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PubMed1990

AIDS/HIV: implications for speech-language pathologists and audiologists.

Great strides have been made in the past year in uncovering the pathogenesis of AIDS/HIV, in administering certain drugs to retard the course of AIDS/HIV, in allaying the concerns of the general public, and in dispelling the many myths regarding AIDS/HIV. ASHA's Committee on Quality Assurance has provided this update as a result of obtaining the most current information from CDC and related AIDS/HIV literature. Human service providers are not at high risk of getting AIDS/HIV as a result of their work with clients, even if they regularly care for persons with AIDS/HIV (American College Health Association Task Force on AIDS, 1987). The risk is associated with coming in contact with blood and body fluids containing visible blood and from needle stick injuries. Guidelines for prevention of transmission of the AIDS virus to caregivers are similar to those of transmission of Hepatitis B. All practitioners should be aware of these guidelines and diligently observe them. This update has relaxed a more stringent approach to guidelines for practitioners when coming into contact with all body fluids since the most recent CDC recommendations caution practitioners to adhere to Universal Precautions if it is anticipated that they might be exposed to blood or body fluids containing visible blood. Also, disposal of materials need not be extraordinary, because only needles, lab waste, and infectious material require the use of hazardous waste red bag container. When practitioners have a question regarding cleaning and maintenance of equipment, it is suggested that they consult manufacturer's instructions. Materials that may come in contact with blood or body fluids should ideally be disposable.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

PubMed1992

AIDS/HIV knowledge level and perceived chance of having HIV among rural adolescents.

Behaviors that increase the risk of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) among adolescents living in rural areas have been reported to be as frequent as those of lower socioeconomic minority youth living in large urban areas. Little is known, however, about whether rural adolescents possess adequate knowledge upon which to make responsible decisions to avoid exposure to HIV. In order to address this deficit, we administered the Centers for Disease Control (CDC) 1989 Secondary School Health Risk Survey to 294 sixth, seventh, and eighth grade students (30.2% sample) from a rural county with significant social problems including epidemic sexually transmitted diseases STDs, sex-for-drugs, poverty, and drug abuse. The sample was 65% African-American, 50% female, with a mean age of 12.9 +/- 1.3 years. Although 68% reported having received school-based AIDS education, a lower proportion (greater than or equal to 10%) the students were found to correctly answer 8 of 17 AIDS/HIV knowledge questions than those from a national comparison group. The mean was 12.8 +/- 3.1 of 17 items answered correct. Lower AIDS/HIV knowledge was associated with lower school grade (rho = 0.46, p less than or equal to 0.0001); being African-American, Hispanic, or Native American (p less than or equal to 0.043); and never receiving school-based AIDS/HIV education (p less than or equal to 0.0001). Based on multivariate analysis of variance (ANOVA), only school-based AIDS/HIV education was a significant predictor (p less than or equal to 0.0001) of knowledge.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

PubMed1990

Developmentally-based AIDS/HIV education.

A growing number of health and education professionals argue that AIDS/HIV education curricula should be developmentally-based. They suggest the principles of developmental psychology be used to design curricula based on the sequentially ordered ways children of different ages understand AIDS. Relying on findings of research on development of children's conceptions of illness, a specific developmentally-based approach to educating school-age children about AIDS/HIV is presented in this paper. For each of three major age groups, the paper describes general characteristics for children's thought processes, ways in which children assimilate information about various aspects of AIDS, and implications for educating children about causes, prevention, and fear of AIDS. The focus of AIDS/HIV education can move from reducing fear in the younger group, to identifying and differentiating causes and noncauses of AIDS in the intermediate groups, to articulating strategies for AIDS prevention in the older group.

Acquired Immunodeficiency Syndrome↗

PubMed1991

AIDS/HIV articles published in selected professional health journals: 1981-1990.

Journals from five professional associations were reviewed to determine the response to AIDS/HIV in their journal: Association for the Advancement of Health Education (AAHE) and Journal of Health Education; American College Health Association (ACHA) and Journal of American College Health; American Public Health Association (APHA) and American Journal of Public Health; American School Health Association (ASHA) and Journal of School Health, and the Society for Public Health Education (SOPHE) and Health Education Quarterly. The project posed the following questions: 1) How many articles on AIDS/HIV were published in the selected journals during the 10-year period from 1981 through 1990?; 2) What types of articles were published during the period, such as editorials, recommendations, guidelines, and research?; and 3) What approaches were shown effective in changing knowledge, attitudes, and behavior? The first article appeared in 1984; 239 articles were published in the five journals reviewed. Each journal devoted at least one entire issue to AIDS/HIV. The articles were categorized as either applied (43.9%) or data-based (56.1%). Since most articles with a research focus did not include pretest and posttest measurements, it proved difficult to determine the most effective methods for changing knowledge, attitudes, and behavior. Evaluation methods that assess the effectiveness of interventions in changing knowledge, attitudes, and behavior are needed.

