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PubMed1991

Tailoring AIDS prevention: differences in behavioral strategies among heterosexual and gay bar patrons in San Francisco.

Three groups of San Francisco bar patrons (heterosexual men, heterosexual women, and gay men) were compared on four sexual risk reduction strategies for AIDS: safer sex practices (particularly adoption of the use of condoms), reducing the number of sexual partners, taking the HIV antibody test, and determining the characteristics of a potential sexual partner. Heterosexuals reported fewer sex partners and were more likely than gay men to interview potential partners. Gay men were more likely to use condoms and the HIV antibody test than their heterosexual counterparts. These findings encourage the design of interventions that take advantage of shaping and reinforcing strategies already in use in each group, and suggest when it is necessary to teach new strategies.

Acquired Immunodeficiency Syndrome↗
PubMed1997

The associations between risk behaviour and reported history of sexually transmitted diseases, among young women: a population-based study.

The aim of this study was to determine the associations between risk behaviour and women's reported sexually transmitted diseases (STDs). All the women aged 19, 21, 23 and 25, residing in a specified housing area, were invited to answer a questionnaire regarding their sexual behaviour, smoking and alcohol consumption and previous history of STD. Of the 611 women participating, one out of 4 women had a history of at least one STD. In an univariate analysis, self-reported STD was found to be related to age, having more than 4 lifetime sexual partners, having practised intercourse at first date, inconsistent use of condoms, alcohol consumption of more than 3 bottles of wine per month and smoking. These factors were, however, not independent of each other and when subjected to a multivariate logistic regression analysis 2 factors, i.e. the lifetime number of sexual partners (more than 4 partners vs one; OR 7.94, (3.41-18.50)) and coitus on first date (practised more than once vs never, OR 2.99 (1.55-5.78)) emerged as independently associated with a previous STD.

Adult↗
PubMed2002

Six-year follow-up of preventive interventions for children of divorce: a randomized controlled trial.

CONTEXT: Compared with their peers with nondivorced parents, adolescents with divorced parents are more likely to have mental health problems, drop out of school, and become pregnant. The long-term effects of intervention programs for this population are unknown. OBJECTIVE: To evaluate the long-term effectiveness of 2 programs designed to prevent mental health problems in children with divorced parents. DESIGN AND SETTING: Six-year follow-up of a randomized controlled trial of 2 intervention programs (mother program: 11 group and 2 individual sessions; mother plus child program: mother program and 11 group sessions for children) and a control condition (books on postdivorce adjustment), which was conducted in a large metropolitan US city from April 1998 through March 2000. PARTICIPANTS: A total of 218 families (91% of the original sample) with adolescents aged between 15 and 19 years were reinterviewed. MAIN OUTCOME MEASURES: Externalizing and internalizing problems, diagnosed mental disorders, drug and alcohol use, and number of sexual partners. RESULTS: Eleven percent of adolescents in the mother plus child program (95% confidence interval [CI], 3.8%-18.2%) had a 1-year prevalence of diagnosed mental disorder compared with 23.5% (95% CI, 13.8%-33.2%) of adolescents in the control program (P =.007). Adolescents in the mother plus child program had fewer sexual partners (mean [SE], 0.68 [0.16]) compared with adolescents in the control program (1.65 [0.37]; P =.01). Adolescents with higher initial mental health problems whose families were in the mother plus child program had lower externalizing problems (P =.007) and fewer symptoms of mental disorder (P =.02) compared with those in the control program. Compared with controls, adolescents whose mothers participated in the mother program and who had higher initial mental health problems had lower levels of externalizing problems (P<.001); fewer symptoms of mental disorder (P =.005); and less alcohol (P =.005), marijuana (P =.02), and other drug use (P =.01). CONCLUSIONS: In adolescents of divorced parents, the mother program and the mother plus child program reduced symptoms of mental disorder; rates of diagnoses of mental disorder; levels of externalizing problems; marijuana, alcohol, and other drug use; and number of sexual partners.

Adaptation, Psychological↗
PubMedDate not supplied

Correlates of sexually transmitted bacterial infections among U.S. women in 1995.

