AIDS knowledge in minorities: significance of locus of control.

A convenience sample of 587 subjects from the community health centers of Harris County, Texas, completed a structured interview that included questions on knowledge of AIDS transmission and prevention and on the Wallston Health Locus of Control (HLOC) Scale. HLOC score was a strong independent predictor of AIDS knowledge, with high externality associated with less knowledge. In a regression equation predicting AIDS knowledge, HLOC contributed 3% of the variance after education and ethnicity were accounted for. Hispanic and black individuals had a higher external orientation than white individuals. These findings suggest the need to address personal beliefs and perceptions concerning risk and to consider HLOC when educating patients and the public about AIDS.

AIDS knowledge in low-income and minority populations.

A convenience sample of 587 subjects was selected from the waiting areas of community health centers in Harris County, TX. They completed a structured interview that included questions on their knowledge of acquired immunodeficiency syndrome (AIDS) transmission and prevention. Hispanic patients were interviewed in their preferred language. They were given a cumulative correct score for 10 questions on AIDS. An ANOVA showed significant differences in knowledge between each radial group. Cumulative scores were whites, 78 percent correct; blacks, 68 percent correct; and Hispanics, 61 percent correct. Only 58 percent of Hispanics reported that using a condom during sexual intercourse lowered the risk of contracting AIDS, compared with 84 percent of whites and 83 percent of blacks. A regression analysis showed significant effects for both education and racial group, but not for age and sex. These findings show that knowledge of AIDS can be predicted according to the race and education of the population using these community health centers. Additional attention should be focused on educating low-income blacks and Hispanics about AIDS.

An AIDS training program for rural mental health providers.

A total of 194 mental health care providers in Arkansas, primarily from rural areas and small communities, participated in a four-hour training program designed to improve their knowledge about the psychosocial and neuropsychiatric aspects of HIV and AIDS. Participants' responses to questionnaires completed before and after training indicated that the program was successful in achieving its goal. However, only a minimal number of providers reported completing drug, alcohol, and sexual histories and AIDS risk assessments for any of their patients before the training occurred. The authors emphasize the importance of AIDS training for rural providers.

AIDS and family planning counseling of psychiatrically ill women in community mental health clinics.

Eighty-two of 83 mental health professionals, including psychiatrists, were surveyed to determine their attitudes and behaviors toward AIDS prevention and family planning counseling with psychiatrically ill female outpatients. Nearly all reported that information should be provided on AIDS and family planning. However, they reported that they had raised topics of AIDS with only 19% of patients and family planning with only 25% of patients. This lack of communication was confirmed by patients' own reports. Factors which might relate to this lack of communication are explored.

PIP: 82 mental health professionals including psychiatrists and 80 female chronic psychiatric patients (50% schizophrenia and 37% schizoaffective and affective disorders), both groups from 5 public funded university affiliated county mental health clinics in the US, completed questionnaires concerning AIDS and family planning. 87% of the mental health professionals believed they should take responsibility to educate patients about family planning and 95% said they should educate them on AIDS. 73% of patients felt mental health professionals should provide family planning information and 87% felt that the professionals should inform them about AIDS. Yet only 19% of mental health professionals had talked to their patients about AIDS and 8% of patients brought AIDS up as an issue. The corresponding numbers for family planning were 25% and 12%. Female professionals were more likely to discuss family planning than male professionals (p.05), but both male and female professionals were equally as likely to discuss AIDS. Mental health professionals tended to underestimate the percentage of patients who sought medical treatment outside the mental health clinics and the percentage of patients who had accurate knowledge about AIDS (p.05). For example, only 43% of the mental health professionals claimed that patients had seen a physician in the past year while 76% of the patients said that they did indeed visit a physician in the past year. 82% of mental health professionals said that patients were anxious during sexual history taking, but only 27% of patients actually reported being anxious (p.05). These results indicated that their is a definite lack of communication between mental health professionals and patients. The overestimation of patient anxiety during sexual history taking may represent anxiety on the part of the mental health professionals.

AIDS, minority patients, and doctors: what's the risk? Who's talking?

We asked 39 physicians providing primary care for a mostly minority patient population to respond to a questionnaire concerning their attitudes and behavior toward AIDS risk assessment and preventive counseling and to indicate their beliefs concerning patients' knowledge and behavior. Most of the 36 physicians who responded (92%) agreed that physicians must educate their patients about AIDS. They also reported that patients who engage in risk-taking behavior may not know much about AIDS transmission and prevention. Despite these beliefs, these doctors reported that they gave advice to only 11% of their male patients and 14% of their female patients. More than one third of physicians reported feeling uncomfortable talking about patients' sexual preferences and practices. To identify patients at risk and to help prevent AIDS, methods must be found to make physicians more comfortable discussing sexual issues with their patients, especially their minority patients.

Susceptibility and synergy studies of methicillin-resistant Staphylococcus epidermidis.

Methicillin-resistant Staphylococcus epidermidis is an important cause of cerebrospinal fluid shunt infections and prosthetic valve endocarditis. Agar dilution minimum inhibitory concentrations were determined for 100 strains of methicillin-resistant S. epidermidis which were isolated from clinical specimens. Vancomycin inhibited all 100 strains at /=3.12 mug/ml. Of the five cephalosporins and one cephamycin tested, cefamandole was the most active in vitro, inhibiting 97 strains at /=10(2) kill by the combination over the most effective single antibiotic at 24 h) was demonstrated with vancomycin (1.56 mug/ml) plus cefamandole (6.25 mug/ml) in 14 of 14 strains, vancomycin plus cephalothin (6.25 mug/ml) in 14 of 14 strains, vancomycin plus rifampin (0.008 to 0.012 mug/ml) in 6 of 12 strains, rifampin plus cefamandole in 9 of 12 strains, and rifampin plus cephalothin in 10 of 12 strains. The emergence of populations of bacteria resistant to 0.2 mug of rifampin per ml developed in three of five methicillin-resistant S. epidermidis strains tested. The addition of either vancomycin, cephalothin, or cefamandole to the rifampin prevented the emergence of resistance in these three strains. Clinical trials of synergistic antibiotic combination therapy for serious methicillin-resistant S. epidermidis infections are indicated.