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M Melbye

Publications and source records attributed to M Melbye.

At least 145 records · Page 8Linked to original sources
PubMed1992

[First year experience with a system of mandatory reporting of HIV-positive cases in Denmark].

During the period 1. Aug. 1990 to 31. July 1991, a total of 87,779 HIV-tests were carried out in Denmark on individuals other than blood donors according to the laboratory notification system. Of these 853 were HIV-positive which corresponds to a HIV prevalence of 0.97%. During the same period, 602 persons were notified by doctors as HIV-positive, corresponding to a percentage of notifications of 70. Out of the 602 persons, 84 were repetitions. The sex of two persons was not stated. Further 164 (36%) were previously found to be HIV-positive. Thus there remained 332 (64%) persons who could be classified as positive for the first time. In the material of HIV-positive individuals for the first time, 79% were men and 21% women. The mean age for men was 36 years and 26 years for women (p less than 0.001). 66% of the men were estimated to be infected by homosexual contact, 19% by heterosexual contact and 9% by intravenous drug use. Nineteen of the heterosexually infected men (39%) stated that they had been infected by a woman from a high-endemic region, three by a female drug user and 24 (49%) did not know the source of infection. Thirty of the heterosexually infected women (63%) were considered to be infected by a man from a high-endemic region and 21 of these women were born and had grown up in this region. Six of the women (13%) were considered to have been infected by a bisexual man and eight (17%) by a man without known risk behaviour. HIV-positive persons were notified from all Danish counties, including 57% from Greater Copenhagen. The geographical distribution is not identical for the two sexes. For men, 63% were from Greater Copenhagen and 14% from Jutland while the corresponding distribution for women were 35% and 28% (p = 0.001).

Adolescent↗
PubMed1992

Second primary cancers following anal and cervical carcinoma: evidence of shared etiologic factors.

The authors examined the incidence of second primary cancers occurring after cervical and anal cancer. Data from the Connecticut Tumor Registry for 1935-1988 and eight other US tumor registries for 1973-1988 were used. Women with primary invasive cervical cancer had a relative risk of 4.6 (95% confidence interval (CI) 2.4-8.1) for subsequent invasive anal cancer. Increased relative risks after cervical cancer were also found for cancers of the oral cavity (relative risk (RR) = 2.2), stomach (RR = 1.5), rectum (RR = 1.4), larynx (RR = 3.4), lung (RR = 3.0), vagina (RR = 5.6), bladder (RR = 2.7), for kidney (RR = 1.9); decreased relative risks were noted for melanoma (RR = 0.5) and breast cancer (RR = 0.8). Patients with a primary diagnosis of anal cancer had relative risks for subsequent invasive and in situ cervical cancer of 1.3 (95% CI 0.2-4.5) and 3.4 (95% CI 0.9-8.8), respectively. Anal cancer was also associated with increased relative risks of subsequent lung (RR = 2.5) and prostate (RR = 1.8) cancers, whereas the relative risk of uterine cancer was 0.2 (95% CI 0.0-0.9). These findings support other evidence for common factors, such as human papillomavirus infection and cigarette smoking, in the etiology of cervical and anal cancer.

Anus Neoplasms↗
PubMed1992

Interactions between persons at risk for AIDS and the general population in Denmark.

A nationwide study of sexual behavior was undertaken among 4,680 randomly selected Danes aged 18-59 years. The median number of sexual partners (lifetime) was highest for men aged 30-34 years (eight partners) and for women aged 25-29 years (seven partners). After adjustment for age and sex, having had greater than or equal to 5 sexual partners in the past year was strongly associated with living in larger cities, intravenous drug use, and having sex with a prostitute, a bisexual man, an intravenous drug user, or a resident of sub-Saharan Africa. The frequency of ever having had anal intercourse was highest among women aged 20-34 years (range, 27%-36%) and was independently associated only with increasing number of sexual partners (lifetime). Overall, 2.7% of men reported any homosexual experience, among whom most (88%) had also had heterosexual intercourse. Prostitute contact (ever) was reported by 13% of all men and was associated with a high educational level, a history of travel, a greater number of sexual partners, and intravenous drug use. Overall, sexual contact with someone considered at high risk of human immunodeficiency virus (HIV) infection (a homosexual/bisexual man, intravenous drug user, prostitute, or sub-Saharan African resident) was reported by 15.9% of men and 4.8% of women. Among active blood donors (past year), 12.5% of men and 4.0% of women had engaged in potentially risky behavior. HIV testing was deliberately sought more often by respondents exposed to someone at increased risk of HIV infection (10.6%) than by those unexposed (6.5%, p less than 0.01). Exposure to persons at risk of HIV infection is considerable in Denmark. The majority of persons who have had potential exposure to HIV have not yet been tested for HIV.

