-
[show abstract]
[hide abstract]
ABSTRACT: HIV-negative, inner-city adolescents with HIV-infected parents are considered to be at high risk for acquiring HIV themselves.
Using a modified theory of health behavior, this study examined the effects of maternal HIV infection and psychosocial variables
on the onset of sexual and drug risk behavior in 144 HIV-negative adolescents with and without HIV-positive mothers. Adolescents
and their mothers were interviewed when the youths were 10–14 years old and again when they were 13–19 years old. By follow-up,
42% of youths reported the onset of vaginal sex (vs 5% at baseline). Marijuana and alcohol use increased from 6 and 38%, respectively,
at baseline to 25 and 60% at follow-up. Among those reporting risk behaviors, 40--50% reported onset prior to 14 years. Youth
and family psychosocial variables, but not maternal HIV status, were associated with risk behaviour outcomes.
Journal of Youth and Adolescence 04/2012; 36(3):265-278. · 2.72 Impact Factor
-
Ouzama Nicholson,
Fay Dicandilo,
James Kublin,
Xiao Sun,
Erin Quirk,
Michelle Miller,
Glenda Gray,
Jean Pape,
Michael N Robertson,
Devan V Mehrotra,
Steven Self,
Katherine Turner,
Jorge Sanchez,
Punnee Pitisuttithum,
Ann Duerr,
Sheri Dubey,
Lisa Kierstead,
Danilo Casimiro,
Scott M Hammer
[show abstract]
[hide abstract]
ABSTRACT: Abstract The safety and immunogenicity of the MRK adenovirus type 5 (Ad5) HIV-1 clade B gag vaccine was assessed in an international Phase I trial. Three-hundred and sixty healthy HIV-uninfected adults were enrolled on five continents. Subjects received placebo or 1 × 10(9) or 1 × 10(10) viral particles (vp) per dose of the MRKAd5 HIV-1 gag vaccine at day 1, week 4, and week 26. Immunogenicity was evaluated using an IFN-γ ELISPOT gag 15-mer assay with positive responses defined as ≥55 SFC/10(6) PBMCs and ≥4-fold over mock control. The vaccine was well tolerated. The most common adverse events were injection site reactions, headache, pyrexia, diarrhea, fatigue, and myalgia. At week 30, geometric mean ELISPOT responses were 24, 114, and 226 SFC/10(6) PBMCs in the placebo, 1 × 10(9) vp/dose, and 1 × 10(10) vp/dose groups, respectively. Overall, responses to 1 × 10(10) vp were 85% and 68% in subjects with low (≤200) and high (>200) baseline Ad5 titers, respectively. The MRKAd5 HIV-1 gag vaccine was immunogenic in diverse geographic regions. Gag ELISPOT responses were greater in the 1 × 10(10) vp/dose groups than in the 1 × 10(9) vp/dose groups. Data from this first international study indicate that adenovirus-vectored vaccines are well tolerated and may be immunogenic in subjects from regions with high prevalence of preexisting Ad5 immunity.
AIDS research and human retroviruses 11/2010; · 2.18 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Acute human immunodeficiency virus (HIV) infection in a breast-fed infant is a rare diagnosis in developed countries. We present a six-month old girl with postnatally acquired HIV infection complicated by Pneumocystis jéroveci pneumonia, cytomegalovirus pneumonitis and encephalopathy. Her mother had tested negative for HIV during pregnancy. Children infected by mothers during an acute seroconversion may have more rapid disease progression.
The Pediatric Infectious Disease Journal 08/2007; 26(7):653-5. · 3.58 Impact Factor
-
Archives of Pediatrics and Adolescent Medicine 01/2007; 160(12):1307-8. · 4.14 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Purulent fluid collections, including brain abscess and subdural empyema, are exceedingly rare in association with meningococcal meningitis. We present a 5-month-old infant with meningococcal meningitis and sepsis complicated by an intracerebral abscess.
The Pediatric Infectious Disease Journal 09/2006; 25(8):754-6. · 3.58 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Improvements in treatment-related knowledge and self-efficacy may improve clinical outcomes in HIV-infected populations. We examined whether caregivers' knowledge and self-efficacy was associated with better clinical outcomes and anti-retroviral therapy (ART) adherence among HIV-infected children.
Caregivers of 77 perinatally HIV-infected children were administered a semi-structured interview which included scales of HIV treatment-related knowledge, adherence self-efficacy and caregiver reports of child medication adherence.
While caregivers correctly answered 74% of the knowledge questions, specific misconceptions were noted. Caregivers rated themselves as having high adherence self-efficacy, but were least confident in their ability to adhere to ART if it caused side effects or might result in social disclosure. Higher caregiver treatment-related knowledge and self-efficacy were associated with better clinical outcomes, as measured by viral load and CD4+ count, but not with caregiver reports of ART adherence.
While additional factors may be important determinants of adherence to ART in this population, improving the HIV treatment-related knowledge and self-efficacy of caregivers may help to improve the clinical outcomes of HIV-infected children.
Care providers should address both misconceptions that might serve to undermine adherence as well as factors that limit patients' self-efficacy in adhering to treatment, prior to the initiation of ART and throughout the course of treatment.
Patient Education and Counseling 07/2006; 61(3):405-10. · 2.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Nontuberculous mycobacterial (NTM) infections are rarely diagnosed in hematopoietic stem cell transplant (HSCT) recipients. We describe a case of disseminated Mycobacterium avium complex with gastrointestinal tract involvement in a HSCT recipient. We reviewed NTM infections among pediatric HSCT patients at our institution from 2000-2004 and identified 2 additional cases. Fourteen published case reports of NTM disease in children are reviewed.
The Pediatric Infectious Disease Journal 04/2006; 25(3):263-7. · 3.58 Impact Factor
