Black South African freshmen's experience of first coitus and contraception.
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Adolescent↗
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Changes in the sexual life of Czechoslovak women born between 1911 and 1958.
In the course of 26 years the authors have collected sexual history data via interview on 1779 gynecological patients, aged 20 to 40. All had been married for at least 1 year. None sought consultation for sexological difficulties. According to the year of birth they were divided into five subgroups from 1911-1920 up to 1951-1958. During that time the average age of women at first sexual intercourse decreased from 20.75 years to less than 18 years. The percentage of orgastic women grew from 31% to 79%, and high coital activity in marriage rose from 40% to 86%. There was a decreasing number of women who came from a family of more than six children. The percentage of women who had secondary or college education increased. A significant acceleration of menarche was found only in the subgroup of women born after 1950.
Adult↗
AIDS related information, attitudes and behaviours among Italian male young people.
In order to evaluate the AIDS related sources of information, knowledge, attitudes and behaviours among male young people it was filled in a multi-choice anonymous questionnaire by 2018 subjects, called for the first medical examination to Italian Navy and by 1348 recruits. The data from the latter group were used to make comparisons with our previous survey carried out in 1988. The most important sources of information on AIDS were mass media and school, on sexuality friends and family. AIDS awareness was greater among the high educated subjects and positively influenced by mass media and school as sources of information. In agreement with these data, knowledge was better about AIDS than about sexuality. Risk perception was positively influenced by the AIDS-related knowledge for called youth and a greater intolerance towards infected people was observed among the less educated and the less AIDS-aware subjects. On average 46% of the called up young men and 74% of recruits declared to be sexually active: among these, the mean age at the first sexual intercourse was 16, over 60% declared to have had multiple partners, over 30% unknown partners and over 30% didn't use condoms; 20% of called up and 38% of recruits indicated 2 or 3 risk behaviours. Factors determining sex-related risks were different according to the behaviour and the considered group. These results suggest that it is important for young people to be well informed about sex and AIDS before the beginning of sexual activity, if possible during compulsory school.
Acquired Immunodeficiency Syndrome↗
Seventeen-year review of sexual and contraceptive behavior on a college campus.
OBJECTIVES: We reviewed current sexual and contraceptive behavior of college-age men and women and compared the findings with those of similar studies in 1974 and 1979. STUDY DESIGN: A randomly selected population questionnaire was provided to students registered in the spring 1991 semester. Of the 1921 survey forms mailed, 772 (40.2%) were returned. The CHIFIT test was used to determine representativeness of sample population to target population. RESULTS: Proportionately more women than men responded, although the age grouping and academic standing were consistent with the university population. Of the 772 responses, 84.2% were sexually active with a mean age at onset of 17.8 years. Half (50.3%) always used contraception with oral contraceptives as the first choice and condoms second. Sexually transmitted diseases were reported by 19.1%. More than one fourth (27.8%) had been tested for human immunodeficiency virus or acquired immunodeficiency syndrome. Fifteen percent (15.1%) reported being forced to have sex, and 50% of these incidents had occurred before age 19. CONCLUSIONS: On a comparison with findings in 1974 and 1979, more students had participated in sexual activity beginning at a younger age with slightly less use of contraception.
Contraception↗
Duration of relative protection of screening for cervical cancer.
The reduction in cervical cancer among women with at least one previous negative Pap smear can be assessed in terms of the time elapsed since the last smear was taken. One indicator of the utility of screening is the duration of relative protection, commonly calculated as the inverse of the disease odds ratio. Most investigations of the extent of relative protection provided by Pap testing have relied on data from centrally organized screening programs or case-control studies. For geographic areas without mass screening programs or tumor registries, reliance on subject recall of Pap tests is required. We conducted a case-control investigation of cervical cancer and interviewed 153 Maryland women with invasive disease and two control groups: 153 case-nominated controls and 392 randomly selected controls. The duration of relative protection of screening for disease was 4-6 years for both control groups [relative protection (RP) = 4.30, 95% confidence interval (CI) = 1.5-12.7 for neighborhood controls, RP = 3.63, 95% CI = 1.4-9.6 for random controls]. These findings held after adjusting for education, ever treated for a sexually transmitted disease, smoking, age at menarche and at first sexual intercourse, number of pregnancies, lifetime contraceptive use, and utilization of obstetrician-gynecologist services; the RPs increased upon adjustment. However, there was a decline in the RP with increased duration. Our findings are directly comparable to reports where smears have been verified, suggesting that self-reports of previous tests may be reliable as a method to evaluate the utility of screening.
