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Partner condom use among adolescent girls with sexually transmitted diseases.

PURPOSE: To explore associations of self-reported condom use with sexual risk knowledge and behaviors, perceptions of peer condom use, and communication with sexual partners about condom use among adolescent girls with sexually transmitted diseases (STDs). METHODS: Adolescent girls with cervicitis or pelvic inflammatory disease (PID) completed a 62-item self-administered questionnaire on sexual risk knowledge and behaviors, condom use, perceptions of peer condom use, and condom use negotiation with partners. Associations with frequency of condom use and condom use at last sexual intercourse were analyzed. RESULTS: A total of 24 girls were enrolled: 13 with cervicitis and 11 with PID; 22 had complete data for analysis. Compared with girls who reported low frequency of condom use, girls who reported condom use all or most of the time were younger (16.7 vs. 19.5 years; p = .008), were less likely to have a prior history of STD (67% vs. 0%; p = .03), and were more likely to think that all or most of their friends use condoms (72% vs. 0%; p = .02). Compared with girls who had not used a condom with last sexual intercourse, girls who had used a condom were younger (16.2 vs. 17.9 years; p = .04), had fewer lifetime partners (2.7 vs. 8.4; p = .03) and had higher mean scores in condom use negotiation (29.1 vs. 24.4; p = .02), and were more likely to think that all or most of their friends used condoms (100% vs. 31%; p = .001). Knowledge about condoms and STD prevention was high (mean 14.3 +/- 2.3 of 16) but was not associated with condom use. CONCLUSIONS: STD interventions for partner condom use among high-risk adolescent girls must recognize the decrease in condom use with increasing age and focus on maintaining safer sex behaviors, building condom use negotiation skills, and promoting the perception of condom use by friends.

Adolescent↗

Sociodemographic associations of physical, emotional, and sexual intimate partner violence in Spanish women.

PURPOSE: To measure the lifetime prevalence of physical, emotional, and sexual Intimate Partner Violence (IPV) in women attending general practice in Spain and to assess sociodemographic factors associated with the different types of abuse. METHODS: The sample included 1402 randomly selected women, aged 18 to 65 years, attending general practice in three Spanish regions. A self-administered structured questionnaire specifically developed for the study was used. Given the overlap between the different types of lifetime abuse, various categories were created by combining the different types. Multiple logistic regression models were developed to identify the sociodemographic factors independently associated with the different categories of abuse. RESULTS: Lifetime prevalence of IPV was 32%, and 14.4% referred having experienced emotional abuse alone. Factors independently associated with all categories of abuse included being separated/divorced/widowed, having three or more children, and lacking social support. Increasing age was protective for physical and emotional abuse (odds ratio = 0.96; 95% confidence interval = 0.93-0.99). Women with the lowest monthly family income (< 600 euro) (1 euro = 1.32 euro) were most likely to experience all IPV categories, except for emotional abuse alone. CONCLUSIONS: IPV is a common problem in general practice. The identification of factors associated with this public health problem is essential for its prevention and treatment.

Adolescent↗

Frequency and intensity of crack use as predictors of women's involvement in HIV-related sexual risk behaviors.

Recent trends in the progression of the AIDS epidemic in the United States indicate that women's rates of acquiring HIV are escalating more rapidly than are men's. Consequently, there has been both an increasing interest in and a need for research targeting substance-abusing women's involvement in HIV risk behaviors. In recent years, strong suggestive evidence has arisen to suggest that women who use crack cocaine are at an elevated risk for acquiring HIV, probably as a result of their involvement in high-risk sexual behaviors. The present study is based on a sample of 1723 women from 22 locales around the United States who used crack cocaine at least once during the previous 30 days but who reported never having injected drugs at any point in their lifetime. Women were divided into four groups based on their frequency and intensity of using crack. In subsequent analyses, this grouping was used to predict the extent to which female crack users engage in five sexual risk behavior measures (number of sexual partners, number of drug-injecting sexual partners, number of times having sexual relations while high on alcohol and/or other drugs, number of times trading sex for drugs and/or money, and proportion of all sexual acts involving the use of protection). The data revealed that the women who used crack with the greatest frequency and the greatest intensity were the most heavily involved in risky sexual behaviors. They differed quite sharply from their lower-intensity and/or lower-frequency crack-using counterparts in terms of their HIV risk behavior involvement and in terms of their actual HIV seroprevalence rates.

Acquired Immunodeficiency Syndrome↗

Negotiating sexual agency: postmenopausal women's meaning and experience of sexual desire.

