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PubMedDate not supplied

A case control study of nutritional factors and cervical dysplasia.

The association of nutritional factors with cervical dysplasia was examined through a case-control study. Analysis was conducted in 257 cases and 133 controls confirmed both by cytological examination and colposcopic findings. A 24-h dietary recall questionnaire was used to assess nutritional intake. Various risk factors (including age at first intercourse, number of sexual partners, parity, cigarette smoking, oral contraceptive use, human papillomavirus type 16 infection, and age and race) were adjusted for their potential confounding effects. While analyses were also performed to adjust for total calories, results were not changed significantly. Among the nutrients examined, vitamin A intake showed a significantly increased risk at the lowest quartile compared to the highest quartile, with an odds ratio of 2.2 (95% confidence interval, 1.2-4.2). A significant trend of increasing risk was also observed with lower intake of vitamin A (P = 0.05). Riboflavin showed increased risk at the two lower quartiles of intake with a trend test P value of 0.04. Increased risk was also found for lower intakes of vitamin C compared to the highest intake level. For folate, increased risk was found in the second highest quartile compared with the highest quartile with an odds ratio of 2.0 (95% confidence interval, 1.0-3.8). The calcium:phosphorus ratio showed an increased risk at the lowest level (odds ratio, 2.0; 95% confidence interval, 1.0-4.3). Insufficient intake of vitamin A, riboflavin, ascorbate, and folate is associated with an increased risk of cervical dysplasia.

Adult↗
PubMed1993

Human papillomaviruses and other influences on survival from cervical cancer in Panama.

OBJECTIVE: To determine the influence on survival from cervical cancer of human papillomaviruses (HPVs) and other factors including age, herpes simplex virus type 2 (HSV-2) antibody status, and number of pregnancies. METHODS: We followed 196 women diagnosed with invasive cervical cancer in Panama for an average of 32 months. Clinical and risk-factor information was obtained from these women through an interview and review of medical records. We assessed HPV DNA status by testing tumor specimens using polymerase chain reaction, Southern blot, and slot blot techniques. Kaplan-Meier survival curves and Cox proportional hazards model were used to assess the risk of mortality associated with selected variables. RESULTS: Eighty-one percent (N = 144) of the women tested for HPV were positive. Absence of HPV DNA was associated with a 1.9-fold excess risk of mortality (95% confidence interval [CI] 1.1-3.3) after controlling for age, clinical stage at diagnosis, number of pregnancies, and HSV-2 seropositivity. Women diagnosed with cervical cancer before the age of 30 had a ninefold excess risk of dying compared with those diagnosed at age 50 or older (relative risk [RR] 9.3, 95% CI 3.4-25.5). Parity was also an independent prognostic factor. Women with six or more pregnancies had a 2.5-fold excess risk of dying compared with women with three or fewer (95% CI 1.2-5.3). Years of education, presence of HSV-2 antibodies, age at first intercourse, number of sexual partners, oral contraceptive use, and cigarette smoking were not significantly associated with prognosis. CONCLUSION: These findings suggest that women negative for HPV DNA, those who are diagnosed at an early age, and those who have multiple pregnancies might have more aggressive tumors.

Adult↗
PubMed1993

Sexual activity among never-married men in northern Thailand.

We use data collected in 1991 to investigate sexual activity among never-married men in Thailand, with a focus on age at first intercourse, characteristics of sexual partners, and conditions under which men visit prostitutes. We sampled men from a broad spectrum of northern Thai society, including university undergraduates, soldiers, and semi-skilled/unskilled workers. We found that except for the students, the majority of each subsample is sexually experienced; prostitutes are the most common type of sexual partner for all groups. Alcohol consumption is associated with several measures of sexual activity. Condom use with prostitutes varies among the subsamples. Among men who have both prostitute and nonprostitute partners, the majority of those who do not use condoms with prostitutes also do not use condoms with their nonprostitute partners. We consider the implications of these results for the AIDS epidemic in Thailand.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Human papillomavirus infection in women with and without abnormal cervical cytology].

