Gender roles and HIV sexual risk vulnerability of Roma (Gypsies) men and women in Bulgaria and Hungary: an ethnographic study.

Roma, the largest ethnic minority group in Central and Eastern Europe, have cultures that are traditional, often closed, and autonomous of majority populations. Roma communities are characterized by pervasive social health problems, widespread poverty, limited educational opportunities, and discrimination. Although some evidence suggests high levels of HIV sexual risk behaviour among Roma, little is known about the cultural and social context in which risk behaviour occurs. In-depth interviews were used to elicit detailed information about types of sexual partnerships and sexual risk behaviour practices occurring in them, use and perception of protection, knowledge and beliefs about AIDS and STDs, and sexual communication patterns in a sample of 42 men and women aged 18-52 living in Roma community settlements in Bulgaria and Hungary. Analysis of the interview data revealed that men have great sexual freedom before and during marriage, engage in a wide range of unprotected practices with primary and multiple outside partners, and have much more relationship power and control. In contrast, women are expected to maintain virginity before marriage and then sexual exclusivity to their husbands. Condom use is not normative and is mainly perceived as a form of contraception. Although awareness of AIDS was common, it was generally not perceived as a personal threat. Misconceptions about how HIV is transmitted are widespread, and women - in particular - had very little knowledge about STDs, HIV transmission, and protective steps. There is an urgent need for the development of HIV prevention programs culturally sensitive to Roma populations in Eastern Europe, where HIV rates are rapidly rising.

Excretory function of denervated kidney after inhibition of prostaglandin synthesis and furosemide administration in conscious dogs.

The experiments were carried out on unanaesthetized dogs with exteriorized ureters for separate urine collection from the left (denervated) and the right (intact) kidney. The osmolality and concentrations of sodium, potassium, calcium, magnesium, zinc, copper, chloride and creatinine were determined in the plasma as well as in the urine of the two kidneys. The function of the denervated and the innervated kidney was compared prior to and after indomethacin administration (5.0 mg/kg b.w.). The excretory function of both kidneys was also compared after furosemide treatment alone (0.5 mg/kg b.w.) as well as indomethacin pretreatment. Renal denervation increased urine flow rate, calcium and copper excretion. After administration, sodium excretion from the denervated kidney was higher than that from the intact one. Calcium excretion of the two kidneys did not differ significantly, while copper excretion from the denervated kidney was diminished, Furosemide administration after pretreatment with indomethacin did not lead to any difference between the denervated and intact kidney. The results show that renal nerves and prostaglandins participate jointly in the regulation of sodium, copper and calcium excretion. Renal prostaglandins do not change the response of the denervated kidney to furosemide as compared to the intact kidney.

Dynamics of renal excretory function after furosemide or ethacrynic acid administration to unanaesthetized dogs after mannitol infusion or chronic renal denervation.

To unanesthetized dogs with exteriorized ureter allowing separate collection of urine from both kidneys, furosemide 0.2 mg/kg b.w. or ethacrynic acid 0.22 mg/kg b.w. was given intravenously. The volume of collected urine and the excretion of sodium, chloride, potassium and calcium were studied. The dynamics of diuretic administration was programmed. After unilateral renal denervation furosemide or ethacrynic acid was given and the response of the denervated (left) and intact (right) kidneys was compared. Prior to renal denervation the same dogs were infused with a 15% mannitol solution in a quantity and at a rate causing an increase of diuresis approximately equal to that after renal denervation. The effect of furosemide given with and without mannitol infusion was compared. Description of the dynamics of renal excretory function used by us allowed to demonstrate the modulating role of renal nerves in the regulation of water, chloride and sodium excretion after the administration of diuretics. The principal part of the compensatory reabsorption of chloride after renal denervation occurred in the ascending limb of Henle's loop. Comparison of calcium excretion after renal denervation and administration of furosemide with that after mannitol and furosemide allows to assume that after renal denervation calcium load from the proximal to the distal tubules does not increase.