To determine the patterns and determinants of mobility in persons with HIV infection or AIDS on a population basis.
Descriptive cross-sectional population health study.
650 full members (i.e., HIV-positive) of the Vancouver Persons with AIDS Society who were residents of British Columbia and who allow the society to include unsolicited material with their monthly newsletter.
Migration history, access to HIV-related care at diagnosis, current and pre-HIV sociodemographic characteristics, and current health status.
Two hundred and fifty-two persons living with HIV/AIDS participated in the study. At the time of the survey, the majority of subjects were male (94 percent), aged between 30 and 54 years (87 percent), and able to carry out daily activities without assistance (84 percent). The median time since the known date of HIV infection was 6 years. Access to care at diagnosis was associated in this population with being diagnosed in the largest metropolitan area in the province (OR = 2.14; 95 percent CI: 1.18, 3.87), a pre-HIV income of $30,000 or more per annum (OR = 0.49; 95 percent CI: 0.27, 0.89), a known date of diagnosis prior to 1990 (78 percent versus 64 percent; p = 0.019), and living in the same residence from the date of known HIV diagnosis to the date of the survey (63 percent versus 51 percent; p = 0.024).
Although no definitive causal association can be provided by this cross-sectional analysis, our results clearly highlight several ways in which the need for treatment and care potentially affect where persons with HIV/AIDS choose to live.
The aim of this study was to assess the acceptability of human immunodeficiency virus (HIV) testing among migrants in Finland and the factors contributing to non-acceptance.
The Finnish Migrant Health and Wellbeing Study 'Maamu' was the first national population-based Health Interview and Examination Survey (HIS/HES) among migrants in Finland. A total of 386 Kurdish, Russian and Somali immigrants in Helsinki participated in the study.
Despite the participants' different sociodemographic backgrounds, a high rate of test acceptability (92%, 95% CI 90-95) was achieved. HIV test acceptance was associated with pretest counselling, ability to understand spoken Finnish or Swedish and employment status. No participants tested positive for HIV.
The results imply that a universal HIV testing strategy is well accepted in a low-HIV prevalence immigrant population and can be included in a general health examination in immigrant population-based surveys.
The survival pattern was studied for 687 Danish AIDS patients (93% of notified cases in the study period) who were diagnosed with AIDS during the period from 1980 to 1990. The median survival was 17 months. Factors significantly associated with a shortened survival were transfusion-acquired HIV infection, age > 40 years, year of diagnosis before 1987, and the presence of either disseminated infection with Mycobacterium avium-complex, Cytomegalovirus chorioretinitis or malignant lymphoma at time of the AIDS diagnosis. There was also a significant association between survival and CD4 cell count at time of AIDS diagnosis. Patients who had CD4 cell counts above 200 x 10(6)/l had twice as long a survival as patients who had CD4 cell counts less than 50 x 10(6)/l. The prognosis of Danish AIDS patients remains poor. The most important determinant of survival time appears to be the degree of immune deficiency at time of diagnosis.
Do patients and health care workers have the legal right to know each other's HIV status? Professor Flanagan argues that they do not. Given that with appropriate precautions the risk of transmitting HIV in the health care setting is extremely small and that the discriminatory consequences of HIV disclosure can be extremely high, it is suggested that the right of a patient or a health care worker not to disclose their HIV status must outweigh the other's "right to know."
A private member's bill is expected to be introduced in the spring 2004 session of the Alberta Legislative Assembly that will allow for forced testing of individuals for HIV, hepatitis, and other bloodborne diseases if their bodily fluids come into contact with emergency workers or Good Samaritans. The bill will likely have strong support from within the ranks of the governing Conservatives.