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PubMed2001

Determinants of condom use intentions of university students in Ghana: an application of the theory of reasoned action.

The study examined the applicability of the Theory of Reasoned Action to the study of condom use intentions of students at a university in southern Ghana. The data supported the model, explaining 33% of the variance in students' condom use intentions. Subjective norms and the perceived disadvantages of condom use were significant determinants of intention, with the former being more important. Respondents who intended to use condoms consistently ("intenders") and those with no such intentions ("non-intenders") were equally motivated to comply with the wishes of their significant referents (sexual partners, close friends, parents and medical doctors). The critical difference was that "intenders" consistently held a stronger belief than "non-intenders" that their significant referents approved of condom use. Significantly, whereas "intenders" believed that their sexual partners would approve of condom use, the "non-intenders" held the contrary belief that their partners would disapprove of such behavior. This suggests that AIDS education interventions targeting a similar audience like the university students in this study should shift their foci away from individuals alone and instead, focus simultaneously on individuals, their sexual partners and their broader social networks in order to enhance perceptions of peer acceptance of condom use.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cervicovaginal human papillomavirus infection in suburban adolescents and young adults.

To investigate the prevalence rates of and risk factors for genital human papillomavirus (HPV) infection in white, middle-class adolescents, we obtained specimens for HPV from 107 patients undergoing pelvic examination at a suburban adolescent health service. Specimens were obtained by means of cervicovaginal lavage and were analyzed for HPV DNA by Southern blot analysis. The subjects' mean age was 18.5 (+/- 2.0 SD) years; 47% of the subjects were seen for contraception, 36% for possible pregnancy, 12% for a gynecologic complaint, and 5% for a general examination. We detected HPV in 32% of patients; HPV types included 6/11 (6%), 16 (3%), 18 (15%), 31 (3%), 42 (6%), 45 (18%), and 56 (6%). The DNA type was classified as uncharacterized in 47%, and 3% had more than one type. Univariate analysis revealed that patients found to have HPV were more likely to have more than two sexual partners, to have been sexually active for more than 2 years, to have had menarche before 12 years of age, and to have a history of sexually transmitted disease; logistic regression multivariate analysis demonstrated that number of partners and age at menarche were independent risk factors for HPV. These data indicate that HPV is common among sexually active teenagers regardless of ethnicity or socioeconomic status. The association of cervicovaginal HPV infection with sexual activity further supports the notion of the sexual transmission of this agent.

Adolescent↗
PubMed1990

Sexual behavior, venereal diseases, hygiene practices, and invasive cervical cancer in a high-risk population.

A case-control study of 759 women with invasive cervical cancer and 1430 controls in four Latin American countries evaluated risk in relation to sexual behavior, histories of specific venereal diseases, and hygiene practices. Early age at first sexual intercourse and increasing number of sexual partners were associated with significantly increased risks even after adjustment for their mutual effects. Risk increased to a twofold excess among women reporting first intercourse at 14 to 15 years of age compared with 20+ years. The number of steady sexual partners was a more important predictor of risk than the number of nonsteady partners, particularly before age 30, possibly reflecting the need for prolonged or repeated exposures to a transmissible agent, or different methods of protection against sexually transmitted diseases or pregnancy. Reported frequency of intercourse was not generally associated with risk, except among women reporting increased frequencies before 20 years of age. Histories of gonorrhea or crab lice were associated with increased risk, but histories of other venereal diseases were not significant predictors. No consistently increased risks were detected for women reporting specific hygiene or douching habits, except the practice of washing the genitalia infrequently during menstruation. These results provide support for a period of increased susceptibility to carcinogens during adolescence, and suggest that this may be an important determinant of the high incidence of cervical cancer in Latin America.

Adolescent↗
PubMed2005

Psychosocial correlates of U.S. adolescents who report a history of forced sexual intercourse.