This study sought to define the prevalence rates of human papillomavirus (HPV) infection and cytologic abnormalities in 3,257 sexually active females 13 to 45 years of age, undergoing routine cervical cytologic screening in the outpatient clinic of an urban hospital. One hundred and fifty patients (4.6%) showed cytologic evidence of cervical human papillomavirus infection (abnormal Pap). We selected a control group (n = 150) with negative cervical cytologic smears. Cells collected were analysed for HPV-DNA by PCR amplification method with probes for HPV types 6.11, 16.18 and 33. The HPV-DNA was detected in 21/300 (7.0%). The prevalence of cervical HPV-DNA types among women with negative cytology was 5.3% (8/150) and 8.6% (13/150) among women with abnormal Pap. The risk of HPV infection seems to be related with age at first intercourse, younger age and number of sexual partners. We did not find relation with the use of oral contraceptives smoking and history of prior sexually transmitted disease.

Adult↗
PubMed1993

Human immunodeficiency virus-infected adolescents: the first 50 patients in a New York City program.

To address the unique manifestations of human immunodeficiency virus (HIV) among adolescents aged 13 through 21 years, a comprehensive evaluation and treatment program for high-risk and HIV-positive adolescents was developed in New York City in 1987. Among HIV-infected youth, mean age of testing was 18.2 years. One third of the HIV-positive patients were female and four fifths were African-American or Hispanic. No significant differences were found between HIV-positive (n = 50) and HIV-negative (n = 43) patients for age at first intercourse, injecting or other illicit drug use, history of sexually transmitted diseases, or survival sex (exchange of sex for money or drugs). HIV-positive males were more likely than HIV-negative males to have engaged in anal intercourse and to report a history of sexual abuse. Among infected females, 82% acquired HIV through heterosexual intercourse. Almost half (48%) of HIV-positive adolescents had significant immune dysfunction at the time of their initial visit (CD4 < 500/mm3) and were eligible for zidovudine. Many HIV-positive adolescents continued high-risk behaviors such as intercourse without condoms, particularly those with ongoing dependence on drugs or alcohol. With the epidemic of HIV infection increasing nationwide among adolescents, specialized, comprehensive programs are needed to counsel and treat HIV-infected adolescents and youth in high-risk situations.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Sexual activity, family life education, and contraceptive practice among young adults in Banjul, The Gambia.

This report presents results from a 1986-87 two-stage probability sample survey of 2,507 young men and women aged 14-24 living in the Greater Banjul region of The Gambia. Although premarital sexual activity was common and began at an early age, lack of knowledge and limited access to modern contraceptives were obstacles to the use of family planning. Of all ever sexually active single persons, only 21 percent of the young women and 7 percent of the young men had practiced contraception at the time of first intercourse. Almost half of the sexually active young adults had ever used contraceptives, with oral contraceptives and condoms being the methods most widely known and used. Results of logistic regression analyses show that attendance at family life education lectures in school had significant positive relationships to both knowledge and use of contraceptives among the young people surveyed. The study presents encouraging evidence that acceptance of modern contraceptive use is beginning to take hold among young people in urban Banjul.

Adolescent↗
PubMed1996

[Sex behavior of women seeking hormonal contraception and women seeking induced abortion].

Using an anonymous questionnaire, the authors assessed the sexual and contraceptive behaviour of 130 applicants for induced abortions and 330 applicants for hormonal contraception. Between the two groups these main differences were found: applicants for abortion used less frequently effective contraception and used more frequently unreliable contraceptive methods. This difference was obvious during the first intercourse as well as during later life. The use of contraception in this group is more limited also as compared with the nationwide average. In the case-history of applicants for abortion previous abortions were more frequent, as well as prostitute behaviour and the prevalence of venereal diseases. As regards heterosexual behaviour the applicants for abortion and applicants for hormonal contraception did not differ substantially. According to the authors the differences between the examined groups depend more on personality traits than sexuological characteristics.

Abortion Applicants↗
PubMed1996

Determinants of smoking behaviour in random samples of Greenlandic and Danish women 20-39 years of age.