Adult↗
Are adolescents who report prior sexual abuse at higher risk for pregnancy?
Adolescents who report prior sexual abuse are at increased risk for adolescent pregnancy. This may result from earlier, more frequent, less well-protected sexual activity or from a greater desire to conceive. To determine the relative contribution of these two possible explanations to the reported association between sexual abuse and adolescent pregnancy, we studied the reproductive and sexual histories of 200 sexually active 13-18 year old females in relation to self-reported sexual abuse. Anonymous questionnaires revealed that 40 (20%) of the 200 subjects reported sexual abuse. Analyses revealed no group differences in the median age of first voluntary intercourse, the frequency of sexual intercourse, or the consistency of birth control use. Compared to their nonabused peers, however, teenagers reporting abuse were more likely to be trying to conceive (35% vs. 14% p < .01), to have boyfriends pressuring them to conceive (76% vs. 44% p < .01), and to have fears about infertility (38% vs. 16% p < .01). Our findings suggest that childhood sexual abuse may increase the risk of adolescent pregnancy by fostering the desire to conceive. Further study is needed to determine why a disproportionate number of sexually abused adolescents desire pregnancy. The efficacy of adolescent pregnancy prevention programs may be improved by identifying previously abused adolescents and by designing educational interventions that specifically address their desire to conceive.
Adolescent↗
History of sexual abuse in incarcerated adolescents with gonorrhea or syphilis.
From July 1983 to June 1984, 2521 adolescents were medically screened at entry into a detention facility in New York City. A medical history, physical examination, serology for syphilis, and culture for gonorrhea were obtained from each entrant. A retrospective chart review was conducted for 136 persons with gonorrhea and/or syphilis (79 boys and 57 girls) and 136 sex-matched infection-negative controls. Several characteristics were compared including age, age at first sexual intercourse, sexual abuse history, contraceptive use, and pregnancy status. Among infected cases, 8% of males and 32% of females reported a history of sexual abuse, whereas among controls, no males and 14% of females reported abuse. A history of sexual abuse was strongly associated with gonorrhea or syphilis (odds ratio = 3.4; 95% confidence intervals, 1.5-8.0). These data suggest an association between sexual abuse and subsequent high-risk sexual behavior manifested by a gonorrhea or syphilis infection.
Adolescent↗
HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth.
In this article, we present data obtained with the psychosocial interview instrument, HEADSS (Home, Education, Activities, Drug use and abuse, Sexual behavior, Suicidality and depression) that was administered to High Risk Youth Clinic clients at their initial visits during a 1-year period. Of the 1,015 new patients, 63% were homeless/runaway youths and 37% were living with their families. Utilizing the HEADSS interview instrument, we compared homeless/runaway youths to nonhomeless youths in a number of areas, including risks for human immunodeficiency virus (HIV) infection. Our results showed that homeless teens tended to be younger, female, and white compared to their nonhomeless counterparts. They were more likely to have dropped out of school and were far more likely to be depressed and actively suicidal. They demonstrated all forms of drug abuse. They engaged in first sexual intercourse at an earlier age, and experienced a higher incidence of sexual abuse and prostitution. They were 6 times more likely to be at risk for HIV infection.
Adolescent↗
Detection of human papillomavirus by nonradioactive hybridization.