BACKGROUND: A comprehensive assessment of the psychosocial risk profiles of adolescents who report forced sexual intercourse remains an important gap in the literature, precluding meaningful discussion of the implications of such experiences. METHODS: Ninth through twelfth grade high school adolescents (n = 13,601) who completed the 2001 national Youth Risk Behavior Survey were participants. Multivariate logistic regression was used to examine all significant independent relationships. RESULTS: The lifetime prevalence of forced sex for females and males was 10.2% and 5.1%, respectively. For the overall sample, feeling sad/hopeless(odds ratio [OR] 1.9), having considered (OR 2.1) or attempted (OR 1.4) suicide, being a victim of physical dating violence (OR 2.8) heavy cigarette use (OR 1.4), binge drinking (OR 0.7), having multiple recent sexual partners (OR 8.3) and unprotected sex (OR 1.7) were correlated with a history of forced sex. Among females, associations were found among sad/hopeless feelings (OR 1.6), having considered suicide(OR 2.2), fighting (OR 1.3), physical dating violence (OR 2.1) heavy cigarette use (OR 1.8), multiple sexual partners (OR 9.3) , alcohol/or drug use before sex (OR 1.6) and unprotected sex (OR 1.5). Among males, associations were found among sad/hopeless feelings (OR 1.8), attempted suicide (OR 1.9), gun carrying (OR 1.8), physical dating violence (OR 4.3), multiple sexual partners (OR 7.8), unprotected sex (OR 1.9), and other ethnicity (OR 3.3). CONCLUSIONS: Although a history of forced sexual intercourse affects a small number of adolescents, it is an important public health issue. The psychological and behavioral correlates of forced sexuality suggest that these youth have been harmed and may further place themselves in harm's way. Furthermore, the profiles of adolescent females and males who report such experiences are distinct in ways that warrant their independent examination and attention.

Adolescent↗
PubMed1995

Strategies for limiting the spread of HIV in developing countries: conclusions based on studies of the transmission dynamics of the virus.

Possible interventions to reduce the spread of human immunodeficiency virus (HIV) include actions that attempt to alter sexual behaviour, such as education aimed at reducing the rate at which individuals acquire new sexual partners, and methods that reduce the probability of transmission between partners, such as the promotion of condom use and the treatment of so-called "cofactor" sexually transmitted diseases. A mathematical model of HIV transmission that is able to mimic different approaches to the control of HIV transmission is employed to study the relative values of different approaches, either used in isolation, or in combination. The nonlinear nature of the term that describes the per capita rate of transmission dictates that for a given degree of intervention, the benefit accruing in terms of reduced HIV spread depends on the prevalence of infection before the introduction of control. Benefit is greatest when HIV prevalence is low. Combination approaches are predicted to be effective but the outcome is less than would be expected on the basis of simply summing the benefits resulting from each type of intervention used in isolation. The success of targeted interventions, aimed at those with high rates of sexual partner change, depends on the heterogeneity in levels of sexual activity within populations and what proportion of the population HIV is able to establish itself in. Targeted interventions are predicted to be very cost effective but their overall success in reducing HIV spread by a significant degree depends on the timing of their introduction (within the time frame of the development of the epidemic) and the pattern of mixing between different risk groups or sexual activity classes.

Adolescent↗
PubMedDate not supplied

A voluntary serosurvey and behavioral risk assessment for human immunodeficiency virus infection among college students.

