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PubMedDate not supplied

A social contagion model of adolescent sexual behavior: explaining race differences.

Black adolescents in the United States consistently report an earlier age of first intercourse than White adolescents. Purely psychosocial explanations of this finding have been less than successful. We propose an "epidemic" model that combines social contagion (a psychosocial process) and pubertal maturation (a biological process). This epidemic model permits social contacts among adolescents of the same age and also among younger and older adolescents. The model statistically fit the actual growth curve of sexuality well for Whites; its fit was not as good for Blacks. From computer simulation analyses, we concluded that pubertal maturation may be more important in accounting for the racial difference in the onset of sexual intercourse than previously thought.

Adolescent↗
PubMedDate not supplied

Let's talk about sex: how comfortable discussions about sex impact teen sexual behavior.

A secondary analysis of data from 1,039 Latino adolescents who participated in a study of a sex education program was conducted to examine the impact of comfortable communication about sex on intended and actual sexual behavior. Results indicate that Latino adolescents have a broad communicative network, including friends, dating partners, and extended family members, with whom they talk about sex. Regression analyses suggest comfortable sexual communication is predictive of less likelihood of being sexually active, older at first intercourse, and increased intentions to delay intercourse.

Adolescent↗
PubMed2002

Seroprevalence of human papillomavirus type 16 infection in the United States.

Infection with human papillomavirus (HPV) type 16 accounts for about half of cervical cancers worldwide. This study investigated the seroepidemiology of HPV-16 infection in the United States by using a population-based survey. Serum samples and questionnaire data were collected from 1991 to 1994 for the National Health and Nutrition Examination Surveys. HPV-16-specific IgG antibody was detected by use of an HPV-16 virus-like particle ELISA. HPV-16 seropositivity in the US population aged 12-59 years was 13.0% (95% confidence interval, 11.5%-14.7%). Seroprevalence was higher in women (17.9%) than in men (7.9%). Age, race/ethnicity, and number of lifetime sex partners were associated with HPV seropositivity in women. Race/ethnicity, age at first intercourse, urban/nonurban residence, years of sexual activity, and having had sex with a man were associated with HPV seropositivity in men. Information on HPV-16 seroepidemiology will be important for designing prevention efforts including vaccine programs.

Adolescent↗
PubMedDate not supplied

Sexual behaviors and other risk factors for Candida vulvovaginitis.

Sexual behaviors are associated with many genital infections, but the role of sexual variables as risk factors for Candida vulvovaginitis has not been clearly determined. To assess the association between sexual behaviors and other risk factors with the presence of Candida vulvovaginitis, we performed a case-control study comparing these potential risk factors in women with and without culture-documented Candida vulvovaginitis in two Midwestern community-based medical offices. Participants included 156 women with Candida vulvovaginitis and 92 controls, ages 18-60. Risk factors for Candida vulvovaginitis, including sexual and partnership behaviors, demographic data, past genital infections, exposures, and diet, were investigated using logistic regression. The presence of Candida vulvovaginitis was positively associated with recent cunnilingus (odds ratio [OR] = 2.22 for five times a month compared with no times, 95% confidence interval [CI] 1.36, 3.84), but was less likely in women who masturbated with saliva in the previous month (OR = 0.30 if masturbated five times vs. no times, 95% CI 0.09, 0.99). Other independent risk factors included knowing the sexual partner a shorter period of time (OR = 1.56 for 1 year vs. 5 years, 95% CI 1.16, 2.13) and lower milk ingestion (OR = 3.57 for no servings vs. two servings per day, 95% CI 2.00, 6.67). Increased number of sexual partners, early age at first intercourse, and increased frequency of intercourse are not related to risk.

Adolescent↗
PubMed2003

Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis.