The presence of the human papillomavirus (HPV) DNA sequence in cervical smears of women with cervical intraepithelial neoplasia (CIN) was investigated through dot blot using a nonradioactive method based on the principle of enhanced chemiluminiscence. From 154 samples examined, 59 (38.3%) had HPV-related sequences determined by dot-blot hybridization; among these, 18 samples (11.68%) reacted either to HPV 6/11 or to HPV 16/18 probes, 20 (12.98%) reacted to only HPV 16/18, and 21 (13.63%) reacted exclusively to HPV 6/11. The relative sensitivity of the method was controlled comparing the results of both tests with those obtained by Southern blot in 32 samples. The risk of HPV positivity was increased in women who first had intercourse at an early age and in patients with CIN II or III. Both associations were significant at the 95% confidence interval (CI). An increased risk of HPV positivity was also associated with patient's age at diagnosis, education levels, number of sexual partners, and use of oral contraceptives, but none of these factors were significant at 95% CI. Other risk factors for cervical cancer, such as the number of pregnancies or cigarette smoking, were not found to be associated with HPV infection and indicate that the association of these factors with cervical cancer probably is independent of HPV infection. Even if HPV is the major risk factor for CIN, this also supports a multifactorial model of cervical cancer etiology with an increased risk of HPV infection.
Adult↗
Factors associated with multiple sex partners among junior high school students.
Twenty-one percent of a sample of inner-city junior high school students were found to be sexually active (n = 403). Only 31% of them reported a single lifetime sexual partner, 25% reported two partners, and 43% reported three or more partners. Logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on the adolescents' lifetime number of sex partners. Respondents whose sexual debut occurred before age 13 years were nine times more likely to report three or more sex partners compared with those whose first sexual intercourse was at age 15 or 16 years, blacks were four times more likely than non-Hispanic whites to report three or more sex partners; and males were four times as likely as females to report this number of sexual partners. Factors not independently associated with the number of sex partners included: age, Asian or Hispanic ethnicity, human immunodeficiency virus (HIV) knowledge, self-efficacy (belief that one can protect oneself from the virus), condom use, and alcohol and drug use. We conclude that a significant proportion of school-based middle adolescents are sexually active and that most of these are at risk for contracting HIV because of behaviors such as having multiple sexual partners. Topics often stressed in school-based HIV education, such as factual knowledge about HIV, avoiding drugs and alcohol, and condom use are not associated with adolescents' choice about their number of sex partners. Intervention programs will have to identify and then target each specific HIV risk behavior and its motivations in order to reduce adolescents' risks of contracting and transmitting the disease.
Adolescent↗
Does American acculturation affect outcome of Mexican-American teenage pregnancy?
The purpose of this study was to determine whether pregnant Mexican-American teenagers who are acculturated to American lifestyles have different medical and psychosocial problems from those who are more recent immigrants. Consecutive pregnant Mexican-American (or Mexican) teenagers attending a university obstetrics clinic for teenagers were divided into two groups based on country of birth of parents and teen, citizenship, preferred language, and years of U.S. residence. There were 60 in the acculturated group (G1) and 56 in the recent immigrant group (G2). Acculturated teenagers were younger at first sexual intercourse, completed more years of schooling, and sought earlier prenatal care (p < 0.05 for all above). Both groups delivered full-term singletons of average birth weight (mean = 3337 g +/- 477 g). All G2 fathers were Mexican, older (p < 0.05), more likely to be married to G2 teens (p < 0.001), and employed (p < 0.01). The G1 fathers completed more years of schooling (p < 0.05), and 10% were non-Mexican. These data underscore the need to consider acculturation, as well as ethnicity in understanding the experience of pregnant teenagers.
Acculturation↗
Prevalence and risk factors for HBV infection among street youth in central Brazil.
PURPOSE: A seroprevalence survey was carried out among 496 street adolescents from 9 to 20 years old in central Brazil to determine the prevalence of hepatitis B (HBV) markers, as well as to assess the role of potential risk factors. RESULTS: The findings reveal that 20.4% of the participants were homeless adolescents without family links, living and/or working on the streets. The age at first sexual intercourse was as low as 9 years old, and approximately 60% of this population had had at least one sexual relationship by the age of thirteen, indicating prepubertal initiation of sexual experiences among street adolescents. 13.5% were HBV marker-positive (anti-HBc) and 2.0% had antigenemia. Street-based youth had a higher HBV marker-positive rate when compared to home-based teens (OR = 4.1, 95% CI: 2.1-8.5) and, similarly, higher HBV prevalence was obtained for those reporting sexual activity versus the group without sexual activity (OR = 2.1, 95% CI: 1.1-3.9), even after adjusting for potential confounders. CONCLUSIONS: We have found that street youth, particularly street-based adolescents, should be considered at-risk group for hepatitis B infection in our region. These findings may be used as a baseline information for policy changes not only in hepatitis B prevention but also to reverse the scenario of adolescents sexual abuse.
