Lack of legal income is strongly associated with an increased risk of AIDS and death in HIV-infected injecting drug users.

The aim of the study was to analyze the impact of soci-economic status in addition to other risk factors in the progression of HIV disease in a cohort of injecting drug users (IDUs) with a mean follow-up of two years. Between 1989 and 1992, 124 HIV-infected IDUs were recruited in a primary care outpatient clinic providing free consultations and free access to therapy. The main outcome measures were death and AIDs-defining events. The proportion of current daily injectors at entry in the study and at the end of follow-up was 67.7% and 57.2%, respectively. The proportion of individuals on maintenance opioid therapy at entry in the study and at the end of follow-up was 0 and 12.1%, respectively. CD4 cell counts below 200 x 10(6)/L at baseline, positive p24 antigenemia at baseline, the lack of legal income and occasional drug use at entry were risk factors for clinical progression and death. When adjusted in a multivariate analysis, the absence of legal income remained associated with death and occurrence of an AIDS-defining event with a relative risk of 5.2 (1.5-18.1) (p = 0.004). Lack of legal income is a strong risk factor for progression of HIV disease in IDUs, that is independent of CD4 cell count and p24 antigenemia.

Complications of abortion performed under local anesthesia.

OBJECTIVE: To assess the incidence of complications of abortion performed under local anesthesia. DESIGN: Prospective study. SETTING: A family planning center in the Paris area. POPULATION: Eight hundred and fifty-eight women admitted for abortion under local anesthesia. MAIN OUTCOME MEASURES: Incidence of immediate (the day of vacuum aspiration) and delayed complications (at the follow-up visit 2 weeks after the procedure). RESULTS: Among the 858 women who underwent vacuum aspiration, 683 (80%) attended the follow-up visit 2 weeks after the procedure. Fifty-nine percent of the 858 women had not had a previous abortion, 25% had had one, and 16% had had two or more. The average duration of amenorrhea was 8.6 weeks (19% at 6 or 7 weeks, 67% between 8 and 10 weeks, and 14% after 10 weeks). The overall complication rate was 3.4% (23/683) (95% CI=2.0-4.8%). The incidence of immediate complications was 1.7% (15/858) (0.8-2.6%) and that of delayed complications 1.2% (8/683) (0.4-2.0%). CONCLUSION: This study confirms the safety and efficacy of abortion by vacuum aspiration under local anesthesia.

PIP: A prospective study was conducted in the largest family planning (FP) center in the Paris area, France, to evaluate safety and the incidence of complications in first-trimester abortions (vacuum aspiration technique) performed under local anesthesia. From January 1 to December 31, 1994, 858 women who underwent vacuum aspiration under local anesthesia in the FP center of Colombes Hospital were studied. Of these, 683 attended the follow-up visit 2 weeks after the procedure. The study was not based on sociodemographic characteristics, but rather on the general population requesting abortion under local anesthesia. Results showed that the average duration of amenorrhea was 8.6 weeks. The overall complication rate of abortion using local anesthesia was 3.4%, whereas incidences of immediate complications were 1.7% and 1.2% for delayed complications. The most frequent immediate complication was incomplete abortion. No differences in complication rates were found according to the attending physicians. Neither immediate nor delayed complication rates were associated with the patient's sociodemographic characteristics. Therefore, the results of this study indicate that the risk associated with abortion under local anesthesia was acceptable, and that the incidence of complications was similar to those for other techniques (abortion under general anesthesia and drug-induced abortion). It confirms the efficacy and safety of abortion by vacuum aspiration under local anesthesia.