Assessing HIV risk among women who have sex with women: scientific and communication issues.

Data on human immunodeficiency virus (HIV) risk faced by women who have sex with women (WSW) are scarce. The biologic risk of female-to-female transmission is not known. Several surveys have reported that certain groups of WSW engage in behaviors that put them at risk for HIV infection, such as unprotected sex with men, unprotected sex or sharing of sex toys with women, and injection drug use. WSW may also be at risk for HIV through use of unscreened semen from sources other than sperm banks. An evaluation of HIV risk behaviors among WSW has been hampered by methodological issues, such as lack of data about the extent of the population, the use of standard definitions in research, and the design of data collection instruments. HIV prevention efforts have been hampered by communication issues, such as what "safer sex" means to this population and difficulties in interactions with health care providers. Prevention interventions for this population must address behaviors that put WSW at risk for HIV infection, including injection drug use and unprotected penile sex. At the same time, the possibility of sexual transmission of HIV via female-to-female sex should not be discounted. Health providers should understand that sexual identity does not necessarily predict sexual behavior and should not make any assumptions regarding HIV risk based on self-reported or presumed sexual identity.

A private organization and public agency partnership in community health education.

The authors address a unique partnership among private and public organizations, that of the American Red Cross and the Centers for Disease Control of the Public Health Service. The partnership stimulates an integrated community response to preventing and controlling human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) at the local level. The partnership channels information and provides education to local communities through the efforts of volunteers and staff members. Information is made available as well through other partnerships established under the cooperative agreement between the American Red Cross and the Centers for Disease Control. These partnerships include other national organizations, such as the National Leadership Coalition on AIDS, the National Association of People with AIDS, the National Urban League, and the National Council of La Raza. Education and information messages are designed to complement and be consistent with information and messages from the Public Health Service through the National AIDS Information and Education Program and the "America Responds to AIDS" public information campaign. The objectives are to mobilize local community support for efforts for HIV infection and AIDS prevention and services, as well as to heighten public awareness of the issues.

Improving community support for HIV and AIDS prevention through national partnerships.

If the transmission of human immunodeficiency virus (HIV) is to be prevented, the environment in which people live should predispose them to engage in and sustain safe behaviors. Too often in public health, the range of organizations that make up that environment are overlooked, and prevention strategies are limited to familiar medical and public health institutions. Improvement in public health does not occur in isolation, apart from the other institutions of society--and so it is with the HIV-AIDS epidemic. Education; business and labor; religion; government; voluntary, civic, and social organizations; and the media can all serve as facilitators or as barriers to creating the environment--at the national, regional, State, or local level--that will prevent and control the spread of HIV infection and AIDS and support the needs of those already infected. Collectively, they become a comprehensive HIV prevention network with access to and influence on the total public. One of the most significant benefits of this network is the multiplier effect on the limited resources of public health. Therefore, as part of its HIV and AIDS prevention strategy, the Centers for Disease Control (CDC) has developed national partnerships to involve the leadership of business, labor and industry, religious institutions and organizations, and voluntary organizations in HIV and AIDS prevention and service. Some of these partnerships are federally funded, others are not. The national partnership program described in this paper has produced increased resources for HIV education and services and has demonstrated the synergistic benefits resulting from public and private cooperation in addressing the HIV epidemic.

Gloved and ungloved: performance time for two dental procedures.

This study examines the time required to perform two routine dental procedures requiring fine hand manipulative skills--a pin placement procedure and an endodontic procedure. No significant time difference was noted in performing the procedures while wearing gloves or not wearing gloves. Twelve dentists who had routinely worn gloves for the past 6 months participated, each performing four procedures.

Progress in infection control in dental education.

While guidelines on proper infection control practices for dentistry have been available for over a decade, evidence suggests that recommended infection control practices are not universally employed in dentistry or dental education. A self-administered written survey was mailed to all U.S. dental schools in spring 1986 to assess the status of infection control curricula, standards, and practices. From the 47 schools that responded it is evident that, while progress is occurring in dental education relative to improved infection control standards and practice, much remains to be accomplished.

Hepatitis B vaccine usage among dental practitioners in the United States: an epidemiological survey.

A telephone survey of 283 nonfederally affiliated dental practitioners in the United States was completed in April 1986. The study's objectives were to determine hepatitis B vaccine usage among dentists nationwide, and to examine the epidemiologic characteristics of vaccinated and unvaccinated subjects. Forty-four percent of the participants had received at least the first of the three doses of HB vaccine. Acceptance of the vaccine was associated with the use of gloves during dental procedures and the subject's perception of high-risk patients in his or her dental practice. The most common reasons for not being vaccinated were concerns about vaccine safety and a lack of perceived need for the vaccine. The vaccination rate in this survey is higher than in earlier studies, indicating that acceptance of the vaccine by dental practitioners is increasing.