CONTEXT: Sexually transmitted diseases (STDs) of bacterial origin such as gonorrhea and chlamydial infection can lead to pelvic inflammatory disease (PID) and infertility. Identifying behaviors and characteristics associated with infection may assist in preventing these often asymptomatic diseases and their sequelae. METHODS: Data from 9,882 sexually active women who participated in the 1995 National Survey of Family Growth describe the characteristics of women who report a history of infection with a bacterial STD or of treatment for PID. Multivariate analysis is used to determine which demographic characteristics and sexual and health-related behaviors affect the likelihood of infection or the occurrence of complications. RESULTS: Overall, 6% of sexually active women reported a history of a bacterial STD, and 8% reported a history of PID. Women who first had sexual intercourse before age 15 were nearly four times as likely to report a bacterial STD, and more than twice as likely to report PID, as were women who first had sex after age 18. Having more than five lifetime sexual partners also was associated with both having an STD and having PID. PID was more common among women reporting a history of a bacterial STD (23%) than among women who reported no such history (7%). In multivariate analyses, age, race, age at first intercourse and lifetime number of sexual partners had a significant effect on the risk of a bacterial STD. Education, age, a history of IUD use, douching and a history of a bacterial STD had a significant impact on the risk of PID, but early onset of intercourse did not, and lifetime number of partners had only a marginal effect. CONCLUSIONS: The pattern of characteristics and behaviors that place women at risk of infection with bacterial STDs is not uniform among groups of women. Further, the level of self-reported PID would suggest higher rates of gonorrhea and chlamydial infection than reported.

Adolescent↗
PubMed1986

[Bowenoid papulosis and its relation to Bowen's disease and atypical condyloma].

All the 5 sexual partners of male patients suffering from bowenoid papulosis and bearing the HPV 16 genome showed cervical lesions induced by HPV. 2 of them proved to be noncondylomatous infections, 3 cases were cervical condylomas, and 2 patients revealed severe dysplasia or carcinoma in situ (CIS). 3 out of 4 women suffering from multicentrical pigmented Bowen's disease of the vulva showed plain condylomas of the cervix, with severe dysplasia or CIS in 2 cases and slight dysplasia in one case. Thus bowenoid papulosis as well as multicentrical pigmented Bowen's disease of the vulva are high risk factors for cervical HPV infection and carcinoma, both for the patients themselves and their sexual partners. Atypical pigmented genital condylomas induced by HPV 6 also bear a risk for cervical HPV infection of the sexual partners. Malignant transformation, however, seems to depend on the type of the infecting virus (mainly HPV 16).

Bowen's Disease↗
PubMed2001

Preventing transmission of hepatitis B virus from people with chronic infection.

BACKGROUND: People with chronic hepatitis B virus (HBV) infection are the major source of HBV transmission in the United States. The Public Health Service recommends prevention counseling for HBV-infected people and vaccination of their household contacts and sexual partners. OBJECTIVES: To describe the implementation of these recommendations by community physicians. METHODS: Telephone survey of 69 people with chronic HBV infection and their healthcare providers, October 1997 through November 1997, in San Diego, California. MAIN OUTCOME MEASURES: Counseling of people with chronic HBV infection and vaccination of their household contacts and sexual partners. RESULTS: Forty-three percent of providers reported providing prevention counseling to their HBV-infected patients to reduce transmission; 16% of patients reported receiving counseling. For the 32 pairs for which both the patient and provider could be reached and the patients were aware of their HBV infection, 20 (63%) providers reported counseling patients, and 10 (50%) of these providers' patients reported receiving counseling. Fifty-five percent of providers recommended vaccination of contacts; 13% of eligible adult household contacts and sexual partners and 20% of eligible child household contacts had begun hepatitis B vaccination. CONCLUSIONS: Prevention counseling of people with chronic HBV infection and vaccination of their contacts occur infrequently despite guidelines and an effective vaccine. Collaborative efforts between providers and people involved in public health are needed to improve delivery of these preventive health services.