The authors conducted a voluntary serosurvey and educational campaign among 3394 undergraduate students attending the University of Maryland at College Park to determine the prevalence of and risk factors for human immunodeficiency virus type 1 (HIV-1) infection. Two students were seropositive (0.06%, 95% confidence interval 0-0.15%). Both were homosexual men with multiple sexual partners. Despite the low prevalence of infection, potential risk factors for transmission of HIV-1 were common, as assessed by a self-administered anonymous questionnaire. These included a previous sexually transmitted disease (12.6%), male homosexual intercourse (4.8% of men), heterosexual anal intercourse (25.3%), heterosexual intercourse with a person at risk (an HIV-1 infected person, a bisexual man, a parenteral drug user, a female prostitute, or a hemophiliac) (5.2%), multiple sexual partners (21% reported 10 or more lifetime partners), and intravenous drug use (1.3%). Assessment of the efficacy of our program by comparing responses on pre- and post-test questionnaires showed gains in knowledge about heterosexual transmission of HIV-1 and an increase in the reported frequency of condom use 1-2 months after participating in the survey. The authors conclude that HIV-1 infections are occurring among college students but in our study group remain confined to persons with known high-risk behavior; however, practices that may support transmission are common, and programs designed to diminish these behaviors among college students are needed.

Adolescent↗
PubMed2001

High prevalence of antibodies to herpes simplex virus type 2 among middle-aged women in Mexico City, Mexico: a population-based study.

BACKGROUND: Herpes simplex virus type 2 (HSV-2) is among the most prevalent sexually transmitted diseases worldwide. In Mexico there is a lack of population-based HSV-2 surveys. GOALS: To determine population-based HSV-2 seroprevalence and risk factors among women in Mexico City. STUDY DESIGN: A random sample of 730 women was identified among the residents of Mexico City. Women ages 25 to 85 years were selected from 3,694 households. Western blot serology testing was conducted on serum samples to determine HSV-2 type-specific serostatus. A structured questionnaire was administered, and multivariate analyses were performed to identify risk factors for HSV-2 seropositivity, which were stratified into two age categories: younger than 50 years of age and 50 years of age or older. RESULTS: The HSV-2 seroprevalence among female participants was 29.8%, with a significant trend of increasing HSV-2 prevalence for each higher level of age (P < 0.001). Female participants had a median age of 46 years and were predominantly monogamous (82.6%). The overall population-based seroprevalence estimated in Mexico City among women was 35.8%. The independent risk factors for HSV-2 seropositivity included a history of two or more sexual partners (odds ratio [OR], 2.2; 95% CI, 1.4-3.4), two or more sexual partners before first pregnancy (OR, 2.3; 95% CI, 1.4-3.7), cohabitation with partner (OR, 2.5; 95% CI, 1.3-4.7), and current vaginal douching (OR, 1.7; 95% CI, 1.2-2.6). CONCLUSIONS: Population-based HSV-2 seroprevalence is endemically high among middle-age women in Mexico City, and clearly is correlated with higher-risk sexual behavior. This elevated HSV-2 seroprevalence may reflect unrecognized HSV-2 transmission throughout life.

Adolescent↗
PubMed2006

Psychological correlates of trading sex for money among African American crack cocaine smokers.

This article compares demographic characteristics, sexual practices, and psychosocial status among 193 African American female crack cocaine users who currently, previously, or never traded sex for money. Current traders were less likely to have a main sexual partner, more likely to have a casual sexual partner, and more likely to smoke larger quantities of crack. There was a significant trend towards current traders reporting lower self-esteem, greater depression and anxiety, poorer decision-making confidence, more hostility, less social conformity, greater risk taking behaviors, and more problems growing up, compared to previous and never traders. These differences suggest that interventions should address self-esteem, risk-taking practices, depression and anxiety as well as other psychosocial factors.

Adolescent↗
PubMed1993

Risk factors associated with cervical human papillomavirus infections: a case-control study.