OBJECTIVE: To assess associations between female and male factors and the risk of recurring Candida vulvovaginitis. METHODS: A prospective cohort study of 148 women with Candida vulvovaginitis and 78 of their male sexual partners was conducted at two primary care practices in the Ann Arbor, Michigan, area. RESULTS: Thirty-three of 148 women developed at least one further episode of Candida albicans vulvovaginitis within 1 year of follow-up. Cultures of Candida species from various sites of the woman (tongue, feces, vulva, and vagina) and from her partner (tongue, feces, urine, and semen) did not predict recurrences. Female factors associated with recurrence included recent masturbating with saliva (hazard ratio 2.66 [95% CI 1.17-6.06]) or cunnilingus (hazard ratio 2.94 [95% CI 1.12-7.68]) and ingestion of two or more servings of bread per day (p </= 0.05). Male factors associated with recurrences in the woman included history of the male masturbating with saliva in the previous month (hazard ratio 3.68 [95% CI 1.24-10.87]) and lower age at first intercourse (hazard ratio 0.83 [95% CI 0.71-0.96]). CONCLUSIONS: Sexual behaviors, rather than the presence of Candida species at various body locations of the male partner, are associated with recurrences of C. albicans vulvovaginitis.

Adult↗
PubMed2001

Sexual factors and the risk of prostate cancer.

A population-based case-control study of prostate cancer was performed in King County, Washington, in White men and Black men aged 40-64 years, between 1993 and 1996. Incident prostate cancer cases (n = 753) were identified from the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) cancer registry. Controls (n = 703) were identified through random digit dialing and were frequency matched to cases on age. Sexual behavior, medical history, and other potential prostate cancer risk factors were ascertained through an in-person interview. There was no relation between sexual orientation and prostate cancer, although the number of men who had sex with men was small. Risk estimates increased directly with the lifetime number of female sexual partners (trend p < 0.001) but not with male partners (trend p = 0.62). Risk also increased with decreasing age at first intercourse, but this effect disappeared after adjusting for the number of female partners. Prior infection with gonorrhea was positively associated with risk (odds ratio = 1.50; 95% confidence interval: 1.0, 2.2), but no effect was seen among men with other sexually transmitted diseases. No relation between lifetime frequency of sexual intercourse and risk of prostate cancer was apparent. These findings are consistent with previous studies that support an infectious etiology for prostate cancer.

Adult↗
PubMed2005

Social class, gender and psychosocial predictors for early sexual debut among 16 year olds in Oslo.

BACKGROUND: Variations in early sexual debut among 16 year olds were investigated by social level variables, parental occupation, gender, ethnicity, family structure, family functioning, and individual level variables, future aspirations, academic and social self-perception, and depressed moods. METHODS: The variations in sexual debut were investigated by examining proportions of 16 year olds reporting their first intercourse before age 16. The data were collected by self-reporting questionnaires administered to in-school-youth, in Oslo. Multivariate logistic regression analyses were used to test for associations. Gender interactions with all variables were tested. RESULTS: Overall, 25% reported early debut. Independent effect of social class on differences in proportions in early sexual debut were found. Gender interaction with social class, ethnicity and academic self-perception as they associate to proportions having had early sexual debut, were found. For girls the pattern of social class differences was linear and the highest proportions were found among working classes. For boys the pattern was U-shaped and upper managerial and manual working class youth had similar, higher proportions of early debutants. High scores of parental monitoring, future aspirations and academic self-concept and low scores of depressed moods, are protective factors. While high social self-perception is positively associated with early debut for both genders. CONCLUSION: Early sexual debut varies according to social class, following gender-specific patterns, among 16 year olds in Oslo. The negative association between early debut and academic self-perception are for boys less influenced by other social and individual level factors, than for girls.

Adolescent↗
PubMed2000

Teenage pregnancy: whose problem is it?

BACKGROUND: The UK has the highest rates of teenage conception in Europe. Teenage conception has been identified in medical literature as a problem for society and teenagers. However, little attempt has been made to see it from the perspective of the teenagers themselves. OBJECTIVE: To explore teenage women's attitudes to sexual health, contraception and pregnancy. METHODS: Ethnographic qualitative study based on in-depth interviews and participant observation. The study took place in young mothers' groups, young persons' clinics and general practices in Bristol. Subjects were 34 young women between the ages of 16 and 20, sampled purposefully in two groups to include young mothers and never-pregnant young women from advantaged and disadvantaged socioeconomic backgrounds. RESULTS: The two groups did not differ in their use of contraception at first intercourse. Young women from more socioeconomically advantaged backgrounds felt that motherhood would not be acceptable to them, but were more tolerant to others who became young mothers. The pregnant/ young mothers revealed more difficulties getting access to reliable contraceptive services, and dissatisfaction with sex education in schools. The pregnant/young mothers found abortion to be less acceptable than the more socially advantaged group. Both groups reported sexual behaviour that involved risks of becoming pregnant, but the more socially advantaged group were more likely to use emergency contraception. CONCLUSIONS: The study demonstrates the importance of taking the views of young people into account when planning both sex education and the provision of contraceptive services.