AIDS Serodiagnosis↗
PubMed1992

An update on knowledge and sexual behaviour among students in Greenland. Monitoring of the stop-AIDS campaign.

Greenland is a considered high risk area for a self-sustained heterosexual HIV-epidemic due to rather relaxed sexual norms in larger segments of the population and a high incidence of sexual transmitted diseases. However, the prevalence of HIV-positives is still low. As part of a monitoring programme longitudinal studies of young peoples' knowledge and sexual behaviour has been established. This paper presents results from the second survey among all students in vocational training and all 10th grade students in the public schools. Previous studies were performed in 1988 and 1989. The present study which took place in April 1991 involved a total of 1201 students, or about 85% of all students in the target groups (95% among students present on the day of surveying). Data collection was based upon standardized self-administered questionnaires. The study showed better knowledge than previously but no marked change in sexual habits. The age of sexual début even appeared to be decreasing. More than half reported a sexual début before the age of 15. More than 20% reported 10 sexual partners or more within the last year. HIV has still not reached the young population in Greenland but when it happens the present sexual behaviour carries a high risk of a self-sustained epidemic.

Adolescent↗
PubMed1992

Responses to anonymous questionnaires concerning sexual behavior: a method to examine potential biases.

OBJECTIVES: Low response rates to voluntary surveys raise questions about how representative the responses are. We compared the behavior and attitudes of responders, willing and reluctant, and nonresponders to anonymous questionnaires about behaviors that might expose participants to the human immunodeficiency virus (HIV). METHODS: Questionnaires were sent to 1080 Danish adults 18 through 59 years including explicit questions about sexual acts and illegal drug use. Identical questionnaires were sent to 3600 other Danes, similarly chosen; packets sent to these persons included cards to be returned separately informing us that they had responded. Questionnaires were sent twice more to nonresponders, who, if they then responded, were considered reluctant responders. One hundred nonresponders were telephoned and asked why they had refused to respond. RESULTS: Enclosing return cards did not affect initial response rate, but prompting boosted replies from 52% to 73%. However, behaviors were generally similar among initial and reluctant responders. One third of nonresponders agreed to respond if we wished (total potential response: 82%). In general, the reasons for nonresponse did not suggest that the life-styles of nonresponders placed them at risk for HIV infection. CONCLUSIONS: This method provides a simple, inexpensive approach to improving response rates and learning about the biases of reluctant responders and nonresponders.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Aetiological parallel between anal cancer and cervical cancer.

It has been postulated that an infectious agent and/or specific sexual behaviour is involved in the aetiology of anal cancer, in analogy with the aetiology established for cancer of the cervix. A case-control study of 29,648 women with cancers registered in the Danish Cancer Registry during 1968-87 tested the hypothesis that anal cancer patients were more likely than patients with colon, stomach, or vulva cancer to have had a previous diagnosis of cervical intraepithelial neoplasia (CIN) or invasive cervical cancer. The odds ratio of CIN, adjusted for age and year of diagnosis, for anal vs colon cancer was 5.2 (95% confidence interval [CI] 3.3-8.3), that for anal vs stomach cancer 3.6 (2.1-6.0), and that for anal vs vulva cancer 1.6 (0.9-2.9). The median time from diagnosis of CIN to diagnosis of the registered cancer was 151 months for anal, 112 months for vulva, 114 months for colon, and 126 months for stomach cancer. The association with previous invasive cervical cancer was also investigated; no patient with cervical cancer in this second analysis had been included in the CIN analysis. The odds ratios were similar. In addition, anal cancer patients were significantly more likely to have had cervical cancer than were patients with vulva cancer (odds ratio 1.8 [1.0-3.9]). The strong association between anal cancer and CIN/invasive cervical cancer suggests that these cancers share common risk factors. The association is at least as strong as that between cervical and vulva cancer.

Adolescent↗
PubMed1991

Kaposi's sarcoma and non-Hodgkin's lymphoma in European AIDS cases. No excess risk of Kaposi's sarcoma in Mediterranean countries.

