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Background: Human immunodeficiency virus (HIV) infection is a major cause of morbidity, mortality, and health-care expenditures in the United States. HIV testing and linkage to care are essential to identify persons early in their course of infection to prevent progression to acquired immunodeficiency syndrome (AIDS) and death, and to reduce transmission. Methods: CDC used 2001-2009 data from the National Health Interview Survey to estimate percentages of persons aged 18-64 years who reported ever being tested for HIV in the United States. Data from the National HIV Surveillance System were used to estimate numbers, percentages, and rates of HIV diagnoses, AIDS diagnoses, and late diagnoses of HIV infection (defined as an AIDS diagnosis made ±12 months from an initial HIV diagnosis) for persons diagnosed with HIV infection during 2001-2008 and reported to CDC through June 2009; these were used to determine populations and regions most affected by HIV and AIDS, late diagnoses, and trends in late diagnoses over time. Results: The percentage of persons aged 18-64 years ever tested for HIV was stable at approximately 40% from 2001 to 2006, increasing to 45.0% in 2009. The percentage of persons with late diagnoses of HIV infection was stable at approximately 37% from 2001 to 2004, decreasing to 32.3% by 2007 (most recent data available). In the 37 states with mature HIV reporting systems in 2007, the percentage of persons diagnosed late ranged from 25.0% to 47.2%. In 2008, most HIV diagnoses, by race/ethnicity, were among blacks or African Americans (51.2%) and, by transmission category, were among non-drug-injecting men reporting male-to-male sexual contact (55.0%). AIDS diagnosis rates were highest in the South and Northeast census regions and in the most populated states. Conclusions: The number of persons in the United States who report ever being tested for HIV is increasing, and fewer persons are being diagnosed late in their infection. However, nearly one third of diagnoses still occur late. Increased testing efforts are needed, particularly among populations that account for most HIV diagnoses. Implications for Public Health Practice: All health-care providers should expand routine HIV screening so that all adults are tested. Members of populations with higher rates of HIV diagnoses and living in geographic areas with high HIV prevalence should be screened more frequently than others. Persons likely to be at high risk for HIV infection (e.g., gay, bisexual, and other men who have sex with men) should be tested at least annually. Public health officials should emphasize the importance of HIV testing and allocate resources to increase testing among populations with the highest rates of HIV diagnoses. [ABSTRACT FROM AUTHOR]

The article presents a report that describes the trends in human immunodeficiency virus (HIV) testing, rates of HIV and acquired immune deficiency syndrome (AIDS) diagnoses, and trends in late diagnoses of HIV infection in the U.S. The 2001-2009 data from the National Health Interview Survey was used to calculate the percentage of persons aged 18-64 years old who reported ever testing for HIV. The report found that 44.8% of persons aged 18-64 years old reported ever being tested for HIV in 2008. In 37 states, nearly 40,000 adults were diagnosed with HIV infection with mature HIV reporting systems in 2008.

Adolescent Impact, a developmentally targeted behavioral intervention aimed at decreasing risk behaviors and promoting health care adherence, was delivered to 83 HIV-infected youth, aged 13-21 years, receiving care in five urban HIV centers. Participants completed a patient satisfaction survey following the 12 part intervention consisting of seven groups and five individual sessions. A feedback questionnaire was also completed during each group session to gain more insight on participant experiences. Several indicators suggested high levels of satisfaction. First, overall attendance was relatively high. Second, participants rated their subjective experience and group content favorably. No differences in satisfaction ratings emerged between perinatally infected adolescents and those who acquired HIV through risk behaviors. However, differences emerged regarding perceived intervention utility and content-specific preferences. Findings suggest that Adolescent Impact participants were satisfied with the intervention and that a heterogeneous group of HIV-infected youth could be advantageously integrated into the same secondary prevention program.

Objective: Our purpose was to identify clinical and psychosocial factors associated with rates of prenatal zidovudine use and adherence among human immunodeficiency virus-infected pregnant women., Study Design: Two hundred sixty-four women completed 2 interviews between October 1996 and November 1998 at prenatal clinics in Miami, Florida; Brooklyn, New York; Connecticut; and North Carolina. Interviews took place after 24 weeks' gestation and then between 32 weeks and delivery., Results: Prenatal zidovudine had been prescribed for 94% of the women, 37% of whom received monotherapy. Among women taking zidovudine, 20% reported incomplete adherence. In multivariate analyses having missed zidovudine doses was positively associated with prenatal illicit drug use (odds ratio, 3.49; 95% confidence interval, 1.30-9.42; P <.05) and missing prenatal vitamins (odds ratio, 2.71; 95% confidence interval, 1.30-5.67; P <.01)., Conclusions: Zidovudine therapies have been successfully implemented in prenatal care settings in the United States. The success of these therapies may be limited among some patients by incomplete regimen adherence, particularly among illicit drug users.