BACKGROUND: The prevalence of smoking among young women is of particular concern in most countries as it does not decline as in men. We studied smoking behaviour in Greenlandic and Danish women over a 2 year period to provide information on the social and behavioural determinants of smoking in women. METHODS: In 1986, samples of 800 women aged 20-39 years were drawn at random from Nuuk/Godthåb (Greenland) and Nykøbing Falster (Denmark). A total of 586 and 661 women were interviewed in Greenland and Denmark, respectively. In 1988, new random samples of 150 women were drawn from the same areas. Totally, 129 Greenlandic and 126 Danish women were included in this study. In 1987, a sample of 732 women aged 20-49 years from Copenhagen was randomly drawn from the computerized Central Population Register. Of these, 623 women completed a questionnaire. RESULTS: Smoking behaviour was almost the same among women in Nykøbing Falster and Copenhagen (54% smoked) while a significantly higher percentage of smokers was observed among women in Greenland (88% smoked). Heavy smoking was most prevalent among Danish women and associated with early debut of smoking. Among Danish women, smoking was associated with use of oral contraceptives, early age at first intercourse, and multiple sexual partners. In Greenland, smoking was associated with early sexual debut and multiple sexual partners. In an extended analysis on a subgroup of Danish women, smoking was also associated with low education and infrequent intake of vegetables. The study showed no development in smoking behaviour in any age group over the two year period between the two studies, neither in Nykøbing Falster nor in Nuuk. CONCLUSION: The high prevalence of moderate smoking among women in Greenland suggests that broad anti-smoking initiatives are urgently needed. The high prevalence of heavy smoking and a social gradient among Danish women may indicate that a strategy focusing on restrictions of smoking may be more relevant than merely continuing a pure anti-smoking information strategy.

Adult↗
PubMed1996

Lifestyle factors and prostate cancer risk: a case-control study in Sweden.

We examined associations between lifestyle factors and subsequent risk of prostate cancer in a population-based case-control study. Information on smoking and alcohol habits, socioeconomic factors, marital status, family history, and sexual habits were obtained from a questionnaire and a face-to-face interview with 256 (74.6%) eligible patients and 252 (76.6%) selected controls, frequency matched by age and screened for prostate cancer with negative findings. Unconditional logistic regression was used to estimate the odds ratios (ORs). Risk was elevated among current smokers of cigarettes (OR, 1.8) and current users of hard liquor (OR, 1.4); however, the lack of dose-response trend for both of these exposures argues against a causal association. We found tentative evidence that early first intercourse, a larger number of sexual partners, and other indices of high sexual activity are associated with increased risk. Similarly, adult height, an indicator of nutrition during childhood and adolescence, was weakly positively associated with risk, although larger studies are needed to establish this link. Unmarried men had a lower risk than married men (OR, 0.3), and socioeconomic status did not appear to be strongly associated with prostate cancer. Men with a father who had prostate cancer had a more than 2-fold increased risk of prostate cancer, whereas those with a brother affected had about a 5-folk risk.

Adult↗
PubMedDate not supplied

Demographic and behavioral factors associated with adolescent pregnancy in Switzerland.

Switzerland has the lowest adolescent fertility rate in Western Europe. According to data collected in 1993 as part of the Swiss Multicentre Adolescent Survey on Health, 5% of 1,726 sexually active adolescents in a group of 3,993 15-20-year-old women enrolled in academic or vocational classes had ever been pregnant; most of these women (80%) had terminated their pregnancy. Adolescents who had ever been pregnant did not differ significantly from those who had not by demographic characteristics. Multiple logistic regression analysis identified seven factors associated with pregnancy: having had four or more sexual partners; not having used contraceptives at first intercourse; ever use of less-effective contraceptive methods; having used illicit drugs during the last 30 days; living apart from one's parents; recently experiencing stress; and perceiving a lack of future prospects.

Adolescent↗
PubMed1996

Differences in clinical manifestations of genital chlamydial infections related to serovars.

