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PubMed2001

Alcohol use and sexual risk taking among hazardously drinking drug injectors who attend needle exchange.

BACKGROUND: To determine if sex-risk days are also alcohol use days for active injection drug users. METHODS: Cross-sectional interview of 187 active injection drug users who scored positively (> or =8) on the Alcohol Use Disorders Identification Test who were recruited between February 1998 and October 1999 from a needle exchange program in Providence, Rhode Island. A sex-risk day was defined as "vaginal sex, anal sex or oral sex without a condom," measured by using a 30 day timeline follow-back procedure. RESULTS: The sample was 64% male and 87% white, and 85% met DSM-IV criteria for alcohol abuse/dependence. Of the total days analyzed (n = 5610), 19% were sex-risk days; on 52% of these days drinking also occurred. By using a generalized estimating equation model to cluster by subject, alcohol use was associated with sex-risk days (odds ratio, 1.76; 95% confidence interval, 1.35-2.29; p < 0.001), when we controlled for gender, age, race, education, cocaine use, injection frequency, exchanging sex for money or drugs, number of sexual partners, and perceived sexual risk of acquiring human immunodeficiency virus from partners. CONCLUSIONS: Alcohol use is associated with sex risk-taking behavior among injection drug users. A substantial majority of participants reported using alcohol before or during sexual relations, which temporally links alcohol use with human immunodeficiency virus injection risk.

Adult↗
PubMed1989

Male partners of women with genital human papillomavirus infection. An assessment of colposcopic abnormalities by histological examination and human papillomavirus hybridization.

Men whose female sexual partners showed histological evidence of human papillomavirus infection were examined. Human papillomavirus DNA was identified in 29 of 35 biopsy samples of colposcopically-identified penile lesions. Human papillomavirus strains that were related to human papillomavirus genotypes 6/11 were observed most commonly (seven of eight patients) in the partners of patients with warty atypia or condylomata, while human papillomavirus strains that were related to human papillomavirus genotypes 16/18 were most-commonly (eight of 15 patients) observed in tissue from the partners of patients with cervical intraepithelial neoplasia. Measurement of human papillomavirus DNA in lesions by the filter in-situ hybridization technique more-frequently indicated human papillomavirus infection (29 of 35 lesions) than did conventional histopathological assessment (21 of 35 lesions) in this "high-risk" group. We conclude that colposcopically-identifiable lesions in male sexual partners are likely to contain human papillomavirus DNA, even if is no definite histological evidence of human papillomavirus infection is present, and that such lesions frequently contain strains of human papillomavirus that have been associated with the development of anogenital carcinoma.

Colposcopy↗
PubMed1999

Seroprevalence and incidence of genital ulcer infections in a rural Ugandan population.

OBJECTIVES: To determine age-sex specific seroprevalence and incidence rates of Treponema pallidum, Haemophilus ducreyi, and HSV-2; to assess the association between HIV-1 status and incidence of these STIs; and HSV-2 serostatus with number of lifetime sexual partners. METHODS: Antibodies against HIV-1, T pallidum, H ducreyi, and HSV-2 infections were tested using approximately 1000 paired (2 year interval) sera collected from a rural adult (15-54 years) population cohort in south west Uganda. RESULTS: Overall HIV-1 prevalence was 4.9%. Prevalence for T pallidum was 12.9% among males and 12.6% among females. The corresponding rates for H ducreyi were 9.8% and 7.3% respectively. HSV-2 prevalence rates were considerably lower in males (36.0%) than in females (71.5%), p < 0.001. Incidence rates for T pallidum per 1000 person years of observation were 8.4 for males and 12.3 for females. The corresponding rates for H ducreyi were 24.6 and 20.0 and for HSV-2 were 73.2 and 122.9 per 1000 person years of observation, respectively. The RR of HSV-2 incidence was 3.69 in HIV seropositive cases versus HIV seronegative after adjusting for age and sex. The corresponding RR for H ducreyi was 3.50 among female HIV positive cases versus negatives with no effect seen in males. Association between HIV-1 prevalence and prevalence of other STIs was significant (Mantel-Haenszel test) for H ducreyi (p = 0.01) and for HSV-2 (p = 0.004) but not for T pallidum (p > 0.4). HSV-2 prevalence was associated with number of lifetime sexual partners (females, p = 0.003; males, p = 0.08). CONCLUSIONS: The results have provided a reliable estimate of the magnitude of the STI problem and demonstrated an association between HIV-1 status and serology of other STIs in a general rural population in sub-Saharan Africa. The study has also highlighted a correlation between HSV-2 seropositivity and number of reported lifetime sexual partners.

