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Source of infection due to hepatitis B virus in Greece.

The possible source of infection due to hepatitis B virus (HBV) was investigated in 260 hospitalized adult patients with acute infections. Blood transfusions (30 patients, 11.5%), illicit drug use (16 patients, 6.2%), homosexuality (five patients, 1.9%), and possible iatrogenic transmission (77 patients, 29.6%) accounted for less than 50% of the cases of hepatitis. Thirty (29.4%) of 102 sexual partners were the most probable source of infection of the patients; three (2.9%) had a history of acute HBV infection two to six months before their partners were admitted to the hospital, and the remaining 27 (26.5%) were characterized as asymptomatic, chronic carriers of hepatitis B surface antigen (HBsAg). The HBsAg carrier rate was higher in men (47.5%) than women (12.9%) and in unmarried (31.6%) than married (25.3%) sexual partners. Hepatitis B e antigen and abnormal serum glutamic pyruvic transaminase levels were detected more frequently in sexual partners who were HBsAg carriers (29.6% and 48.1%, respectively) than in comparable control partners (2.6% and 5.4%, respectively).

Adolescent↗

Relevance of intravenous cocaine use in relation to prevalence of HIV, hepatitis B and C virus markers among intravenous drug abusers in southern Italy.

The purpose of this study was to analyze the relationship between intravenous (i.v) drug use practices and the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) in 146 heterosexual male i.v. drug users (IVDUs) attending a methadone-maintainance treatment program in Catanzaro, Southern Italy. One hundred and forty-six heterosexual male IVDUs attending a methadone-maintainance treatment program in Catanzaro were interviewed in order to obtain the following information: age, number of drug injections (calculated by multiplying the mean number of daily injections by 365 and then by the number of years of injections), number of injection equipment-sharing partners in the last year, number of sexual partners in the last year and possible IV cocaine use. Their sera were studied for the presence of antibodies to HIV, HBV and HCV by commercial enzyme-linked-immuno-sorbent assays run in duplicate. HIV positive samples were confirmed by Western Blot assay. Sixteen per cent of IVDUs were anti-HIV positive, 40% were anti-HBc positive and 68% were anti-HCV positive. Twenty-three per cent were seronegative and 12% were seropositive for all 3 viral markers. Multiple logistic analysis of HIV, HBV and HCV seropositivities in relation to age, number of drug injections, i.v. cocaine use and presence of injection equipment-sharing partners in the last year, showed that: a) older age (more than 27 years) was significantly associated with all 3 viral infections (mainly with HIV); b) i.v. cocaine use was associated with HBV, but even more with HIV; c) injection equipment-sharing partners in the last year was directly associated with HCV and inversely with HIV. No significant association was observed with the number of drug injections and the number of sexual partners. In conclusion, this study: a) demonstrates a difference of prevalence for HIV, HBV and HCV serum markers in this group of IVDUs from Catanzaro, Southern Italy; b) underlines the importance of i.v. cocaine use in the spreading of HIV; c) emphasizes the need of preventive strategies.

Adolescent↗

Parental influences on young people's sexual behaviour: a longitudinal analysis.

Both family structure and processes have been associated with young people's sexual behaviour, but most studies are cross-sectional and focus on only one outcome: age at first intercourse. This paper uses longitudinal data from a survey of Scottish teenagers (N=5041) to show how low parental monitoring predicts early sexual activity for both sexes (with some reverse causation), and for females it also predicts more sexual partners and less condom use. A lot of spending money also predicts early sexual activity and, for males, having more sexual partners. Comfort talking with parents about sex, however, seems to bear little relationship to sexual behaviour.

Adolescent↗

Sexual behaviour changes in a cohort of male sexual contacts of men with HIV disease: a three-year overview.

We describe the sexual behaviour reported by 240 seronegative and seropositive homosexual men over a 3-year period. Sexual partners of men with HIV disease were recruited into a prospective study between July 1984 and July 1985 and were monitored every 3 months thereafter. Data on sexual activities were collected through interviewer-administered questionnaires. The cohort experienced a reduction in both the number of sexual partners and the volume of sexual activity. Reductions in the number of partners were early and dramatic. Changes in sexual activities were gradual and consistent in trend. The greatest reduction occurred in high risk activities (receptive and insertive anal intercourse). After 3 years of follow-up, only 10% of the men continue to be exposed to semen through unprotected receptive anal intercourse and 18% through unprotected receptive oral-genital sex. The proportion of men engaging in oral-genital contact and masturbation remained stable over the 3 years. Once informed of their serostatus, both seropositive and seronegative men reduced their high risk behaviour. The decline in rates of STDs and seroconversion confirmed that this cohort had indeed reduced their high risk behaviour.