As a part of the long-term prospective follow-up study conducted for women with genital human papillomavirus (HPV) infections in Kuopio University Hospital, Finland, since 1981, a case-control study was designed to assess risk factors for genital HPV infections. The cases (n = 691) were women who had been invited to attend the follow-up program on the basis of an abnormal cervical smear consistent with HPV-induced cytopathic changes, i.e., had a clinical HPV infection. The controls (n = 706) were a randomly selected group of women who had normal smears in the screening. Both groups were asked to fill in an extensive questionnaire focusing on detailed epidemiologic data on previous gynecologic and obstetric history, sexual practices, sexual partners, and smoking habits. In the multivariate analysis, eight variables emerged as independent risk factors for prevalent HPV infection. These variables could explain over 80% of the risk for infection. The risk for the infection varied with age, being highest in the age group 20-29 years, thereafter declining in the following 10-year age groups. The strongest independent risk factor was the number of sexual partners during the past 2 years (adjusted odds ratio = 12.1; 95% confidence interval 4.3-33.8 for five or more vs. one or no partners). Among the independent risk factors that increased the risk were also current smoking (adjusted odds ratio = 2.7; 95% confidence interval 1.7-4.3), warts in sexual partner(s) (adjusted odds ratio = 3.2; 95% confidence interval 1.6-6.5), and increasing frequency of sexual intercourse per week. Independent risk factors with a protective effect included a normal result in the last Papanicolaou smear, regular use of an intrauterine device as a contraceptive method, and good personal hygiene. No significant association between oral contraceptive use and risk for HPV infection was found. Condom use did not result in protection from the infection. The results of this study support the concepts that sexual intercourse is the main form of transmission among adults and that sexual promiscuity is the most important determinant for genital HPV infections.

Adolescent↗
PubMed1994

Primary infertility: characteristics of women in North America according to pathological findings.

STUDY OBJECTIVE: To determine, in women with primary infertility, whether specific characteristics or behavioural factors are associated with the various pathological conditions identified as contributing to the infertility. DESIGN: Case-control study. SETTING: Seven institutions in the USA or Canada. PARTICIPANTS: Study subjects were 1750 women who presented with primary infertility, among whom the main pathological cause of infertility was male factor (417), tubal obstruction (231), endometriosis (194), luteal phase defects (153), other ovulatory problems (193), cervical abnormalities (92), and polycystic ovarian disease (84) and 1765 control women who delivered their first child at the same institution. MAIN RESULTS: Except for tubal obstruction and polycystic ovarian disease, the characteristics and behaviours of the women with infertility did not differ appreciably according to the pathological conditions recorded. Women with tubal obstruction had had more sexual partners, an earlier age at first intercourse, were more likely to have used an intrauterine device but less likely to have used a condom, and were more likely to have smoked cigarettes and to have used various recreational drugs than the other women. Women with polycystic ovarian disease were more obese, had had fewer sexual partners, and were less likely to have used cigarettes, contraceptives, and recreational drugs than the other women. CONCLUSIONS: Sexually transmitted infections seem to increase the risk of tubal obstruction but not other causes of infertility. Obesity is associated with polycystic ovarian disease. These data offer few clues to the aetiology of infertility attributed to endometriosis, cervical abnormalities, luteal phase defects, other ovulatory defects, or to male factors.

Age Factors↗
PubMed1990

[The risk factors of invasive carcinoma of the cervix uteri in Latin America].

A study of 759 patients with invasive cervical cancer, 1,430 controls, and 689 sexual partners of the participants who declared that they were monogamous was conducted in Colombia, Costa Rica, Mexico, and Panama from January 1986 to June 1987, to evaluate the risk factors associated with this neoplasm. The principal risk factors identified were: initiation of sexual relations by the woman at an early age, number of stable sexual partners (relationships of more than three months' duration), number of liveborn children, presence of DNA from human papilloma virus (HPV) types 16 or 18, history of venereal disease, lack of exposure to early detection programs, deprived socioeconomic conditions, and number of sexual partners of the partners of the monogamous women. Smoking increased the risk in those women who were shown to have DNA from HPV types 16 or 18. Fifty percent of the patients and 29% of the controls said they had never had a cytological examination (Papanicolaou test). No association was observed between the presence of HPV and sexual behavior. The study showed the need for further research on the possible mechanisms involved in carcinogenesis and infection. The common denominators of the risk factors mentioned are underdevelopment and poverty, which affect broad sectors of these populations. Mass detection programs targeting high-risk groups can reduce the high incidence of cervical cancer in Latin America.