Prior to the AIDS epidemic, Kaposi's sarcoma (non-AIDS-KS) in Europe was mainly a disease of elderly Mediterranean men. In 1989 AIDS data from 15 European countries were collected to study proportional trends in AIDS-related Kaposi's sarcoma (AIDS-KS) in order to determine whether specific factors in Southern Europe might be important in the development of KS among AIDS patients. Another AIDS-related cancer, non-Hodgkin's lymphoma (NHL) was included as a malignancy control. Of 22,367 AIDS cases reported, 3,779 (16.9%) were KS and 741 (3.3%) were NHL. A significant, continuous fall in the percentage of AIDS-KS was seen for both homosexual men and other members of exposure groups during the period 1981-89 (p-trend less than 0.0001). The proportion with AIDS-KS decreased from 40.5% in 1983 to 26.5% in 1988 in homosexual men and from 12.2 to 3.6% in other exposure groups, respectively. No significant change was observed in the proportion of NHL cases among any of the risk groups over time, although a tendency towards a slight increase was noted for homosexual men. Comparing proportional trends of KS and NHL geographically, no significant difference was found overall, by time or by exposure group. In conclusion, a specific decline is observed over time for AIDS-KS. However, if geographically-restricted factors are important in the development of non-AIDS-KS in Europe, the same factors do not appear to affect the risk of AIDS-KS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Immune status as a determinant of human papillomavirus detection and its association with anal epithelial abnormalities.

One hundred and twenty Danish homosexual men were enrolled to characterize risk factors for anal type-specific human papillomavirus (HPV) expression and to examine its association with anal epithelial atypia. Detection of HPV strongly correlated with immunosuppression measured by T-lymphocyte subset markers and rose nearly linearly from 7.3% among subjects with CD4/CD8 ratios above 1.0 to 35.3% among those with a ratio below 0.4 (p trend = 0.003). No association was found between presence of HPV and a wide range of lifestyle factors including number of sex partners/year, smoking, alcohol consumption and illegal drug intake. However, self-reported history of anal condyloma in the past year was correlated with HPV (p less than 0.001). Simultaneous testing for presence of HPV in the oral cavity showed evidence of HPV 16,18 and 31,33,35. Anal smears were abnormal in 19.5% of the men and correlated strongly with presence of HPV (OR = 6.1, p less than 0.001). Type-specific associations were found with HPV 31/33/35 (OR = 8.5) and HPV 16/18 (OR = 3.1) only. The association remained significant after adjusting for immune status. Overall, HPV was detected in 50% of the cases with abnormal smears. However, HPV was found in all subjects with abnormal smears and a CD4/CD8 ratio below 0.4, compared to only 3 of 14 subjects with abnormal smears and a ratio greater than or equal to 1.3. In conclusion, (1) HPV may be missed in a substantial number of infected subjects with a normal immune system. This may have an impact on studies trying to describe risk factors for HPV transmission and its correlation with cancer development. (2) The finding of HPV 16,18 and 31,33,35 in the oral cavity makes oral-genital sexual activity at least a hypothetical route of transmission for these HPV types. (3) HPV appears to play a central role in the development of anal epithelial abnormality.

Adult↗
PubMed1990

Sexual transmission of hepatitis C virus: cohort study (1981-9) among European homosexual men.

OBJECTIVE: To determine the prevalence, incidence, and persistence of positivity for antibodies to hepatitis C virus (anti-HCV) and the potential for sexual transmission of the virus. DESIGN: A cohort analysis covering 1981-9 comparing estimated cumulative incidences of and seroconversion rates for anti-HCV with those of hepatitis B core antibody (anti-HBc) and antibodies to the human immunodeficiency virus (anti-HIV). SETTING: Copenhagen and Aarhus, Denmark. SUBJECTS: 259 Male members of a Danish homosexual organisation. MAIN OUTCOME MEASURES: Correlations of prevalence and incidence with a wide range of sexual lifestyle variables. RESULTS: Only four (1.6%) subjects were positive for anti-HCV in 1981. The estimated cumulative incidence of positivity for anti-HCV was 4.1% in 1984 (seroconversion rate during 1981-4 (2.5%)) and remained at 4.1% in 1989 (seroconversion rate nil during 1984-9). In contrast, positivity for anti-HBC rose from 44.0% in 1981 to 52.7% in 1984 (seroconversion rate 15.5%) and 58.8% in 1989 (seroconversion rate 12.9%), and that for anti-HIV rose from 8.8% to 24.0% (seroconversion rate 16.7%) and 30.1% (seroconversion rate 8.0%) respectively. Three anti-HCV positive patients seroreverted three to five years later. None of the anti-HCV positive subjects had had a transfusion and only one gave a past history of intravenous drug use. Variables in sexual lifestyle correlated with the presence of anti-HBc but not with that of anti-HCV. CONCLUSIONS: In contrast with hepatitis B virus and HIV, sexual transmission of hepatitis C virus seems to be a rare event. Furthermore, antibodies to the virus may become undetectable after several years.

Adult↗
PubMed1990

[The incidence of gonorrhea as an indicator for prevention of AIDS in Greenland].

