Factors associated with prevalent abnormal anal cytology in a large cohort of HIV-infected adults in the United States.

Background: The prevalence of and risk factors for abnormal anal cytology among men and women with human immunodeficiency virus (HIV) infection have not been extensively investigated.

Methods: The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study) is a prospective cohort study of HIV-infected patients in 4 US cities. Baseline questionnaires were administered and anal samples for cytology and human papillomavirus (HPV) detection and genotyping were collected.

Do brief screening questions or provider perception accurately identify persons with low health literacy in the HIV primary care setting?

Rapid and accurate health literacy screening tools could assist interventions to improve care in the HIV clinic setting. Prior studies described brief screening questions for identification of persons with low health literacy, but the performance of these questions in HIV clinics is unknown. We examined the accuracy of provider perception and previously described brief screening questions for identification of low health literacy among 147 persons attending two HIV specialty clinics.

Bone disease in HIV infection: a practical review and recommendations for HIV care providers.

Low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)-infected subjects. Initiation of antiretroviral therapy is associated with a 2%-6% decrease in BMD over the first 2 years, a decrease that is similar in magnitude to that sustained during the first 2 years of menopause. Recent studies have also described increased fracture rates in the HIV-infected population.

Hybrid integration of injector and detector functions for microchip gas chromatography.

Hybrid microchips containing high aspect ratio gas chromatograph (GC) columns with an integrated on-chip split injection and a flame ionization detector were developed. Two different column configurations, spiral and serpentine, both 1 m long by 50 μm wide and 500 μm tall, were fabricated out of electrodeposited nickel. The hybrid chip allowed injection plugs on the order of 1-2 ms, which lowered the height equivalent to theoretical plates (HETP) and allowed a comparison of system level band broadening between the two column configurations.

STD/HIV risk among adults in the primary care setting: are we adequately addressing our patients' needs?

Background: Risk behavior surveys often target sexually transmitted disease (STD) clinic populations, but few studies address risk behaviors in primary care settings.

Methods: This cross-sectional study performed at a university adult primary care clinic evaluated risk behaviors using an anonymous, self-administered survey. The following data were collected: demographics, sexual history, condom use, and confidence discussing STDs.

Immune response to hepatitis B vaccine in HIV-infected subjects using granulocyte-macrophage colony-stimulating factor (GM-CSF) as a vaccine adjuvant: ACTG study 5220.

HIV-infected persons are at risk for HBV co-infection which is associated with increased morbidity and mortality. Unfortunately, protective immunity following HBV vaccination in HIV-infected persons is poor. This randomized, phase II, open-label study aimed to evaluate efficacy and safety of 40 mcg HBV vaccine with or without 250 mcg GM-CSF administered at day 0, weeks 4 and 12.

Aging and HIV infection: a comparison between older HIV-infected persons and the general population.

Background: As HIV-infected persons age, the relative contribution of HIV infection, combination antiretroviral therapy (cART), and the normal aging process to the frequent comorbidities is unknown.

Methods: We prospectively evaluated comorbidities, cardiovascular risk, cognitive function, and anthropomorphic and laboratory parameters of HIV-infected persons aged 50 years and over in two US urban clinics. Results were compared to controls from the National Health and Nutrition Examination Survey (NHANES) matched 1:1 by age, race, gender, smoking status, and body mass index (BMI).

Comparisons of sexual behaviors and STD prevalence among older and younger individuals with HIV infection.

Knowledge of an HIV-infected individual's sexual behaviors and routine sexually transmitted diseases (STDs) testing greatly facilitates HIV prevention efforts, but current data in older individuals are lacking. This study was developed to compare sexual behaviors and STD prevalence between older HIV-infected individuals and their younger counterparts. We conducted a cross-sectional cohort study of HIV-infected individuals > or =18 years who completed an annual behavioral assessment.

Renal and urologic emergencies in the HIV-infected patient.

Antiretroviral therapy has revolutionized the care of individuals infected with the human immunodeficiency virus (HIV) and has fundamentally altered the scope of the disease. Acute renal failure and chronic kidney disease from medication toxicity and comorbid noninfectious illnesses are just as likely today as end-organ injury from the virus itself. Chronic immunosuppression renders HIV-infected patients vulnerable to any of several unique urological infections not frequently seen in immunocompetent patients.

The interplay of sociodemographic factors on virologic suppression among a U.S. outpatient HIV clinic population.

Understanding challenges to virologic suppression is essential to optimizing health outcomes among individuals with HIV. This cross-sectional behavioral assessment was conducted among 514 individuals presenting at an urban U.S.

Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors.

Objective: People living with HIV infection are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV infection are high priorities. We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virological or immunological status, or quality of life (QOL) in HIV-infected adults relative to standard of care treatment in a matched control group.

Non-completion of personality disorder treatments: a systematic review of correlates, consequences, and interventions.

