publicdata/ahrq-gov
1
0
Fork 0
Code Issues Pull requests Projects Releases Packages Wiki Activity Actions
ahrq-gov/archive.ahrq.gov/research/apr02/0402RA32.htm
Scott Williams 58222b51ed Initial commit
2025-02-28 14:14:25 -05:00

165 lines
No EOL
15 KiB
HTML
Raw Blame History

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Research Activities, April 2002: HIV/AIDS Research: HCSUS studies examine Pap screening followup for HIV-positive women and lifestyle changes following HIV diagnosis</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<!-- "metadata" -->
<meta name="Title" content="Research Activities, April 2002" />
<meta name="keywords" content="Agency for Health Care Policy and Research, Agency for Healthcare Research and Quality, AHRQ, AHCPR, AIDS/HIV, ambulatory care, benchmark, child, cost, elderly, health cost, healthcare cost, hospital, long-term care, managed care, markets, mental health, methodology, minority health, nursing, nursing homes, outcome research, out-of-pocket spending, patient care, primary, primary care, research, rural, spending, study, Translating Research Into Practice, TRIP" />
<meta name="description" content="April 2002 issue of online newsletter summarizing published findings from AHRQ-funded studies, new AHRQ publications and products, and funding opportunities." />
<meta name="creator" content="Agency for Healthcare Research and Quality (AHRQ)" />
<meta name="datecreated" content="April 2002" />
<meta name="datereviewed" content="April 2002" />
<meta name="language" content="English" />
<!-- end metadata -->
<link href="/includes/archive.css" rel="stylesheet" type="text/css" />
<link href="/includes/ahrqstyleprint_arch.css" rel="stylesheet" type="text/css" media="print" />
<script>
(function(i,s,o,g,r,a,m){i['GoogleAnalyticsObject']=r;i[r]=i[r]||function(){
(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),
m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)
})(window,document,'script','//www.google-analytics.com/analytics.js','ga');
ga('create', 'UA-75759936-1', 'auto');
ga(' set', 'anonymizeIp', true);
ga('send', 'pageview');
</script></head><body><!-- Google Tag Manager -->
<noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-W4DST4"
height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':
new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],
j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src=
'//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);
})(window,document,'script','dataLayer','GTM-W4DST4');</script>
<!-- End Google Tag Manager -->
<noscript>
Your browser doesn't support JavaScript. Please upgrade to a modern browser or enable JavaScript in your existing browser.
</noscript>
<!-- Page Header v2.0 -->
<a name="top" id="top"></a>
<!--Begin Banner CodeS-->
<div id="ahrqbanner">
<div class="hhsportion">
<a href="#h1" class="skipnav">Skip Navigation</a>
<a href="http://www.hhs.gov" title="U.S. Department of Health and Human Services">
<img src="/images/hhs_banner.gif" alt="U.S. Department of Health and Human Services" />
</a>
<a href="http://www.hhs.gov" title="www.hhs.gov" class="hhsright">
<img src="/images/hhs_link.gif" alt="www.hhs.gov" />
</a>
</div>
<div class="ahrqportion">
<a href="/" title="Archive: Agency for Healthcare Research Quality">
<img src="/images/ahrq_banner.gif" alt="Agency for Healthcare Research Quality" />
</a><form name="searchForm" method="get" action="https://search.ahrq.gov/search" id="banner_searchform">
<label for="search" style="z-index:-1;position:relative;margin-right:-65px; font-size:0px;">Search</label>
<input name="q" type="text" value=" Search Archive" size="11" onfocus="this.value='';" class="gotext" label="Search archive" id="search" />
<input type="hidden" name="entqr" value="0" />
<input type="hidden" name="output" value="xml_no_dtd" />
<input type="hidden" name="proxystylesheet" value="ARCHIVE_Front_End" />
<input type="hidden" name="client" value="ARCHIVE_Front_End" />
<input type="hidden" name="site" value="ARCHIVE_AHRQ_GOV" />
<input src="/images/topbn_GoButton.gif" class="gobtn" name="Submit" onclick="javascript:document.searchForm.submit();" type="image" alt="Search" />
</form>
<a href="https://www.ahrq.gov/" class="ahrqright">www.ahrq.gov</a>
</div><div class="ahrqlinks"><a href="https://www.ahrq.gov/">AHRQ Home&#8212;Live Site</a> | <a href="/">Archive Home</a> | <a href="/sitemap.htm">Site Map</a> <!-- | &nbsp;<img src="/images/envelope1.jpg" alt="" width="21" height="14" /><a href="https://subscriptions.ahrq.gov/service/multi_subscribe.html?code=USAHRQ">E-mail Updates</a> --></div>
</div>
<div id="PrintBanner">
<img src="/images/printbanner_arch.jpg" alt="Archive print banner" />