Abortion, Induced↗
PubMed1989

Evidence that Chlamydia pneumoniae, strain TWAR, is not sexually transmitted.

Serum specimens from 230 sexually active women were tested for antibodies to Chlamydia trachomatis and Chlamydia pneumoniae. The women were randomly selected as controls in a population-based case-control study for ectopic pregnancy. A total of 123 had antibody to C. pneumoniae and 39 had antibody to C. trachomatis. There was an association between prevalence of antibody to C. trachomatis and an increasing number of lifetime sexual partners, early age at first intercourse, and a history of gonorrheal infection. The prevalence of antibody to C. pneumoniae was not related to any of these factors. These results provide evidence that the two human species of Chlamydia have a different mode of transmission and that C. pneumoniae is not sexually transmitted.

Adult↗
PubMed1990

A cross-sectional study of herpes simplex virus types 1 and 2 in college students: occurrence and determinants of infection.

Occurrence rates and determinants of infection with herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) were measured in first- and fourth-year undergraduate students at a state university. This cross-sectional multistage probability sample survey included sociodemographic characteristics, sexual behavior patterns, disease history, and HSV type-specific antibody status. The prevalence of HSV-1 antibody was 37.2% in freshmen and 46.1% in fourth-year students; that for HSV-2 antibody was 0.4% and 4.3%, respectively. A history of cold sores was obtained in 25.6% of the freshmen; none had a history of manifest genital herpes. A history of cold sores was obtained in 28% and a history of genital herpes in 1.1% of the fourth-year students. The case-weighted prevalence of HSV-1 and HSV-2 antibodies was found to be significantly elevated for a number of student characteristics. However, multiple logistic regression analyses indicated that the significant predictors of HSV-1 antibodies in this population were female gender, black race, first intercourse at age less than or equal to 15 years, total years of sexual activity, history of a partner with oral sores, and a personal history of a non-HSV sexually transmitted disease (STD). Predictors of HSV-2 antibody were black race, duration of sexual activity, and history of a non-HSV STD.

Adult↗
PubMed1988

Nutrients in diet and plasma and risk of in situ cervical cancer.

Both plasma and dietary measures of vitamin A status were investigated along with previously established risk factors (number of sexual partners, age at first intercourse, smoking, and oral contraceptive use) in a study of 117 in situ cervical cancer patients and 196 matched community controls in Sydney, Australia. Neither total calories nor retinol from foods was related to cancer risk, nor was plasma retinol. When plasma and dietary indexes were considered together, vitamin C, fruit juices, and plasma beta-carotene showed protective effects. Plasma beta-carotene reduced risk from top to bottom quartile by 80%, vitamin C by 60%, and fruit juices by 50%. Thus the evidence suggests that cancer risk is associated with some aspect of diet that is reflected in the effect of plasma beta-carotene. There is no clear effect of any one nutrient but fruit juices appear protective. Thus vitamin C and beta-carotene are likely candidates.

Adult↗
PubMed1998

Oral cancer risk in relation to sexual history and evidence of human papillomavirus infection.