Cohort Studies↗

Long-term effects of an HIV/STI sexual risk reduction intervention for heterosexual couples.

This randomized clinical trial examined the relative efficacy of a relationship-based HIV/STI prevention intervention for women and their regular male sexual partners at 12 months post-intervention. A total of 217 couples were randomized to (1) a six-session intervention provided to the woman and her sexual partner together (n=81); (2) the same intervention provided to the woman alone (n=73); or (3) a one-session health information education "control" provided to the woman alone (n=63). Findings suggest the intervention was efficacious in reducing unprotected sex at 12 months post-intervention, compared with the education control group. No significant differences were observed when comparing whether couples received the intervention together or when the woman received it alone.

Adolescent↗

Risk reduction among injecting drug users: changes in the sharing of injecting equipment and in condom use.

In an investigation of risk behaviour among injecting drug users in the North-West of England, information was obtained concerning the sharing of injecting equipment, respondent's sexual partners and the use of condoms. Between six and nine months after the initial contact, 169 respondents (56%) were contacted again. The emphasis in the second phase of the project was on changes, if any, in risk behaviour that had occurred in the intervening period. Significant reductions were found in sharing, mostly in the more indiscriminate use of others' injecting equipment. No reduction was observed in sharing between injecting partners and little in sharing between close friends. The number of sexual partners had decreased and the use of condoms, although it increased among those involved in temporary relationships, remained low. Impediments to further progress in risk reduction are discussed.

Adolescent↗

Herpes simplex virus type 2 antibodies: high prevalence in monogamous women in Costa Rica.

We studied the prevalence of antibody to Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 766 randomly selected Costa Rican women 25-59 years of age in a national household survey in 1984-1985. Overall, 97.1% were seropositive for HSV-1 and 39.4% for HSV-2. Only 1.1% of HSV-2 seropositive women gave a history of symptomatic genital herpes. HSV-2 virus antibody increased with age and with the number of lifetime sexual partners. HSV-2 seroprevalence among women who reported only 1 lifetime sexual partner was almost twice as high as the prevalence among women who denied sexual experience (30.5% vs. 17.7%) and reached 79.2% among women with greater than or equal to 4 partners. HSV-2 seroprevalence was lower among women whose partners used condoms: 28.9% for those who had used condoms for at least 2 years vs. 44.3% for those who never used condoms.

Adult↗

The identification and tracking of Candida albicans isolates from oral lesions in HIV-seropositive individuals.

Restriction fragment polymorphism analysis was used to investigate the identity and genotypic relatedness of Candida albicans strains isolated from human immunodeficiency virus (HIV)-infected patients with or without oral candidiasis and from some of their sexual partners. Use of the species-specific DNA probe Ca3 revealed that most subjects carried a single distinct C. albicans strain throughout the course of the study, during both symptomatic and asymptomatic periods. Sexual partners were more likely to carry the same or similar C. albicans isolates than unrelated subjects, raising the possibility of transmission via intimate contact. One patient appeared to acquire his partner's isolate, which then became predominant in both partners in subsequent isolations. These findings indicate that recurrent oral candidiasis is usually caused by a single persistent strain unique to each patient, but that in some cases transmission via intimate contact may occur between sexual partners.

AIDS-Related Opportunistic Infections↗

Immunoglobulin A, G, and M responses to L1 and L2 capsids of human papillomavirus types 6, 11, 16, 18, and 33 L1 after newly acquired infection.

OBJECTIVES: We performed a study to establish the pattern of serological reactivity for immunoglobulins (Ig), to capsids of human papilloma virus (HPV) after new HPV infection in two groups of subjects. METHODS: The pattern of serological reactivity after acquisition of infection with HPV was investigated by measuring IgA, IgM, and IgG antibodies to capsids containing L1 and L2 proteins of HPV types 6, 11, 16, 18, and 33 in longitudinal studies of groups with different patterns of sexual activity. Individuals who tested negative for HPV DNA by the polymerase chain reaction at enrolment, but who became HPV DNA positive during follow up, were examined for antibodies to HPV capsids by enzyme linked immunosorbent assay. One group consisted of 15 young girls (with eight controls who remained HPV DNA negative) who were becoming sexually active and the other comprised 12 male (with five controls) and 35 female (with seven controls) heterosexual attenders of a sexually transmitted disease clinic who had had multiple sexual partners. RESULTS: The sexually inexperienced girls showed IgA and IgG responses, but seldom an IgM response to infection with HPV types 6/11, 16, and 18. No consistent pattern of serological reactivity was apparent for the heterosexuals with multiple partners. The lack of association between current HPV DNA positivity and detectable antibodies in these individuals was possibly related to the duration of infection or to prior exposure to HPV. For the latter group serological reactivity to HPV capsids was significantly greater in women than in men (p = 0.001, p = 0.003, and p = 0.024, for IgG to HPV 6, 11, and 16, respectively). CONCLUSION: The sex difference in antibody response detected in previous studies with assays based on peptide antigens was thus corroborated in the present study with capsid based serological assays. This sex difference might reflect a difference in sexual activity and prior exposure to HPV between men and women in this particular group.