The first case of HIV infection in Greenland was demonstrated towards the end of 1985 and, since then, a general informative campaign was instituted and teaching material about AIDS and HIV infection were prepared for use in schools. This activity was particularly great in 1987 and 1988. The main messages were 1) use of condoms and 2) reduction in the number of sexual partners. The incidence of gonorrhoea has been very high for many years in Greenland and the incidence of gonorrhoea was employed as indicator for the effect of the prophylactic campaign. Investigation revealed a decrease of 67% during the period 1985-1988. The decrease was particularly great in 1988 (58%). There appears to be a direct connection between this observation and the two main messages of the campaign as the employment of condoms increased tenfold during the period 1986-1988 end contact investigations revealed a decrease in the number of unknown sexual partners. On the other hand, no definite decrease in the total number of sexual partners was reported by patients attending the clinic for Venereal Diseases in Godthåb. It is emphasized that the incidence of gonorrhoea has decreased markedly but it is still considerably higher than the incidence in Denmark. Continued and active prophylactic efforts are still required.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The sexual habits of young Greenlanders and their knowledge of AIDS. A study done among students in vocational schools in Greenland in 1989].

A questionnaire investigation was undertaken among young Greenlanders in vocational training about their knowledge of AIDS and their sexual habits as a link in monitoring of the course of AIDS prophylaxis in Greenland. The investigation was anonymous and was carried out in the vocational colleges with assistance of a contact person in the college. All of the students who were present on the day of investigation (264 out of 326 students) participated. The investigation revealed that 3/4 had basic knowledge about AIDS but their knowledge about the routes of infection was less certain. The average age for commencement of sexual activity was 18.9 years for men and 17.3 years for women. Although the investigation revealed that a number of the participants had sexual habits which scarcely differed from those in other countries, the average number of partners within the past year was stated to be 7.5 for men and 4.4 for women. Information which can provide young people with better knowledge about AIDS should be given via colleges and health service institutions to a greater extent. It is also recommended that materials should be developed which are directed particularly to high-risk groups.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Effect of knowledge of human immunodeficiency virus infection status on sexual activity among homosexual men.

One hundred thirty-four homosexual men from a prospective cohort study of AIDS risk from New York City and Washington D.C. and 139 homosexual men from a similar cohort in Copenhagen and Aarhus, Denmark were questioned regarding their sexual practices and knowledge of their human immunodeficiency virus (HIV) status over the previous 12 months. Seventy percent of Danish men and 63% of U.S. men participated in anal intercourse during the previous 12 months. Knowledge of one's own HIV status by itself did not have any significant effect on participation in anal intercourse, partner number, or condom use. Only 23% of U.S. men and 24% of Danish men always asked potential partners about their HIV status. However, men who did ask were very unlikely to choose a partner of opposite HIV status (p less than 0.006). Danish men were more likely to practice anal intercourse without a condom than were the U.S. men (p less than 0.0001); however, Danes were more likely to be in a concordant monogamous relationship than were the U.S. men (p less than 0.001). Fourteen percent of U.S. men and 21% of Danish men were not aware of their own HIV status and 52% of the U.S. cohort and 31% of the Danes had anal intercourse with a man whose status was unknown to them. Overall, only 32% of American and 53% of Danish homosexual men were practicing completely safe sex. We suggest that education to promote the need for awareness of one's own and one's partner's HIV status should be stressed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Acceptability of voluntary population screening for antibodies against HIV. Aarhus Research Group on AIDS.

In order to assess the acceptability of voluntary population screening for antibodies against human immunodeficiency virus (HIV), a random sample of 300 Danish men, aged 20-49 years, were sent a self-administered questionnaire. Among nonrespondents, recruitment attempts were repeated three times with intervals of 8-10 days. In total, 76.7% responded. Two hundred men (87.0% of the respondents) would accept an offer to be tested in an anti-HIV screening programme. Among respondents, 72.9% agreed to identify themselves to the researchers, 22.1% preferred to be tested under a code number known only by the participant himself, and 5% wanted the test information to be completely anonymous. Among the 30 men refusing HIV testing, 40% reported they were not concerned about AIDS, 16.7% expressed concern with confidentiality problems, and another 16.7% had been tested already and for this reason declined to participate. Previous reports have indicated high seroprevalences among nonrespondents and raised prevalences of behavior at high risk for HIV infection among persons who do themselves take the initiative to be tested or who decline to be tested because they worry about confidentiality. Low respondency and the associated disproportional loss of subjects at high risk of HIV infection may bias HIV seroprevalence estimates based on population probability sampling, especially in areas with low HIV infection prevalence. Because of these biases, voluntary population screening is likely to give only lower bound estimates of HIV seroprevalence. So, this technique should only be used in combination with other surveillance approaches.

Adult↗