Adolescent↗
Associations among condom use, sexual behavior, and knowledge about HIV/AIDS. A study of 13,293 public school students.
BACKGROUND: This school-based study explored associations between Mexican young people's condom use, other sexual behaviors, and HIV/AIDS knowledge. METHODS: Students (n=13,293, 11-24 years of age) from a random sample of public schools in the central Mexican state of Morelos completed a self-administered questionnaire. We performed logistic regression analysis of condom use and sexual behavior variables and a knowledge-based index on HIV/AIDS prevention and transmission. RESULTS: Average age at sexual debut was 13.6 +/- 1.9 years among young men and 14.2 +/- 2.2 years among young women; 34.5% of sample participants reported using condoms during their first sexual intercourse. More students had intermediate HIV/AIDS knowledge levels (46%, 95% confidence interval [95% CI], 45.2-46.9) than high levels (37%, 95% CI 36.2-37.8, p <0.01). Students knew more concerning HIV transmission than about prevention of HIV infection. Among young men, high levels of HIV/AIDS knowledge increased likelihood of condom use (odds ratio [OR] 1.4, 95% CI, 1.1-1.7), while among young women high levels of knowledge decreased likelihood of using condoms (OR 0.7, 95% CI, 0.5-1.0). Young men with high levels of HIV/AIDS knowledge were more likely to have had three or more sexual partners (OR 1.7, 95% CI, 1.3-2.2), but young women with high knowledge levels were more likely to have only one lifetime sexual partner (OR 0.6, 95% CI, 0.4-0.9). CONCLUSIONS: As in previous studies in smaller samples, levels of knowledge with regard to HIV/AIDS were low in Mexican youth. HIV/AIDS education programs for Mexican students should focus on conveying knowledge on HIV prevention. Because apparently knowledge is not directly correlated with condom use among young women, prevention strategies that deal with social acceptability of condoms and social skills related with condom negotiation are also needed.
Adolescent↗
Contribution of epigenetic risk factors but not p53 codon 72 polymorphism to the development of cervical cancer in Northeastern Thailand.
Relationships between cervical cancer and risk factors were investigated in Northeastern Thailand. Cases (n = 90) with squamous cell cervical cancer (SCCA) and age matched healthy controls (n = 100) were recruited. The p53 codon 72 polymorphism, proline and arginine allele, was studied by the polymerase chain reaction-restriction fragment length polymorphism. There was no significant difference in the allele and the genotype distribution between the SCCA and the control groups (P > 0.05). Significant difference was observed in the number of sexual partners (P < 0.003) age at the first sexual intercourse (P < 0.03) and number of parities ( P< 0.006). After adjusted by age and p53 genotype, significant difference was still observed in the number of sexual partners (P = 0.017) The partners' smoking increased the risk to develop SCCA. Increased odds ratios were observed when the partner had smoking history both at present (3.31; P < 0.003) and in the past (3.36; P < 0.003). The p53 polymorphism itself may not be a risk factor for cervical cancer in Northeastern Thailand. Much attention should be paid to the presence of other risk factors such as sexual behaviors and smoking habits in the prevention of cervical cancer in this region.
Adult↗
Behavioural risk factors for cervical cancer from a prospective study in Khon Kaen, Northeast Thailand.
Fifty seven cases of cancer of the cervix were identified within a cohort of 16,648 women enrolled in a cohort study of lifestyle and cancer in a rural population of Northeast Thailand. They were compared with 228 matched controls from the same cohort, with respect to demographic, behavioural and reproductive factors potentially associated with risk of the disease. Number of pregnancies and age at having first child were associated with the risk of cervical cancer, but in contrast to studies elsewhere, age at having first sexual intercourse, number of sexual partners and sexually-transmitted infections were not associated with risk. The lack of effect may be simply due to the small size of the study. But it is also likely that these aspects of female sexual behaviour are not very relevant in a relatively conservative rural population. These aspects may be investigated further in future, as new incident cancers are accrued into the cohort.
