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PubMed1994

Sexual communication is associated with condom use by sexually active incarcerated adolescents.

PURPOSE: Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. METHODS: We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. RESULTS: Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. CONCLUSIONS: Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.

Adolescent↗
PubMed1992

Situational factors and thought processes associated with unprotected intercourse in heterosexual students.

Heterosexual students were asked to recall two sexual encounters from the preceding six months: one in which they had unprotected intercourse ('unsafe' encounter) and one in which they resisted a strong temptation to have unprotected intercourse ('safe' encounter). The aims were to record justifications for unprotected intercourse that respondents had given themselves during the unsafe encounter and to identify factors that distinguished between the encounters. In respondents recalling an unsafe encounter (n = 284), the most common self-justification reported was that there was no need for concern since measures to avoid pregnancy had been taken. The first factor that emerged from a Factor Analysis of the self-justification data involved using perceptible characteristics to infer that the partner was unlikely to be infected. Among respondents recalling both encounters (n = 173), there was a trend for type of partner to distinguish between the encounters. With this variable controlled (n = 115), desires, knowledge of condom availability, communication about condom use, degree of boredom, and level of intoxication differentiated between the encounters. The results are discussed in relation to those obtained in our earlier study of gay men.

Adolescent↗
PubMed1992

Determinants of current contraceptive use among Ghanaian women at the highest risk of pregnancy.

This study uses data from the Ghana Demographic and Health Survey (GDHS) of 1988 to examine factors determining the continued low levels of contraceptive use in Ghana. The women currently using efficient contraception are those who have sexual intercourse regularly, who discuss family planning with their partner, whose husbands approve of the use of family planning, and who live in the northern sector of the country. The finding that husband's approval is an important determinant of efficient contraceptive use has significant policy implications for Ghana and other African countries, to motivate both husbands and wives to share fertility control responsibilities.

Adolescent↗
PubMed2004

Update on oral treatments for male erectile dysfunction.

Impairment of erectile function compromises quality of life in millions of men and their partners, many of whom prefer to suffer in silence. It is important to maintain an elevated index of clinical suspicion in patients with erectile dysfunction (ED) risk factors (e.g. hypertension, diabetes, coronary heart disease). There remains a high rate of voluntary discontinuation of therapy associated with most treatment modalities. Since the introduction of sildenafil, a greater awareness and openness regarding the epidemiology and treatment of male erectile dysfunction has emerged. The development of newer and potentially more efficacious phosphodiesterase type 5 (PDE5) inhibitors will serve to treat an even greater number of patients, allowing once daily and more convenient dosing. An increased understanding of the physiological principles of penile erection has allowed the development of novel oral pharmacological therapies. The new agents offer a potential benefit in a broader range of patients and clinical situations. They may provide a more acceptable alternative than other more invasive options (intracavernosal/urethral injection, implant surgery). The dopamine agonist apomorphine acts on the central control of penile erection to allow a sublingual preparation to produce a prompt response. It is not contraindicated in patients on nitrate medication for coronary artery disease, or in patients with depression or on antidepressants. As with any other treatment, the clinician's responsibility in the care of ED patients does not end with the writing of a prescription. Adequate education and follow-up are needed to optimize the efficacy and safety of oral ED therapy. Furthermore, patients and their partners need to be advised that the agents are not effective in the absence of sexual stimulation. Communicating with both the patient and his partner in a discreet, non-judgmental manner that fosters the physician-patient alliance can facilitate the recognition and treatment of ED.

Administration, Oral↗
PubMedDate not supplied

Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature.

