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PubMed1992

[Psychosexual behavior as a risk factor for cervix cancer].

Seventy-two patients with cervical cancer (n = 24), ovarian cancer (n = 24), or no disease (n = 24) were questioned about sexual activity and personal relationships. The interviews were conducted in a semistandardized fashion according to the Tübingen Sexual Therapy Scale. Patients with invasive cervical cancer did not have a larger number of sexual partners, an earlier age of first intercourse, greater sexual activity or less stable relationships than patients with ovarian cancer of healthy women. There was no statistical difference among the groups with regard to the relationships. However, patients with cervical cancer reported greater degrees of satisfaction with both sexuality and relationships.

Adult↗
PubMed2005

[Testing pattern and prevalence of Chlamydia infection among women].

BACKGROUND: Chlamydia notification rates have increased in Norway over the recent years. The increase in notification cannot be interpreted as an increase in chlamydia prevalence since knowledge of testing patterns and prevalence of chlamydia by sex and age is virtually absent. MATERIAL AND METHODS: A data set, applying the woman as unit for analyses, comprising all test activity in one Norwegian county, was created for the period 1990-2003 (women 15-59 years old, resident in Sør-Trøndelag County, n = 56,220). Tests registered within 60 days from the previous test were excluded. Outcome measures are age-specific testing rates (first test), cumulative incidence of first test and incidence of repeated testing, proportion of positive first tests and cumulative incidence of being diagnosed with chlamydia before the age of 25, and 12-month incidence of chlamydia. RESULTS: Testing rates were high among young women throughout the study period. By the age of 25, almost all women had been tested at least once for chlamydia (85-90%). By the end of the year following the first test, one in five women with a negative first test and one in three women with a positive first test had been tested for chlamydia at least once more. The proportion of positive tests was highest among the youngest women (9-11% for women 15-24 years from 2000). Cumulative incidence of diagnosed chlamydia by the age of 25 years was 15% for women born 1976-79. Incidence of chlamydia during the first year after the first test was 2-3%. The relative risk for being diagnosed with chlamydia after the first test was highest for women who initially tested positive, and for teenagers. INTERPRETATION: The prevalence of chlamydia is high among young women. However, many women are not tested within a reasonable time after their first intercourse. Increased testing rates among teenagers can be achieved by focusing on easily available tests implying self-sampling methods.

Adolescent↗
PubMed2005

Province of residence and active syphilis infection among Zambian men and women: new evidence from population-based data.

This study examined the risk factors for active syphilis infection in a subset of nationally-representative population-based survey of Zambian men and women. Syphilis prevalence was 6.5% for women = 2107) and 7.4% for men (N = 1745). In the multivariate model, province was a strong risk factor for active syphilis infection, with Copperbelt, Eastern, Luapula, Lusaka, North-Western and Western Provinces presenting significantly higher risk for women, and Copperbelt, Eastern and Lusaka Provinces presenting significantly higher risk for men compared to the Northern Province. In addition to province, age, education, age at first intercourse, marital status, history of genital sore or discharge, and having ever paid for sex were independent predictors of syphilis infection. Given the ongoing HIV-1 epidemic in Zambia, more aggressive diagnosis and treatment of active syphilis infections, particularly in high-risk provinces, are important strategies to reduce reproductive morbidity and curb HIV-1 transmission.

Adolescent↗
PubMed2006

Does vaginal douching affect the risk of vaginal infections in pregnant women?

OBJECTIVE: To evaluate the relationship between vaginal douching and vaginal infections among women in early pregnancy. METHODS: We conducted this study in the Department of Gynecology and Obstetrics, Family Planning Center, Dr. E. Hayri Ustundag Hospital, Izmir, Turkey, between March 2003 and December 2004. We examined the vaginal swabs of 129 women, asking for termination of pregnancy in a family-planning center as both wet-preparations and cultures for vaginal microorganisms, and recorded the informations on women's vaginal douching habit. RESULTS: Among 129 women examined, 80 had at least one type of vaginal microorganisms. Of 67 vaginal douche users, 48 (71.6%) had at least one type of vaginal organisms, whereas of 62 nonusers, only 32 (51.6%) had microorganism, although age, educational status, coital frequency, age at the first intercourse were not statistically different between the vaginal douche-users and non-users. Especially, Group B Streptococcus (GBS), Enterococcus spp. and Candida spp. were found more frequent in vaginal douche-user women. CONCLUSION: We found that vaginal douching tends pregnant women to genital tract the incidence of vaginal infections, especially those caused by Enterococcus spp. and GBS. As such infections may render such women to high risk in terms of perinatal mortality and morbidity, it would be appropriate to discourage vaginal douching in pregnant women.

Adolescent↗
PubMed1991

The association between pregnancy and human papilloma virus prevalence.

