Increasing trend of Cesarean deliveries in HIV-infected women in the United States from 1994 to 2000

BACKGROUND: Meta-analysis and randomized clinical trial results reported in June 1998 indicated a significant reduction in perinatal HIV transmission rates among mothers undergoing a cesarean section (C-section). OBJECTIVE: The objective of this study was to examine recent trends in and factors associated with C-section deliveries among HIV-infected women in the United States. DESIGN: A multisite pediatric medical record review of a cohort of HIV-exposed and HIV-infected infants in the Pediatric Spectrum of HIV Disease (PSD) Cohort study (n = 6467) and the national Pediatric HIV/AIDS Reporting System (HARS) (n = 8,306) was conducted. SETTING/PATIENTS: All infants born between 1994 and 2000 to HIV-positive mothers referred to the PSD study or to a Pediatric HARS hospital or clinic site were enrolled. RESULTS: The proportion of deliveries by C-section was steady at about 20% from 1994 through June 1998. From July 1998 through December 2000, this proportion increased to 44% in the PSD study and to nearly 50% in the Pediatric HARS. On analysis by multiple logistic regression, delivery of infants by C-section was associated with the release of study results (OR = 2.83), delivery in four PSD sites in reference to Texas (OR: 2.02-1.43), having private medical care reimbursement (OR = 1.62), and having maternal prenatal care (OR = 1.43). CONCLUSIONS: The PSD and Pediatric HARS data demonstrate a sharp increase in C-section rates mainly among HIV-infected women in the United States after the release of the meta-analysis and randomized clinical trial results in 1998. This finding highlights the rapid impact of study results on obstetric practice. It underscores the critical role of prenatal care in offering perinatal interventions such as scheduled C-section when indicated to reduce the likelihood of HIV transmission.     

A meta-analytic review of HIV behavioral interventions for reducing sexual risk behavior of men who have sex with men

This meta-analysis examines the efficacy of international HIV prevention interventions designed to reduce sexual risk behavior of men who have sex with men (MSM). We performed a comprehensive search of published and unpublished English-language reports of HIV prevention interventions that focus on MSM and evaluated changes in risky sexual behavior or biologic outcomes related to sexual risk. Data from 33 studies described in 65 reports were available as of July 2003. Studies with insufficient data to calculate effect sizes were excluded from the meta-analysis. Interventions were associated with a significant decrease in unprotected anal intercourse (odds ratio [OR] = 0.77, 95% confidence interval [CI]: 0.65-0.92) and number of sexual partners (OR = 0.85, 95% CI: 0.61-0.94) and with a significant increase in condom use during anal intercourse (OR = 1.61, 95% CI: 1.16-2.22). Interventions successful in reducing risky sexual behavior were based on theoretic models, included interpersonal skills training, incorporated several delivery methods, and were delivered over multiple sessions spanning a minimum of 3 weeks. Behavioral interventions provide an efficacious means of HIV prevention for MSM. To the extent that proven HIV prevention interventions for MSM can be successfully replicated in community settings and adapted and tailored to different situations, the effectiveness of current HIV prevention efforts can be increased.     

儿童青少年肥胖防控实施方案

随着我国经济社会快速发展和人民生活水平显著提高,儿童青少年膳食结构及生活方式发生了深刻变化,加之课业负担重、电子产品普及等因素,儿童青少年营养不均衡、身体活动不足现象广泛存在,超重肥胖率呈现快速上升趋势,已成为威胁我国儿童青少年身心健康的重要公共卫生问题。     

天津市保健食品企业行动起来规范市场

保健食品从1999年零开始到现阶段,全国产品已发展到3000个,产值500亿元人民币。天津市产品150多个,年销售额达3.1亿元,2000年比1999年增长32％,已成为国民经济新的增长点,成为广大消费者关注的新兴产业。 然而,近一个阶段以来,违反市场规范的现象屡有出现。急功近利,为在短期内收回成本,采取广告“轰炸”;甚至作虚假广告宣传,夸大功能,误导了消费者,使保健食品可信度有所降低。 这些不正当的行为,不但直接损害了消费者的权益,也给企业本身造成负面影响。 为此,天津市营养保健品协会经与有关企业认真讨论磋商,普遍认为:广大规范的保健食品企业应该团结起来,以加强自身管理;以执行各项法规为准绳;建     

骨质疏松性骨折中西医结合诊疗专家共识

骨质疏松性骨折;中西医结合诊疗;规范;专家共识     

欢迎订阅《中国初级卫生保健》杂志

《中国初级卫生保健》杂志是由国家卫生健康委员会主管、中国初级卫生保健基金会主办的综合指导类期刊。本刊以各级卫生健康行政管理人员,初级卫生保健理论和政策研究专家,基层卫生人员,公共卫生、预防保健人员,以及各大专院校、科研院所相关研究人员为主要读者对象。     

《中国初级卫生保健》杂志欢迎您投稿

《中国初级卫生保健》杂志由国家卫生健康委员会主管、中国初级卫生保健基金会主办,创刊于1987年,是国内唯一一本以研究初级卫生保健理论、政策、技术方法为内容的综合指导类期刊。曾被评为“全国优秀科技期刊”“中国期刊方阵双百期刊”,现被《中国核心期刊(遴选)数据库》《中国学术期刊综合评价数据库统计源期刊》《中文科技期刊数据库(全文版)》等多家数据库收录。本刊以各级卫生健康行政管理人员,初级卫生保健理论和政策研究专家,基层卫生人员,公共卫生、预防保健人员,以及各大专院校、科研院所相关研究人员为主要读者对象。