HIV-positive men face multiple challenges when deciding whether to disclose their serostatus to sex partners. The purpose of this literature review (1996-2004) is to identify valid and reliable research results that identify factors influencing serostatus disclosure to sex partners by men who are HIV-positive. Articles included in the review were identified through an electronic search using pertinent terms related to disclosure to sex partners, followed by a search of references for additional articles. A compilation of research results for 17 articles is presented under the headings of background, contextual, and psychosocial factors influencing disclosure. An analysis of the data suggests that differences in disclosure rates vary based on sex partner factors including serostatus, relationship status, and number of sex partners. Rates of disclosure to primary sex partners ranged from 67% to 88%, suggesting that nearly one third of main sex partners were not disclosed to and were at risk of contracting HIV, whereas a pattern of lower disclosure among casual partners was evident. As the number of sex partners increased, the likelihood of disclosure to all sex partners decreased, ranging from one quarter (25%) to slightly over half (58%). In addition, perceived efficaciousness and positive outcome expectations were the most frequent theoretical constructs embedded in the research associated with disclosure, suggesting that these factors play an important role in the process of disclosure to sex partners. Interpersonal factors that positively influenced self-disclosure included spousal support, emotional investment, and communication about safe sex, including asking about a partner's serostatus. Self-disclosure was not consistently associated with safer sex. Recommendations for future research are presented, based on the results included in this review.

Age Factors↗
PubMed2004

Having a good relationship with their mother: a protective factor against sexual risk behavior among adolescent females?

STUDY OBJECTIVE: To assess whether having a good relationship with their mother was a protective factor against risky sexual behavior for female adolescents and whether it was independent of family structure. DESIGN: Cross-sectional survey of in-school adolescents aged 14-19 years. SETTING: Catalonia, in northeast Spain. PARTICIPANTS: A total of 3677 females divided according on whether they had a good (n=3335) or a bad (n=342) relationship with their mother. MAIN OUTCOME MEASURES: Rates of sexual activity and sexual behavior. RESULTS: Adolescents in the good relationship group were significantly younger, more likely to live in an intact family, to have a good relationship with their father and siblings, and to talk about sexuality and their partner with their mother. They were also less likely to have ever had sexual intercourse. Among those sexually experienced, they were significantly older at first intercourse and less likely to have multiple partners or a history of STI. After adjusting for potential confounders, females in the good relationship group were less likely to be sexually active and to have had multiple partners, independently of family structure. CONCLUSIONS: Having a good relationship with their mother is a protective factor against sexual intercourse and having multiple sexual partners independently of family structure. Communication between generations and having a good relationship with their father and siblings also play an important role.

Adolescent↗
PubMed1997

Counseling patients with genital warts.

Counseling patients about any sexually transmitted disease (STD) is difficult, for both the physician and the patient, but a diagnosis of genital warts presents particular challenges. For many patients, being told that they have any STD comes as a shock. Although fear is a common reaction, the relationship between human papillomavirus (HPV) and cancer has made the presence of genital warts especially frightening. This fear is heightened by the fact that treatment will not eradicate the underlying HPV infection, and the threat of recurring warts provides a constant reminder that the patient may never be truly cured. Thus a diagnosis of HPV involves many difficult issues, including poorly understood psychological sequelae in the patient, discomfort on the part of the physician, and notification of the patient's partner(s). Finally, issues of communication, lifestyle modification, and long-term management must be addressed.

Condylomata Acuminata↗
PubMed2004

Which African men promote smaller families and why? Marital relations and fertility in a Pare community in Northern Tanzania.

This research comes in the wake of increasing interest in men's roles in childbearing decisions in sub-Saharan Africa. While some of the findings indicate that men tend to hinder fertility decline, we aimed to identify which men desire fewer children, under what circumstances, and why. The research was done in a Pare community in Northern Tanzania. It is our hypothesis that differences in men's fertility desires and decisions are to be sought in the context of their conjugal union. This paper, based on data from a case study from two Pare villages, attempts to examine the relationship between male attitudes toward reproduction and marital relations. The methodology consisted of a combination of an ethnographic study and in-depth interviews. A subsequent survey, the questions for which were derived from the qualitative work, was administered in order to verify the generalisability of the findings of the qualitative work. Findings show that those men who desire fewer children are younger, educated at least to the primary and often to the secondary level, their wives have also completed at least primary school, they are more affluent, and they are likely to be Christian. They are in a marital relationship where the partners chose each other, they communicate with their wives about important issues, and make joint decisions, including the number of children they should have. The discussion relates the differences in the marital patterns and fertility preferences to differences in the life plans of Christians and Muslims in this community.

Adolescent↗
PubMed2003

Perceived condom use self-efficacy among at-risk women.