The purpose of this feminist grounded theory study was to understand the meaning and experience of postmenopausal women's sexual desire. Data collection from 22 postmenopausal women who were ongoing participants of the TREMIN Research Program on Women's Health occurred via audiotaped, telephone-based, semistructured interviews. Women's descriptions of their sexual needs and desires led to the discovery of the core category, negotiating sexual agency, which refers to women's ability to act on behalf of their sexual needs, desires, and wishes. Women negotiated their sexual agency within three main domains (or axial codes): their own sexual self, their partners, and the medical system. An important finding was women's internalization of sociocultural assumptions that privilege their male partners' sexual needs over their own. The findings of this study, especially the contexts in which women negotiate their sexual agency, are important for women, women's health care providers, and women's life partners to understand.

Aged↗

Sexual partnership patterns as a behavioral risk factor for sexually transmitted diseases.

CONTEXT: Women's and men's number of sexual partners and protective practices such as condom use can have a direct effect on their risk of contracting sexually transmitted diseases (STDs), including HIV. METHODS: The 1988 and 1995 cycles of the National Survey of Family Growth and five rounds of the General Social Survey conducted from 1988 to 1996 are used to examine women's and men's numbers of recent sexual partners. Levels of direct risk for STDs (two or more partners in the past year) and the social and demographic correlates of multiple partnership are analyzed among women and men. In addition, women's indirect risk for STDs (their partners' involvement with other partners in the past year) is used to estimate their overall risk of STDs through multiple partnerships. RESULTS: At least three-quarters of sexually active U.S. women and men in the late 1980s and mid-1990s had had only one sexual partner in the preceding 12 months. Moreover, there is no indication that the proportion with more than one partner in the past year changed substantially over that period. Nevertheless, combining women's and men's partnership reports suggests that about 17 million women aged 15-44--34% of those sexually active in the past year--were at risk for STDs because of direct exposure to multiple partners (5.4 million), indirect exposure (6.3 million) or both direct and indirect exposure (5.5 million). In all, 21% of women were at direct risk and 23% were at indirect risk. In comparison, among men aged 18-44, 24% were at direct risk for STDs and an unknown proportion were at indirect risk. Multivariate analyses indicated that unmarried individuals, women younger than 40 and men aged 20-29, blacks and women in the South were all at elevated risk for STDs because of multiple partnership. Overall, in 1995, 19% of sexually active women aged 15-44 had used condoms to protect against STDs over the preceding year, and 19% of those sexually active in the three months before the survey were current condom users. Condom use specifically for STD prevention was more common among women reporting both direct and indirect risk for STDs (58%) and among those at direct risk (46%) than among other women; women whose partners put them at indirect risk only were less likely to be current or recent condom users than women who were not at risk or were only at direct risk. CONCLUSIONS: There is a continuing need to educate people regarding their risk for STDs, to increase the use of existing barrier methods and to develop new methods that protect against STD infection. In addition, if we are to develop a better understanding of the extent of STD risk through multiple partnership, the collection of information on number of partners and relationships between partners must be expanded and improved.

Adolescent↗

HIV prevention among Asian-American college students: does the health belief model work?

This study examined the predictive utility of the health belief model (HBM) in relation to prevention of HIV infection among Asian-American college students. Four research hypotheses were proposed. Three of these hypotheses proposed a positive relationship between perceived susceptibility, severity, and benefits, and HIV-preventive behavior. The fourth research hypothesis postulated a negative relationship between perceived barriers to prevention and actual HIV-preventive behaviors. Results indicated that severity and barriers are significant predictors of the adoption of HIV-preventive behaviors among Asian-American students. Severity was a significant predictor of becoming more careful about the selection of intimate partners, reducing the number of sexual partners, and generally positive changes toward safer sexual behavior, whereas barrier was a significant predictor of becoming more careful about the selection of intimate partners, reducing the number of sexual partners, and ensuring that sexual partners are not HIV infected. It also appeared that cultural factors, such as beliefs about HIV, illness, prevention, sexuality, and homosexuality, need to be incorporated into tests of the model to enhance its predictive power. Implications of the results and suggestions for further research are discussed.

Acquired Immunodeficiency Syndrome↗

[Sexually transmitted diseases symptoms in adults: prevalence and risk factors].