BACKGROUND: Experimental models and analyses of human tumors suggest that oncogenic, sexually transmittable human papillomaviruses (HPVs) are etiologic factors in the development of oral squamous cell carcinoma (SCC). We conducted a population-based, case-control study to determine whether the risk of this cancer is related to HPV infection and sexual history factors. METHODS: Case subjects (n = 284) were 18-65-year-old residents of three counties in western Washington State who were newly diagnosed with oral SCC from 1990 through 1995. Control subjects (n = 477) similar in age and sex were selected from the general population. Serum samples were tested for HPV type 16 capsid antibodies. Exfoliated oral tissue collected from case and control subjects and tumor tissue from case subjects were tested for HPV DNA. Odds ratios (ORs) were calculated after adjusting for age, sex, cigarette smoking, and alcohol consumption. RESULTS: Among males only, oral SCC risk increased with self-reported decreasing age at first intercourse, increasing number of sex partners, and a history of genital warts. Approximately 26% of the tumors in case subjects contained HPV DNA; 16.5% of the tumors contained HPV type 16 DNA. The prevalence of oncogenic HPV types in exfoliated oral tissue was similar in case and control subjects. The ORs for HPV type 16 capsid seropositivity were 2.3 (95% confidence interval [CI] = 1.6-3.3) for all oral SCCs and 6.8 (95% CI = 3.0-15.2) for oral SCCs containing HPV type 16 DNA. The joint association of cigarette smoking and HPV type 16 capsid seropositivity with oral SCC (OR = 8.5; 95% CI = 5.1-14.4) was stronger than predicted from the sum of individual associations with current smoking (OR = 3.2; 95% CI = 2.0-5.2) and seropositivity (OR = 1.7; 95% CI = 1.1-2.6). CONCLUSIONS: HPV type 16 infection may contribute to the development of a small proportion of oral SCCs in this population, most likely in combination with cigarette smoking.

Adult↗
PubMed1983

Sexual and socioeconomic factors affecting the risk of past infections with herpes simplex virus type 2.

Between November 1978 and May 1980, a cross-sectional survey of 566 females and 391 males, aged 35 to 50 years, living in metropolitan Toronto, was conducted to examine the influence of socioeconomic status and sexual behavior on the occurrence of antibodies to herpes simplex virus type 2. Antibodies to the virus were detected in 17.5% of females and 12.8% of males. Lower socioeconomic status was associated with an increased risk of herpes simplex virus type 2 seropositivity for females but not for males. An increased risk of seropositivity was associated in both sexes with young age at first intercourse, multiple sexual partners, and renting rather than owning their residence. The risk associated with each of these attributes remained when the effects of the other attributes including socioeconomic status and age at interview were controlled. The greatest risk was associated with renting. If the renting effect is real, it suggests that there is some determinant of risk not measured by this study, which is more important than socioeconomic status or sexual behavior.

Adult↗
PubMed1987

The role of contraceptive use in cervical cancer: the Maryland Cervical Cancer Case-Control Study.

Recent evidence on the importance of sexual history and sexually transmissible agents in cervical cancer has been reported. Case-control studies have frequently demonstrated increased risk of cervical cancer for women using oral contraceptives, while laboratory results have shown that vaginal spermicides inactivate various sexually transmissible agents. To determine the role of contraceptive use in cervical cancer, 153 cases of Maryland women with invasive cervical cancer and age, race, and residence-matched controls were interviewed in 1985, focusing on sexual history, health care utilization patterns, screening history, contraceptive use, and smoking. Overall, lifetime use of contraceptives was protective of cervical cancer (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.2-0.7). Use of oral contraceptives (OR = 0.48), diaphragm (OR = 0.29), and vaginal spermicides (OR = 0.28) were more frequent in controls than cases. After adjustment for behavioral factors (age at first intercourse, smoking, gaps in Papanicolaou smear testing, and obstetrician-gynecologist visits), use of vaginal spermicides remained significant (OR = 0.30), although use of oral contraceptives and barrier methods of contraception failed to remain significant. The effectiveness of vaginal spermicides in preventing cervical cancer may be due to their antiviral action.

Adult↗
PubMed1994

Epidemiology of pelvic inflammatory disease.

The epidemiologic study of pelvic inflammatory disease (PID) is hindered by symptoms that differ substantially from case to case, and by a substantial number of "silent" cases with few or no symptoms. Demographic data indicate that PID is primarily a disease of the young. Race also appears to be a determinant, but whether for biologic or sociologic reasons is not known. Women who are not married face a greater risk for PID than married women. The majority of PID cases are associated with sexually transmitted diseases. Consistent with this finding is the pattern of risk factors related to sexual behavior: young age at first intercourse, high frequency of intercourse, and a large number of sexual partners all increase the risk of PID. On the other hand, barrier methods of contraception appear to reduce the risk of PID, as does oral contraception. Perhaps the best publicized risk factors for PID is another contraceptive, the intrauterine device (IUD). The increased risk of PID in IUD users appears to be confined to new users and women at high risk of sexually transmitted disease infection. Douching and cigarette smoking may also be associated with the development of PID, but the evidence is weak.

