Abstract

PIP: The acquired immune deficiency syndrome (AIDS) is fueling a campaign that encourages use of the condom to combat the spread of sexually transmitted diseases. Condom use is being advocated even when one partner is practicing another form of contraception. The threat of AIDS has spread beyond the original risk groups -- homosexual and bisexual men, intravenous drug users, and transfusion recipients -- to include heterosexual men and women. Researchers from the Centers for Disease Control said at the recent conference, Current Issues in Reproductive Health, that clinicians should take the following steps to control the disease: encourage using condoms to protect against sexually transmitted diseases, even if the patient uses another form of contraception; take steps to prevent perinatal transmission of the AIDS virus, human T-lymphotropic virus type III (HTLV-III); develop ways to use serologic tests for identifying AIDS-infected women of childbearing age; if infection is identified in non-pregnant women, counsel them on the most effective birth control methods; and if infection is identified after a woman is pregnant, discuss the indications for abortion. Dr. Mary E. Guinan, associate director of the CDC's Division of Sexually Transmitted Diseases, said women are most likely at greater risk of heterosexual transmission of the AIDS virus than men. She says that she believes "this is because of semen deposition in women." The virus believed to cause AIDS, HTLV-III, is present in the semen of men with AIDS or HTLV-III infection. Homosexuals are already being advised to use condoms. Intensive education is required to convince patients to accept using condoms in addition to other contraceptive methods. They need to be made aware of the condoms' role in preventing disease transmission. Dr. Harold Jaffe, chief of the epidemiology section of the CDC's AIDS task force, reports that the CDC defines AIDS as an illness at least moderately indicative of an underlying cellular immune deficiency. The definition also includes the presence of any of several clinical conditions, e.g., Kaposi's sarcoma in a patient under 60 years old, pneumocystis carinii pneumonia, and a whole range of other serious infections. Using the CDC's case definition, the agency has received reports of about 14,000 AIDS cases in the US. The risk groups account for the following proportions of those cases: 73% among homosexual men; 17% among intravenous drug users; 1% among hemophiliacs or patients with coagulation disorders; 2% among transfusion recipients; 1% among heterosexual contacts of individuals in other risk groups; and about 7% among people with unknown risks -- about half of whom are Haitian. About 200 pediatric cases of AIDS have been reported to the CDC. The infection is believed to be spread perinatally. Researchers are experimenting with antiviral compounds for treating AIDS and vaccines for preventing the disease, but the results are unclear.