OBJECTIVE: To evaluate the prevalence of sexually transmitted disease (STD) symptoms and associated risk factors in an adult population. METHODS: A population-based cross-sectional study was conducted among residents of the metropolitan area of Pelotas, Brazil. Subjects were 20 years old or more. A self-administered questionnaire was used to gather information about sexual behavior and STD symptoms. Multivariate analysis was undertaken using logistic regression. RESULTS: The prevalence of STDs was 13.5%. A higher risk of STDs was found in non-white younger women with more sexual partners and who did not use condoms in their last sexual relationship. Among men, early initiation of sexual activity and anal sex were positively associated with the outcome. Higher risks were found among women with lower schooling. CONCLUSIONS: The present study identified a significant prevalence of STD symptoms in this population and showed differences in risk factors according to gender. Since many STDs are asymptomatic and symptomatic cases are often either not perceived as disease by patients or not diagnosed in health services, the actual prevalence may be even greater. The study results suggest that cohabitation with a sexual partner does not reduce the risk of STDs in this population and showed sex differences for risk factors, both of which should be taken into account while approaching this issue.

Adolescent↗

Using a new HPV detection system in epidemiological research: change of views on cervical dyskaryosis?

UNLABELLED: The prevalence of human papillomavirus (HPV) rises with increasing histological severity of neoplasia, more cigarettes smoked per day and higher lifetime number of sexual partners in women with cervical dyskaryosis. Recently, the highly sensitive SPF10 primers and Inno-LiPA (line probe assay) HPV prototype research assay became available for the detection and typing of HPV. BACKGROUND: using this system, we challenged the previously reported findings. STUDY DESIGN: the study group comprised 304 women referred because of abnormal pap smears in whom a histological diagnosis was made. Data on the lifetime number of sexual partners and smoking behaviour were obtained by questionnaire. HPV analysis was performed on cervical scrapes obtained at the enrollment visit. RESULTS: oncogenic HPV was found in 288 (95%) women. A total of 86 (30%) out of these 288 women disclosed multiple types. HPV 16 occurred significantly less often in multiple infections than was expected on the basis of chance alone. The grade of neoplasia was significantly associated with the presence of oncogenic HPV, and this association depended on the presence of HPV type 16. No association was found between grade of neoplasia and the presence of multiple HPV types. Neither the lifetime number of sexual partners nor smoking were associated with oncogenic HPV, the five most frequent HPV types separately or the presence of multiple types. CONCLUSION: we conclude that the association between the detection of HPV and the epidemiological risk factors, as found with the GP5/6 PCR in the past, could not be confirmed when using SPF10 PCR primers and LiPA HPV genotyping. We suggest that the number of sexual partners and smoking may be determinants of high HPV viral load rather than determinants of the presence of HPV per se.

Cervix Uteri↗

The examination of vaginally inserted plastic tampon applicators for genetic markers and evidence of prior sexual intercourse.

Vaginally inserted plastic tampon applicators were obtained from 42 female volunteers. The applicators were examined for the presence of ABH blood group substances, phosphoglucomutase (PGM), amylase, acid phosphatase, P30, and intact spermatozoa. Each applicator was accompanied by a control blood sample, a saliva specimen, a brief sexual and menstrual history, and method of birth control of the donor. Eight of the male sexual partners of the donors submitted blood and saliva samples. One male sexual partner submitted only a saliva sample. ABH blood group substances corresponding to the donor were recovered from 36 of the 42 applicators. The remaining 6 applicators revealed a combination of the donor's and sexual partner's ABH substances. The female's PGM type was recovered from 34 of the applicators. The remaining 8 applicators failed to show PGM activity. Of the applicators, 15 indicated evidence of prior sexual intercourse by the detection of ABH substances not consistent with the applicator donor (6 samples), high levels of acid phosphatase (11 samples), or recovery of spermatozoa (8 samples) or some combination of these. All applicator samples failed to show the presence of either P30 activity or PGM factors foreign to the female.

Acid Phosphatase↗

The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study.

PURPOSE: To prospectively examine the relationship between mother-daughter communication about sex and selected sexual risk behaviors among inner-city adolescent females. METHODS: Participants were 219 sexually experienced females, 12 to 19 years of age, recruited from an inner-city adolescent medicine clinic in Philadelphia, PA, and randomly assigned to the control group of an HIV-risk reduction intervention study. Analyses were limited to data from control group participants to avoid confounding intervention effects. Poisson regression was employed to model three self-reported sexual risk behaviors: number of male sexual partners, number of episodes of sexual intercourse, and number of episodes of unprotected intercourse. Mediation effects were evaluated using variables from the Theory of Planned Behavior. Data were analyzed using Poisson regression. RESULTS: Higher levels of mother-daughter sexual risk communication were associated with fewer episodes of sexual intercourse and unprotected intercourse at 3-month follow-up. There was evidence that the relationship of communication to unprotected intercourse was mediated by condom use self-efficacy. Mother-daughter sexual risk communication was not significantly associated with adolescents' reports of numbers of male sexual partner. CONCLUSIONS: This prospective study supports the notion that mothers who communicate with their daughters about sex can affect their daughters' sexual behaviors in positive ways. These findings lend support for the design and implementation of family-based approaches to improve parent-adolescent sexual risk communication as one means of reducing HIV-related sexual risk behaviors among inner-city adolescent females.