The objectives of this study are to assess the confidence in their ability to use condoms among at-risk women and identify predictors for the women's condom use self-efficacy. Structured interviews were conducted with 250 adult women in Atlanta, Georgia, between August 1997 and August 2000. Overall, the women reported feeling moderately to moderately-strongly confident in their ability to use condoms consistently. Multivariate analysis showed women with higher condom use self-efficacy were significantly younger, experienced childhood neglect, had higher self-esteem, communicated better with their sex partner, and had fewer drug problems. Findings suggest the importance of addressing condom use self-efficacy in HIV risk reduction programs with a specific focus on women and the need to be attuned to tailored needs for specific subgroups such as older women or women who encountered childhood neglect.

Adult↗
PubMed2000

Postsynaptic filopodia in muscle cells interact with innervating motoneuron axons.

Precise synaptogenesis is crucial to brain development, and depends on the ability of specific partner cells to locate and communicate with one another. Dynamic properties of axonal filopodia during synaptic targeting are well documented, but the cytomorphological dynamics of postsynaptic cells have received less attention. In Drosophila embryos, muscle cells bear numerous postsynaptic filopodia ('myopodia') during motoneuron targeting. Here we show that myopodia are actin-filled microprocesses, which progressively clustered at the site of motoneuron innervation while intermingling with presynaptic filopodia. In prospero mutants, which have severe delays in axon outgrowth from the CNS, myopodia were present initially but clustering behavior was not observed, demonstrating that clustering depends on innervating axons. Thus, postsynaptic filopodia are capable of intimate interaction with innervating presynaptic axons. We propose that, by contributing to direct long-distance cellular communication, they are dynamically involved in synaptic matchmaking.

Actins↗
PubMed2001

Two-hybrid analysis of domain interactions involving NtrB and NtrC two-component regulators.

Signal transduction by two-component regulatory systems involves phosphorylation of the receiver domain of a response regulator by the transmitter domain of the cognate histidine kinase. In the NtrBC system, phosphorylation of NtrC by NtrB results in transcriptional activation of nitrogen-regulated genes. We have used the yeast two-hybrid system to probe interactions between domains of the NtrB and NtrC proteins from Klebsiella pneumoniae. We constructed fusions from each of a series of proteins or protein domains to the activation and the DNA-binding domains of GAL4 and analysed expression of GAL1:lacZ and GAL1:HIS3 reporters in yeast. The DNA-binding domain of NtrC and the so-called sensor domain of NtrB appeared to provide the major determinants for dimerization of the fusion proteins. A strong and specific interaction was also shown between NtrB and NtrC, localized to the HN region of the NtrB transmitter module and to the NtrC receiver domain, whereas other domains of these proteins do not appear to contribute to the recognition specificity. The results presented here indicate that communication between two-component partners also involves protein-protein interactions that can be detected in vivo, suggesting that the yeast two-hybrid system is a powerful genetic tool for identifying functional partners of prokaryotic signal transduction pathways.

Bacterial Proteins↗
PubMed2005

Nonstandardized assessment approaches for individuals with traumatic brain injuries.

Nonstandardized assessment procedures serve a variety of purposes, including determining competencies in domains for which there are no standardized tests, describing performance in the context of real-world settings and activities, and exploring the effects of systematic changes in communication and cognitive demands and partner supports. This article reviews evidence on the use of nonstandardized procedures for the assessment of individuals with traumatic brain injury and offers recommendations for the use of the procedures that are supported by the available evidence.

Aphasia↗
PubMedDate not supplied

The PsychoedPlusMed approach to erectile dysfunction treatment: the impact of combining a psychoeducational intervention with sildenafil.

We investigated the effect of adding a psychoeducational intervention to oral sildenafil (PsychoedPlusMed) in the treatment of erectile dysfunction (ED). Overall treatment satisfaction, as measured by the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS; Althof & Seftel, 1995), was significantly higher in the PsychoedPlusMed patients than in the sildenafil-only patients at 12 weeks and at 24 weeks. PsychoedPlusMed participants reported higher satisfaction with treatment onset, treatment duration, and sexual confidence. PsychoePlusMed participants also reported an increase in communication about sex with their partner. A brief psychoeducational intervention can improve treatment satisfaction with sildenafil therapy for ED.

