Adeno-associated virus may play a protective role against human papillomavirus-induced cervical lesions independent of HIV serostatus.

This study investigated the prevalence of adeno-associated virus (AAV) and human papillomavirus (HPV) DNA in cervical samples of HIV-seropositive and -seronegative women attending a clinic in south-eastern Brazil. Both viruses were investigated by polymerase chain reaction (PCR) and cytological exams were performed. AAV was typed by PCR and restriction fragment length polymorphism analysis. AAV prevalence was 19.7% (56/284), with 18.7% (21/112) and 20.3% (35/172) in HIV-positive and -negative women, respectively. AAV type 2 was the single virus type detected. AAV was detected with higher frequency in HPV-infected women (P < 0.05) as was HPV in HIV-positive women (P < 0.05). The AAV-HPV co-infected women showed a lower rate of atypical squamous cells of undetermined significance or cervical intraepithelial neoplasia development compared with those infected only with HPV. The prevalence of AAV2 confirms this type as the most common in human samples. This is the first report examining AAV in cervical samples of HIV-infected women and indicates that HIV infection does not appear to influence AAV prevalence or AAV-HPV co-infection.

Predicting condom use in young women: demographics, behaviours and knowledge from a population-based sample in Brazil.

The goal of this study was to assess condom use and related behaviour in young women in Vitória, Brazil. From March to December 2006, a cross-sectional sample of women aged 18-29 years was recruited into a population-based study. Risk behaviours for HIV and sexually transmitted infections (STIs) were surveyed. Condom use at last intercourse was assessed as a principal outcome describing protective sexual behaviour. Of 1200 eligible women identified, 1029 (85.8%) enrolled. Among them, 904 (87.9%) reported a history of sexual activity. Only 36.6% reported condom use at last intercourse; those who did were more likely to report commercial sex work (odds ratio [OR] 9.01 [1.46-55.55]), to state that STI prevention was a primary reason for using condoms (OR = 6.84 [4.81-9.71]), to have been previously diagnosed with an STI (OR = 2.39 [1.36-4.21]), to report that 'it is easy to tell a sexual partner they will not have vaginal/anal sex without a condom' (OR = 2.30 [1.56-3.39]), to report that sexual intercourse is only risky when people have anal sex (OR = 1.98 [1.22-3.22]); and less likely to be married (OR = 0.65 [0.54-0.78]), and to find it difficult to use condom consistently in all sexual encounters (OR = 0.36 [0.25-0.52]). Women who reported condom use were more concerned with preventing STIs, and to report less difficulty insisting on condom use with partners.

Risk factors and prevalence of HIV infection in people seeking health care in an STI clinic in Brazil.

Comprehensive care for people seeking assistance in sexually transmitted infections (STI) clinics provides access to a group of patients in need of HIV prevention interventions and represents appropriate locations for the implementation of these activities. The goal of this study was to determine the risk factors for HIV infection. A profile of patients seeking care in an STI clinic in Vitória, Brazil; including the motives for this, the risk factors and the prevalence for HIV was carried out. Patients were systematically interviewed regarding demographic information, motivation for seeking assistance, risk exposures, and clinical data. Blood samples were collected to test HIV infection in 562 people enrolled in the study. Prevalence of HIV infection was 6.8 per cent (95 per cent CI 4.7-8.9). Prevention and STI symptoms were the main reasons for seeking care. Variables found to be independently associated with HIV infection were: age (> = 30 years) [OR = 3.24 (95 per cent CI 1.40-7.52)]; seeking medical assistance [OR = 3.88 (95 per cent CI 6.22-40.95)]; and illicit drug use [OR = 14.58 (95 per cent CI 6.11-34.72)]. These results found high prevalence of HIV infection in this population and reinforce the need for ongoing STI prevention activities to further decrease HIV and other STI.

Mother to child transmission of HIV in Vitória, Brazil: factors associated with lack of HIV prevention.

Screening HIV infection in pregnancy provides an ideal opportunity to make an early diagnosis in women in order to provide treatment to reduce vertical transmission to the newborn. The objectives were to describe the profile of HIV-infected pregnant women attending municipal hospitals in Vitória and to identify the causes associated with the lack of HIV therapeutic prophylaxis. Descriptive analysis of antenatal and HIV surveillance data of pregnant women in Vitória, Brazil from 1997 to 2001 was performed. HIV infection was reported in 208 pregnant women. Their median age was 23 years, antenatal care was reported in 96.2% and HIV infection was diagnosed during antenatal care in 60.1%. Zidovudine (ZDV) therapy was initiated in 88% of the cases, 57.9% of which started before 20 weeks of gestation. The remaining 12% of the total of pregnant women received no therapy. Factors associated with lack of mother to child transmission (MTCT) prevention were: test not available (14 cases), delay of test result (seven cases) and patient's refusal to take medication (four cases). After delivery, 8.2% of the newborn did not receive ZDV and 14 women breastfed. Among the 196 live births, 3.1% (95%CI 1.9-4.3) of MTCT was reported. These data from an area with comprehensive HIV and antenatal surveillance provide an opportunity to identify gaps in public health efforts to reduce MTCT.

