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PubMed1992

Long-term sequelae of acute pelvic inflammatory disease. A retrospective cohort study.

OBJECTIVE: Our objective was to prospectively assess the frequency and predictors of long-term sequelae of acute pelvic inflammatory disease. STUDY DESIGN: We performed a retrospective cohort study of 140 women admitted for treatment of pelvic inflammatory disease to San Francisco General Hospital in 1985, locating and interviewing 51 women by telephone a median of 37 months later. RESULTS: Twelve (24%) women had pelvic pain for 6 months or more after hospitalization, 22 (43%) had subsequent episode(s) of pelvic inflammatory disease, and 40% were involuntarily infertile. A history of pelvic inflammatory disease prior to admission was associated with infertility (p = 0.05), chronic pelvic pain (p = 0.03), and pelvic inflammatory disease subsequent to hospitalization (p = 0.06). Longer duration of abdominopelvic pain before admission and younger age at the time of first sexual intercourse were associated with both infertility (p = 0.02, p = 0.04) and subsequent pelvic inflammatory disease (p = 0.04, p = 0.0008). CONCLUSIONS: Further studies are needed to more accurately assess the incidence and predictors of long-term sequelae of pelvic inflammatory disease. A reduction in adverse outcome will require more stringent efforts at education and reduction of risk-taking behaviors.

Acute Disease↗
PubMed1996

Bacterial colonization of the vagina during pregnancy in four ethnic groups. Vaginal Infections and Prematurity Study Group.

OBJECTIVE: Our purpose was determine whether there are ethnic differences in vaginal colonization with organisms reputed to be associated with preterm delivery. STUDY DESIGN: In seven urban medical centers in the United States from 1984 to 1989, 13,747 predominantly low-socioeconomic-status women at 23 to 26 weeks' gestation were grouped according to ethnic origin. Each had a vaginal culture for multiple organisms and Gram's stain and pH test to diagnose bacterial vaginosis. Multivariate analyses with adjustment for maternal age, insurance status, marital status, smoking history, education level, age at first sexual intercourse, and number of male partners in the past year were also performed to determine the odds ratio for a black woman versus a white woman having a positive test result. RESULTS: For nearly every organism studied, Asian-Pacific Islander and white women had the lowest percentages of positive test results whereas black women had the highest. When black and white women are compared, black women were more likely to be colonized with Chlamydia trachomatis, 16% versus 5%; Neisseria gonorrhoeae, 2.5% versus 0.4%; Bacteroides sp., 25% versus 14%; bacterial vaginosis, 23% versus 9%; and the four other organisms evaluated. Adjustment for potential confounders including certain health behaviors did not markedly change the risk of a black woman having a positive test result, with the odds ratios for colonization with each organism ranging from 1.8 to 6.4. CONCLUSIONS: Highly significant differences exist in vaginal colonization patterns among women of different ethnic groups, with the highest rates of potentially pathogenic organisms observed in black women and the lowest in Asian-Pacific Islander women. Differences in health behaviors do not explain the variation in colonization rates.

Adult↗
PubMed1997

Contraceptive practices of women requesting termination of pregnancy: a study from China.

In order to develop a program for prevention of unwanted pregnancies, we conducted a survey of contraceptive practices and reasons for contraceptive failures of 1520 women seeking abortion at eight large hospitals in Zheng Zhou City, Henan Province, P.R. China, during the period from March 1996 to May 1996. The most frequent cause of the unplanned pregnancy was contraceptive failure (71.9%) 61.7% (938) of these current pregnancies were potentially predictable by virtue of nonuse of contraception (427) or by recognition of contraceptive failures (511). Among the contraceptive failures, the proportion of condom mishaps was the highest (29.7%), next was IUD failures (23.5%), then rhythm miscalculation (15.9%). Most of abortion seekers (77.1%) used some contraceptive methods previously. But only 19.7% of them used a contraceptive method at the first sexual intercourse. Among 1520 abortion seekers. 57.6% had used condoms previously; 50.9% of the condom users had at least one instance of condom mishap. The rhythm method had been used by 31.7% of abortion seekers previously; 59.1% of the rhythm users had at least one instance of rhythm failure. Of the 16.8% of abortion seekers who had used pills, 58.0% of them had pill failures Among condom and pill failures, most of them (46.4% condom users and 56.0%, pill users) belonged to the users failure category (poor compliance). Of those seeking abortion 56.4% had experienced at least one instance of previous abortion; 5.3% had experienced previous abortions at least two times. Emergency contraception had been utilized by only 10 subjects prior to this current pregnancy.