Adolescent↗
PubMed1998

Adolescent contraception.

Adolescent pregnancy rates have declined modestly, most likely because of the increased use of condoms, especially at first intercourse. Condom distribution in schools appears to be effective in promoting condom use without increasing sexual activity. Although, to date, no contraceptive has been as effective as Norplant in reducing teen pregnancy, use of the method has declined dramatically. Depo-Provera use is increasing, but continuation rates are disappointing and the impact on teen pregnancy rates is as yet unknown. Emergency contraception remains underutilized, and interventions to improve oral contraceptive compliance are beginning to be explored. School-based programs that provide contraception without adding a strong educational component fail to improve contraceptive use or reduce pregnancy rates. Use of any contraceptive by teens is cost effective.

Adolescent↗
PubMed1993

Behavioral and sociodemographic risks for frequent visits to commercial sex workers among northern Thai men.

OBJECTIVE: The transmission of HIV-1 in Thailand has recently been attributed to exposure to infected commercial sex workers (CSW). We sought to identify risk factors for patterns of CSW visits among northern Thai men. DESIGN: Retrospective recall of lifetime and recent CSW visits and associated risk factors were obtained by interview. SETTING: Two military bases in northern Thailand. PARTICIPANTS: We enrolled two cohorts (n = 2417) of young men, aged 19-23 years, who were conscripted into the Royal Thai Army and Air Force from six provinces in northern Thailand in May and November 1991. MAIN OUTCOME MEASURES: Frequency of self-reported lifetime and recent sex with CSW. RESULTS: Multivariate results showed that lower socioeconomic status, early first intercourse and substance-use factors (alcohol, marijuana, other drugs, and smoking) associated with lifetime and recent sex with CSW. Sexual intercourse with other female partners, lower price paid at last CSW visit and frequency of condom use with CSW did not differentiate frequent from infrequent CSW visitors. CONCLUSIONS: Limits in the frequency of sex with CSW, improved condom practices and reduction of drinking prior to CSW visits would all appear to provide substantial protection from exposure to HIV-1 in this setting.

Adult↗
PubMed1996

A controlled HIV/AIDS-related health education programme in Managua, Nicaragua.

OBJECTIVES: To evaluate the impact of a community-wide intervention to increase HIV/AIDS-related knowledge, change attitudes and increase safer-sex practices in Managua, Nicaragua. DESIGN AND SETTINGS: Household-based health education intervention trial comprising a knowledge, attitudes and practices (KAP) survey at baseline, a health education intervention and a follow-up KAP survey. Four neighbourhoods were included, two received the intervention, and the other two served as controls. Randomly selected residents aged 15-45 years were interviewed at baseline (n = 2160) and follow-up (n = 2271) using an identical questionnaire. The intervention consisted of a health education campaign that emphasized HIV transmission and condom use. OUTCOME AND ANALYSIS: Knowledge levels regarding transmission and prevention of HIV infection, self-reported use of condoms, levels of worries about HIV/AIDS and perceptions of personal risk of HIV infection. Comparisons between baseline and follow-up employed chi 2 tests with continuity correction. The influence of the intervention was examined in multivariate logistic models including an appropriate interaction term. RESULTS: Intervention and control samples were comparable with regard to sex, age, and age at first intercourse. Significantly less intervention residents had formal education (P < 0.001). At baseline, outcome variables were generally similar in control and intervention samples. Condom use increased from 9 to 16% (P = 0.003) among intervention women, but only from 9 to 11% (P = 0.5) in control women (test for interaction, P = 0.08). Among men, increases were from 31 to 41% (P < 0.001) and from 30 to 37% (P = 0.06), respectively (test for interaction, P = 0.3). Levels of worries about HIV/AIDS decreased in all groups, but perception of individual risk increased only among intervention women (test for interaction, P = 0.02). CONCLUSIONS: This household-targeted health education intervention appears to have had some effect; however, sustained efforts are needed further to improve levels of knowledge and to increase condom use in Managua.

Adolescent↗