Seroprevalence of HIV, hepatitis B virus, and syphilis in women at their first visit to public antenatal clinics in Vitória, Brazil.

BACKGROUND: In some countries, HIV infection in pregnancy has become a common complication of pregnancy. GOAL: To determine the seroprevalence of HIV, hepatitis B virus, and syphilis among pregnant women, and to assess risk factors for these infections. STUDY DESIGN: A cross-sectional study was performed. METHODS: Pregnant women attending antenatal clinics of Vitória Municipality from March to December 1999 were included in this study after giving written informed consent. The women were systematically interviewed. During the interview, their demographics and patterns of risk behavior were explored. A blood sample was collected for testing HIV, hepatitis B virus, and syphilis. RESULTS: The participants in this study were 1608 pregnant women. The prevalence of HIV infection was 0.8% (95% CI, 0.4-1.2), hepatitis B virus carriers 1.1% (95% CI, 0.8-1.3), and syphilis 3% (95% CI, 2.6-3.5). The potential risk behaviors were found to be a history of STDs (6.5%), condoms never used (52.8%), prostitution (0.5%), noninjection drug use (6.3%), blood transfusion (1.5%), and intravenous drug abuse (0.7%). CONCLUSION: These results show the necessity of implementing programs aimed at preventing transmission of these infections in women and their children.

Sexually transmitted diseases among female prisoners in Brazil: prevalence and risk factors.

BACKGROUND: Sexually transmitted diseases (STDs) have become an important medical problem in prisons. GOAL: To determine the prevalence of and risk factors for STDs among female inmates in a Brazilian prison. STUDY DESIGN: All female prisoners at the Espírito Santo State Prison were offered enrollment in this cross-sectional study. An interview exploring demographics, criminal charges, and risk behavior was conducted. Blood and genital specimens were collected for STD testing. RESULTS: Of 122 eligible women, 121 (99%) agreed to participate. Prevalence rates were: HIV 9.9%, human T-cell lymphotrophic virus type I 4.1%, hepatitis B virus 7.4%, hepatitis C virus 19%, syphilis 16%, gonorrhea 7.6%, chlamydial infection 11%, human papillomavirus-related cytologic changes 9.3%, trichomoniasis 30%, and bacterial vaginosis 15%. Previous or current drug abuse (54%), injection drug use (11%), and blood transfusion (16%) were associated with at least one STD. Condom use was infrequent. CONCLUSION: The prevalence of STDs and of behaviors leading to ongoing transmission are high among female inmates in Vitória, Brazil, and demonstrate the potential importance of prevention activities targeting this population.

Narrative Assessment Profile: discourse analysis for school-age children.

The assessment of narrative skills of school-age children is described using a comprehensive discourse analysis approach, the Narrative Assessment Profile. The following dimensions of narration are evaluated: topic maintenance, event sequencing, explicitness, referencing, conjunctive cohesion, and fluency. The purpose of this article is to describe the development of these six dimensions and their symptoms in impaired narrative discourse. Assessment and intervention guidelines are presented.

Analgesic and antiinflammatory effects of dipyrone in rat adjuvant arthritis model.

Dipyrone, a pirazolone derivative, is a known analgesic drug with minor toxic effects associated with its administration. The aim of the present study was to determine the analgesic and antiinflammatory effects of dipyrone in a model of chronic inflammation (adjuvant-induced arthritis in rats). Hind-paw hyperalgesia was detected in arthritic rats from the 10th to the 16th day of observation. Edema development was maximum (twofold increase) at the 14th day of observation compared to control animals and reduced at the 16th day of observation. Dipyrone (1-50 mg/kg) dose-dependently reduced both hind-paw hyperalgesia and edema from arthritic rats. However, it was shown to be more potent as analgesic than antiinflammatory in the present model. In contrast, indomethacin (2 mg/kg) and dexamethasone (0.4 mg/kg) completely inhibited hind-paw hyperalgesia and edema development. Our results indicate that dipyrone reduced the hyperalgesia and edema in arthritic rats by a mechanism not involving release of prostaglandin-like substances. The possibility of dipyrone inducing analgesia in arthritic rats through a peripheral action supports the use of dipyrone as an alternative choice drug for the treatment of pain associated with arthritislike diseases in selected cases.

Developmental changes in narrative and non-narrative discourse in children with and without brain injury.

This study presents a set of narrative and non-narrative tasks and analytic procedures for examining the discourse development of children with perinatal brain injury and typically developing children. Three oral discourse genres were collected at ages 5, 6, and 7: script, picture description, and replica play narration. Genre performances were assessed for the presence of hypothesized genre features. Results suggest these tasks and procedures are able to characterize development in discourse abilities for both a normative group and for children with perinatal brain injury. The group of children with brain injury produced shorter discourse performance with more off-task talk. This group also showed difficulty in fully differentiating the various genre types and in creating integrated discourse performances. However, most of these children demonstrated considerable growth in control of genre features over this time period. The possible utility of these tasks and procedures for clinical assessment is discussed.