Non-completion of treatment is a major concern in the provision of therapies for people diagnosed with personality disorder, with adverse consequences for services, therapists, and other patients. Of even greater concern is that non-completion of treatment may limit the effectiveness of therapy for individuals. Our main aim in this study was to conduct a systematic review of the literature on psychosocial treatments for personality disorder to identify factors associated with treatment non-completion.

Can you hear me now? Limited use of technology among an urban HIV-infected cohort.

Recent studies support technology-based behavioral interventions for individuals with HIV. This study focused on the use of cell phone and internet technologies among a cohort of 515 HIV-infected individuals. Socio-demographic and clinic data were collected among individuals presenting at an urban Midwestern university HIV clinic in 2007.

Alcohol consumption is associated with poor health in HIV clinic patient population: a behavioral surveillance study.

Previous research reports that populations with HIV consume higher rates of alcohol than general population. This cross-sectional study (n = 391) was conducted to measure alcohol consumption, factors associated with consumption, and the relationship between alcohol and HIV viral loads among individuals receiving HIV care. Increased alcohol consumption was associated with being male, lower education attainment, and lacking a current HAART prescription.

Routine screening for depression: identifying a challenge for successful HIV care.

Individuals with HIV experience fluctuating levels of distress throughout the course of HIV infection. This study was conducted to examine the associations of depressive symptomatology with HIV disease in a cohort of individuals who are engaged in routine medical care. This cross-sectional study examined the prevalence of depressive symptoms that were measured as part of a standard of care behavioral assessment among individuals at an urban HIV clinic in the Midwest.

Looking for meaning: eye movements are sensitive to overlapping semantic features, not association.

Theories of semantic memory differ in the extent to which relationships among concepts are captured via associative or via semantic relatedness. We examined the contributions of these two factors, using a visual world paradigm in which participants selected the named object from a four-picture display. We controlled for semantic relatedness while manipulating associative strength by using the visual world paradigm's analogue to presenting asymmetrically associated pairs in either their forward or backward associative direction (e.

HIV and aging: two converging epidemics.

With the aging of the Human immunodeficiency virus (HIV) epidemic, we are now faced with unprecedented and complex challenges, which need to be addressed in order to maximize care of the older HIV-infected population. Older persons have greater comorbidity than their younger counterparts. The compound effects of HIV infection, its treatment and increasing age on the incidence and prevalence of cardiovascular disease, malignancies, cognitive impairment, depression and frailty are of increasing concern.

A review of nucleoside reverse transcriptase inhibitor use to prevent perinatal transmission of HIV.

Worldwide, women comprise > 50% of all people living with HIV and the vast majority of these women are of childbearing age. In fact, a significant proportion of these women are identified as HIV-infected during pregnancy. Preventing perinatal transmission has been one of the greatest prevention successes of the HIV epidemic with < 2% of live births resulting in an HIV-infected infant.

Frailty among HIV-infected persons in an urban outpatient care setting.

Objectives: Frailty among HIV-infected persons is increasingly recognized but data are limited. We aimed to determine frailty prevalence, predictors and clinical significance in this population.

Methods: This was a prospective cross-sectional study of HIV-infected persons > or =18 years attending Washington University HIV Clinics between June and December 2008.

Factors associated with renal dysfunction within an urban HIV-infected cohort in the era of highly active antiretroviral therapy.

Background: Kidney disease remains a prevalent problem in HIV care. The contribution of highly active antiretroviral therapy (HAART), HIV disease factors and traditional factors needs further evaluation.

Methods: A cross-sectional study of all patients seen at an HIV outpatient clinic during 2005 was performed.

Sub-optimal CD4 recovery on long-term suppressive highly active antiretroviral therapy is associated with favourable outcome.

Objectives: To examine risk factors for sub-optimal CD4 recovery on suppressive highly active antiretroviral therapy (HAART) and assess long-term clinical and immunological outcomes.

Methods: Retrospective analysis of 286 HIV-positive patients from a university clinic who initiated HAART with CD4 count <350 cells/microL between January 1996 and July 2006 and achieved > or =52 weeks of viral suppression (VS). Sub-optimal and optimal CD4 count recovery were defined by gains of <150 and > or =150 cells/microL during the first year of VS, respectively.

The study to understand the natural history of HIV and AIDS in the era of effective therapy (SUN Study).

Treatment of human immunodeficiency virus (HIV) infection with highly active combination antiretroviral therapy has increased survival and shifted the spectrum of HIV-associated morbidity and mortality from opportunistic infections toward a variety of other medical conditions. The prospective cohort Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN Study) monitors the clinical course of HIV-infected individuals treated with combination antiretroviral therapy in 4 US cities. Every 6 months, clinical assessments, medical record abstraction, audio computer-assisted self-interview, and neurocognitive measurements are completed and blood and urine specimens are banked centrally.