Adolescent↗

Comparative behavioral epidemiology of gonococcal and chlamydial infections among patients attending a Baltimore, Maryland, sexually transmitted disease clinic.

Between April 1988 and May 1989, 400 males and 400 females attending a Baltimore, Maryland, sexually transmitted disease clinic were enrolled in a study evaluating and comparing behaviors associated with culture-proven gonococcal or chlamydial infection. The subjects were enrolled consecutively, and were all seen by the same clinician. Among participants of each sex, gonorrhea but not chlamydia was associated with increasing numbers of recent (the past 30 days) sexual partners. Compared with males with neither infection, factors independently associated with increased risk of gonorrhea included age less than 20 years (odds ratio (OR) = 1.93), the presence of genitourinary symptoms (OR = 8.07), and recent exposure to a new sexual partner (OR = 2.78); risk for chlamydial infection in males was associated with genitourinary symptoms (OR = 2.83) and was significantly reduced in those reporting multiple recent (OR = 0.19) or new (OR = 0.07) sexual partners. Among females, age less than 20 years was independently associated with gonococcal (OR = 1.86) and chlamydial (OR = 7.79) infections in comparison with females with neither infection. No other behavioral factors were associated with chlamydial infection for females in this study; however, having a regular sexual partner was associated with significantly elevated risk of gonorrhea (OR = 3.85), while the presence of genital tract symptoms was associated with diminished risk (OR = 0.29) for gonorrhea. These data suggest that there are differences in the behaviors associated with gonorrheal and chlamydial infections and that different strategies may be useful in efforts to control these infections.

Adolescent↗

Sexual behaviour of women living with HIV/AIDS naïve for antiretroviral therapy: the ICONA-BEHEPI Study.

This study describes the sexual behaviours of women living with HIV, and assesses differences by history of drug use. Its general aim is to contribute in the design of programmes to help people with HIV/AIDS (PWH/A) adopt and maintain safe sexual behaviours. A self-administered questionnaire on sexual and drug use behaviours was distributed to study participants. Between 1997 and 1999, 573 women with HIV infection naive to antiretroviral therapies completed the questionnaire (of whom 234 reported a history of injection drug use (IDU) and were enrolled in the study. Non-IDU women reported fewer sexual partners, both in their lifetime and in the preceding month, than IDU women: 19% of IDU and 4% of non-IDU women reported more than 25 lifetime sexual partners (p < 0.001). Interestingly, 83% of non-IDU women were infected by their regular partners: these women reported the lowest number of sexual partners. No difference emerged between IDU and non-IDU women in terms of number of sexual intercourse in the two weeks preceding the interview or in terms of condom use in the last intercourse (reported, overall, by 54% of these 573 women). Among women who had sex partners at the time of interview, more non-IDU (65%) than IDU (43%) women reported HIV-positive partners (p < 0.001). Overall, these findings stress a marked heterogeneity in the levels of past and recent sexual promiscuity according to history of drug use. It suggests the need to differentiate and individualize messages about self-protection and behaviours that may prevent further spread of HIV infection.

Adult↗

[A KABP (knowledge, attitude, belief and behavior) study about AIDS among taxi drivers and hotel attendants in Beijing].

This article reports the KABP study on 448 taxi drivers and 556 hotel attendants in Beijing for the first time in China. A self-administered questionnaire was used to investigate knowledge, attitude, belief and practice (KABP) about AIDS. In terms of knowledge, 23.8% of hotel attendants and 36.8% of taxi drivers did not know that contact with blood could transmit HIV. Thirtyfive percent of hotel attendants and 42.2% of taxi drivers did not believe that intravenous drug users were at high risk. Some drivers (13.6%) and hotel attendants (3.4%) reported having multiple sexual partners. Forty-one point nine percent of taxi drivers and 16.6% of hotel attendants preferred the idea of multiple sexual partners. Among hotel attendants, a negative association was found between knowledge about AIDS and multiple sexual behavior (P < 0.01). Regarding attitude toward condom use, 56.2% of taxi drivers and 47.8% of hotel attendants who have had a sexual experience thought that condom use interfered with sexual pleasure. Seventy-six point eight percent of taxi drivers and 79.8% of hotel attendants believed that they could change their behaviors in order to minimize the chances of getting HIV. This study indicates that HIV education is important in reducing the number of sexual partners and promoting the use of safe sex practices like condom use. Furthermore, as reported by the study population, education can change behavior.

