Document 0674
 DOCN  M94A0674
 TI    The acquired immunodeficiency syndrome in the Northern Territory of
       Australia: an impending Fourth World epidemic?
 DT    9412
 AU    Heath T; Bowden F; Sheppard K; Currie B; Royal Darwin Hospital,
       Casuarina, N.T.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:45 (abstract no. FE5).
       Unique Identifier : AIDSLINE ASHM5/94348981
 AB    Until recently HIV infection in the Northern Territory (NT) has been an
       urban disease of non Aboriginal people. Risk factors for HIV infection
       and indicator diseases for AIDS have been similar to those found in
       other Australian States. There is concern however, given the
       demographics of other sexually transmitted diseases (STD) in the NT,
       that the introduction of HIV into the rural Aboriginal community may
       result in the widespread heterosexual transmission seen in some
       developing nations. High incidences of ulcerative STD and difficulties
       in diagnosis, effective contact tracing and treatment auger poorly for
       the control of HIV infection. Pneumocystis carinii pneumonia is
       currently the most common opportunistic infection encountered in AIDS
       patients (57%). Despite the high incidence of Cryptococcus neoformans
       var. gattii, the 2 cases of cryptococcal infection complicating HIV have
       been var. neoformans. Mycobacterium Avium Complex infection has been
       documented in 50% of patients, but there have been no cases of HIV
       associated tuberculosis to date. Numerous endemic infectious agents can
       be predicted to interact unfavourably with HIV infection should it
       become established in Aboriginal communities. Tuberculosis,
       cryptococcosis, parasitic diseases such as scabies and strongyloidiasis,
       melioidosis and other pyogenic infections and syphilis could all be
       expected variously to cause unusual manifestations, hyper-infection
       syndromes and difficulties in control. HTLV-1 is also endemic in central
       Australian Aboriginals. HTLV-1 is known to facilitate the progression of
       HIV infection. The complex interaction between HTLV-1, HIV and other
       endemic infections needs further elucidation. Control of HIV infection
       in the NT requires a coordinated approach, with measures for STD and
       tuberculosis control especially important. The challenge is to integrate
       AIDS education, contact tracing and treatment into primary care in ways
       acceptable to communities.
 DE    Aborigines/*STATISTICS & NUMER DATA  AIDS-Related Opportunistic
       Infections/EPIDEMIOLOGY/PREVENTION &  CONTROL/TRANSMISSION
       Cross-Sectional Studies  *Disease Outbreaks  Human  HIV
       Infections/*EPIDEMIOLOGY/PREVENTION & CONTROL/TRANSMISSION  Incidence
       Northern Territory/EPIDEMIOLOGY  Risk Factors  Rural
       Population/*STATISTICS & NUMER DATA  Sexually Transmitted
       Diseases/EPIDEMIOLOGY/PREVENTION & CONTROL/  TRANSMISSION  Urban
       Population/*STATISTICS & NUMER DATA  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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