Adolescent↗
PubMed1989

HIV infection in patients attending clinics for sexually transmitted diseases in England and Wales. Collaborative Study by Consultants in Genitourinary Medicine and the Public Health Laboratory Service.

A national study of the prevalence of HIV antibody designed to monitor sexual spread of HIV infection in England and Wales was made of homosexual and heterosexual patients attending sexually transmitted disease clinics in four districts in 1985, seven in 1986, and 14 in 1987. Patients were invited to participate and were counselled. Among homosexual men in two clinics in south east England, HIV antibody was found in 92 (12.9%) of 711 in 1985, 65 (15.2%) of 428 in 1986, and 81 (14.6%) of 556 in 1987: corresponding findings in the other regions were 16 (5.0%) of 321, 41 (6.3%) of 654, and 21 (3.1%) of 678. The prevalence of HIV antibody was higher in homosexual than bisexual men, in patients aged 25 years or more, or with one or more specified minor complaints. Among heterosexual patients in the south east in 1986, HIV antibody was found in seven (3.0%) of 230 men and three (1.3%) of 233 women and in 1987 in 10 (1.0%) of 962 men and seven (0.7%) of 949 women. In other areas corresponding findings in 1986 were two (0.2%) of 950 men and three (0.4%) of 752 women and in 1987 were three (0.06%) of 5312 men and one (0.02%) of 4778 women. All but one of the heterosexual patients with the antibody were intravenous drug abusers or had had sexual contacts in or were from an area abroad with a high prevalence of AIDS. Failure to identify a heterosexual patient with HIV antibody not in a risk group (other than that of being an attender at the clinic) or who did not have a sexual partner in a risk group suggests that their prevalence in the patient population of the clinics in the south east is less than one in 700 and in the other regions less than one in 3000. Refusals to participate increased during the study but comparisons of patients who agreed and refused in terms of age, the presence of symptoms suggesting AIDS, travel abroad, and number of sexual partners a month showed little evidence of selective bias.

Adult↗
PubMed1994

Sexual activity and risk of HIV infection among patients with schizophrenia.

OBJECTIVE: This study sought to determine the frequency and types of sexual behavior among patients with schizophrenia and to assess the behavior with respect to risk of HIV infection. METHOD: Ninety-five inpatients and outpatients with a research diagnosis of schizophrenia underwent a series of face-to-face interviews to determine their sexual activity and correlate it with demographic characteristics, psychopathology, and medication side effects. RESULTS: Forty-four percent of the patients had been sexually active in the preceding 6 months, and 62% of these had had multiple partners. Sexual activity was associated with greater general psychopathology. Having multiple sexual partners was associated with younger age, a lower level of functioning, the presence of delusions, and more positive symptoms. Of the sexually active patients, 12% reported at least one partner who was HIV positive or injected drugs, or both, and 50% had exchanged sex for money or goods. Ten percent of the patients had engaged in homosexual activity in the preceding 6 months and 22% during their lifetime; the frequency was similar among men and women. Consistent condom use was uncommon. CONCLUSIONS: A substantial proportion of schizophrenic patients had recent histories of sexual abstinence, but an almost equal number were sexually active. Sexual activity was usually accompanied by behavior related to HIV risk. Sexual activity and having multiple partners were associated with certain measures of more severe illness. Younger patients were more likely to have multiple partners but were also more likely to use condoms. There is a need for aggressive prevention strategies with this population.

Adolescent↗
PubMed1994

Impact of sexual habits on the clinical evaluation of male HPV infection.

A series of 199 male regular sexual partners of women attending an STD clinic for the examination and treatment of HPV-associated diseases was examined by peniscopy, surgical biopsy and nucleic acid hybridization for the presence of clinical, histological and molecular markers pathognomic of HPV infection. There was a 100% correlation between condylomata acuminata and detection of HPV type 6 or 11 DNA. Papillary lesions displayed neither histological signs of HPV infection, nor did they harbor HPV DNA (viral types 6, 11, 16, 18, 33) while 44.9% (22/49) of acetowhite epithelia showed HPV-suggestive histological changes. Of the 19 analysed for HPV DNA, 15.8% (3/19) harbored HPV 6/11 and 16 DNA. Regular male and female sexual partners did not always harbor the same HPV types, showing that latent or occult infection and the sexual habits of each individual play an important role in the clinical manifestations of HPV infection observed in sexual couples. The present data show that: i) the likelihood of developing a clinical HPV lesion was affected, to a large extent, by the previous sexual history and habits in the partners of women with flat condylomata, while partners of women with condylomata acuminata or CINs displayed a higher correlation with the current state of infection in their regular partner; ii) despite the assessed infective state of their consorts, men with a low lifetime number of sexual partners seldom displayed HPV-associated acetowhitening.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗
PubMedDate not supplied