Acquired Immunodeficiency Syndrome↗

Knowledge and attitude of youth (ages 15-25 years) to HIV/AIDS and to routine HIV screening.

BACKGROUND: AIDS is still an incurable disease and is very costly to control. Since the first case of Acquired Immune Deficiency Syndrome (AIDS) in Nigeria was reported in 1986, the human immune deficiency virus (HIV) infection has attained epidemic proportion. In an effort to control this rapid spread, certain preventive measures have been developed. In spite of these and the campaigns to control it, the knowledge and attitudes of youths towards HIV/AIDS leaves much to be desired. OBJECTIVE: To determine knowledge and attitude of youths (15 - 25 years) of HIV/AIDS and to Routine HIV Screening. STUDY DESIGN: The study was cross-sectional. SETTING: The study was carried out at the University of Benin Teaching Hospital, Benin City, Nigeria, between January and December 2003. RESULTS: Five thousand three hundred and twenty STUDY POPULATION: The knowledge and attitude of youths (15 - 25 years) of HIV/AIDS and to routine HIV screening was assessed, using anonymous questionnaires, among 9500 respondents, 4950 males and 4550 females. 5750 respondents were from the University of Benin with a population of 20,000 students while 3750 were from some of the Secondary Schools (post primary Schools) randomly selected in Benin City, Nigeria. The University of Benin Teaching Hospital where the work was done is adjacent to the University of Benin. The Secondary Schools selected where the work was done were within a radius of 20 kilometers of the Teaching Hospital and were 5 in numbers with average of 750 students selected per school. Subjects (56%) indicated that they have heard about HIV/AIDS, 4180 (44%) had no knowledge of HIV/AIDS at all. 2240 of 5320 (42.1%) had some knowledge; 1593 (29.9%) had adequate knowledge and only 1487 (28.0%) had sufficient knowledge. 6365 (67%) did not believe it exists and as a result they are not bothered by it. 825 of the 3750 secondary school students had multiple sexual partners. Majority had single partners for those who had at all. While among the University students 2990 (52%) had multiple sexual partners, while others had between one and two sexual partners. Only 36210 (38%) believe it is real and a killer disease frightened about it and are already changing their sexual behaviours; 1900 (20%) believe it is a western propaganda to enslave the developing world. Three thousand nine hundred and ninety respondents (42%) would agree to routine HIV screening and 5510 (58%) would not agree to routine screening. The reasons adduced for rejecting routine HIV screening included psychological trauma, not necessarily high cost of and lack of anti-retroviral drugs, infringement on fundamental human rights, fear of living with positive screening, stigmatization and victimization at place of work if positive. CONCLUSION: Intensive massive awareness campaign through Radio, Televisions jingles and education about HIV/AIDS of the population is recommended to alter their current negative attitude to routine HIV testing and increase their knowledge about HIV/AIDS and perhaps help to change their sexual behaviours.

Acquired Immunodeficiency Syndrome↗

The association between substance use, unplanned sexual intercourse and other sexual behaviours among adolescent students.

AIMS: To determine the prevalence of high-risk sexual behaviours and the influence of substance use and unplanned sexual intercourse on multiple sexual partners, inconsistent condom use and reasons for not always using condoms among adolescent students. DESIGN: A standardized self-reported anonymous questionnaire administered to a representative sample of students. SETTING: The Canadian provinces of Nova Scotia, New Brunswick, Newfoundland and Labrador, and Prince Edward Island in 1998. PARTICIPANTS: 9997 students in grades 9, 10 and 12 in the public school system. MEASUREMENTS: Items on sexual intercourse, unplanned sexual intercourse, number of sexual partners, condom use, alcohol use, episodes of binge drinking and drunkenness, cigarette smoking and cannabis use. FINDINGS: About 37.5% of males and 39.7% of females reported having engaged in sexual intercourse in the 12 months prior to the survey. Of those, 68.0% of males and 61.5% of females reported having engaged in unplanned sexual intercourse, 40.9% of males and 32.1% of females reported having more than one sexual partner, and 49.9% of males and 64.1% of females reported inconsistent condom use. Unplanned sexual intercourse under the influence of alcohol or other drug was found to be an independent risk factor for multiple sexual partners and inconsistent condom use. CONCLUSION: The demonstration of an association between substance use, unplanned sexual intercourse and other sexual behaviours lends support to a harm minimization approach, including the provision of non-judgemental information and interventions addressing unplanned sexual intercourse under the influence of a substance.