AIDS-Related Opportunistic Infections↗
PubMed1991

Genital human papilloma virus infection in males. A clinico-pathologic study.

From March 1987 to December 1988, 402 male sexual partners of 317 women with human papilloma virus (HPV) infection of the lower genital tract and 85 with HPV-associated cervical and/or vulvar intraepithelial neoplasia (CIN and/or VIN) were submitted to clinical examination and peniscopy. The latter was performed at a 6-15 X magnification after a 3 min exposure to 5% acetic acid solution. Visible lesions were biopsied. Thirty-one patients had clinical evidence of HPV infection in the glans, penile shaft or urethra, and 222 had peniscopic evidence of subclinical aceto-white lesions. Of 31 patients with clinical lesions, 11 showed also aceto-white subclinical lesions. Of 253 peniscopically positive males, 237 were biopsied and 191 of these were histologically ascertained. Three patients had penile intraepithelial neoplasia, one with clinical appearance of a Buschke-Löwenstein tumor. The incidence of HPV infection in male sexual partners of women affected by HPV infection of the lower genital tract associated or not with intraepithelial neoplasia is lower than expected. However, clinically negative males should not be considered disease free; in fact, 12 patients, negative at the first examination, showed histological evidence of HPV infection at subsequent controls. Therefore, follow-up of at least 6 months should be allowed to identify HPV bearing males. The reported low frequency of HPV infection may be due to the fact that the males may harbour the virus in the urethra, prostate or seminal vesicles or penis without any clinical evidence of disease. Although research for HPV-DNA in intraurethral and penile scraping material might be useful for diagnosis, peniscopy with a 5% acetic acid application remains the clinical test for evaluating HPV infection in males. The importance of peniscopy should be viewed with respect to the prevention of infection or reinfection of the female sexual partners, in addition to the specific diagnostic purpose in male patients.

Adolescent↗
PubMed2004

Urinary urgency and frequency, and chronic urethral and/or pelvic pain in females. Can doxycycline help?

PURPOSE: Persistent urinary urgency and frequency, and chronic urethral and/or pelvic pain in women are often a diagnostic and therapeutic challenge. This can be frustrating for patients and physicians. The search for an infectious agent often proves futile and after multiple ineffective treatment regimens patients may be classified as having interstitial cystitis or referred to a psychiatrist as the last option. We evaluated whether treatment with doxycycline of the patient and her sexual partner would be beneficial. MATERIALS AND METHODS: Women presenting with a history of urinary urgency and frequency, and chronic urethral and/or pelvic pain often associated with dyspareunia and/or a history of recurrent urinary tract infection were evaluated. Initial examinations included urethral and cervical/vaginal swabs, serum analysis, urine examination and culture, and bladder barbitage. A total of 103 women with a median age of 46 years (range 21 to 84) and with a median symptoms history of 60 months (range 3 to 480) were included. All patients had trigonal leukoplakia at cystoscopy, in 15% an infectious organism was identified and 30% had leukocyturia. All were treated with doxycyclines, and a vaginal antimicrobic and/or antimycotic agent following the same regimen, including treatment of the sexual partner. RESULTS: After treatment with doxycycline 71% of the women were symptom-free or had a subjective decrease in symptoms. CONCLUSIONS: Treatment with doxycycline is effective in more than two-thirds of patients complaining of persistent frequency and urgency, chronic urethral and/or pelvic pain, and dyspareunia as well as a history of recurrent urinary tract infections. In women with negative urinary cultures but a history of urgency/frequency probative treatment with doxycycline is justified and endoscopic findings may support the hypothesis of chronic infection. This should be done especially before contemplating psychiatric treatment or diagnosing the patient with interstitial cystitis. We attribute this high success rate to simultaneous treatment of the sexual partner, who may be an asymptomatic carrier, although this remains to be proved.

Adult↗
PubMed2005

Sexual abuse in childhood and sexual dysfunction in adulthood: an Australian population-based study.

This study examined self-reported adult sexual functioning in individuals reporting a history of childhood sexual abuse (CSA) in a representative sample of the Australian population. A sample of 1793 persons, aged 18-59 years, were randomly selected from the electoral roll for Australian states and territories in April 2000. Respondents were interviewed about their health status and sexual experiences, including unwanted sexual experiences before the age of 16 years. More than one-third of women and approximately one-sixth of men reported a history of CSA. Women were more likely than men to report both non-penetrative and penetrative experiences of CSA. For both sexes, there was a significant association between CSA and symptoms of sexual dysfunction. In assessing the specific nature of the relationship between sexual abuse and sexual dysfunction, statistically significant associations were, in general, evident for women only. CSA was not associated with the level of physical or emotional satisfaction respondents experienced with their sexual activity. The total number of lifetime sexual partners was significantly and positively associated with CSA for females, but not for males; however, the number of sexual partners in the last year was not related to CSA. CSA in the Australian population is common and contributes to significant impairment in the sexual functioning of adults, especially women. These consequences appear not to extend to the other areas of sexual activity considered in this study.