OBJECTIVES: To study the association of serovars of Chlamydia trachomatis with clinical manifestations of genital tract infection and socio-demographic characteristics. METHODS: In 1986-88 the C trachomatis isolates from 159 heterosexual men and 116 women attending a sexually transmitted disease (STD) clinic were collected and typed accordingly. A medical history was recorded, a physical examination took place and samples were taken for laboratory diagnostics. RESULTS: Serovars E, F and D were the most common for both men (75%) and women (67%). Men infected with serovars of the C-complex had more often a history of STD (p = 0.06). The opposite was demonstrated in women (p = 0.07). In addition, women younger than 18 years at first intercourse were more often infected with C-complex serovars (p = 0.05). For men, the serovars F/G less often produced symptoms of urethral discharge (p = 0.01) than the serovars of the B-complex and C-complex and were less often associated with the presence of 10 or more leukocytes in a Gram-stained smear (p = 0.04). CONCLUSIONS: In this study, infections with serovars F and G caused less obvious symptoms and signs of inflammation in men; in women no differences were found in the clinical manifestation of infections with different serovars.

Adolescent↗
PubMedDate not supplied

First coitus for adolescents: understanding why and when.

BACKGROUND: Correlates of initiation of coitus for teenagers were examined, and participants were asked their reasons for initiating or postponing the onset of coitus. METHODS: Questionnaires were completed privately by 218 patients aged 13 to 18 years. Questions explored the reasons adolescents cite for their sexual decisions and the role of peer influence in these decisions. RESULTS: Correlation was noted in young teenagers between perception of peer sexual behavior and participant's initiation of coitus. Reasons stated for engaging in first intercourse reflect both active choices and loss of control. Reasons for refraining included fear of pregnancy and sexually transmitted diseases, lack of developmental readiness and opportunity, and social sanctions. Morality was cited infrequently as a reason for postponing sexual behavior. CONCLUSIONS: Results suggest that sexuality education should address the direct and curious questions of younger teenagers about sexuality, help youth define strategies that they can use to evaluate and resist peer pressure, and give more generalized attention to ways of helping youth feel competent. Physicians and other health educators might focus on helping older youth define how and when they know they are ready to have intercourse, consider ways of expressing sexuality that do not jeopardize health, and improve communication skills when talking with friends and potential partners about sexual issues.

Adolescent↗
PubMedDate not supplied

Chlamydial serology and histerosalpingography in predicting tubal disease in infertility patients.

To evaluate the role of Chlamydial serology and hysterosalpingography (HSG) in predicting tubal disease, alone or combined with versus laparoscopy, which is known to be the gold standard but an invasive procedure. In 135 patients who suffered from infertility for at least 2 years admitted to Zeynep Kamil Women and Children's Hospital, Department of Infertility between January 5, 1993 to March 18, 1995. Chlamydial antibody titers were measured, HSG were performed. Tubal disease was identified by laparoscopy. 19 patients with endometriosis and 22 patients who could not be followed were excluded from study group. The final study group comprised 94 patients who had antibody titers, HSG laparoscopy. Sensitivity, specificity, positive and negative predictive values of each diagnostic test were calculated, differences in proportions and means were calculated using chi 2 test and analysis of variance, respectively. For HSG, sensitivity was 88.9%, specificity was 78%, positive predictive value (PPV) was 71% and negative predictive value (NPV) was 92%. For chlamydial antibody titers, sensitivity was 52%, specificity was 68%, PPV was 37% and NPV was 80%. For both HSG and Chlamydial antibody titers, sensitivity was 34%, specificity was 64%, PPV was 36% and NPV was 62%. In our study population 35 (37%) of the infertile women had tubal factor identified by laparoscopy and 37% of these had positive Chlamydial antibody titers. These findings indicate that in our population tubal factor has an important place among causes of infertility but in its etiology Chlamydial infection does not seem to play a major role contrary to previous reports. This can be explained by lower incidence of Chlamydial infections due to infrequency of multipartner sexual relationships and advanced age of first intercourse among women in society. Measurement of antibody titers neither by itself nor in Combination with HSG were not found to be cost-effective and beneficial. We propose conventional HSG as a single, cost-effective procedure since it is also almost as predictive as laparoscopy in detecting tubal disease among our infertile population.

Adult↗
PubMed1997

[Contraceptive behavior in the population of the Czech Republic: results of a national survey].

