PRIMARY CARE NURSING & HIV GYNECOLOGIC MANIFESTATIONS

外阴阴道假丝酵母菌病是严重痛苦和 艾滋病毒感染妇女的发病率。预防这一问题的方法 难题包括积极的患者教育和阴道 卫生，通过使用外源性药物恢复正常的阴道菌群 乳酸菌，以及局部和系统的抗真菌预防。然而， 人们对这些策略的相对有效性知之甚少。 给艾滋病病毒携带者的女性。考虑到开出的大量药物 对于艾滋病毒携带者来说，重大药物相互作用的可能性，以及 关于抗真菌耐药微生物的选择，有以下几个问题 有充分理由探索局部治疗方案预防红斑狼疮的效果 外阴阴道念珠菌病。一种有效、无毒、患者可接受的 预防外阴阴道念珠菌病的方法将有助于 对艾滋病妇女的门诊管理具有重要意义。 我们建议进行随机、双盲、安慰剂对照的 三种初级保健护理策略在预防糖尿病中的应用 外阴阴道念珠菌病，其中艾滋病毒感染的妇女谁不是 接受系统抗真菌治疗的患者将根据 他们的基线CD4计数(100,100-300,300-500，&gt；500)和随机 以与三个学习臂之一相同的概率收到：1)标准 护士-助产士单独护理(病人教育和监测)，2)标准 嗜酸乳杆菌明胶的护理加自身给药 胶囊每周阴道内注射一次，或3)标准护理加自我护理 克霉唑500 mg阴道片，每周一次。

Vulvovaginal candidiasis is the source of significant distress and morbidity among HIV infected women. Prophylactic approaches to this difficult problem include aggressive patient education and vaginal hygiene, restoration of normal vaginal flora through the use of exogenous lactobacilli, and local and systemic antifungal prophylaxis. However, little is known about the comparative effectiveness of these strategies for women with HIV. Given the large number of pharmaceuticals prescribed for people with HIV, the potential for significant drug interactions, and concern regarding selection for antifungal resistent organisms, there are good reasons to explore the efficacy of local regimens for prophylaxis of vulvovaginal candidiasis. An effective, non-toxic, and patient-acceptable approach to prophylaxis of vulvovaginal candidiasis would contribute significantly to outpatient management of women with HIV. We propose to conduct a randomized, double-blinded, placebo-controlled trial of three primary care nursing strategies for prophylaxis of vulvovaginal candidiasis, in which HIV infected women who are not receiving systemic antifungal therapy will be stratified according to their baseline CD4 count (<100, 100-300, 300-500, >500) and randomized with equal probability to one of three study arms receiving: 1) standard nurse-midwifery care alone (patient education and monitoring), 2) standard care plus self-administration of Lactobacillus acidophilus gelatin capsules intravaginally once a week, or 3) standard care plus self- administration of clotrimazole 500mg vaginal tablets once a week.