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[Mycoplasma hominis and Ureaplasma urealyticum in different gynecologic diseases].

The incidence of Mycoplasma hominis (M. hominis) y Ureaplasma urealyticum (U. urealyticum) was investigated in 113 endocervical samples obtained from women who were seen for different gynecological pathologies. Forty-seven (42%) patients were positive to these microorganisms; 26 cases (23%) were positive for M. hominis and 21 (19%; p = NS) for U. urealyticum. Average age was 32.1 +/- 7.7 years; the average number of sexual partners was 1.7 +/- 1.1. Eleven of 17 patients with 3 o more sexual partners were positive for Genital Mycoplasma (GM), and U. urealyticum was found more often in this group. A higher incidence of GM was found in women between 26 and 30 years (34%); 57.5% of the patients with positive cultures for GM had begun sexual activity before 20 years of age. M. Hominis was found in 61% of women with no parity and U. urealyticum in 71% of parous women. The cultures were positive in 10 of 14 patients with pelvic inflammatory diseases (PID). A cervical biopsy was taken from 52 cases and the diagnosis of cervical intraepithelial neoplasia (CIN) was made in 49 (94%) but only 24 of them were positive for GM (50%). Thirty-five patients suffered sterility, and 12 (34%) were positive for GM, however all positive cases consulted because of primary sterility. The conclusions obtained from this study are: 1) Near half of the patients was positive for GM and none of the species was predominant over the other. 2) The more sexual partners the higher was the incidence of GM, especially U. Urealyticum. 3) The lower the age of the first sexual intercourse the higher the probability of contamination with these microorganisms. 4) M. hominis was more common in nulliparous women and U. urealyticum was found more often in parous patients; the number of deliveries did not have influence in these findings. 5) A statistical significance between GM and PID was found (p = 0.03). 6) GM have no influence on spontaneous abortion. 7) No statistical significance was found between GM and the beginning and evolution of CIN. 8) No relation statistically significative was found between GM and sterility.

Adolescent↗

Mass Media, Sex, and Sexuality.

The average age of first sexual intercourse, the high rate of teenage pregnancies, and the spread of sexually transmitted diseases indicate the extent to which sex and sexuality have created major threats to adolescent health. A crucial factor is the highly sexual content of the media. The authors examine factors that determine selection of and reaction to sexual content in the media, including gender and racial differences and family structure.

Journal Article↗

AIDS knowledge, condom attitudes, and risk-taking sexual behavior of substance-abusing juvenile offenders on probation or parole.

AIDS knowledge, condom attitudes, and sexual behavior were examined in a sample of 193 substance-abusing juvenile offenders on probation or parole. The majority of these youths reported being sexually active, and many admitted to early onset of sexual activity as well as unsafe sexual practices. Potential predictors of condom use by these juveniles were examined including age, condom use at first sexual experience, number of sexual partners in the last 6 months, locus of control, AIDS knowledge, condom attitudes, perceived risk for AIDS, self-efficacy for avoiding HIV, condom use by peers, delinquency risk, race, and gender. General attitudes toward condoms and the reported use of a condom at first sexual intercourse experience were the only statistically significant predictors of subsequent condom use. The relevance of these findings to the development of AIDS prevention programs for juvenile offenders is discussed.

Acquired Immunodeficiency Syndrome↗

Comparison of sexual behaviors between male homosexuals and male heterosexuals in Taiwan.

BACKGROUND: Homosexuality and sexual behavior have attracted great attention in the acquired immunodeficiency syndrome (AIDS) epidemic. This study primarily explores the risky behaviors and patterns of sexual behavior of male homosexuals in Taiwan. METHODS: Comparison study methodology was adopted. Ninety-two male homosexuals, as the study group, were recruited from gay bars and gay organizations, and 91 male heterosexuals, with similar ages and educational levels, were recruited as a control group for comparison. Semi-structured interviews were carried out and anonymous questionnaires were self-administered. RESULTS: (1) The mean age at the time of first sexual intercourse of the study group was younger than that of the control group. (2) The rate of having two or more sexual partners in the study group was significantly higher. (3) However, the rate of condom use during recent intercourse was higher in the control group than in the study group. (4) Sexual knowledge and attitudes toward sexuality in the study group were more open, but their sexual desires, as rated by the questionnaire, were more suppressed than those of the control group. (5) In terms of courtship, the study group was less constrained by the social values of marriage and tended to separate sex from love. CONCLUSION: Similar to western studies, our study found that the study group in Taiwan adopted more risky sexual behaviors. Each group had its particular sexual behavioral pattern and subculture of sexuality. However, a longitudinal follow-up study with ethnographic perspective is necessary for a more sophisticated understanding of the trends and changes of sexual behavior in homosexuals.