Based on an anonymous survey by means of questionnaires in a representative sample of the population of the Czech Republic above the age of 15 years (862 men and 857 women) the use of different types of contraception was investigated at the onset of sexual life with a steady or casual partner, as well as attitudes to contraception. From the results ensues that during the first intercourse no contraception was used by more than half the respondents, a condom was used only by 19% men and 14% women, in particular younger men and women. In a steady partnership the most frequent method of contraception is coitus interruptus, whereby about one third have experience with hormonal contraception and two thirds of the respondents have experience with condoms. Among younger age groups of men and women there are more users of hormonal contraception and condoms. The position is similar in intercourse with casual partners. Only 5% men and 4% women oppose any contraception, almost one quarter are in favour of the so-called "natural" method and almost three quarters consider it necessary. The attitudes of atheists, younger and better educated women are more liberal.

Adolescent↗
PubMedDate not supplied

Attitudes toward sexual responsibility and parenting: an exploratory study of young urban males.

The self-reported sexual and parenting behaviors and attitudes of 42 urban males aged 16-22 who had fathered a child were compared with those of 49 demographically similar young men who were not fathers when they sought medical care at a public health center. Use of a questionnaire and structured interviews established that both groups had similar levels of self-esteem and similar ages at first intercourse. Fathers were less likely than the other respondents to feel that parenthood would interfere with their future (71% vs. 92%) or to have a concrete five-year plan (57% vs. 90%). They were more likely to believe that family (62% vs. 37%) and peers (68% vs. 40%) looked favorably upon early parenthood, to have a mother who was a teenage parent (74% vs. 47%) and to state that they lacked an adequate father figure while growing up (50% vs. 18%). Fathers also reported more frequent sexual activity and less consistent contraceptive use than did the others.

Adolescent↗
PubMed1998

[Contraceptive behavior of young Latin-American adults living in Montreal].

Recent research on the contraceptive practices of Hispanics adolescents living in Latin America and the United-States indicates that their practices are inadequate. However, contraceptive practices can vary according to levels of traditionalism and acculturation. In order to verify these hypotheses, the contraceptive behaviors of a group of 114 young adults from both genders of Hispanic origin were evaluated. Results indicate that half of the participants did not use any contraceptive method during the first intercourse and that condoms were the most common method. Contrary to American results, acculturation levels were not significant in contraceptive use. Degree of traditionalism in sexual roles was more significant.

Adult↗
PubMed1997

[Contraceptive behavior in the population of the Czech Republic: results of a national survey].

Using an anonymous questionnaire the authors investigated in a representative group of the Czech population above 15 years of age (862 men and 857 women) the use of the main contraceptive methods. During the first intercourse more than half the respondents did not use any contraception, a condom was used only by 19% men and 14% women. In a steady partnership the most frequent method of contraception is coitus interruptus, whereby experience with hormonal contraception was reported by cca one third and with a condom by two thirds of respondents. Among younger men and women there are more users of hormonal contraception and condoms. Only 5% of the examined men and 4% of the women opposed any type of contraception, almost one quarter of respondents use only so-called "natural methods" and almost three quarters of the respondents consider them an essential part of sex life. The attitudes of atheists and junior and more educated women are more liberal.

Adolescent↗
PubMed1998

[Use of condoms among the population of the Czech Republic: results of a national study].

Based on an anonymous survey, using questionnaires, in a representative group of the population of the Czech Republic above 15 years of age (862 men and 857 women) the authors investigated the use of condoms at the onset of sex life and with a steady and casual sexual partner. From the results ensues that the use of condoms in our population is lower than in advanced western European countries and the USA. During the first intercourse it was used only by 19% men and 14% women, in particular those of younger age groups. In a steady partnership two thirds of the respondents have experience with a condom, however, only one fifth uses it regularly. The position is similar during intercourse also with casual sexual partners, though the respondents use it more frequently. However not even then one third of men and almost half the women do not use protection by condoms. The most important influence on the reported use of condoms is exerted by the factors of sex (men, probably to appear socially in the most favourable light report its more frequent use) and age (condoms are used more frequently by younger men and women). In the Czech population the effect of religion and education is not important in this respect.

Adolescent↗