Four studies completed since 1995 have highlighted the importance of the relationship between the provider and the patient in enhancing adherence behavior. This study extends this work by comparing adherent and nonadherent clients in one high-volume HIV clinic in which the majority of care is provided by nursing staff. The sample comprised 130 clients (108 adherent and 22 nonadherent). Adherence status was determined by clinic staff using established procedures. The indicator of the patient-provider relationship was satisfaction with the care provider as measured within the Patient Satisfaction Questionnaire. Client groups differed significantly on perception of interpersonal manner of care provider (p =.018), care provider conduct total (p <.001), and quality total (p =.017). These findings are consistent with earlier work and underscore the potential importance of the patient-provider relationship as a focus of care for nurses.
The purposes of this study were to (a) identify behaviors that put adolescents at risk for HIV infection by retrospectively comparing a cohort of HIV positive and negative young adults and (b) determine gender-specific high-risk profiles. HIV-positive (n = 61) and HIV-negative (n = 124) individuals from two midwestern cities completed a survey tool prepared by the investigators examining six areas of behavior and activity identified in the literature as high risk. Alcohol use, drug use, and gang-related behaviors were not associated with HIV status in these young adults. Early, frequent, and unprotected sex with large numbers of partners were the predictive risk factors for HIV-seropositive status. Gender profiles, however, differed. Whereas the female profile suggested that early and unprotected sex were the only reliable predictors, HIV-positive male subjects had larger numbers of partners, engaged in more risky sexual behaviors, were more likely to have experienced sexual abuse before and during adolescence, and were more likely to have used cocaine during their adolescence. Conclusions include the confirmation of a resurgence of HIV among young males having sex with males and confirmation of females as the largest growing group of HIV-positive young adults.
Objective-To determine the variation in management of genital herpes by genitourinary physicians, and whether their duration of experience or gender influence their clinical management. Methods-A postal questionnaire was sent to UK consultant genitourinary physicians with detailed questions about management of primary and recurrent herpes. The gender and duration of genitourinary medicine experience of the physicians were also recorded. Results-One hundred and eighty two questionnaires were sent, 112 (62%) returned. Eighty-one (72%) physicians treat all patients with primary genital herpes, but physicians with more than 20 years experience were significantly (p < 0.05) more likely to treat only "severe"y primary attacks. Most experienced physicians were also most likely (p < 0.05) to prescribe topical acyclovir. Prescription of suppressive acyclovir was also influenced by the experience of the physician, the least experienced physicians being more likely to prescribe to patients who were HIV antibody positive or to those entering new relationships, whereas the more experienced prescribed to those patients who were particularly anxious (p < 0.05 for each of these). Male physicians were significantly more likely to agree with the proposition that men cope better with genital herpes (54%) than female physicians (24%, p < 0-01).
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