 practices were sent an introductory letter; 294 were eligible to participate. Of these, 186 GPs (63% of eligible GPs) agreed to participate. Ninety two GPs (31% of eligible GPs) from 62 practices referred 307 patients to the study (range 1-14 patients). There were no significant differences between referring and non-referring GPs with respect to sociodemographic characteristics. Referring GPs were very supportive of GP participation in research and strongly agreed that GPs should be reimbursed for involvement in trials. CONCLUSIONS: Patient recruitment by GPs may be aided by the use of a range of strategies including financial reimbursement. GPs who agree to participate will not always recruit patients. Closer collaboration and understanding between primary healthcare professionals and researchers may further enhance recruitment to clinical trials.

Attitude of Health Personnel↗

PubMedDate not supplied

Differences in access to zidovudine (AZT) among symptomatic HIV-infected persons.

OBJECT: To evaluate socioeconomic factors that determine whether symptomatic HIV-infected persons are offered zidovudine (AZT). DESIGN: Cross-sectional survey conducted as part of the Robert Wood Johnson Foundation's AIDS Health Services Program. SETTING: Public hospital clinics and community-based AIDS organizations in nine American cities. PATIENTS: 880 HIV-seropositive outpatients interviewed between October 1988 and May 1989. MAIN RESULTS: Males were more likely to have been offered AZT than were females (adjusted odds ratio 2.99; 95% confidence interval 1.67 to 5.36), those with insurance were more likely to have been offered AZT than were those without (adjusted odds ratio 2.00; 95% confidence interval 1.25 to 3.21), and whites more likely to have been offered AZT than were non-whites (adjusted odds ratio 1.73; 95% confidence interval 1.11 to 2.69). Intravenous drug users were less likely to have been offered AZT than were non-drug users (adjusted odds ratio 0.44; 95% confidence interval 0.28 to 0.69). Persons who had had an episode of Pneumocystis carinii pneumonia were more likely to have been offered AZT than were persons who had AIDS and had not had Pneumocystis carinii pneumonia (adjusted odds ratio 2.95; 95% confidence interval 1.71 to 5.11). CONCLUSION: The authors conclude that traditionally disadvantaged groups have less access to AZT, the only antiretroviral agent demonstrated to increase survival of patients who have symptomatic HIV infection.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Umbanda healers as effective AIDS educators: case-control study in Brazilian urban slums (favelas).

During a 12-month period (November 1994-October 1995), Afro-Brazilian Umbanda healers (Pais-de-Santo) taught 126 fellow healers from 51 Umbanda centres (terreiros) located in seven overcrowded slums (favelas) (population 104-343) in Brazil's northeast, the biomedical prevention of AIDS, including safe sex practices, avoidance of ritual blood behaviours and sterilization of cutting instruments. A face-to-face educational intervention by healers, marginalized in society yet respected by devotees, which blended traditional healing-its language, codes, symbols and images- and scientific medicine and addressed social injustices and discrimination was utilized in this project supported by the Brazilian Ministry of Health, National Program in STDs/AIDS. Significant increases (P < 0.001) in AIDS awareness, knowledge about risky HIV behaviour, information about correct condom use, and acceptance of lower-risk, alternative ritual blood practices and decreases (P < 0.001) in prejudicial attitudes related to HIV transmission were found among mobilized healers as compared to 100 untrained controls. Respected Afro-Brazilian Pais-de-Santo can be creative and effective partners in national HIV prevention programmes when they are equipped with biomedical information about AIDS.

Acquired Immunodeficiency Syndrome↗