Adolescent↗

Sexual risk profile of young men in Vancouver, British Columbia, who have sex with men and inject drugs.

We compared sexual risk behaviors of men who have sex with men and inject drugs (MSM/IDU) with those of other men who have sex with men (MSM). Of 910 MSM surveyed, 106 (12%) injected drugs in the previous year. MSM/IDU were younger than MSM and more likely to be HIV-seropositive, Aboriginal, economically disadvantaged, engaged in the trade of sex for money or drugs, and to report having female sexual partners. MSM/IDU reported more casual sexual partners and in multivariate analyses were twice as likely to report unprotected receptive anal intercourse with casual partners. These results, combined with those from previous analyses, suggest that the higher risk for HIV seroconversion among MSM/IDU in this cohort is attributable mainly to sexual rather than injection-related exposures. Controlled assessments are needed to identify optimal sexual risk reduction strategies for MSM/IDU.

Adult↗

Prevalence of hepatitis C virus infections among heterosexuals with multiple partners.

A study among heterosexual men and women with multiple sexual partners was carried out to assess the seroprevalence of antibody against hepatitis C virus (HCV). The 468 participants were recruited among visitors to the Clinic for Sexually Transmitted Diseases in Amsterdam. Sera were tested by an enzyme-linked immunosorbent assay (ELISA; Ortho), a recombinant-based immunoblot assay (RIBA; Chiron), and the polymerase chain reaction (PCR). A total of 468 persons were tested, and seven (1.5%) were found ELISA positive. Another 25 (5%) were ELISA indeterminate. Six of the seven ELISA-positive cases were RIBA positive. Further serum samples from five HCV ELISA-positive persons were tested by PCR, and four were found to be positive. The HCV ELISA-positive/RIBA-indeterminate reaction was PCR negative. None of the 17 RIBA-tested sera of the ELISA-indeterminate group yielded a positive result. There was a good correlation between an ELISA optical density/cut-off ratio greater than 2 and a positive RIBA result. The risk factor for HCV appeared to be the type of sexual partner, i.e., belonging to a "high-risk" group for human immunodeficiency virus infection and origin from hepatitis B-endemic countries. It is concluded that HCV may be transmitted through heterosexual contact but probably with low efficiency.

Adult↗

Sexuality in head and neck cancer patients.

OBJECTIVE: To describe sexual functioning and its relationship with age, extent of disfigurement, performance status, and psychological functioning in head and neck cancer patients following radiation therapy with or without surgery. DESIGN: Descriptive study, self-report survey, convenience sample. SETTING: Academic tertiary care Veterans Administration Medical Center. PATIENTS: Fifty-five of 101 consenting patients responded to the questionnaire. Mean age of the patients was 65.1 years (range 48 to 76); 54 were men. The mean duration since diagnosis was 30.6 months (range 3 to 216). All patients received radiation therapy and 26 also underwent surgery. MAIN OUTCOME MEASURES: Instruments included were: The Derogatis inventory of Sexual Functioning, Multidimensional Health Locus of Control. The Center for Epidemiological Studies Depression Scale, Hopkins Symptom Check List, and List Performance Status Scale. RESULTS: Eighty-five percent showed interest in sex. Fifty-eight percent were satisfied with their current sexual partner and 49% were satisfied with their current sexual functioning. Most of them were able to fantasize: however, a majority reported arousal problems, 58% did not participate in sexual intercourse, and 58% had orgasmic problems. Most patients were not depressed. As a group these patients reported significantly more somatic distress but significantly less generalized feeling of distress when compared with a group of nonpatient nurses. Patients with "powerful others" locus of control showed significantly worse sexual functioning. There was no correlation between sexual functioning and performance status or severity of disfigurement. Patients younger than 65 years of age had more advanced disease, lower performance status and significantly poorer sexual functioning; those older than 65 years were more satisfied with their sexual partner and current sexual functioning. CONCLUSION: Despite experiencing sexual problems, sexuality continues to be a priority in the majority of patients studied.

Aged↗