Adult↗
PubMed2006

Interpersonal issues surrounding HIV counseling and testing, and the phenomenon of "testing by proxy".

This multimethod study explored challenges faced by women in close heterosexual relationships who decided to test for HIV, and their experiences with instituting safer sexual practices and partner testing. Eighty-one women who sought HIV counseling and testing and had a regular male sexual partner were interviewed on five occasions, and 18 of these women and 15 men later took part in one of four focus groups (women only, men only, or couples). Findings identified difficulty understanding the unpredictability of HIV transmission, gender differences in how partners interpret their susceptibility to HIV, and male resistance to safer sex and testing. We also identified a pervasive phenomenon of "testing by proxy"--the belief that if one partner tests negative for HIV after having unprotected intercourse, the untested partner's serostatus is deemed to be negative. This dangerous practice must be addressed in public health prevention efforts. Programs aiming to reduce heterosexual HIV risk for women must include their male partners and incorporate effective interpersonal communication skills.

Adolescent↗
PubMed2002

Convergence and divergence in spouses' perspectives on women's autonomy in rural India.

This study explores similarities and differences in the perceptions of rural Indian women and their husbands with regard to various dimensions of women's autonomy and investigates the extent to which various reproductive outcomes--contraception, unmet need, recent fertility, and spousal communication--are influenced by individual partners' views of women's autonomy. Data are drawn from a 1993-94 community-based study of women's autonomy in Uttar Pradesh and Tamil Nadu, states that are, respectively, more and less patriarchal. Matched data were obtained from 1,660 women and their husbands. Results indicate no more than a loose agreement between women and their husbands concerning the dimensions of women's autonomy within the home. Where disagreement is expressed, husbands are more likely to project a comparatively liberal picture of their wives' autonomy than do their wives, and the inference can be made that in surveys men tended to provide more "acceptable" responses than when they were questioned in greater depth. Findings also suggest that cultural context affects the influences that wives' and their husbands' perceptions of women's autonomy have on reproductive outcomes. A clear regional divide is seen, net of individual and household characteristics, in the influence of almost every aspect of women's autonomy.

Adolescent↗
PubMed1990

Sexual issues at menopause.

Although the desire for sexual encounters and the frequency of coitus decrease with menopause, sex in the elderly is no longer considered taboo and continues to be an important and acceptable activity for most older persons. Couples in their 50s or older expect continued sexual involvement, but most consider intercourse the only legitimate form of sexual exchange and reject other forms of sexual activity. Sexual dysfunctions which impair coital ability, especially ejaculatory difficulties in the male and genital atrophy and loss of vaginal lubrication in the female, are frequent. Menopausal couples are often not knowledgeable about physiologic aging changes that affect sexual performance and are reluctant to communicate sexual difficulties to their partner. Without professional counseling and/or pharmacologic intervention, these conditions may lead to sexual frustration and abstinence. The identification and treatment of problems, as well as patient education, are imperative in caring for the menopausal patient.

Aging↗
PubMed2002

The developing synapse: construction and modulation of synaptic structures and circuits.

Synapse formation and stabilization in the vertebrate central nervous system is a dynamic process, requiring bi-directional communication between pre- and postsynaptic partners. Numerous mechanisms coordinate where and when synapses are made in the developing brain. This review discusses cellular and activity-dependent mechanisms that control the development of synaptic connectivity.

Animals↗
PubMed2003

Perceptions of power equality among drug-using women.

This study examined the associations between perceptions of the power equality in a current sexual relationship and each of several alternative indicators of power in a sample of drug-using women. Using targeted sampling, 262 women were recruited from the streets of Anchorage, Alaska. A battery of face-to-face questionnaires was administered to adult women who gave evidence of recent drug use (track marks or positive urinalysis) and had been recently sexually active. Perceived power equality was associated with physical, verbal, and sexual abuse, self-efficacy, sexual communication, and income for main partners, and the trade of sex and traditionalism of her views on home and family for casual partners. These findings suggest that power is a complex, multifaceted construct, and that type of relationship must be considered when trying to understand the meaning of power within drug-using women's lives. Implications for risk behavior interventions are discussed.

Adult↗