</div>
<a name="h1"></a>
<!-- End banner code -->
<!-- End of Page header -->
<!-- Content Body -->
<div id="mainContent">
<table width="100%" border="0" cellspacing="0" cellpadding="0" >
<tr valign="top">
<td width="70%">
<!-- Center Content section -->
<table width="100%" border="0" cellpadding="0" cellspacing="0" style="margin-left:10px; margin-right:10px;margin-top:5px" summary="This table gives the layout format of the bread crumb area and the center content area.">
<!--DWLayoutTable-->
<tr>
<td class="crumb_link"><div id="crumbContent">
<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> &gt; <a href="/research/resarch.htm" class="crumb_link"><em>Research Activities</em> Archive</a> &gt; <a href="." class="crumb_link">April 2002</a> </span></p>
</div>
</td>
</tr>
<tr>
<td><h1><a name="h1" id="h1"></a>HIV/AIDS Research </h1>
</td>
</tr>
<tr>
<td><div id="centerContent"><div class="headnote">
<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
<h2><a name="head3">HCSUS studies examine Pap screening followup for HIV-positive women and lifestyle changes following HIV diagnosis</a></h2>
<p>Two recent studies from the <a href="https://www.ahrq.gov/data/hcsus.htm">HIV Cost and Services Utilization Study</a> (HCSUS) address issues in preventive screening and health-promoting behavior among people with HIV infection. Individuals who have HIV infection need to be concerned about detection of possible comorbid conditions. In addition, developing a more healthy lifestyle can have clinical benefits. </p>
<p>One HCSUS report found that 81 percent of HIV-positive women had a Pap test in the prior year, and 95 percent of those with initially abnormal Pap test results had scheduled followup Pap testing or colposcopy (insertion of a magnifying lens into the vagina to examine the tissues of the cervix and vagina). A second HCSUS study concluded that most people diagnosed with HIV make healthy changes in their lifestyle following diagnosis. </p>
<p>HCSUS is led by Samuel A Bozzette, M.D., Ph.D., of the University of California, San Diego, and RAND, and Martin F. Shapiro, M.D., Ph.D., of RAND and the University of California, Los Angeles. The studies, which are summarized here, were supported in part by the Agency for Healthcare Research and Quality (HS08578).</p>
<p><strong>Stein, M.D., Cunningham, W.E., Nakazono, T., and others. (2001, August). "Screening for cervical cancer in HIV-infected women receiving care in the United States." <em>Journal of Acquired Immune Deficiency Syndromes</em> 27, pp. 463-466.</strong></p>
<p>Invasive cervical cancer is a serious gynecologic manifestation of HIV infection, and it occurs in HIV-infected women three times as often as in uninfected women. Regular Pap tests with appropriate followup when results are abnormal could prevent nearly all deaths from cervical cancer. Current opportunistic infection guidelines recommend annual Pap smears after two initial smears, 6 months apart, are normal. However, the benefit of Pap testing depends on access of HIV-infected women to this screening.</p>
<p>The investigators examined sociodemographic, clinical, and provider factors associated with screening for cervical cancer among 624 women being treated for HIV infection, part of the nationally representative HCSUS cohort. Women were asked if they had received a Pap test in the past year and whether, if the results were abnormal, they were scheduled for another Pap test or colposcopy within 3 months. Of these HIV-positive women, 81 percent had received a Pap test in the past year. Women who had a gynecologist and primary care physician at the same clinical site were almost twice as likely as other women to report Pap testing. Among the women who reported abnormal Pap test results and who did not have vaginal infections, 95 percent were scheduled for a repeat Pap test or colposcopy, and 85 percent had received a repeat Pap test or colposcopy within 3 months.</p>
<p>Earlier studies associated lower socioeconomic status and lack of health insurance with lower screening rates, but this study did not replicate these findings. The high rates of Pap testing and referral for followup of abnormal results were encouraging. Organizing care so that gynecologic and general HIV services are provided at the same site appears to be one promising strategy to improve these rates further.</p>
<p><strong>Collins, R.L., Kanouse, D.E., Gifford, A.L., and others. (2001). "Changes in health-promoting behavior following diagnosis with HIV: Prevalence and correlates in a national probability sample." <em>Health Psychology</em> 20(5), pp. 351-360.</strong></p>