Age Factors↗
PubMed1988

Human immunodeficiency virus and female prostitutes, Sydney 1985.

One hundred and thirty two female prostitutes and 55 non-prostitutes who were tested for antibodies to human immunodeficiency virus (HIV) were surveyed by questionnaire at this centre. The two groups were well matched for age and were very similar in other except for numbers of their sexual partners. Questions were asked about drug taking, sexual practices, general health, and episodes of sexually transmitted diseases (STDs). None of the women in the survey was found to be seropositive, but both groups were found to be seriously at risk of HIV infection through using intravenous (IV) drugs, having unprotected sexual intercourse with men who used IV drugs, having unprotected sexual intercourse with bisexual men, or exposure to several STDs.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Sexual behaviour in women attending a genitourinary medicine clinic.

In 1025 women attending a genitourinary medicine (GUM) clinic, sexual experience had started at an increasingly early age during the past 30 years, from a mode of 19 in the early 1950s to 16 in the early 1980s. Up to the age of 40, sexually active older women had as many recent sexual partners as younger women. Oral intercourse (fellatio) was practised by 714 (70%) women, and 378 (37%) experienced ejaculation in the mouth. Anal intercourse was practised by 200 (20%) women and 90 (9%) experienced ejaculation in the anorectum. The prevalence of all these practices increased with age. Women attending a Family Planning Association (FPA) clinic reported a similar prevalence of these practices, and differed from GUM clinic women only in the number of sexual partners in the preceding year. In the GUM group, black women reported significantly fewer recent sexual partners than did white women, and significantly fewer black women practised oral intercourse or permitted anal penetration. Full anal intercourse with ejaculation into the anorectum was practised at least occasionally by 9% (80/873) of white and 8% (10/131) of black women.

Adult↗
PubMed1991

Contraception and sexuality in an area-specific group of Swedish women 15-34 years of age.

In a community-based study in a Swedish suburban/rural area, all women aged 15-34 years (n = 671) were invited to the local health centre to be examined for chlamydia infection and for an interview. The attenders were asked about contraceptive history, age at first intercourse, number of life-time sexual partners and socioeconomic background. The net attendance was 69%, and contraceptive information on an additional 20% could be gathered through medical records. The average age at first intercourse was around 16 years, and the average number of sexual partners in the age-groups 20-24, 25-30 and 31-34 years was 4.0, 5.6 and 6.1, respectively. Of all women, around 75% had used contraception at first intercourse, and there was no tendency to a changing pattern during the past 20 years studies through the interviews. Combined estrogen-progestagen pills were by far the most used contraceptive method, presently being used by 42% of the contracepting women, followed by condom (23%), IUD (19%) and other hormonal methods (10%). It is concluded that sexual life in Sweden starts earlier than it did 30 years ago, that the number of sexual partners is higher, that most women in the studied group were efficient contraceptors, and that hormonal contraception was by far the most common method.

Adolescent↗
PubMed1990

[The incidence of gonorrhea as an indicator for prevention of AIDS in Greenland].

The first case of HIV infection in Greenland was demonstrated towards the end of 1985 and, since then, a general informative campaign was instituted and teaching material about AIDS and HIV infection were prepared for use in schools. This activity was particularly great in 1987 and 1988. The main messages were 1) use of condoms and 2) reduction in the number of sexual partners. The incidence of gonorrhoea has been very high for many years in Greenland and the incidence of gonorrhoea was employed as indicator for the effect of the prophylactic campaign. Investigation revealed a decrease of 67% during the period 1985-1988. The decrease was particularly great in 1988 (58%). There appears to be a direct connection between this observation and the two main messages of the campaign as the employment of condoms increased tenfold during the period 1986-1988 end contact investigations revealed a decrease in the number of unknown sexual partners. On the other hand, no definite decrease in the total number of sexual partners was reported by patients attending the clinic for Venereal Diseases in Godthåb. It is emphasized that the incidence of gonorrhoea has decreased markedly but it is still considerably higher than the incidence in Denmark. Continued and active prophylactic efforts are still required.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Who pays for sex? An analysis of the increasing prevalence of female commercial sex contacts among men in Britain.