Abortion, Induced↗
PubMed1997

Determinants for contraceptive use in young, single, Danish women from the general population.

Determinants for contraceptive use were studied in 5031, non-pregnant women aged 20-29 years from the general population in Denmark. Most women (72%) had never been pregnant, 34% had a history of a sexually transmitted disease, and 22% had ever had a legal abortion. Current contraception was most frequently condoms (60%) or oral contraceptives (33%). Among the women who used OCs or IUD, 32% reported additional condom use (double contraception). Important predictors of using one contraceptive method were lifetime number of sexual partners, parity, and age at first sexual intercourse for condoms and age for oral contraceptives. Also, women with a previous legal abortion were more likely to use condoms currently and women with a history of STDs were less likely to use condoms, but more likely to use OCs. Lifetime number of sexual partners was the only predictor of double contraception. Our data suggest a potential for reducing the number of unintended pregnancies and STDs in single women by increasing the information about the double principle in contraception.

Abortion, Induced↗
PubMed1997

Effects of a randomized health education intervention on aspects of reproductive health knowledge and reported behaviour among adolescents in Zimbabwe.

Unwanted teenage pregnancy and the attendant morbidity and mortality necessitate an understanding of the factors influencing adolescent sexuality and the implementation of programmes designed to improve their knowledge and reproductive behaviour. A randomized controlled study on reproductive health knowledge and behaviour was undertaken among adolescent pupils drawn from a multi-stage random cluster sample. A self-administered questionnaire was used to assess aspects of reproductive health knowledge and behaviour at baseline followed by a health education intervention, except for control schools. Results are based on 1689 responses made up of 1159 intervention and 530 control respondents. There was a significant increase in correct knowledge about aspects of menstruation in intervention as compared with control schools [odds ratio (OR) = 4.5, 95% confidence interval (CI) = 3.4-6.1). Significantly, (OR = 2.0, 95%CI = 1.1-3.9) more pupils from intervention than control schools scored correctly on practice relating to menstruation. Pupils from intervention schools were more likely (P < 0.001) to know that a boy experiencing wet dreams could make a girl pregnant and that a girl could get pregnant at her first sexual intercourse (OR = 1.4, 95%CI = 1.1-1.9). Knowledge of family planning was low in both groups at baseline but was high at five months follow-up in the intervention schools. The findings point to the need for early school-based reproductive health education programmes, incorporating correct information on reproductive biology and the subsequent prevention of reproductive ill health.

Adolescent↗
PubMed2001

Correlates of initiation to cannabis use: a 5-year follow-up of 15-19-year-old adolescents.

Initiation to cannabis is often the first step in the use of illicit drugs. We studied the correlates of initiation in a 5-year follow-up study. A total of 21.4% of the subjects reported using cannabis at some time. Of the 139 users, 89.2% had tried cannabis not more than once or a few times. This initiation to cannabis was related to male gender, absence of mother, frequent lack of interest and early age at first sexual intercourse in logistic regression analysis. These factors seem to be useful in predicting initiation to cannabis.

Adolescent↗
PubMed2000

Comparison between hybrid capture II and polymerase chain reaction results among women at low risk for cervical cancer.