<p>Certain behaviors may have especially harmful effects among people with HIV infection. Cigarette smoking has been linked to greater risk of infections among HIV-positive people and also to maternal-fetal transmission of HIV. Alcohol use is related to poor immune functioning in HIV disease. Perhaps the most important effect of improving diet and exercise is to reduce cardiovascular risk, which may be high in the HIV-positive population in part due to possible vascular complications of antiretroviral therapy. </p>
<p>Most of the nationally representative HCSUS sample of 2,864 people receiving HIV care had made healthy changes in their lifestyle since HIV diagnosis. Nearly half (43 percent) increased their physical activity, and over half (59 percent) improved their diet. Also, nearly half (49 percent) of smokers and 80 percent of alcohol and drug users either quit or cut down. </p>
<p>People with more education were most likely to improve their diets, and those with higher emotional well-being and lower propensity to deny their HIV illness were more likely to reduce substance use. People who were younger, functioned well physically, did not have wasting syndrome, and had high self-rated health were more likely to increase their physical exercise. People diagnosed with Pneumocystis carinii pneumonia were more likely to reduce smoking than those who had not contracted this opportunistic infection.</p>
<p>These healthy behavior changes apparently reflected an effort to cope with and control a potentially devastating disease. Individuals who made these positive changes tended to want more information about HIV and its treatment, wanted to be more involved in their own medical care, and tried to cope in positive ways with HIV infection. Most individuals had made healthy changes since HIV diagnosis, but the time elapsed since testing HIV positive was not related to change. This suggests that the change toward healthier behaviors may have taken place very soon after an individual learned of his or her infection. If so, this may be a critical time for counseling, skills training, and education designed to encourage lifestyle changes and healthy behaviors. </p>
<p class="size2"><a href=".">Return to Contents</a><br />
<a href="0402RA33.htm">Proceed to Next Article</a></p>
<div class="footnote">
<p> The information on this page is archived and provided for reference purposes only.</p></div>
<p>&nbsp;</p>
</div>
</td>
</tr>
</table>
<!-- End of Center Content section -->
</td>
</tr>
</table>
</div>
<!-- End of Content Body -->
<!-- Footer graphic 1.2-->
<table cellspacing="0" cellpadding="0" border="0" width="100%">
<tr>
<td width="125" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_1.jpg" width="125" alt="AHRQ" /></td>
<td width="100%" background="/images/bottom_ahrq_bkg.jpg" ><img src="/images/bottom_ahrq_bkg.jpg" width="10" height="34" alt="" /></td>
<td width="310" background="/images/bottom_ahrq_bkg.jpg"><img src="/images/bottom_ahrq_2.gif" alt="Advancing Excellence in Health Care" width="310" height="34" /></td>
</tr>
</table>
<!-- Footer links section -->
<div id="banner_Footer2"><p> <a href="https://www.ahrq.gov/">AHRQ Home</a> | <a href="https://info.ahrq.gov" class="footer_navlink">Questions?</a> | <a href="https://www.ahrq.gov/contact/index.html" class="footer_navlink">Contact AHRQ</a> | <a href="https://www.ahrq.gov/sitemap.html" class="footer_navlink">Site Map</a> | <a href="https://www.ahrq.gov/policy/electronic/accessibility/index.html" class="footer_navlink">Accessibility</a> | <a href="https://www.ahrq.gov/policy/electronic/privacy/index.html" class="footer_navlink">Privacy
Policy</a> | <a href="https://www.ahrq.gov/policy/foia/index.html" class="footer_navlink">Freedom of Information Act</a> | <a href="https://www.ahrq.gov/policy/electronic/disclaimers/index.html" class="footer_navlink">Disclaimers</a> | <a href="http://www.hhs.gov/open/recordsandreports/plainwritingact/index.html" class="footer_navlink">Plain Writing Act</a> <br />
<a href="http://www.hhs.gov" class="footer_navlink">U.S. Department of Health &amp; Human Services</a> | <a href="http://www.whitehouse.gov" class="footer_navlink">The White House</a> | <a href="http://www.usa.gov" class="footer_navlink">USA.gov: The U.S. Government's Official Web Portal</a></p>
</div>
<div id="banner_Footeraddress"><p>Agency for Healthcare Research and Quality <img src="/images/bottom_dot.gif" alt="" /> 5600 Fishers Lane Rockville, MD 20857 <img src="/images/bottom_dot.gif" alt="" /> Telephone: (301) 427-1364</p></div>
<!-- End of Footer links section -->
</body>
</html>
Reference in a new issue View git blame Copy permalink