Adult↗

Cervical intraepithelial dysplasia (CIN 3) and history of herpes genitalis (HSV2) in women living in Attica, Greece.

This article presents a study on women living in Attica, Greece (an area of 4.5 million inhabitants) who visited the outpatient clinics of two specialized hospitals for a follow-up for cervical intraepithelial neoplasia (CIN 3). A random sample of 170 women with CIN 3 and a control group of 195 women coming from the general population were interviewed. A semi-structured designed questionnaire was used as an instrument for data collection. The aim of the study was to search for a possible correlation between CIN 3 and a past history of herpes genitalis (HSV2) of the women and/or their partners. According to the results, CIN 3 is more frequent among women between 26 and 40 years of age. The majority of the patients (70.3%) reported a past history of HSV2, but only 10.9% of the subjects in the control group had the same medical history (p = 0.000). Sixteen percent of the patients and only 5.3% of the subjects in the control group reported infection of their sexual partners with HSV2. 75 patients (44.6%) stated that they did not know if their sexual partners had a past history of HSV2, while only 27 women (13.3%) in the control group reported the same (p = 0.000). Patients reported more sexual partners than women in the control group.

Adolescent↗

Human immunodeficiency virus infection risk among female sex partners of intravenous drug users in southern Arizona.

Epidemiologic data suggest that women who are sexual partners of intravenous drug users (IVDUs) are at increasing risk for infection with human immunodeficiency virus (HIV). The article reports a study describing living conditions, sex risk behaviors, knowledge about acquired immunodeficiency syndrome (AIDS), and perceptions of AIDS risk among female sexual partners of IVDUs living in southern Arizona. One hundred and twenty-three women who did not use IV drugs but had had sex with an IVDU in the last 6 months were interviewed. Eighty percent belonged to an ethnic minority, and 20% were white. Condom use was infrequent regardless of the number of sexual contacts. Sex was primarily heterosexual, with unsafe vaginal intercourse being the most common practice. Barriers to condom use were self-related and partner related. Some women lacked knowledge about sexual transmission of AIDS. All women reported getting AIDS information in the last 6 months and felt some risk of contracting the disease. AIDS risk reduction interventions should include HIV education and focus on barriers to condom use.

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↗

Prevalence and risk factors of asymptomatic chlamydial infection among students in Japan.

The objective was to determine the prevalence of asymptomatic Chlamydia trachomatis infection (CTI) among students in Japan, and to examine risk factors and methods of prevention. A total of 1004 students were analysed. Urine samples were checked for chlamydial DNA using polymerase chain reaction techniques. Prevalence of CTI was 8.3%. Risk factors were age and a history of four or more sexual partners for females, and history of CTI and contact with new sexual partners for males. Age did not represent a risk factor for male students. A correlation was identified between history of genital infection and experience with commercial sex workers for male students. Sex education programmes should be implemented encouraging use of condoms not only by students over 18 years, but also by senior high school students. Development of efficient and practical screening systems tailored to the current status of school health management in Japan is also needed.

Adolescent↗

High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China.

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). We investigated sexual risk, risk perception, HIV and condom knowledge, and utilization of prevention services in the first large sample of MSM recruited in Beijing. Four hundred eighty-two MSM were sampled from September 2001 to January 2002. Forty-nine percent of participants reported unprotected anal intercourse with men during the previous 6 months. However, only 15% perceived they are at risk for HIV and many had misconceptions about HIV transmission routes and limited knowledge about condoms. Less than one quarter obtained free condoms (24%) and condom lubricants (19%) in the past 2 years. Multiple logistic regression analysis showed that unprotected insertive anal intercourse was associated with not having a Beijing residence card, having six or more male sexual partners, not having sex with women, having a lifetime history of sexually transmitted diseases (STDs), and having never tested for HIV. Unprotected receptive anal intercourse was independently associated with having six or more male sexual partners, not having sex with women, having a lifetime history of STDs, having never tested for HIV, and having less exposure to HIV prevention services. In addition, 28% reported having sex with both men and women during the previous 6 months, and 11% had unprotected intercourse with both men and women. This finding suggests that MSM are a potential bridge of HIV transmission to heterosexual women (or vice versa) and that addressing the HIV prevention needs of MSM may benefit the wider population.