PURPOSE: Hybrid Capture (HC) is a new and powerful tool to detect DNA/RNA of several infectious agents. Regarding HPV DNA detection HC II has shown no false positive results due to contamination and its inter-laboratory reproducibility reaches 98%. It is also simpler and costs less than other methods such as Polymerase Chain Reaction (PCR) and it has shown a high correlation to clinical findings. Our objective is to compare HC II and PCR results among women at low risk for cervical cancer.METHODS: This is a cross-sectional study which enrolled 977 asymptomatic women aged 15 and 70 years. Squamous columnar junction samples were obtained and analyzed for HPV DNA either by HC II and PCR. Epidemiological factors and cyto-pathologic results were related to HPV DNA status. The Pearson Chi-square test and multiple logistic regression were performed to relate epidemiological and cytopathological variables and HPV DNA status.RESULTS: About 15.4% and 15.9% of women were HPV DNA positive by HC II and PCR respectively. Both were highly associated with cytology (P < 0.0001). The correlation to histopathology was also good with a higher significance for HC II. Factors related to HPV DNA detection by PCR were: oral contraceptive use (OR = 1.26; 95% CI = 1.2-1.62); history of genital HPV infection (2.11; 1.13-4.59); 3 or more sexual partners (1.35; 1.10-1.83); education (<primary (1.43; 1.01-1.99); secondary (1.42; 1.03-1.99). For the HC II the related variables were: being single (1.26; 1.01-1.62); aged sixteen years or less at first sexual intercourse (1.37; 1.03-1.89).CONCLUSIONS: The results suggest that HC II is highly comparable to PCR regarding HPV DNA detection. HC II is also significantly associated with cytology and histopathology results indicating that it may be used as adjunctive or stand-alone test for screening programs.

Journal Article↗
PubMed2002

Mothers' influence on the timing of first sex among 14- and 15-year-olds.

PURPOSE: To better understand maternal influence on the timing of first sex for adolescents. METHODS: Using data from the National Longitudinal Study of Adolescent Health, Cox proportional hazard models were used to assess the association between maternal characteristics and the timing of first sex. Matched dyads of mothers and their adolescent children were used. RESULTS: Of the 2,006 adolescents aged 14 and 15 years who reported to be virgins, 95 males (10.8%) and 162 females (15.8%) indicated they had initiated sex within the follow-up period, 1 year later. For males, few variables beyond the controls used in the models were predictive of timing of first sexual intercourse. For females, mother's satisfaction with her relationship with her daughter (hazard ratio =.62), mother's strong disapproval of her daughter having sex (hazard ratio =.56), and frequency of communication with the parents of her daughter's friends were associated with later sexual debut (hazard ratio =.88). CONCLUSION: Based on the variables in the model, mothers' values and beliefs and relationship satisfaction have more influence on daughters than on sons.

Adolescent↗
PubMed2000

Vaginal douching in adolescents attending a family planning clinic

Background: One of the variables most consistently associated with vaginal douching is race, with African-American women douching more regularly. Sparse data exists in the medical literature about the practice of vaginal douching among adolescents. The purpose of this study was to assess the prevalence, knowledge, attitude, and practices of vaginal douching among adolescent females attending a public family planning clinic, and determine whether African-American (AA) females douche to a greater degree than Caucasian females.Methods: In this cross-sectional study, a one-page questionnaire was administered to all adolescent females (</=19 years of age) presenting to a public family planning clinic in a small southern city. Participant charts were abstracted for demographic and clinical information. Chi-square analysis, Pearson's correlation coefficient, and odds ratio were used in data analysis conducted in SPSS for Windows software.Results: Of the 169 participants, the mean age was 17.0 years (+/-1.5 years), 53% were Caucasian, 47% were AA, and 74% were nulliparous. Sixty-nine percent of participants reported vaginal douching, mostly for hygienic reasons (68%). Those reporting vaginal douching were more likely to have a history of one or more sexually transmitted diseases (O.R. 3. 7, 95% C.I. 1.5-9.0, p < 0.01). Age of first douche correlated positively with age of first sexual intercourse (r = 0.34, p < 0. 001). African-Americans did not douche to a greater degree than Caucasians. Among those who douched, AA females were more likely than Caucasians to believe that the reason women douche was after a period (p < 0.01) and after sex (p < 0.05), and to agree that douching clears up a discharge (p < 0.05) and odor (p < 0.01) from the vagina. Caucasians were more likely than AA to believe that some discharge from the vagina is normal (p < 0.05), and most women never need to douche (p < 0.01).Conclusions: Vaginal douching was a common practice among adolescent females attending a public family planning clinic in a small southern city, and racial differences were noted in knowledge of and attitude toward vaginal douching. This suggests development of a culturally-based educational program to convince AA and Caucasian adolescent females to cease vaginal douching.

