In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) developed guidelines for preventing opportunistic infections (OIs) among persons infected with human immunodeficiency virus (HIV); these guidelines were updated in 1997 and 1999. This fourth edition of the guidelines, made available on the Internet in 2001, is intended for clinicians and other health-care providers who care for HIV-infected persons. The goal of these guidelines is to provide evidence-based guidelines for preventing OIs among HIV-infected adults and adolescents, including pregnant women, and HIV-exposed or infected children. Nineteen OIs, or groups of OIs, are addressed, and recommendations are included for preventing exposure to opportunistic pathogens, preventing first episodes of disease by chemoprophylaxis or vaccination (primary prophylaxis), and preventing disease recurrence (secondary prophylaxis). Major changes since the last edition of the guidelines include 1) updated recommendations for discontinuing primary and secondary OI prophylaxis among persons whose CD4+ T lymphocyte counts have increased in response to antiretroviral therapy; 2) emphasis on screening all HIV-infected persons for infection with hepatitis C virus; 3) new information regarding transmission of human herpesvirus 8 infection; 4) new information regarding drug interactions, chiefly related to rifamycins and antiretroviral drugs; and 5) revised recommendations for immunizing HIV-infected adults and adolescents and HIV-exposed or infected children.

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Objectives-To determine frequencies of childhood sexual abuse (CSA) and its demographic and mental health correlates among HIV-positive men who have sex with men (HIV+ MSM).Methods-Cross-sectional analysis of baseline data collected among 593 HIV+ MSM enrolled in the Positive Connections intervention. Data included frequencies of CSA, demographics, and the number of total sex and anal sex contacts contextualized by partners' HIV infection status and condom use.Results-Of participants, 47% reported CSA, with 32% reporting CSA occurring 'often' or 'sometimes.' Men reporting CSA were more likely to be Latino (OR: 2.6) or African-American (OR: 1.8) versus white study participants (p=.0007). CSA reported 'often' or 'sometimes' was associated with increased total sexual contacts (rate ratio: 1.3, for each; p < 0.0001) and unsafe anal intercourse contacts (rate ratio: 1.5 and 2.0, respectively; p < 0.0001) compared with men not reporting CSA.Conclusions-History of CSA is highly prevalent among HIV+ MSM engaging in risk behavior, and appears more common among men of color. Findings suggest that HIV+ MSM reporting CSA are at significantly increased risk for acquiring or transmitting HIV or STI due to increased contact rates versus men without CSA histories.