Adolescent↗

Sexual behaviour and HIV knowledge among Dermatology cum Genitourinary Clinic attendees, Johor Bahru, Malaysia.

A study was conducted in the Dermatology cum Genitourinary Clinic, Hospital Sultanah Aminah Johor Bahru to determine a local population's knowledge of HIV and their sexual behaviour in relation to it. A total of 231 men and 217 women were interviewed. The sexual culture seen is one of relatively late age of first sexual intercourse, low level of partner change and low level of condom use. Men reported a higher involvement in risk behaviour. Nearly all the respondents (95.8%) have heard of HIV/AIDS but had incorrect perceptions of its mode of transmission and its associations with risk groups. This study enable us to gain background information about our patients sexual behaviour and HIV knowledge. There is a need to continue HIV education to improve our public's HIV knowledge and the results of this study provides a baseline against which future educational interventions can be gauged.

Adolescent↗

[Beliefs, attitudes and knowledge about sex education].

BACKGROUND: Previous reports show that Chilean teenagers have an inadequate knowledge about sexuality and reproduction. AIM: To compare the knowledge about sexuality among adolescents coming from private and public schools, with and without sexual education programs. MATERIAL AND METHODS: A structured anonymous inquiry, containing multiple choice and open questions, was applied to a sample of 229 adolescents attending seventh and eighth grade of junior school, in private and public schools of Temuco, Chile. RESULTS: Eleven percent of adolescents had already their first sexual intercourse at a mean age of 12.2 +/- 2.4 years old. Of these, 96% came from public schools. An overall analysis of tests, disclosed a 53% of correct answers to the inquiry. Adolescents coming from private schools had a better performance than those coming from public schools. Sexual attitudes were not influenced by sexual education programs. CONCLUSIONS: Adolescents coming from private schools have a better sexual knowledge level and more conservative attitudes towards sexuality. Overall knowledge is inadequate albeit overvalued. These teenagers are high risk group for unwanted pregnancies and sexually transmitted diseases and require efficient sexual education programs.

Adolescent↗

[Cervix uteri lesions and human papiloma virus infection (HPV): detection and characterization of DNA/HPV using PCR (polymerase chain reaction].

The prevalence of human papillomavirus (HPV) genotypes was estimated by the polymerase chain reaction (PCR), in archival paraffin was embedded tissues. The case group consisted of 84 women aged 21-67 years (mean, 40 years) who were referred to the Department of Gynaecology (Oncology Centre, Coimbra) with citopathologically abnormal smears. This group was selected from a population of women who had undergone a screening programme (1990/94) in Central Region of Portugal. All these patients (n = 84) had a colposcopic directed cervical biopsy. HPV detection and typing was performed by the PCR method in the Department of Virology (National Health Care Institute, Lisbon). The prevalence of DNA/HPV found, concerning all epithelial cervical lesions studied and classified as squamous intra-epithelial lesions (SIL) and cervical cancer was 97.8%. On the basis of the data presented in this study, it was estimated that there was a statistically significant prevalence of low risk HPV types (HPV 6/11) in low grade SIL, 83.3%, and a statistically significant prevalence of high risk HPV types (HPV 16,18,31,33,51) in high grade SIL, 58.4%, as well as cervical cancer lesions in 100%. We conclude that there was a statistically significant difference between women with low and high grade SIL for HPV infection, with low and high risk HPV types, respectively. The risk factors for cervical cancer investigated (age at first sexual intercourse, multiple sexual partners, parity, use of oral contraceptives) were not associated to statistically significant differences concerning low grade SIL and high grade SIL. The clinical and therapeutic procedures were evaluated for the same five years (1990/94). It may be concluded that there would be no significant difference in clinical procedure for high grade lesions and cervical cancer, in which the treatment had been frequently radical (cone biopsies, simple or radical hysterectomy) and in which the HPV infection persisted frequently and was associated to high risk types (HPV 16 in 50% of these cases). On the other hand, it may be concluded that HPV detection in cervical biopsies, especially for low grade SIL lesions, which were evaluated in this study with a more conservative procedure (clinical evaluation only, punch biopsies, loop diathermy, CO2 laser vaporisation, cone biopsies), could identify women with high risk HPV types who might be at risk of developing dysplasia and cervical cancer.

Adult↗

Characteristics of clients attending confidential versus anonymous testing clinics for human immunodeficiency virus.

