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The AIDS epidemic has disproportionately hit adults in their 30s and 40s. Due to the latency of the HIV infection, this means that the illness is often acquired in the late teens to early thirties. Falling into this age range are some 12 million college students, among whom the prevalence of HIV infection and AIDS is not known. The knowledge, risk practices, and HIV infection rates of this group must be determined so that effective preventive and treatment programs can be developed. In the present study, anonymous HIV testing was offered to undergraduate college students attending the University of Maryland. The 3,394 students who participated in the study filled out questionnaires about knowledge and risk factors for HIV transmission. They were tested for HIV antibodies, and received HIV-related counseling and education. The average age of the subjects was 22.3 years. A total of 47.5 percent were male, 81.4 percent were white, 8.9 percent were black, and 2.6 percent were Hispanic. The results revealed that 87.1 percent of the students had experienced intercourse (anal or vaginal), and that the students had an average of four sexual partners during their lifetimes. Ten or more sexual partners were reported by 21 percent of the study participants. Potential risk behaviors were reported by 11.9 percent of the men and 5.8 percent of the women surveyed. While 12.6 percent of the students had a history of a sexually transmitted disease, 24.9 percent of those practicing risk behaviors had a history of a sexually transmitted disease. Condoms were regularly used by only 17.5 percent of men and 12.9 percent of women. Two students in this sample tested positive for HIV antibodies; both were homosexual and reported 30 and 50 sexual partners, respectively. Questionnaires that were administered after the HIV antibody testing showed an increase in the frequency of condom use and increased awareness of heterosexual HIV transmission. These findings indicate that programs to diminish risk behaviors among college students are needed and can be successfully utilized. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection with the human immunodeficiency virus (HIV) should be treated early with antiviral agents to delay the progression of HIV infection and decrease the symptoms of disease. An AIDS vaccine is currently being tested in HIV-infected patients. However, HIV-infected patients can only be treated early if the infection is detected early. HIV infection can occur from several weeks to more than three years between exposure to the virus and the detection of HIV antibodies (immune proteins directed against the virus). Certain immune and genetic methods, including measurement of reverse transcriptase, polymerase chain reaction (PCR), and HIV antigen capture, have been effective in identifying HIV infection at an early stage, even before HIV antibodies can be detected. A case is described of a 40-year-old homosexual man who did not have HIV antibodies and was in good general health. Although he admitted to being promiscuous in the past, the patient had been involved in a monogamous relationship for eight months. He did not have a history of blood transfusion, intravenous drug use, or sexually transmitted disease. The patient was tested for HIV infection by monitoring the function of the immune T helper (Th) cells, the presence of HIV DNA, and HIV antibodies at 1, 5, 13, 16, and 19 months. When peripheral blood mononuclear cells (PBMC) are exposed to viral antigens, or elements of the virus that trigger an immune reaction, PBMC proliferate or grow rapidly into immune T cells and release interleukin-2, a factor that increases the growth of T cells. The patient's PBMCs were exposed to proteins that were similar to HIV antigens and the ability of the PBMCs to release interleukin-2 and proliferate into T cells was assessed. In addition, the presence of HIV DNA in PBMCs was assessed using PCR, which amplifies or makes several copies of DNA in amounts that are sufficient for analysis. The presence of HIV antibodies and p24 antigen, an indicator of HIV infection, in the blood were also monitored. The Th tests were positive from 5 to 19 months, indicating exposure of PBMC to HIV, whereas PCR and blood tests were positive only at 19 months. Thus, Th tests are effective in detecting HIV antigens before HIV antibodies and HIV DNA can be measured. (Consumer Summary produced by Reliance Medical Information, Inc.)

Antibodies to human immunodeficiency virus type 1 (HIV-1) have been found in various body fluids such as saliva, breast milk, cervical secretions, and semen. Most cases of HIV infection are transmitted when body fluids cross mucosal membranes during sexual contact. Secretory IgA (immunoglobulin A) is the major type of antibody which is present in mucosal secretions and is known to protect against certain viral infections. A study was conducted to see if saliva from five individuals contained antibodies to HIV-1; the subjects had received a vaccine against a biotechnologically-derived protein of HIV-1, the envelope or outer coat of the virus (rgp160). Two individuals received a high dose of rgp160, three received a low dose, and five additional subjects received various types of control vaccines. Using the ELISA test, a routine screening test, none of the individuals immunized with rgp160 were found to have antibodies to HIV in their blood serum. However, when testing by Western blot analysis, a more sensitive test, one out of the three individuals who received the low dose and both of those who received the high dose were found to have antibodies in their serum. One of these individuals contained antibodies in the saliva as well, as detected by Western blot analysis. The presence of antibodies in saliva indicates that it is possible to stimulate production of secretory antibodies using vaccines against rgp160. The development of secretory antibodies may be necessary for protection against HIV infection. The presence of antibodies in saliva may inhibit the transmission of the virus across mucosal membranes. (Consumer Summary produced by Reliance Medical Information, Inc.)