This study examined the effects of pregnancy on the prevalence of HPV infection, comparing 69 pregnant and 54 nonpregnant age-frequency matched female patients. HPV prevalence was detected by DNA hybridization using the ViraPap/ViraType dot blot procedure. The prevalence of HPV among pregnant women increased with gestational age from 8.0% in the first trimester, to 16.7% in the second, and 23.1% in the third trimester. This finding suggests that HPV infection may be activated by hormonal or other effects of pregnancy and may explain why number of pregnancies is known to be associated with increased risk of cervical dysplasia and cancer. Oncogenic HPV types 16/18 and 31/33/35 were identified with almost equal frequency in the study population whereas HPV 6/11 was seen rarely. The logistic regression models indicate that there were no significant differences between HPV positive and HPV negative groups by age, income, number of sex partners, age of first intercourse, average frequency of intercourse per month, number of pregnancies, oral contraceptive duration, or pregnancy status. There were no interaction effects. A current Pap result of cervical dysplasia (OR = 8.9; 95% confidence interval: 2.1, 38.8), oral contraceptive use (OR = 0.1; 0.03, 0.6), and education (OR = 1.4; 1.1, 1.8) were significant predictors of HPV status.

Adolescent↗
PubMed2006

Sexual behaviour, contraception and fertility among in-school adolescents in Ikenne Local Government, south-western Nigeria.

A cross- sectional study was conducted among in-school adolescents in six secondary schools in the health districts of Ikenne Local Government to assess the sexual behaviour, contraception and fertility experiences of the adolescents between the months of May and November 2002.Relevant information was collected from 1140 in-school adolescents with the aid of pre-tested, structured, self-administered questionnaires, selected by using multistage and stratified random sampling techniques Information sought from the questionnaires included socio-demographic characteristics of the respondents, parental background, their sexual behaviour, knowledge and use of contraception, human development, pregnancy and fertility experiences, information on sexually transmitted infections (STIs) and HIV/AIDS. During the same period, twelve (12) Focus Group Discussions (FGDs) sessions were conducted using an FGD Guide in the selected schools to highlight differences in opinions of students and also to highlight identification of the group consensus. The mean ages at first intercourse were 13.9 +/- 2.8 years and 14.8 +/- 2.4years for males and females respectively. Boys initiated sex earlier than girls. This difference was found to be statistically significant (p<0.05). Sexual intercourse had been experienced by 28.5% of the adolescent students, significantly more (37.6%) males than females (20.4%) The school adolescents that responded as being married were.4.5% (26males, 23 females) of the respondents. Knowledge on contraception was 36.9% and 22.1% for male and female students respectively, more males than females had knowledge of contraception in a significant proportion, apparently due to increase awareness of the male condom among males. Current use of contraception was equally low, and was found to be 10.9% and 6.0% for males and females respectively. The reasons for non-use were mainly that of non-availability (22.3%), cost (11.8%) negative attitude towards contraception due to societal disapproval (33.2%) and lack of knowledge of how to use them (21.3%). The proportion of adolescents that had ever experienced symptoms associated with Sexually Transmitted Infections (STIs) was 26.8%. Multiple factors were found to be responsible for the deplorable reproductive health situation of the adolescents in this community. The need for provision of sexuality and life planning education in schools including the provision of Youth friendly health services in the community were highlighted.

Adolescent↗
PubMed1991

Self-reported pelvic inflammatory disease in the United States, 1988.

OBJECTIVE: --To assess any changes in the characteristics of women with self-reported pelvic inflammatory disease (PID) between 1982 and 1988 and to evaluate the role of additional behavioral factors. In 1982, PID was a frequent problem among American women of reproductive age, occurring in one in seven. It was also more common among older (greater than or equal to 30 years) than younger women, more common among blacks than among whites, and more common among formerly married women than among those currently married. DESIGN: --We analyzed data on self-reported PID from the cycle IV National Survey of Family Growth, conducted in 1988. SAMPLE: --The survey was conducted with a multistage probability sample of 8450 women. RESULTS: --The findings from 1982 were all replicated. Additional variables available in 1988 show that PID is more common among women with multiple (two or more) sexual partners (10% to 22%) compared with those with only one lifetime partner (7%) and among women who report a history of sexually transmitted disease (STD) (26%) compared with those with no STD history (10%). Controlling for other variables, age, race, vaginal douching, age at first intercourse, STD history, and number of lifetime partners emerged as independent predictors of self-reported PID among American women of reproductive age. CONCLUSION: --PID is still a widely prevalent condition among American women, PID is associated with a variety of risk factors for STD. Prevention of lower genital tract infection is crucial to avoiding PID and its sequelae.

Adolescent↗
PubMedDate not supplied

A possible role of Chlamydia trachomatis in unexplained infertility and sterility.