OBJECTIVES: To compare risk behavior between subjects attending anonymous and confidential clinics for human immunodeficiency virus testing, and to assess whether anonymous testing results in a higher accrual of persons at risk for HIV. METHODS: An anonymous questionnaire that addressed sociodemographic and risk behavior aspects was administered to 140 subjects attending an anonymous clinic and 124 attending a confidential clinic in the Tel Aviv area. A logistic regression analysis was used to compare the effects of various behavioral factors on the probability of attending each clinic. RESULTS: Chronological age, age at first sexual intercourse, and the percent of married subjects were similar in both clinics. However, there was a significant difference in the sex ratio and in educational attainment (85.0% versus 55.6% were males, P < 0.001; and 58% vs. 34% had over 12 years of education, P < 0.001, in the anonymous and confidential clinics respectively). There was a striking difference between the two clinics with regard to sexual experience characteristics: of the subjects reaching the anonymous clinic 21.4% were homosexual and 10.0% bisexual versus a total of 2.6% in the confidential clinic. A logistic regression analysis, comparing the effects of various behavioral factors on the probability of attending each clinic, showed that gender (male), high education, homosexuality, number of partners and sexual encounter with sex workers were the strongest predictors for selecting anonymous HIV examination. CONCLUSIONS: Individuals at high risk for HIV, such as homosexuals and bisexuals, prefer to attend an anonymous clinic.

AIDS Serodiagnosis↗

[Impaired fertility in women infected with HIV-1. Implications for sentinel serosurveillance].

BACKGROUND: Given the relationship between HIV infection and fertility, antenatal clinic-based HIV prevalence may not provide a good estimate of the community HIV prevalence. The objective of this work was to evaluate the impact of HIV infection on fertility among women attending antenatal clinics in Bobo-Dioulasso (Burkina Faso), and to discuss possible implications on HIV sentinel surveillance. METHODS: In the context of a phase II/III clinical trial of a short course of Zidovudine during pregnancy (DITRAME - ANRS 049 trial) we consecutively proposed voluntary counselling and HIV testing (VCT) to 1349 women aged at least 18 years, carrying a pregnancy of 7 months or less and living in Bobo-Dioulasso. During pre-test counselling session, a standardised questionnaire was administered to collect detailed information regarding socio-demographic characteristics and obstetrical history. Blood samples were then taken and tested for HIV after written informed consent. RESULTS: Mean age (+/- standard deviation) at first sexual intercourse was similar among HIV-infected (HIV+) (16.7+/- 2; n=83) and HIV-negative (HIV-) women (16.9+/- 2; n=1336). However, HIV+ women aged 25 years and above had, on the average fewer pregnancies (3.8+/- 1.5; n=37) than HIV- women (5.0+/- 2.3; n=567), p<0.01. Similarly, these HIV+ women had, on average, less live births (2.8+/- 1.3; n=35) than HIV- ones (3.7+/- 2.1; n=555), p=0.02. Other sexual and obstetrical characteristics such as maternal age, proportion of primigravidae, stillbirths or spontaneous abortions were comparable between HIV+ and HIV- women. CONCLUSIONS: Our data suggest that the level of fertility of HIV+ women aged 25 years and above is significantly lower than for HIV- women. Therefore, HIV+ women in this age group are likely to be under-represented among antenatal clinic attendees. These findings suggest adjusting antenatal clinic-based HIV sentinel surveillance data for age and fertility in order to derive a good estimate of the community HIV prevalence.

AIDS Serodiagnosis↗

[Contraception knowledge and practices in pregnant adolescents].

The purpose of this article is to describe the knowledge and the background in the use of contraceptive methods in 100 pregnant adolescents in the prenatal care of the Hospital General "Dr. Manuel Gea González". In our study it was showed a lack of knowledge regarding the methods during the first sexual intercourse in the half of cases. At the time of the interview, only one-third of the adolescents had a suitable knowledge on at least one constraceptive method. It is very important for pregnant adolescents to have access to sex education including the use of contraceptive methods. This in turn, should impact positively to postpone the next pregnancy.

Adolescent↗

[Survey on the high risk behaviors related to acquired immunologic deficiency syndrome and sexually transmitted diseases among men who have sex with men in mainland China].