BACKGROUND: In the United Kingdom the incidence of sexually transmitted infections (STI) and risky sexual behaviours is increasing. The role of commercial sex in this trend is poorly understood. Little is known about the men who pay for sex. We examined the epidemiology of female commercial sex contacts reported by men in 1990 and 2000. METHODS: National probability sample surveys of sexual attitudes and lifestyles (Natsal) of men aged 16-44 resident in Britain in 1990 (n = 6000) and 2000 (n = 4762). RESULTS: The proportion of men who reported paying women for sex in the previous 5 years increased from 2.0% (95% CI 1.6 to 2.5) in 1990 to 4.2% in 2000 (95% CI 3.6 to 4.9). In both surveys, paying for sex was more frequent in men aged between 25 years and 34 years, who were never or previously married, and who lived in London. There was no association with ethnicity, social class, homosexual contact, or injecting drug use. Men who paid for sex were more likely to report 10 or more sexual partners in the previous 5 years; only a minority of their lifetime sexual partners (19.3%) were commercial. They were more likely to meet partners abroad and to report previous STI. Only 15% reported having had an HIV test. CONCLUSION: The proportion of men who reported paying for heterosexual sex has increased, and these men have multiple commercial and non-commercial partners. Their higher rates of STI and low level of HIV testing suggest the need for prevention interventions for clients as well as sex workers.

Adolescent↗
PubMed1991

Sexual behaviors of intravenous drug users in treatment.

Sexual behaviors of a group of 313 intravenous drug users (IVDUs) (225 men, 88 women) were assessed by a structured interview at the start of an AIDS prevention project. Although the majority were celibate or monogamous during the prior year (men 52.5%, women 64.3%), many IVDUs had multiple sexual partners in that time, including 19.6% of men and 7.2% of women reporting five or more. Married male and female IVDUs were more likely to have multiple sexual partners than married people in general population samples. Only 38.5% of male and 35.4% of female IVDUs ever used condoms during the previous 5 years. Percentage of sexual encounters in which condoms were used correlated significantly with the number of partners for women (r = 0.37, p less than 0.01), but not for men (r = 0.03, ns). Use of intravenous drugs in the prior year, sharing of needles, use of stimulants, exchange of sex for money or drugs, and combining sexual events with drug use were all associated with greater numbers of sexual partners. A subset of male IVDUs engages in the dual-risk behaviors of needle sharing and unprotected intercourse with multiple partners. This group could act as a highly efficient vector for human immunodeficiency virus transmission and should become a focus of intensive preventive intervention.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Severity of alcohol dependence and social functioning of male patients with alcoholism. I. Functioning in the sharing of marital roles].

The relations between social functioning and severity of alcohol dependence of 40 male patients from Dependence Treatment Ward in Bydgoszcz were studied. Using the MAST, CAGE, and self clinical scale the cohort was divided into two groups: less and more severe dependent probands. The demographic and social data of patients from both groups did not differ significantly. Social functiong was evaluated by use the Scale of Social Roles taking into consideration the set of marital roles (with basic roles of sexual partner, friend, guardian, and family support). The disposition to perform the role, privileges, fulfilling the duties, activity, and harmonization of the role were estimated in each of the role mentioned above and in every patient. It was shown that subjects more dependent on alcohol are significantly less active in the role of sexual partner and in support of family, as well as are less effective in performing such roles and are more egoistic in the role of sexual partner than men less dependent on alcohol. No differences were found in other roles among studied groups. The revealed differences were discussed in the aspect of psychologica and interactive hanges in marital couple.

Adult↗