Lifetime number of partners as the only independent risk factor for human papillomavirus infection: a population-based study.

BACKGROUND AND OBJECTIVES: Previous studies of relationships between genital human papillomavirus infection and tentative risk factors have yielded conflicting results, possibly because of inaccuracy of the viral detection methods used and differences in selection criteria. GOAL OF THIS STUDY: To determine human papillomavirus prevalence and identify risk factors in a group of young Swedish women. STUDY DESIGN: This was a population-based study involving completion of a structured questionnaire, analysis of cervical scrapings for human papillomavirus and Chlamydia trachomatis, and serologic tests for C. trachomatis and herpes simplex virus antibodies. RESULTS: The prevalence of human papillomavirus infection was 22% among the sexually active women and 4% among the virgins. A number of factors were associated with human papillomavirus prevalence in univariate analysis, but logistic regression analysis showed that lifetime number of male sexual partners was the only independent risk factor for human papillomavirus infection (adjusted odds ratio, 7.45; 95% CI, 2.79-19.92 for six or more partners vs. one partner). CONCLUSION: Human papillomavirus infection is a prevalent sexually transmitted disease among young Swedish women, and the lifetime number of male sexual partners is a major risk factor.

Adult↗
PubMed1997

STD services for women at truck stop in Tanzania: evaluation of acceptable approaches.

AIDS continues to be the commonest cause of death in Tanzania among those aged between 15 and 45 years. Both ulcerative and non-ulcerative sexually transmitted diseases have been identified as major co-factors in HIV transmission. Certain groups including long distance truck drivers and their sexual partners have been reported as having a disporportionate effect on the transmission dynamics of STD including HIV, in a population. In 1993 African Medical and Research Foundation decided to add an STD component to their HIV/AIDS prevention programme along the Tanzania-Zambia highway which had been targeting truck drivers and their sexual partners through peer education and condom distribution since 1989. A study to evaluate the acceptability and feasibility of four different approaches of delivering STD services, was conducted over a period of one year. The approaches for delivering STD services were: special STD services offered twice a week at a site and at hours of the women's choice, special outreach services once every three months, or STD services integrated into the nearest Primary Health Clinic. Drugs were provided at three of the four interventions. 1,330 women at seven truckstops, participated in the evaluation study. The women were generally satisfied with all approaches that included the provision of drugs. The most expensive and ineffective way of treating STD was by not providing drugs. These findings confirm the fact that it is feasible to provide STD services to women at high risk in HIV high transmission areas. These women would utilise STD services provided in a manner that suits them if mobilised and encouraged by their peer educators.

Adult↗
PubMed1992

The prevalence of antibodies to hepatitis C virus in patients with chronic liver disease.

OBJECT: to determine the prevalence of antibodies to hepatitis C virus in selected groups of patients with chronic liver disease. METHODS: serum specimens were obtained from 39 patients with chronic liver function abnormalities of uncertain cause (group A), from 15 patients with autoimmune chronic active hepatitis (group B) and from 10 patients with chronic hepatitis B (group C). In an extension of the study, serum was collected from sexual partners of patients found to be HCV seropositive. A second generation ELISA assay (Abbott) was used to analyse the specimens. RESULTS: ten patients (26%) in group A were seropositive, one (7%) in group B and three (30%) in group C. Risk factors for infection included blood transfusion in three, intravenous drug use in six (including the only positive patient in group B) and both factors in another patient. Only one of the 10 sexual partners tested was positive but this subject was also an intravenous drug user. CONCLUSIONS: hepatitis C virus is a significant cause of chronic liver disease in Christchurch. Important risk factors include blood transfusion and intravenous drug use although sporadic cases occur. Transmission to sexual partners is uncommon. The second generation assay does not appear to give false positive results in autoimmune chronic active hepatitis.

