George A. Lamb

Effect of changing patterns of care and duration of survival on the cost of treating the acquired immunodeficiency syndrome (AIDS).

We performed a two-year cost of illness study of 240 AIDS patients (55 percent of all Massachusetts cases) diagnosed and treated at five hospitals from March 1984 through February 1986. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of inpatient and outpatient hospital records. The yearly inpatient cost per patient decreased by 28 percent from

DEMOGRAPHIC AND EDUCATIONAL CHARACTERISTICS OF INNER CITY MIDDLE SCHOOL PROBLEM ABSENCE STUDENTS

38,369 in year one to

Increased suppressor T cells in probable transmitters of human immunodeficiency virus infection.

27,714 in year two. These changes were related to shorter lengths of stay (from 20.6 days to 16.8 days per hospitalization, mean difference of 3.8 days, 95% CI of the difference -.2, 7.8), and less costly hospitalizations (from

Medical costs of ambulatory patients with AIDS-related complex (ARC) and/or generalized lymphadenopathy syndrome (GLS) related to HIV infection, 1984-85.

12,463 to

Patterns of blood donations among individuals at risk for AIDS, 1984.

9,957, mean difference of

School absence; a problem for the pediatrician

2,506, 95% CI of the difference

School absence: a problem for the pediatrician.

135,

The Relation between Nitrite Inhalants, Unprotected Receptive Anal Intercourse, and the Risk of Human Immunodeficiency Virus Infection

4,877). The probability of hospitalization, however, was similar in both years. These patterns of care were still evident after controlling for transmission category, race, site, mortality, insurance, age, gender, number and type of opportunistic diseases and time since diagnosis. Although the cost per patient per year decreased between years one and two, median survival increased by 70 percent (from 10 to 17 months). Hence overall estimated lifetime costs increased by 24 percent.

Medical care costs of AIDS in Massachusetts

Results of a study of characteristics of middle school students revealed highly significant differences between problem absence students and non-problem absence students on all study variables except sex. Characteristics such as increasing grade, being behind appropriate grade, busing and special education status, and the particular school attended were highly correlated with this behavior, as were race and increasing age.

Corroboration of Sexual Histories among Male Homosexual Couples

To evaluate behavioral and immunologic factors related to transmission of human immunodeficiency virus (HIV) by homosexual intercourse, we studied a population of 329 homosexual/bisexual men (155 partner-pairs) seen in a community health center and medical outpatient clinic. Logistic regression analysis showed that behavioral risk factors for infection in the 130 HIV-infected men included: receptive anal intercourse (OR 4.6, 95% CI-1.8, 12.1); receptive fisting (OR 2.5, CI-1.1, 7.0); nitrite use (OR 2.3, CI-1.2, 4.6); history of gonorrhea or syphilis (OR 2.3, CI-1.4, 3.9); and history of sexual contact with men from areas with many AIDS cases (OR 1.9, CI-1.0, 3.5). Comparing seven men who were probable transmitters of HIV and 11 men who had not transmitted HIV to their uninfected partners despite unprotected insertive anal intercourse, we found no differences in HIV isolation from peripheral blood mononuclear cells, circulating HIV antigen detection, or presence of neutralizing antibody to HIV. Helper T-cell numbers were not significantly different between the two groups, but transmitters had more suppressor T-cells than did nontransmitters.