The purpose of these analyses was to provide a prospective examination of the impact of HIV on birth weight using clinical, behavioral, psychosocial, and demographic correlates. HIV-positive (n = 319) and HIV-negative (n = 220) pregnant women matched for HIV risk factors (i.e., drug use and sexual risk behaviors) were interviewed during the 3rd trimester of pregnancy and 6 weeks postpartum. Medical chart reviews were also conducted for the HIV-seropositive pregnant women to verify pregnancy-related and birth outcome data. In a logistic regression analysis, model chi2(9, N = 518) = 124.8, p < .001, controlling for parity and gestational age, women who were HIV seropositive were 2.6 times more likely to have an infant with low birth weight. In addition, Black women and those who did not live with their partners were more than 2 times as likely to have infants with low birth weight, and those who smoked were 3.2 times more likely to have infants with low birth weight. Knowing that women with HIV, those who are Black, and those not living with a partner are at highest risk for adverse birth outcomes can help those in prenatal clinics and HIV specialty clinics to target resources and develop prevention interventions. This is particularly important for women with HIV because birth weight is associated with risk of HIV transmission from mother to child.

Objective: Violence is highly prevalent among women with HIV. Determining whether HIV is causally related to violence, and whether risk for violence is increased by certain HIV prevention practices, has been difficult., Methods: We review recent literature concerning (1) violence and HIV serostatus, including the risk for violence associated with disclosure of a positive serostatus, and (2) violence associated with requests that male sex partners use condoms., Results: Studies suggest that women with or at risk for HIV come from populations that are also at risk for violence. Violence is not statistically increased among HIV-infected women compared to demographically and behaviorally similar uninfected women. However, for a small proportion of women, violence may occur around disclosure or in response to condom negotiation., Conclusions: Integrating violence screening and referral into HIV services could help many women obtain the assistance they need while minimizing the risk for violence that may be associated with partner notification or condom requests.

The impact of simultaneous changes in biological and social context on the mental health of adolescents was examined by testing the hypothesis that normative developmental transitions can be associated with increased dysphoria if they occur in close temporal proximity. Girls experiencing physical changes associated with middle or later stage pubertal development during the initial high school or college year were predicted to experience more dysphoria than those experiencing these changes during non-transitional times, with negative pubertal attitudes exacerbating the relation. Pubertal status and dysphoria of high school and college students were assessed. Among females experiencing pubertal changes, dysphoria was indeed highest for the 15 and 19 year olds, and lower for the 16, 17, and 18 year olds with females viewing menstrual onset as negative experienced depressive symptoms of moderate clinical severity. This pattern did not emerge for males, or females not experiencing pubertal changes. In contrast, the hypothesis was not supported when transition time was operationalized using grade level. Implications for psychopathology risk are discussed.

The authors present a case of a mandibular neurilemmoma discovered on routine radiographic examination of an asymptomatic young woman. The lesion was surgically removed and there was no radiographic evidence of recurrence. A review of the literature is presented and the differential diagnosis, prognosis and treatment of this benign neurogenic tumor are discussed.

This study examined the ways in which normal, depressed, and conduct-disordered adolescents differ with regard to self-image. Normal and psychiatrically hospitalized adolescents completed the Offer Self Image Questionnaire for Adolescents (OSIQ). Patients were grouped on the basis of their DSM-III diagnoses, and their OSIQ scores were compared. Major depressive disorder, particularly the first episode, was associated with poor self-evaluation in multiple areas, while conduct disorder was associated with almost no specific self-image deficits. For younger (12- to 15-year-old) adolescents, a repeated episode of depression was associated with a poorer self-image than was a diagnosis of dysthymic disorder or atypical depression, but a better self-image than a single episode of depression, suggesting that at this age, repeated episodes are met with internal adaptation rather than continued self-devaluation. Adolescents who received a diagnosis of both conduct disorder and major depression reported an overall level of self-image disturbance between those with either of these disorders alone, suggesting that acting-out behaviors may attenuate the self-devaluing experience of depression. Results are discussed in terms of current issues in adolescent development and developmental psychopathology.