Adult↗
PubMedDate not supplied

High-risk behaviors for transmission of syphilis and human immunodeficiency virus among crack cocaine-using women. A case study from the Midwest.

This study examines the drug use patterns, sexual practices, condom use, knowledge and attitudes toward sexually transmitted diseases (STD)s and AIDS, and seroprevalence of human immunodeficiency virus (HIV) and syphilis among women who use crack in Dayton, Ohio. In 1990, two indigenous outreach workers recruited 150 participants who were not in drug treatment programs, who were 18 years of age or older, and had used crack in the previous 3 months. Structured interviews revealed that 90% of the sample were black, 78% used crack "daily," 93% had multiple sexual partners, and 49% had 10 or more male sexual partners in the last 3 months. A majority (67%) of the women felt they were in need of drug treatment. No reactive syphilis serologies were detected in 138 serum samples; 2 women (1.4%) were HIV seropositive. This case study provides insight into the high-risk sexual behaviors of crack users in a medium-sized, midwestern city. The study demonstrates the value of indigenous outreach prevention and STD screening initiatives in reaching this segment of our society, which has a high risk of acquiring STDs.

Adolescent↗
PubMed1990

The diagnosis and treatment of genital human papillomavirus lesions.

A gynecologist in solo practice reviewed three years of experience in the diagnosis and treatment of human papillomavirus (HPV). Infected women were asked to have their sexual partners diagnosed and treated. One hundred nineteen women and 57 men were examined. This article describes common HPV lesion types and examination methods for both sexes. Magnification and use of dilute acetic acid are emphasized. The most common treatments and the pros and cons of various therapeutic methods are discussed. The results of treatments with podophyllin, trichloroacetic acid, electrodesiccation, cryosurgery, CO2 laser, topical 5-fluorouracil and combinations of these also are presented. The sexual partner co-treatment is explained, and the author summarizes his choice of treatment.

Female↗
PubMed2006

Estimating the prevalence and impact of antidepressant-induced sexual dysfunction in 2 European countries: a cross-sectional patient survey.

OBJECTIVE: Sexual dysfunction is a common side effect of antidepressant treatment, but recognition of the problem is variable. The aim of this study was to estimate the prevalence and impact of sexual dysfunction during antidepressant treatment in 2 European countries. METHOD: A cross-sectional survey of 502 adults in France and the United Kingdom. All participants were diagnosed with depression and taking a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI), starting within the previous 3 months. Information was gathered about other medications and conditions known to impair sexual functioning, recent changes in sexual functioning, and the impact of any changes. The Medical Outcomes Study 12-Item Short-Form Health Survey and the Arizona Sexual Experience Scale were administered to measure health status and sexual functioning. Data were collected from June to July of 2002. RESULTS: Applying a prevalence estimate algorithm, 26.6% of the French sample and 39.2% of the U.K. sample were classified as having antidepressant-induced sexual dysfunction; 34.2% of men and 32.5% of women were classified with antidepressant-induced sexual dysfunction. There was no clear pattern of antidepressant-induced sexual dysfunction related to specific antidepressants. Patients with antidepressant-induced sexual dysfunction reported that changes in sexual functioning negatively affected their self-esteem, mood, and relationships with sexual partners. 23.8% of the French sample and 25.2% of the U.K. sample reported that they perceived that their partner was dissatisfied with their sex life. CONCLUSION: The prevalence of antidepressant-induced sexual dysfunction in this study is similar to previous estimates reported in the literature. The impact of antidepressant-induced sexual dysfunction is substantial and negatively affects quality of life, self-esteem, mood, and relationships with sexual partners.

Adrenergic Uptake Inhibitors↗
PubMed2006

The effectiveness of sex education and HIV education interventions in schools in developing countries.