To estimate the presence of latent Chlamydia Trachomatis (C.T.) infections, we have carried out a study on a selected group of couples affected by unexplained sterility and infertility. We examined 193 women and, as control group 210 healthy fertile women. For both groups the main risk factors that could explain the infection epidemiology have been analyzed. The parameters considered are age of first intercourse, number of partners, social-economic conditions and number of voluntary abortions. Amongst all the causal agents of sexually transmitted diseases (STD), C.T. was most common, with an incidence of about 12 per cent in the study group versus the 5.7 per cent of the control group (chi 2 = 4.12).

Abortion, Habitual↗
PubMed1990

Occurrence of IgA and IgG antibodies to select peptides representing human papillomavirus type 16 among cervical cancer cases and controls.

We used an enzyme-linked immunosorbent assay to test sera from 186 cases of invasive cervical cancer and 172 age-matched controls for IgG and IgA antibodies to an human papillomavirus 16 E7 peptide and to peptide 245, representing an epitope in E2. Cases had significantly higher mean absorbance values than controls for both immunoglobulin isotypes to E7 and elevated mean values for IgG to peptide 245. Since absorbances were not normally distributed we analyzed cervical cancer risk for seropositive and seronegative women. Of the traditional cervical cancer risk factors, cigarette smoking, educational level, number of pregnancies, time interval since last Papanicolaou smear, and age at first intercourse influenced the distribution of seropositivity to some of the viral antigens. Adjusting for these variables, the odds ratios of cervical cancer associated with IgG to E7 was 5.28 [95% confidence (95% CI) = 2.4-11.6] and that with IgA to E7 was 2.67 (95% CI = 1.3-5.3). IgG to peptide 245 was less strongly associated, odds ratio 1.68 (95% CI = 1.2-3.3), and IgA to peptide 245 was not significantly associated with disease. These findings suggest that antibodies to E7 are markers for invasive cervical cancer. However, seropositivity correlated poorly with clinical state, survival, or the presence of human papillomavirus DNA in the cancer tissue.

Antibodies, Viral↗
PubMed1990

Demographic and historic variables in women with idiopathic chronic pelvic pain.

A comprehensive historic, demographic, and medical questionnaire was administered to 106 women referred to a multidisciplinary clinic for evaluation of idiopathic chronic pelvic pain and to 92 age-matched, pain-free control patients presenting for routine annual examination. Although racial distribution, mean gravidity and parity, and rates of elective abortion were similar in both groups of respondents, spontaneous abortion was reported significantly more frequently among women with pelvic pain. Patients in the study group were also more likely to be on active military duty, to have undergone previous nongynecologic surgery, and to have sought treatment for unrelated somatic complaints. Finally, although the mean ages at first intercourse were similar, women with idiopathic pelvic pain reported a higher total number of sexual partners and were significantly more likely to have experienced previous significant psychosexual trauma. These findings confirm that predisposing psychosocial variables are important in the pathogenesis of idiopathic pelvic pain and emphasize the significance of multidisciplinary evaluation and management.

Abortion, Spontaneous↗
PubMed1990

Case-control study of cancer of the vulva.

A case-control study of 209 vulvar cancer patients and 348 community controls allowed assessment of risk factors for this rare tumor. As with cervical cancer, risk increased with the number of reported lifetime sexual partners, with five or more partners associated with two- to threefold increases in risk compared with zero to one partner. This factor largely explained the associations of risk with early age at first intercourse and low socioeconomic status. An independent association, however, was noted between vulvar cancer and a history of genital warts (relative risk 15.2; 95% confidence interval 5.5-42.1). Women who reported a previous abnormal Papanicolaou smear were at excess risk (relative risk 1.8), as were current smokers (relative risk 2.0). A significant interaction was noted between smoking and genital warts, with women reporting both having 35 times the risk of those with neither factor. Menstrual, reproductive, and hygiene factors were generally unrelated to risk. The relationships with sexual factors and genital warts support a common etiology for cervical and vulvar cancers. Future studies should focus on the etiologic agents for genital warts--the human papillomaviruses--and their enhancement by other factors, especially smoking and/or immune deficiencies.

Adult↗
PubMed1990

The association between Chlamydia trachomatis and ectopic pregnancy. A matched-pair, case-control study.

We performed a case-control study of the association of past exposure to Chlamydia trachomatis and ectopic pregnancy with 306 case patients with an ectopic pregnancy and 266 pregnant patients who served as controls. The geometric mean antichlamydial antibody titer among cases was 75 +/- 10.2 vs 13 +/- 11.0 among controls. The matched-pair odds ratio for ectopic pregnancy and IgG titer of 1:64 or greater to C trachomatis was 3.0 (95% confidence interval, 2.1 to 4.4). Adjusting for age at first intercourse, total lifetime partners, douching, history of infertility, and parity yielded a relative risk of 2.4 (95% confidence interval, 1.5 to 3.3). Current douching remained an independent risk factor after controlling for chlamydial exposure, with an adjusted relative risk of 2.1 (95% confidence interval, 1.3 to 3.5). The population attributable fraction for chlamydial infection was 0.47 and that for douching was 0.45. The results stress the need for control of C trachomatis infections and for further study of specific douching behaviors as risk factors for ectopic pregnancy.