Journal Article↗
PubMedDate not supplied

Incest, gamete donation by siblings and the importance of the genetic link.

Recently, several requests have emerged in which women wished to be impregnated with donor eggs fertilized with spermatozoa of their brother. An important argument advanced against such applications is that it is a kind of incest. Four definitions of incest are reviewed in this article to evaluate the acceptability of these demands. The first three (sexual intercourse, reproduction with gametes of first-degree relatives and symbolic incest) do not apply to the cases. However, when the sister and her brother intend to raise the child as social mother and father, these requests should be considered as "intentional incest". If the brother only functions as an uncle, the request of the woman resembles the currently accepted practice of oocyte donation from sister to sister. In that case, the wish to receive gametes from a first-degree relative is motivated by the wish to establish as far as possible a genetic link with the child.

Consanguinity↗
PubMed2006

Knowledge, attitude and practice towards HIV/AIDS in a rural Kenyan community.

The aim of this research was to explore people's knowledge, attitude, behaviour and practice towards HIV/AIDS and sexual activity in rural Kenya, where HIV is widespread. The study community was located in south-eastern Kenya, 50 km north of Mombassa, and had an estimated population of 1500. Subjects aged between 16 and 49 were recruited using a stratified cluster-sampling method and they completed self-administered questionnaires. Almost all respondents knew the word 'IV' Around 50% knew of a person living with HIV. About 80% gave 'death' or 'fear' as words representing their image of AIDS. With regard to sexual activity, the distribution of answers to the question 'how many partners have you ever had in your life' was bimodal in males but had only one peak in females, indicating that some men have a large number of sexual partners in their lifetime. First sexual intercourse was at around 12-13 years for both sexes, but female teenagers were more sexually experienced than their male counterparts.

Adolescent↗
PubMed1997

Assessment of sexual functioning for Chinese college students.

Participating in this study were 305 Chinese college students in Hong Kong. Objectives included (i) examination of the psychometric properties of the Chinese version of the Derogatis Sexual Functioning Inventory (DSFI), (ii) exploration of the associations among various domains of sexual functioning, and (iii) description of Chinese students' sexual behavior. The Chinese DSFI shows satisfactory internal consistency, except the Information, Drive, and Satisfaction subscales. In general, sex-related domains such as sexual information, experience, drive, attitudes, fantasy, and satisfaction were related to each other and to body image. Compared to their counterparts in the U.S., Chinese college students were relatively sexually inexperienced and conservative. Mean ages of students having their first sexual intercourse experience were 17.14 for males and 18.13 for females; 11% of the students had premarital sexual intercourse experience, and the mean frequencies were once weekly for males and once or twice per month for females. Compared to female students, twice as many males acknowledged masturbation (21.4 vs. 43.8%), 4.2-8.2% students had experienced oral-genital sexual stimulation and 0-1.2% anal sexual activities.

Adolescent↗
PubMed2005

[Examination of victims of sexual violence--the problem of false reports].

Some people claim to be victims of sexual violence and abuse the judicial system by filing a false police report. Generally, motivation for such behaviour is assumed to be that the self-proclaimed victims try to avoid taking responsibility for a sexual act in which they have been an active, willing participant. Concise motivations include attempts to mask a sexual affair from a partner, or to mask a first sexual intercourse by pretending to be the victim of an act of violence. By the nature of many judicial systems that are abused for such purposes, clinical forensic specialists are confronted with such cases far more often than clinical doctors not serving judicial authorities. In adults, history, injuries and other findings often show patterns that can be recognized as evidence of deception or as signs for self-inflicted injury for the trained specialist. This is far less often the case in infants and children.

