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Partner patterns in the sexual behavior of unmarried, rural Thai men.

"After a brief discussion of related studies of Thai youths' attitudes toward sexual activity, data from a 1988 national survey of young males (ages 15-24) about their family planning knowledge, attitudes, and practices are used to document the age pattern of sexual initiation, the prevalence of youths' encounters with commercial sex workers, the prevalence of their experience with non-commercial partners...and the degree to which the two patterns--commercial and noncommercial--are 'networked' because young men engage in both types of sexual activity. Finally, background characteristics of male youths that are associated with these patterns of sexual activity are examined."

Adolescent↗

Family communication about HIV/AIDS and sexual behaviour among senior secondary school students in Accra, Ghana.

BACKGROUND: Sexually active adolescents in Ghana are increasingly at risk of HIV and other sexually transmitted infections. As a primary agent of socialization, the family can exert a strong influence on adolescent sexual behaviour. Therefore, to aid in the design and implementation of effective prevention programmes, it is important to understand the role of the family in influencing sexual behaviour among school-going adolescents. OBJECTIVES: To evaluate the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana. METHOD: A sample of 894 students (56.9% girls, 43.1% boys; mean age = 17.4 years, SD = 1.40) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire, a self-administered instrument developed by the Centers for Disease Control and Prevention. Analytical techniques utilized included logistic regression and chi-square. RESULTS: Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS. Logistic regression analysis showed that student-family communication about HIV/AIDS was not associated with sexual activity. However, communication about HIV/AIDS between students and parents or other family members increased the odds of using a condom at last sexual intercourse. CONCLUSIONS: The findings of this study suggest that prevention programmes that seek to educate Ghanaian school-going adolescents about sexual risk behaviour must strongly encourage communication about HIV/AIDS between students and family members.

Adolescent↗

Characteristics of women by smoking status in the San Francisco Bay Area.

To better understand why smokers are more likely to develop cervical cancer than nonsmokers, we investigated laboratory and demographic differences between the two groups. Women between the ages of 18 and 49 who attended eleven community clinics in the San Francisco Bay Area were studied to investigate differences between smokers and nonsmokers. The 332 smokers and 365 nonsmokers were queried about smoking habits, sexual and reproductive history, and recent diet. Cervical mucus specimens were cultured for yeast, lactobacillus, and other microorganisms. Results showed that white Hispanic women were less likely to smoke than white non-Hispanic women. Smokers, when compared to nonsmokers, consumed larger quantities of coffee, soft drinks, liquor, and beer in the 24 h prior to the interview. Women who smoked were more likely than those who did not smoke to have had first sexual intercourse before age 16, had a greater number of lifetime sexual partners, and were more likely than nonsmokers to have been pregnant. After controlling for number of sexual partners, smokers reported a history of chlamydia, gonorrhea, and/or pelvic inflammatory disease more often than did nonsmokers, and cervical mucus of smokers was more likely than that from nonsmokers to contain greater than 8500 microorganisms/ml.

Adolescent↗

Evaluation and follow-up of abnormal Pap smears.

An estimated 13,500 cases of invasive cervical cancer and 6,000 related deaths occur each year in the United States. These numbers can be significantly reduced if all women are regularly screened with Papanicolaou (Pap) smears and undergo colposcopy when abnormalities are detected. Screening with Pap smears should begin at age 18 or at the age of first sexual intercourse and should be repeated every one to three years, depending on individual risk factors, until age 65. Screening may be discontinued in women over age 65 who have had normal findings on two consecutive Pap smears. Risk factors for cervical cancer include sexual intercourse before age 20, more than two sexual partners in a lifetime, cigarette smoking and genital human papillomavirus (HPV) infection. Use of a spatula and Cytobrush for cervical sampling will improve the chances of collecting an adequate sample containing endocervical cells. Family physicians must know the significance of various cervical abnormalities reported by the laboratory. In women with cervical or genital HPV infection and persistent inflammatory cervical changes unresponsive to appropriate therapy, colposcopy is necessary to screen for underlying dysplasia.

Aftercare↗

Colposcopy in a family practice residency. The first 200 cases.

BACKGROUND: The incidence of abnormal Papanicolaou smears has increased dramatically in the last decade. Many family physicians now find it necessary to perform colposcopies themselves to provide optimal care for their patients. There is little literature that evaluates the performance of this procedure by family physicians. METHODS: The findings of the first 200 colposcopies performed in a community hospital-based family practice residency program are reported. Descriptive data were prospectively gathered between August 1987 and December 1989. RESULTS: The median age of the patients was 25 years, the median number of sexual partners was three, and the median age at the time of first sexual intercourse was 17 years. The majority had colposcopy performed because of a class III Papanicolaou smear (108 [54%]). Twenty-five (12.5%) were pregnant at the time of colposcopy; for this reason a biopsy was not performed on 19 of the patients. An average of three distinct cervical lesions were seen in each patient. The most frequent histologic finding was some degree of dysplasia (116 of 181 biopsied [64%]). Twenty-two cases of severe dysplasia (carcinoma in situ) were found. However, no cases of invasive carcinoma were found. CONCLUSIONS: High-quality colposcopy and effective treatment with appropriate referral can be done at the primary care level for most patients. Many patients failed to return for follow-up evaluation after treatment, indicating the need for better tracking of patients.

Adolescent↗