Adult↗
Repeat induced abortions and contraceptive practices among unmarried young women seeking an abortion in China.
OBJECTIVE: To determine the rates of repeated abortion and contraceptive use among unmarried young women seeking an abortion in China. METHODS: We used an anonymous self-administered questionnaire at abortion clinics in Beijing, Changsha, and Dalian from January to September 2000. RESULTS: Of 4547 unmarried young women seeking an abortion, 33.0% reported having had one previous induced abortion. Of those who had had more than one abortion, only 29.7% used a contraceptive method at their first sexual intercourse after the procedure; and of the 446 women who chose contraception, 41.3% used the traditional methods of withdrawal or rhythm. Although 65.0% of the young women had used condoms at least once, only 9.6% did so consistently and correctly; 47.7% of the current pregnancies were associated with nonuse of any contraceptive, and 52.3% were related to contraceptive failure. CONCLUSION: The rate of unmarried young women seeking repeated abortions was high in China on 2000. The rate of consistent condom use was low, and the rate of contraceptive failure was higher.
Abortion, Induced↗
Adolescent complainants of sexual assault; injury patterns in virgin and non-virgin groups.
INTRODUCTION: Misconceptions about the likelihood of sustaining injuries following rape or sexual assault can have a detrimental effect on the justice process. This is particularly noticeable with regard to first time intercourse. Forensic physicians have a duty to put any examination findings in context. This study sets out to compare the findings in virgin and non-virgin adolescents seen at the St Mary's Sexual Assault Referral Centre, after an allegation of non-consensual intercourse. METHODOLOGY: The records of all females aged 12-17 years old, examined in an 18 month period were reviewed. RESULTS: Two hundred and twenty-four clients fitted this group with a mean age of 14.8 years. Eighty-one were "virgins" and 97 had been sexually active prior to the assault. The virgin group took longer to present for examination then the non-virgin group (90 h compared to 44 h). Of all clients 51% had a non-genital injury. These tended to be minor. 32% of the non-virgin group had a genital injury. In the virgin group, 53% had a genital injury, however only 32% had the type of genital injury that would leave permanent evidence of penetration (i.e. if examined several weeks or more later). Alcohol use prior to assault was common. CONCLUSIONS: Genital and or body injuries are not routinely found in adolescents after an allegation of rape or sexual assault even when there has not been previous sexual experience. The absence of injury does not exclude the possibility of intercourse, whether with or without consent.
Adolescent↗
Comparative analysis of characteristics of women with cervical cancer in high- versus low-incidence regions.
OBJECTIVE: To identify particular characteristics that might help explain the markedly higher rate of invasive cervical cancer in southern China as compared with Australia. METHODS: One hundred eighty-five women with cervical cancer were recruited between 1999 and 2001: 106 from Guangzhou and Changsha (southern China), and 79 from Sydney (southeast Australia). Demographic and risk factor information was obtained by questionnaire; clinicopathologic data were extracted from hospital records. The human papillomavirus (HPV) status of cancer biopsies was ascertained by consensus PCR assays, direct sequencing and/or Amplicor trade mark hybridisation. RESULTS: The mean age of the Chinese was significantly lower than the Australians (44 versus 53 years), although mean age at first sexual intercourse was similar. Australian women were more likely to smoke, to report multiple sexual partners and to have a history of sexually transmitted diseases (but not of genital warts). However, they were better educated, were more frequent users of barrier contraception and were far more likely to report regular Pap smears before diagnosis. The HPV positivity rate of Chinese cancers (83%) was less than Australian tumours (90%); but HPV 16 and 18 were the most common genotypes in both populations (59% and 77%), and predominated in cancers from younger women. HPV types 58 or 59 were amplified from 12 (14%) of the Chinese but from only one Australian cancer. CONCLUSIONS: Cervical cancer is not only more common in China but also develops at a younger age than in Australia. While significant differences in some risk factors were observed, the much lower participation in cervical screening in southern China is likely to be of greatest consequence.
Adult↗