Acquired Immunodeficiency Syndrome↗

PubMed1992

AIDS/HIV crisis in developing countries: the need for greater understanding and innovative health promotion approaches.

Epidemiologic data on morbidity and mortality have shown that the acquired immunodeficiency syndrome/human immunodeficiency virus (AIDS/HIV) epidemic is relatively widespread in the developing countries of the world, especially in the already economically deprived regions of Sub-Saharan Africa. Africa is estimated to have approximately 5 million seropositive individuals, and by the year 2000, this number is expected to include 10 million HIV-infected children. Improved control over this epidemic can only come through a greater understanding of the specifics of the disease and, eventually, the introduction of more effective and innovative health promotion campaigns targeted at medical personnel, traditional healers, families, and persons with AIDS. Comprehensive health promotion campaigns, carefully using mass media strategies in addition to more community-based programs, all operating under "decentralized" AIDS control programs, are reasoned to be the most efficacious approach that African and other developing countries can use to successfully contain the AIDS/HIV epidemic. Given the reality of the following factors: Pattern II (ie, transmission of AIDS via heterosexual sexual activity) is the main mode of HIV transmission in Africa, the traditional dominant roles males have in sexual relations, and the positive relationship between sexually transmitted diseases and AIDS, health promotion campaigns must focus specifically on addressing at-risk culturally related sexual values and behaviors in African communities. Failure to address these and other related factors will certainly lead to an escalation of the AIDS/HIV epidemic in Africa and, therefore, concomitant devastation in the human and societal realms of the region.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

AIDS/HIV: implications for speech-language pathologists and audiologists.

Although research is underway to answer the many unknown questions about AIDS/HIV, there are many myths that continue to plague the public as well as health care and education workers. In this report, the ASHA Committee on Quality Assurance provides factual information about what is known about AIDS/HIV and delineates a list of suggested precautions which speech-language pathologists and audiologists can utilize when providing speech-language-hearing service. Practice and legal issues will continue to be addressed as our knowledge about the provision of services to AIDS/HIV patients/clients expands. Consequently, practitioners will need to update their knowledge through continuing education programs and/or products. Similarly, graduate training programs will have to continually update their curriculum and clinical practicum training to meet these changing needs.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Current perspectives on AIDS/HIV education and counseling.

This whole issue of Patient Education and Counseling is devoted to current perspectives on AIDS/HIV education and counseling. The results of 15 completed empirical studies and empirically-based reviews are described, highlighting the central role of education and counseling in research and clinical practice in the AIDS/HIV arena in the USA, UK, Australia, The Netherlands, and Israel. The articles concern: readability of educational materials, format of informed consent, participation of drug users in HIV-testing, measurement of condom use, safe sex among the young and non-monogamous, sexual network analysis, high-risk sexual behavior among gay men, prostitution, public reactions towards people with AIDS, teachers' attitudes towards AIDS, measurement of mental adjustment to AIDS, influencing quality of life by counseling, satisfaction with HIV counseling, the influence of psychosocial factors on the course of HIV infection, and a report on the recently held 10th International Conference on AIDS.

Counseling↗

PubMed1992

An evaluation of a school-based AIDS/HIV education program for high school students.

The effect of a 1-hr school-based AIDS/HIV education program on the knowledge and attitudes of high school students was evaluated with a modified version of the Centers for Disease Control Health Risk Survey. One urban and one suburban school each were randomly assigned to an educational intervention (n = 535) or a control group (n = 659). All students received a posttest 2 weeks after the intervention. Knowledge was based on responses to 12 true-false questions (pretest alpha = .76, posttest alpha = 0.81). Principal components analysis was used to develop three attitude scales and risk-taking behavior was assessed by self-report. Data were analyzed with Kruskall-Wallis analysis of variance (ANOVA) and multivariate ANOVA. The groups did not differ in knowledge level at pretest. At posttest the education group had significantly (p < or = 0.006) higher knowledge even after controlling for the effects of previous AIDS education (p < or = 0.019), gender (p < or = 0.007), and Hispanic ethnicity (p < or = 0.048). After the education program, students were less worried about exposure to the AIDS virus, but were more worried (p < or = 0.048) about AIDS acquisition during their adult life. Although single school-based AIDS/HIV education programs may increase knowledge, more extensive education may be needed to change the behavior and attitudes of older high school students.

Acquired Immunodeficiency Syndrome↗

PubMed1990

A professional preparation course on AIDS/HIV infection.

