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  1. 1

    Statement by the chairman of the Technical Working Group on Diagnosis of HIV Infection in Women and Children.

    World Health Organization [WHO]. Technical Working Group on Diagnosis of HIV Infection in Women and Children

    In: International Conference on the Implications of AIDS for Mothers and Children: technical statements and selected presentations jointly organized by the Government of France and the World Health Organization, Paris, 27-30 November 1989. Geneva, Switzerland, WHO, Global Programme on AIDS, 1989. 39-40. (WHO/GPA/DIR/89.12)

    According to World Health Organization estimates, there are about 2 million women and children throughout the world infected with the human immunodeficiency virus (HIV), most of whom remain asymptomatic and unidentified. At least 30% of infants whose mothers are HIV-positive will become infected before, during, or soon after birth. At present, HIV antibody tests are unable to diagnose perinatally acquired HIV infection in infants under 18 months of age. In such cases, the diagnosis can be made only on the basis of clinical signs and symptoms such as unexplained neurological abnormalities, developmental regression, recurrent severe bacterial infections that fail to respond to conventional therapy, lymphocytic interstitial pneumonitis, or opportunistic infections related to cellular immunodeficiency. Given the importance of timely diagnosis of HIV infection, research focused on both the development of sensitive, specific laboratory tests for the diagnosis of HIV in infants under 18 months of age and refinement of the case definition of pediatric acquired immunodeficiency syndrome (AIDS) should be prioritized. Policy decisions as to whether women of reproductive age should be tested for HIV infection should be based on laboratory testing and counseling resources, the availability of medical and social services for women and children, and the overall prevalence of HIV infection in the locality or country.
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  2. 2

    Report of a technical advisory meeting on research on AIDS and tuberculosis, Geneva, 2-4 August 1988.

    World Health Organization [WHO]. Global Programme on AIDS

    [Unpublished] 1989. 21 p. (WHO/GPA/BMR/89.3)

    A technical advisory meeting on research on AIDS and tuberculosis was held to review and prioritize ongoing and planned research in the field, suggesting essential studies and study design. Studies in need of international collaboration, as well as subjects not covered by ongoing and planned research were considered, with attention given to recommending frameworks for development. The final major objective of the meeting was to determine key areas of TB programs requiring strengthening to facilitate such research, and to suggest developmental steps for improvement. The report provides opening background information of tuberculosis, AIDS, and the relationship between the 2, then launches into a discussion of urgently needed research. Epidemiological, diagnostic, clinical presentation, prevention, and treatment studies are called for under this section heading, each sub-section providing objectives, justification, and specific research questions. Design examples for selected research studies constitute an annex following the main body of text. When planning for action on suggested research, the report acknowledges the need for resources, organizational structures, detailed plans and timetables, and collaborative arrangements. 7 areas in which WHO could provide assistance are offered, followed by discussion of strengthening tuberculosis control capacity in WHO, and at the country and local levels. Selection of research sites is considered at the close of the text.
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  3. 3

    Report of the WHO Meeting on Criteria for HIV Screening Programmes, Geneva, 20-21 May 1987.

    World Health Organization [WHO]. Special Programme on AIDS

    [Unpublished] 1987. 12 p. (WHO/SPA/GLO/87.2)

    The usefulness of proposed screening programs for human immunodeficiency virus (HIV) infection must be weighed carefully against potential harmful effects. Because of complex social and ethical issues and the lack of any specific intervention against acquired immunodeficiency syndrome (AIDS), screening programs may be intrusive and divert resources from educational programs. 21 participants from 17 countries attended a special meeting in May 1987 convened by the WHO Special Program on AIDS to discuss criteria for HIV screening programs. There was general consensus among participants that readily accessible counseling and testing for antibody to HIV, provided on a voluntary basis, are more likely to result in behavior changes that reduce the spread of AIDS than are mandatory screening initiatives. There was also agreement that mandatory screening of targeted populations is less likely than a voluntary approach to reach effectively those persons whose behavior can be influenced to reduce the risk of infection. To facilitate awareness of the complexities inherent in mandatory screening of at risk populations such as drug abusers and prostitutes, this report includes a list of criteria that must be considered and resolved in the planning process. These criteria are: what is the rationale of the proposed program, what population is to be screened, what test method is to be used, where is the laboratory testing to be done, what is the intended disposition of data obtained from testing, what plan will be used for communicating results to the person tested, how is counseling to be accomplished, what is the social impact of screening, and what legal and ethical considerations are raised by the proposed screening program?
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