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122. Allen LS, Gorski RA. Sexual orientation and the size of the anterior commissure in the human brain. ;89:-

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title >An essay on hiv and multiple bereavement syndromeessays the hiv and ..
(26) Schulberg HC, et al. (1998) Treating Major Depression in Primary Care Practice: An Update of the Agency for Health Care Policy and Research Practice Guidelines. Archiv of Gen Psychiatry. 55, 1121-1127.

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the hiv multiple bereavement syndromes Myths significant experience of …
(24) Practice Guidelines for the Treatment of Patients with HIV/AIDS. (2000) American Psychiatric Association. Am J Psychiatry. 157, suppl, 1-61.


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HIV and opportunistic infections, HIV medications, and the psychosocial stress of HIV illness cause substantial psychiatric morbidity over the course of illness. Psychiatric syndromes seen in HIV-infected patients are of multiple and mixed etiologies (primary psychiatric disease predating HIV infection, substance-induced, medical illness and treatment-induced/exacerbated), and require aggressive screening, diagnosis and treatment. A broad range of medication and psychosocial interventions have been demonstrated to be effective when administered with frequent follow-up and outcomes assessment and treatment modification for inadequate response within the first 3 months. These should be administered in conjunction with high quality HIV medical care that addresses neuromedically- caused or exacerbated psychiatric syndromes. Psychiatric medication should be employed with careful attention to drug interactions with HIV medicines.

Mental health issues surrounding bereavement and HIV …
By December 1993, the number of cases of AIDS diagnosed in adolescents and adults in the United States totaled 355,936. Among the 311,578 men with AIDS, 62 percent had as their primary risk factor sex with other men, whereas only 2 percent contracted AIDS from heterosexual activity. Women accounted for a much smaller number of AIDS cases (44,357). When AIDS in women was related to sexual activity, it was most often associated with heterosexual contact with an HIV-positive man (35 percent of cases).

Palliative Care of Patients with HIV

It is likely that many students enter professional schools with antihomosexual values that go unchallenged during their education. A recent survey of American medical schools, for example, found that on average only 3 1/2 hours were devoted to the topic of homosexuality during the four-year curriculum. This is notable, since there is evidence that experience with gay and lesbian faculty members and participation in educational activities such as small-group discussions may influence students to develop more favorable attitudes toward homosexual people.

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A small number of lesbians have been reported to be HIV-positive, almost always as a result of exposure to risk factors other than contact with a partner of the same sex. However, since vaginal secretions and menstrual blood are known to be implicated in female-to-male transmission of the virus, lesbians in relationships with seropositive women or who have multiple partners, including men or women of unknown HIV status, are routinely advised to use safe-sex practices. Nonetheless, no medically tested strategy for women to avoid contact with body fluids of same-sex partners has been developed that adequately addresses the particular issues presented by female anatomy and physiology.

Stages Bereavement Essay – 860808 | VITAL ProJeX

The high risk of contracting infection with HIV among homosexual men is usually attributed to contact with semen during unprotected receptive anal intercourse or other practices associated with the exchange of body fluids. Efforts to educate gay men in safe-sex practices to prevent HIV infection have been only partially effective in changing behavior. Those who continue to engage in unprotected anal intercourse with multiple partners tend to be younger, to belong to minority groups, to engage in sexual acts more frequently, to use drugs or alcohol in connection with sex, to have psychiatric disorders, and if previously tested for HIV, to be seronegative. Such men may have adequate cognitive information about HIV transmission but may entertain a false notion that they personally are “safe” when they engage in high-risk sexual behavior. Lapses in safe-sex precautions by men who ordinarily do practice safe sex are also common -- in 45 percent over the previous six months in one study.

Grief in the Context of HIV: Recommendations for Practice

Of heterosexually active adults in the general population, about 20 percent of men have had 1 sexual partner during their lives, 55 percent have had up to 20 partners, and about 25 percent have had 20 or more partners. Some older studies conducted before the epidemic of the acquired immunodeficiency syndrome (AIDS) indicated that homosexual men were more likely than heterosexual men to have had a very large number of sexual partners. More recent population-based studies have found this to be relatively uncommon. For instance, Fay et al. found that of men who had homosexual contact after the age of 20, almost all had 20 or fewer homosexual partners in their lifetimes. Of 1450 men in the sample, only 2 were reported to have had 100 or more same-sex partners. The inconsistency in the data on the number of sexual partners of homosexual men probably reflects flaws in the sampling techniques of the earlier studies (e.g., recruiting subjects in gay bars) and their completion before the human immunodeficiency virus (HIV) epidemic. The overlap between gay and heterosexual men with respect to the number of partners is considerable, although a small subgroup of gay men have had sex with a great many more partners than almost any heterosexual men. Women have been studied less than men, but the existing data show that lesbians resemble heterosexual women more than gay men in their sexual behavior. For instance, women of any sexual orientation are more likely to view sexual desire as a function of emotional intimacy and to value romantic love and monogamy. Almost all married women are sexually active only with their husbands, and unmarried women are very unlikely to have more than one partner in a given three-month period. Blumstein and Schwartz reported that women in lesbian couples had fewer outside partners than women in heterosexual couples. Lesbian couples generally have less sexual activity than their heterosexual counterparts but report higher levels of intimacy and as much or more satisfaction with the sexual relationship.