Adult↗
PubMedDate not supplied

A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior.

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

Adolescent↗
PubMed1989

The prevalence of abnormal cervical cytology in a group of New Zealand women using contraception: a preliminary report. The New Zealand Contraception and Health Study Group.

Between 1980 and 1986, cervical smears were obtained from 9430 women throughout New Zealand to determine their eligibility to enter the New Zealand contraception and health study. Excluded were 128 women in whom the smear was unsatisfactory or the cytological diagnosis was inconclusive. The prevalence of mild dysplasia or worse was 4.3% and of carcinoma in situ/invasive carcinoma was 0.5%. Risk factors that were identified were age at first intercourse, number of sexual partners, age and smoking. Over the age range studied (essentially 20-39), the prevalence of dysplasia decreased slightly with increasing age but the prevalence of carcinoma in situ/invasive cancer increased from 0.18% at ages 20-24 to 0.74% at ages 35-39.

Adolescent↗
PubMed1988

The prevalence of positive test results for Chlamydia trachomatis by direct smear for fluorescent antibodies in a south Texas family planning population.

Chlamydia trachomatis is a major human genital pathogen implicated as a leading cause of involuntary infertility in women. To assess the prevalence of results positive for C trachomatis by a direct immunofluorescent test in a family planning population, mass screening of all patients attending five urban family planning clinics was conducted for a two-month period. The objectives of this study were to assess the prevalence of positive C trachomatis test results in this population and to evaluate the commonly accepted demographic/behavioral risk factors reported in previous studies. A total of 2,761 subjects were tested using the MicroTrak collection kit. The subjects ranged in age from 12 to 69 years. The overall rate of positive test results was 10.5%. Significant associations between C trachomatis test results and the following variables were observed: race/ethnicity, age, marital status, existence of multiple partners and positive gonorrhea tests. Chlamydial infection was not significantly associated with income, pregnancy, current contraceptive method or age at first intercourse. While the results of the study indicated both agreement and disagreement with other clinical investigations, the fact that 10.5% of a largely asymptomatic population exhibited chlamydial infection has major implications for the management of women's reproductive health care.

Adult↗
PubMed1987

[Epidemiology of cervix cancer--a review].

Cervical cancer behaves epidemiologically like a venereal disease of low infectiousness. Early age at first intercourse and multiple sexual partners have been shown to exert strong effects on risk. There are wide differences in the incidence between different countries also influenced by the introduction of screening. Although the general picture remains one of decreasing incidence and mortality, there are signs of an increasing cervical cancer risk probably due to changes in sexual behavior. HSV 2 infection could not be confirmed to play the anticipated role in the aetiology of cervical cancer. Smoking and HPV 16/18 are currently important issues in a concept of multifactorial, stepwise carcinogenesis at the cervix uteri.

Colombia↗
PubMed1988

National estimates of teenage sexual activity: evaluating the comparability of three national surveys.

In this article, we examine the reliability with which teenage sexual activity was reported in three recent national surveys. Unlike other study-effects analyses of objective demographic phenomena such as births and marriages, ours focuses on a more sensitive question--age at first intercourse as reported in three very different surveys. Specifically, we compare reports for the 1959-1963 cohort in the 1979 Kantner-Zelnik Study of Young Women, the 1982 National Survey of Family Growth, and the 1983 wave of the National Longitudinal Survey of Youth. For the ages when the majority of teens become sexually active (16-19), the three surveys provide comparable estimates of early sexual activity. For the younger teen ages, however, there is some disagreement among the estimates. Nevertheless, all three studies produce consistent estimates of the determinants of sexual activity throughout the teen years.

Adolescent↗
PubMed1987

Sexual and reproductive risk factors for invasive squamous cell cervical cancer.

A case-control study of 418 women with invasive squamous cell cervical cancer and 704 population controls enabled evaluation of risk factors for this relatively rare cancer. Consistent with an infectious etiology was a pronounced effect of multiple sexual partners, with those reporting 10 or more partners being at a significant threefold excess risk. Early first intercourse also was associated with some residual effect on risk, although the relationship was not linear, nor the explanation readily apparent. Those with multiple births were at significantly elevated risks, even after adjustment for sexual parameters. Menstrual and hygiene factors, including use of tampons, vaginal deodorants, and douching products, were not consistently related to risk. Histories of specific infections involving the genital tract were poor predictors of risk, since few women provided positive responses, but those with nonspecific diseases were at a significant twofold excess risk.

Adult↗