Adolescent↗

The etiology of non-specific urethritis in active duty Marines.

We studied patients with non-specific urethritis and control subjects at our dispensary. These patients and controls were matched for age, rank and sexual activity, and studied for the presence of bacteria, virus, Trichomonas and Mycoplasma. No significant bacteria were found in either group. No Trichomonas was identified, only 1 herpes II was recovered and no cytomegalovirus was found. Mycoplasma were cultured from patients and controls. The rate of colonization varied, depending upon several factors, but the significant factors seemed to be associated with the number of sexual partners. Those men with more than 1 sexual partner had a significantly increased colonization with Mycoplasma.

Adolescent↗

Cost-benefit analysis of selective screening criteria for Chlamydia trachomatis infection in women attending Colorado family planning clinics.

Women attending family planning clinics in Colorado during 1988 were screened for Chlamydia trachomatis infection by enzyme immunoassay (EIA, Chlamydiazyme, Abbott Laboratories; Abbott Park, IL). Cervical specimens from 11,793 women attending 22 family planning clinics were analyzed. Patient history and physical exams were used to assess risk factors for infection. A total of 913 individuals (7.7%) had positive culture results for C. trachomatis. Multivariate analysis showed that infection was significantly related to endocervical bleeding, cervical mucopurulent discharge, a new sexual partner in the last 3 months or multiple previous sexual partners (greater than 3) in the last year, pregnancy, the use of oral contraceptives, and age. Increased odd ratios were observed for the combination of endocervical bleeding and mucopurulent discharge and sexual history that included partners over the previous year as well as the most recent 3 months. A combination of these criteria was used to selectively screen women attending Colorado family planning clinics on an ongoing basis. A cost-benefit analysis employing a model reported previously showed a significant financial benefit associated with universal screening over either selective screening or no screening for C. trachomatis in this population.

Adolescent↗

The relationship between alcohol use and risk-taking sexual behaviors in a large behavioral study.

BACKGROUND: Sexually transmitted infections (STIs) present a continuing challenge to the efforts to prevent disease in the military. Since the degree of high-risk sexual behavior is a primary determinant for acquiring STIs, the identification of personality traits or situations associated with such behavior is of special interest. METHODS: Data for this study were obtained from the 1998 Department of Defense Survey of Health Related Behaviors Among Military Personnel. The survey instrument was a self-administered questionnaire that was conducted using a stratified, two-stage, two-phase probability design to obtain representative samples of U.S. active duty personnel worldwide. RESULTS: More frequent episodes of alcohol intoxication were associated in a dose-dependent manner with an increased risk of having more sexual partners in the previous 12 months. Men and women who experienced intoxication more than 3 days per week were, respectively, 4.55 and 6.18 times more likely to have more than one sexual partner in the previous year. CONCLUSIONS: This study is based on retrospective self-report and may be subject to recall bias as well as information bias due to the sensitive nature of the subject matter. However, the results are compatible with a personality-based hypothesis, in which individuals with certain sensation-seeking tendencies may incur an increased risk for sexually transmitted infections.

Adolescent↗

Timing of puberty and sexuality in men and women.

We examined the relations among timing of puberty, timing of first experience of sexual arousal, strength of sex drive, and sexual attitudes and behaviors in 277 men (M age, 22.4 years) and women (M age, 21.8 years). Kinsey had suggested that earlier maturers have a stronger sex drive and, therefore, engage in a higher frequency of sexual behaviors (including same-sex contacts) than do later maturers. The purpose of this study was to test Kinsey's claim. Participants completed questionnaires on pubertal timing, timing of first experience of sexual arousal, sex drive in adulthood, sexual attitudes (e.g., sociosexuality or degree of comfort with casual sex), and sexual behaviors (e.g., lifetime number of sexual partners). Timing of puberty (i.e., emergence of secondary sex characteristics) was related to these variables for men but not for women. Timing of first sexual arousal was related to several aspects of adult sexuality in both sexes, but particularly in women. Earlier first sexual arousal was associated with having a higher sex drive, a less restricted sociosexual orientation, and with having had more sexual partners than was later first sexual arousal. Earlier first sexual arousal, but not timing of puberty, was related to sexual orientation for women only. We discuss classes of explanations for these results.

Adult↗