Disclosure of HIV status: cultural issues of Asian patients.

Disclosure of human immunodeficiency virus (HIV) status is a difficult emotional task creating opportunities for both support and rejection. For Asian patients there may be additional self-imposed barriers to disclosure that are rooted in cultural values. The purpose of this article is to describe how Asian cultural values of harmony and avoidance of conflict affect the disclosure experiences of HIV-positive Asian American and immigrants. Effective practice guidelines have been developed based on this information. Based on in-depth interviews with 16 HIV-positive Asian men, three focal issues were identified that serve as barriers to disclosure to family members: protection of family from shame, protection of family from obligation to help, and avoidance of communication regarding highly personal information. Additionally, patients felt disclosure was inhibited by the lack of HIV education to which families living overseas may have access. This is compounded by their lack of access to translated materials that they could send to family members. Similar to past disclosure research with non-Asian samples, the findings suggest that gay Asian men seek emotional support from gay friends. They would consider disclosing to relatives only when health reasons necessitated it. It is essential that helping professionals be attentive to the dishonor that patients may experience through disclosure and the stigma associated with being gay. Patients who are considering making a disclosure may need assistance with thinking through ways to provide HIV/acquired immune deficiency syndrome (AIDS) education to those family members that have little knowledge in this area. This may include translating or locating informational brochures translated into the family's language.

Intramuscular iron replenishment and replacement combined with testosterone enanthate in maintenance hemodialysis anemia: a follow-up of up to 8 years on 16 patients.

Sixteen chronic uremics who showed exhausted bone marrow iron stores and mean hematocrit values of 20.9 +/- 4.2% at the time of starting maintenance hemodialysis (HD) were treated by means of intramuscular iron dextran (IMD) (400 mg/month) for six months. By the end of this replenishment period, stainable bone marrow iron was observed and mean hematocrit values increased to 27.2 +/- 4.9% (p greater than 0.001). At this time, 200 mg of IMD/month and testosterone enanthate (1.5 g/month) were prescribed for the whole follow-up period (up to 8 years). The observed mean hematocrit values were up to 46.1 +/- 1.6%. Major side effects were not observed. The process of slow iron reabsorption from the intramuscular injection site (up to 4 weeks) also implies the splitting of iron from dextran, therefore preventing bone marrow deposits of iron dextran complexes which make iron unavailable for erythropoiesis. High doses of testosterone enanthate can normalize hematocrit values of maintenance hemodialysis patients with replenished bone marrow iron stores.