OBJECTIVE: To review the impact of sex education and HIV education interventions in schools in developing countries on both risk behaviours for HIV and the psychosocial factors that affect them. METHODS: We conducted a systematic review. Searches identified studies in developing countries that evaluated interventions using either experimental or strong quasi-experimental designs and measured the impact of the intervention on sexual risk behaviours. Each study was summarized and coded, and the results were tabulated by type of intervention. FINDINGS: Twenty-two intervention evaluations met the inclusion criteria: 17 were based on a curriculum and 5 were not, and 19 were implemented primarily by adults and 3 by peers. These 22 interventions significantly improved 21 out of 55 sexual behaviours measured. Only one of the interventions (a non-curriculum-based peer-led intervention) increased any measure of reported sexual intercourse; 7 interventions delayed the reported onset of sex; 3 reduced the reported number of sexual partners; and 1 reduced the reported frequency of sexual activity. Furthermore, 16 of the 22 interventions significantly delayed sex, reduced the frequency of sex, decreased the number of sexual partners, increased the use of condoms or contraceptives or reduced the incidence of unprotected sex. Of the 17 curriculum-based interventions, 13 had most of the characteristics believed to be important according to research in developed and developing countries and were taught by adults. Of these 13 studies, 11 significantly improved one or more reported sexual behaviours, and the remaining 2 showed non-significant improvements in reported sexual behaviour. Among these 13 studies, interventions led by both teachers and other adults had strong evidence of positive impact on reported behaviour. Of the 5 non-curriculum-based interventions, 2 of 4 adult-led and the 1 peer-led intervention improved one or more sexual behaviours. CONCLUSIONS: A large majority of school-based sex education and HIV education interventions reduced reported risky sexual behaviours in developing countries. The curriculum-based interventions having the characteristics of effective interventions in the developed and developing world should be implemented more widely. All types of school-based interventions need additional rigorous evaluation, and more rigorous evaluations of peer-led and non-curriculum-based interventions are necessary before they can be widely recommended.

Adolescent↗
PubMed2004

Scale-free networks and sexually transmitted diseases: a description of observed patterns of sexual contacts in Britain and Zimbabwe.

BACKGROUND: Sexually transmitted infections spread through a network of contacts created by the formation of sexual partnerships. In physics, networks have been characterized as "scale-free" if they follow a power law with an exponent between 2 and 3. OBJECTIVE: The objective of this study was to test statistically whether distributions of numbers of sexual partners reported from different populations are well described by power laws. STUDY DESIGN: Power laws and an exponential null model are fitted by maximum likelihood techniques to reported distributions of numbers of partners. Data are taken from 4 population-based surveys, 3 from Britain and 1 from rural Zimbabwe. RESULTS: The networks can be described by power laws over a number of orders of magnitude. In addition, the derived exponents differ significantly and meaningfully, with an "accelerating network" formed between men who have sex with men (MSM). CONCLUSIONS: A scale-free network approach provides a reasonable description of distributions of reported numbers of sexual partners.

Adolescent↗
PubMedDate not supplied

Sexual patterns and human immunodeficiency virus infection among homosexuals in Taiwan.

Between 1988 and 1991, 64 homosexual men and 43 bisexual men were screened for human immunodeficiency virus (HIV) in Southern Taiwan; 5 of them were found to carry HIV antibodies. According to a self-administered questionnaire completed before screening, the average age of the men in the study group was 27 years, and the average duration of practiced homosexuality was 3.8 years. Occupations included student, merchant, laborer, officer, and soldier, and many of the men (45/107) had some junior college or university level education. A relatively high proportion (48/107) of these subjects reported having only 1 sexual partner, and there was a significant association between HIV antibody status and number of sexual partners (P = 0.025). Of the 107 subjects, 58 had practiced anal intercourse and more than a third of them (37/107) indicated that they had participated in receptive anal intercourse, 42 in insertive anal intercourse, and 21 in both of the above. All five carriers of HIV had practiced receptive anal intercourse, in which transmission of HIV from inserter to receptor was highly likely (P = 0.004). Of the men who came forward for HIV testing, the bisexual men tended to be older and often married.

Adult↗