This paper describes the conceptualization, development, planning, and implementation of a new professional preparation course entitled "AIDS/HIV Education: Issues and Strategies." The 15-week, campuswide course was offered through the Dept. of Health Science Education at the University of Florida during spring semester 1990. Though universities have been identified as providers of preservice education for future teachers and health professionals, current activities often have been deemed inadequate to meet the needs of those charged with providing AIDS/HIV education. This course was implemented to address an array of issues related to HIV education, ranging from epidemiological and biomedical information and educational strategies to examination of personal and ethical issues surrounding the disease. Delivery of a successful course and student reaction are discussed, along with recommendations for programs considering similar educational efforts. A detailed planned information packet is available from the authors.

Acquired Immunodeficiency Syndrome↗

PubMed1995

[AIDS/HIV related knowledge, attitude and behavior of acupuncture therapists in Aichi Prefecture].

To promote AIDS prevention measures in Japan, the actual state of knowledge, attitudes and behaviors (KAB) of workers at risk for HIV infection requires clarification. In the present study, acupuncture therapists in Aichi Prefecture were evaluated for level of their KAB. By using a self-administered questionnaire, the KAB condition of 500 acupuncture therapists was surveyed from September-November in 1993. Responses from 494 (98.8%) were available for analysis. Results showed that knowledge level on general issues regarding HIV epidemics was good. The main sources for information on AIDS/HIV were TV, general lectures, public reports and magazines. More than 80% of acupuncture therapists sterilize their needles by autoclave or boiling and 60% of them use disposable needles. Furthermore, 97% of the therapists reported utilizing one or the other of these methods. More than a half of them have participated in AIDS education programs. While about 30% of them responded that they are able to accept HIV carriers as clients, 20% of them expressed negative responses. There appears to be a discrepancy between their level of knowledge of HIV transmission routes and their practical attitude towards clients with AIDS and/or HIV carriers. A more appropriate education program based on behavioral science is desirable to lessen discrepancy distance between general knowledge and preferable behavior regarding AIDS/HIV.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Assessing AIDS/HIV prevention: what do we know in Europe?

An EC concerted action on the assessment of AIDS/HIV prevention strategies was conducted between 1989 and 1992. The aim of this concerted action (CA) was to bring together researchers who are active in this assessment field, make an initial appraisal of the results of AIDS prevention efforts, in various population groups in Europe and develop an assessment methodology. Five areas of study were selected for the CA: the population as a whole ("general population"), men who have sexual relations with other men, intravenous drug users, migrant populations, monitoring of sexually transmitted diseases (STDs) to determine changes in behaviour. For each of these areas, a working group composed of the leading researchers in the field in Europe was constituted and commissioned by the project administration and coordination team to collate and analyse data on prevention efforts and their assessment in different countries of Europe. This review presents the main results from the groups responsible in each area in the concerted action. A number of general conclusions from the results of this concerted action are drawn.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Assessing AIDS/HIV prevention: what do we know in Europe? General population.

One aim of this EC Concerted Action Programme has been to compare and contrast AIDS/HIV prevention strategies aimed at the general population, and the methods used to assess them, in order to arrive at a better understanding of how public education in this area might optimally be effected and evaluated. To this end, data have been collected on interventions and their evaluation for selected European countries by means of site visits, postal questionnaires and expert meetings of those involved. These data have been analysed where possible in relation to other relevant variables including the social and political context in which AIDS public education has taken place, the existing tradition of health education, the financial and manpower resources available and the nature of the HIV epidemic in each country. Initial analysis shows that there have been remarkable parallels between AIDS public education campaigns in different European countries in terms, for example, of their sequence and progression, and their content. At the same time, essential differences are apparent with respect to the ease with which it has been possible to implement strategies, the tone and style of initiatives, and their reception by and effect on the general population. Attempts to attribute these differences to specific cultural, political or operational factors are difficult, but the cross national comparison holds valuable lessons for both campaigns and their evaluation.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Acute appendicitis in patients with AIDS/HIV infection.

Nine patients known to have acquired immunodeficiency syndrome (AIDS) and/or human immunodeficiency virus (HIV) infection and operated on for acute appendicitis are presented. Six of the nine patients did not have an elevation in the white blood cell count preoperatively. Two patients underwent diagnostic laparoscopy prior to exploration. In four cases, a perforated appendix was removed. Seven patients had persistent postoperative fever, while all nine had a significant lack of leukocytosis after surgery. Other than the absence of a preoperative increase in white blood cell count, the presenting characteristics of this group were similar to those expected in immunocompetent patients. However, concern for a possible opportunistic infection etiology and a desire to avoid operating on these patients resulted in an undue delay prior to exploration. The use of diagnostic laparoscopy aided in earlier and more accurate diagnosis. Despite persistent postoperative fever, appendectomy was performed in patients with AIDS/HIV infection without significant increase in morbidity and mortality.

