CD4 lymphocyte concentrations in patients with newly identified HIV infection attending STD clinics: potential impact on publicly funded health care resources

Article Abstract:

Publicly funded sexually transmitted disease (STD) clinics perform much of the testing for human immunodeficiency virus (HIV) infection and subsequent counselling of HIV-infected patients. (HIV is the causative agent of AIDS.) The rate of HIV infection was about 4 percent among patients at 2 STD clinics, where 9 out of 10 patients had no symptoms at the time they were tested. Controversy remains about performing HIV tests on patients without symptoms, but 85 percent of those who test positive for HIV do alter unsafe sex practices. To set priorities on referrals and determine the current and future needs of patients diagnosed with HIV infection, T lymphocyte (a type of white blood cell) subset testing and tuberculosis skin testing were routinely offered. Over a 9-month period, 223 newly diagnosed HIV-infected patients underwent T lymphocyte testing. Concentrations of white blood cells carrying CD4+ receptors indicate when to initiate various types of treatments. Results revealed that many of the patients found to have HIV infection qualified for zidovudine therapy and treatment to prevent Pneumocystis carinii pneumonia and tuberculosis. Zidovudine appears to prolong the development of AIDS. Unfortunately, few patients had the resources to finance the recommended care, and ultimately payment would be borne by state and federal governments. However, the cost of failure to initiate early intervention will be greater health care costs in the future as HIV-infected patients will require far more hospital care and lose more days at work. If zidovudine reduces the transmission of HIV, failure to pay for early zidovudine therapy will contribute to increased transmission of the AIDS virus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical economics, Services, Statistics, Demographic aspects, HIV patients

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Effect of HIV posttest counseling on STD incidence

Article Abstract:

Individuals who are tested for infection with human immunodeficiency virus (HIV) and receive posttest counseling appear to continue high-risk sexual practices and may have a high risk of contracting a sexually transmitted disease (STD). Out of 1,309 patients who were tested for HIV infection and received posttest counseling, 615 were HIV-positive and 694 were HIV-negative. Sixty of the HIV-negative patients (9.7%) and 61 of the HIV-positive (8.8%) patients were diagnosed at least once with syphilis, gonorrhea or trichomoniasis. Twenty-four HIV-positive patients (3.9%) and 71 HIV-negative patients (10.2%) were diagnosed with inflammation of the urethra or pelvic inflammatory disease. Nine HIV-positive patients (1.5%) and 23 HIV-negative patients (3.3%) returned for testing after having a STD-infected sexual partner.

Evaluation, Testing, Prevention, HIV (Viruses), HIV, Study and teaching, Sexually transmitted disease prevention, AIDS (Disease), Health counseling

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