Crime Victims↗
PubMed2003

A prospective investigation of the impact of childhood sexual abuse on the development of sexuality.

The sexual attitudes and activities of 77 sexually abused and 89 comparison women (mean age = 20.41, SD = 3.38) were assessed 10 years after disclosure in a longitudinal, prospective study of the long-term effects of childhood sexual abuse. Abused participants were more preoccupied with sex, younger at first voluntary intercourse, more likely to have been teen mothers, and endorsed lower birth controlefficacy than comparison participants. When psychological functioning earlier in development was examined, sexual preoccupation was predicted by anxiety, sexual aversion was predicted by childhood sexual behavior problems, and sexual ambivalence (simultaneous sexual preoccupation and sexual aversion) was predicted by pathological dissociation. Findings also indicate that biological father abuse may be associated with greater sexual aversion and sexual ambivalence.

Adolescent↗
PubMed1996

Epidemiological evidence of cervical intraepithelial neoplasia without the presence of human papillomavirus.

The aim of this paper was to provide epidemiological evidence to support the notion that cervical intraepithelial neoplasia (CIN) without human papillomavirus (HPV) is a true entity. If a diagnosis of HPV-negative cervical neoplasia is erroneous, one would not expect there to be any differences in risk factors between HPV-positive and HPV-negative patients. Patients at a gynaecological outpatient clinic of a university hospital [a total of 265 consecutive women with dyskaryotic cervical smears who were subsequently diagnosed with CIN I (n=37), CIN II (n=48) or CIN III (n=180)] completed a structured questionnaire regarding smoking habits and sexual history. Analysis of an endocervical swab for Chlamydia trachomatis, analysis of a cervical scrape for HPV, and morphological examination of cervical biopsy specimens were also performed. HPV was found in 205 (77.4%) out of the 265 women. Univariate analysis showed that current age (P=0.02), current smoking behaviour (P=0.002) and the number of sexual partners (P=0.02) were significantly associated with the presence of HPV. Age at first sexual intercourse, a past history of venereal disease or genital warts, and current infection with Chlamydia trachomatis were not associated with the presence of HPV. Using multivariate logistic regression analysis, the number of sexual partners and current smoking behaviour showed an independent significant association with HPV. HPV-negative and HPV-positive CIN patients differ with respect to the risk factors for HPV. These findings suggest that HPV-negative CIN is a separate true entity.

Adult↗
PubMed1996

Case-control study of risk factors for prostate cancer.

One hundred and one patients with histologically confirmed prostate cancer and 202 hospital controls individually matched by age (+/- 2 years), hospital admittance and place of residence, were interviewed during the period 1990-94 in two towns in central Serbia (Yugoslavia). In an analysis using multivariate logistic regression, the followng factors were significantly related to prostate cancer: (1) occupational physical activity during the year preceding the disease [odds ratio (OR)=3.87, 95% confidence interval (95% CI)=2.09-7.16]; (2) occupational exposure to asbestos, steel, dyes and lacquers, bitumen, pitch, iron, nickel, lead, fertilizer and certain other agents (OR=2.13, 95% CI=1.05-4.32); (3) nephrolithiasis (OR=4.52, 95% CI=1.34-15.30); (4) 'other' diseases in medical history such as chronic bronchitis, chronic rheumatic diseases, hypertension, cardiomyopathy, diabetes mellitus, renal diseases, eye diseases and tuberculosis (OR=3.14, 95% CI=1.56-6.33); (5) a greater number (> or = 3) of brothers (OR=2.08, 95% CI=1.35-3.22); and (6) greater numbers (> or = 8) of sexual partners (OR=2.24, 95% CI=1.13-4.44). Marital status, age at first marriage, educational level, age at first sexual intercourse, frequency of sexual intercourse, venereal diseases, tonsillectomy, appendectomy, hernia inguinale and hydrocele, anthropometric characteristics, smoking history, sport and recreational activities and family history of prostatic neoplasms were not found to be independently related to prostate cancer.

Adult↗