Acquired Immunodeficiency Syndrome↗

PubMed1989

Infection prevention and control in the era of the AIDS/HIV epidemic.

The chronology of important events in the AIDS/HIV epidemic is presented in Table 2. Nurses are the largest group of health care workers and persons who provide direct care and handle sharp objects regularly. As the number of persons infected with HIV increases and as more infected persons become ill enough to require care, the opportunity for an individual nurse to have contact with an infected person will increase. Because many persons with HIV infection also have Kaposi's sarcoma and other malignancies, some oncology nurses may have more contact with HIV-infected individuals than nurses in general. However, it is well established that the major risk for HIV infection is from puncture injuries, and a number of strategies are available and are being developed to make needle and sharps handling safer. Nurses must take personal responsibility for knowing how to reduce their own risks for exposure to HIV and other infectious agents while keeping in mind the need not to increase risks of nosocomial infections in patients. Thus, all nurses need a comprehensive understanding of the purposes of barriers (eg, gloves, gowns, masks, handwashing, room assignment) and when and how to use them correctly. In addition, all nurses who have contact with blood and body fluids should take responsibility for their own immunity to hepatitis B by obtaining hepatitis B vaccination. By using all of these strategies in combination, many infection risks to nurses and patients will be minimized.

Acquired Immunodeficiency Syndrome↗

PubMed1989

AIDS/HIV counselling in occupational health.

AIDS/HIV counselling will increasingly become part of the role of occupational health professionals. Issues that arise in the occupational setting include: occupational transmission, knowledge and attitudes, problems with family and friends, AIDS dementia, and uncertainty. Dilemmas can occur in relation to contamination incidents, HIV positive employees, or staff refusing to work because of fears of HIV/AIDS. It it easier to deal with the problems that arise if the issues have been thought through beforehand. Examples are given of problems that have occurred in a setting of occupational health in the British Health Service and their resolution is discussed.

Counseling↗

PubMed1989

AIDS/HIV infection and employment: the role of occupational health services.

Occupational health services need to be active in the development of local policies about AIDS/HIV and employment. Employment issues include the possible hazards from HIV infected employees, which are more fears than real risks, and the problems faced by HIV infected employees. Pre-employment HIV screening does not eliminate HIV from the workforce and involves much extra work. The occupational health service can be a source of confidential counselling for HIV infected individuals and will need to advise on work fitness. HIV as a bar to certain jobs is difficult to justify. The problems relating to HIV infection at work are best dealt with by education of staff at all levels.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Perception of learning needs and preferred learning methods about AIDS/HIV among registered nurses working in the community in Texas.

It is important for nurses and other healthcare workers to recognize that patients who present themselves for health care could already be infected with human immunodeficiency virus (HIV). Therefore, appropriate and sensible infection control precautions should be taken at all times. An assessment of nurses' knowledge of acquired immunodeficiency syndrome (AIDS)/HIV provides information to guide further continuing education efforts. This study describes the learning needs and preferred learning methods regarding AIDS/HIV among registered nurses working in a community in Texas. Respondents confirmed the need for important content areas regarding primary, secondary, and tertiary prevention such as universal precautions, protection from infectious diseases, and occupational hazards for healthcare providers. Several teaching methodologies were included. Self-paced instruction was the least preferred teaching-learning method; hands-on methodology was most preferred for the topics of clinical manifestations, long-term care, testing, and counseling.

Attitude of Health Personnel↗

PubMed1992

Short and medium term projections of the AIDS/HIV epidemic by a dynamic model with an application to the risk group of homo/bisexual men in Amsterdam.

Several methods exist for short term projection of the numbers of AIDS cases. Some use extrapolation of empirical curves fitted to data up to a given time, whereas others such as the popular method of 'back projection' or actuarial methods also use information about the process. In this paper we describe a dynamic model based on a distributed modelling technique allowing for variability both in infectiousness and in age distribution of the population at risk. Some model parameters are taken from the literature, others are estimated from AIDS incidence data from the homo/bisexual population in Amsterdam. The model described here simulates prevalence and incidence of HIV infection. We present prediction intervals for two years from January 1990 onwards. We discuss three scenarios based on the estimated model, two of which consider early treatment with anti-viral drugs. Given the model and the state of the epidemic in Amsterdam, early treatment intervention must be combined with very drastic measures for reducing infectivity in order to have any serious impact on the course of the epidemic.

Acquired Immunodeficiency Syndrome↗