OBJECTIVE: To understand the high risk behaviors related to acquired immunologic deficiency syndrome (AIDS) and sexually transmitted diseases (STDs) among men who have sex with men (MSM) in mainland China. METHODS: A self-administrated anonymous mail survey was carried out in MSM throughout the mainland of China in 1999. RESULTS: One thousand eight hundred questionnaires were mailed out and 729 effective questionnaires were collected. The response rate was 40.5%. The average age of subjects was 31 years old. Their average age at first sexual intercourse with a man was 18.6 years old. Average number of male sexual partners were 39.2 out of which 75.7% reported having had anus-intercourse. In the latest year, 63.6% reported ever having sex with strange men, 39.8% reported ever having group sex, 9.3% reported having sold sex and 3.8% having bought sex. 50% of them reported ever having sex with women. One hundred thirty-three reported having been diagnosed STD. Sixty-two reported having tested for HIV antibody and 11 were positive. Two-thirds reported ever using a condom when having sex. CONCLUSION: High risk sexual behaviors were prevalent among MSM in mainland China with HIV infection rate already reaching a high level. Women having sex with MSM are at a greater risk of HIV infection.

Acquired Immunodeficiency Syndrome↗

[Analysis of risk factors for cervical cancer in Xiangyuan County, Shanxi Province].

OBJECTIVES: To investigate the risk factors for cervical cancer in the areas of high incidence, and provide evidence for current intervention of cervical cancer. METHODS: In the areas of Xiangyuan County, Shanxi Provicne with high incidence of cervical cancer, 1 997 women were interviewed using a questionnaire, including baseline information, menstrual, marital and pregnancy histories, sexual behavior, health habits, contraception, medical history and family history of cancer, etc., after its screening with six kinds of methods. All subjects, including 84 cases with pathological diagnosis of greater than cINI, and 1 784 cases with pathological diagnosis of normal, were tested for high-risk HPV. RESULTS: The overall rates of HPV infection were 20.8% (415/1 997) in high-risk subjects, 97.7% and 14.2% in the cases and control groups, respectively. Univariate analysis showed that risk factors with statistical significance included high-risk HPV infection, age at first sexual intercourse, history of pregnancy and abortion, the number of sexual partners and family history of cancer. Analysis with non-conditional logistic regression model revealed high-risk HPV infection, multiple sexual partners and family history of cancer associated obviously with occurrence of cervical cancer. In addition, there was significantly positive relationship between HPV infection, which increased with the number of sexual partners, and extramarital sexual activity both in males or females. CONCLUSIONS: The main risk factor for cervical cancer in this region was high-risk HPV infection, which related to sexual behavior, hygienic habits during menstruation and puerperium. It was particularly important to detect and treat precancerous lesions and to implement behavior modification. In addition, further research on genetic susceptibility was suggested.

Abortion, Induced↗

Commercial sex workers in Kathmandu Valley: profile and prevalence of sexually transmitted diseases.

This paper presents a socioeconomic profile and the prevalence of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), among 341 female commercial sex workers (CSWs) in Kathmandu Valley. Most of the CSWs are from outside the valley, but from within Nepal. Over 50% of the CSWs have a secondary or higher level of education. The average age of the CSWs is 21 years. The average age of first sexual intercourse was 16 years; and, at entering the sex trade, 18 years. The most frequently reported type of sexual activity is vaginal intercourse followed by anal intercourse. Although a large proportion of CSWs are aware of condoms, only one-fifth of them reported using condoms most of the time they had intercourse. The majority of the CSWs are aware of general types of STDs. Slightly over 60% are aware of AIDS, and the majority of them know of at least one mode of AIDS transmission. Gynecological examination based on symptoms revealed that 72% of the CSWs were infected with some type of STD. About 47% had vaginal discharges, 36% had pelvic inflammatory disease, 24% had ulcerative disease, and 4% had urethritis. Blood tests of the CSWs revealed that 28% had VDRL (a test for syphilis), hepatitis B, or HIV. The prevalence of VDRL was the most common, followed by hepatitis B. Of the 341 CSWs, 3 (0.9%) were HIV-positive.

Asia↗

[Knowledge, attitudes, and practices regarding sexually transmitted diseases among students in 3 high schools in Cassino].

In order to plan a health education programme in high schools in Southern Latium, a survey on knowledge, attitude and behaviour about Sexually Transmitted Diseases and AIDS was carried out among students of three high schools in Cassino. An anonymous, self-administered questionnaire was submitted to all students of the last two years in those schools. The results show a good knowledge of Cassino's students about HIV transmission, in similar or higher proportion respect to analogous surveys conducted in Italy or abroad. We found a good knowledge only about AIDS, Herpes genitalis and Syphilis, while knowledge about Hepatitis B, Condyloma acuminatum and Gonorrhoea is not satisfactory. Considering that 38% of male and 17% of female students declared to have already had their first sexual intercourse, the results suggest that there is a strong need to implement an educational intervention on sexuality and STD.

Adolescent↗