Adaptation, Psychological↗
PubMed2000

Hispanic women and AIDS: gendered risk factors and clinical implications.

Current theory and research indicate that Hispanic women's increased risk for AIDS is due to sociocultural and psychological factors that are influenced by gender. Hispanic women's low social status limits their ability to negotiate safer sex behaviors for AIDS prevention. Female gender identity, based upon the desire for interpersonal attachment, places Hispanic women at risk for AIDS through a fear of abandonment by male sexual partners who perceive safer sex behaviors as unmasculine. Male sexual partners' beliefs, practices, and behaviors, such as bisexuality and the practice of anal intercourse, increase Hispanic women's AIDS risk. The experience of involuntary sexual encounters and the lack of power to determine sexual behaviors and practices within these encounters also place Hispanic women at risk for AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Predictors of maintained high-risk behaviors among impoverished women.

The researchers sought to explore and describe the demographic, cognitive, psychosocial, and behavioral factors associated with the continued risky behavior of a convenience sample of homeless and drug-addicted women two to four weeks after they had completed an AIDS education program. The sample included 942 crack users and 767 women who had multiple sex partners. Analyses revealed that impoverished women who maintained multiple sexual partners were less likely to be in drug recovery programs than in homeless shelters. They were more likely to share needles and be involved sexually with male injection drug users compared with impoverished women who did not maintain multiple sexual partners. Persistent crack users were older than those who reported cessation of crack use, were more often African American, and were more likely to have sex partners who were injecting drug users. Women who demonstrated less improvement in depression and distress scores, concerns, use of affective coping, appraisal of threat, and social support were more likely to maintain crack use and multiple partners. The study's implications for the design of intervention programs aimed at risk reduction based on ethnicity are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Sexual risk behaviors of Gay, Lesbian, and bisexual youths in New York City: prevalence and correlates.

The lifetime and recent sexual risk behaviors of 156 Gay, Lesbian, and bisexual youths, recruited from Gay-focused organizations in New York City, were examined. The data indicated seven reasons why the youths are at risk for HIV and other STDs: They initiated sex during early adolescence; their first sexual partners were older than they were; HIV barrier methods (e.g., condoms) were initiated subsequent to sexual debut; many lifetime sexual partners and encounters were reported; some youths exchanged sex for goods; many youths reported having had at least one partner at risk for HIV; and the youths engaged in unprotected sexual behaviors during the past 3 months. Significant gender differences emerged (e.g., the male youths reported more lifetime same-sex partners than the female youths; the female youths reported more lifetime other-sex partners than the male youths). Recent sexual risk behaviors (i.e., numbers of same-sex partners, encounters, and unprotected sex during the past 3 months) were related significantly to the youths' average degree of emotional involvement in or average duration of intimate relationships.

Adolescent↗
PubMed2002

High incidence of cervical human papillomavirus infection in women during their first sexual relationship.

The prevalence of cervical human papillomavirus increases with increasing numbers of sexual partners, leaving the impression that this infection is acquired only as a result of high risk sexual behaviour. Using longitudinal data from 242 women who had only had one sexual partner, we found that the risk of acquiring cervical human papillomavirus infection was 46% (95% CI 28-64) at three years after first intercourse and that the median time from first intercourse to first detection of human papillomavirus was only three months.

Adolescent↗
PubMed2005

Some myths and anomalies in the study of Roman sexuality.

This paper seeks to dispel several myths prevalent in the scholarship on Roman sexuality: that a freed slave was still obligated to serve his former master's sexual demands (I.A.), that the cinaedus cannot be the same as the modern male homosexual because the cinaedus was thought capable of performing cunnilinctus (I.B.), that exoleti were male prostitutes (I.C.), that the Romans were implacably hostile to lesbianism and that they constructed the lesbian as a phallic monstrosity (II.). It also draws attention to some neglected, unfamiliar, or misinterpreted evidence-anomalous on the current understanding of Roman sexuality, where women, boys, and lower-class men are supposed to have equal standing as potential passive sexual partners for adult men-for adult men whose sexual partners are exclusively male, and either active or passive: exoleti as active partners (I.C.), a puer delicatus who is prized for a masculine appearance rather than a feminine one (I.D.), and the Warren Cup, which glorifies a world of exclusively male-male sexuality (I.E.).

Adolescent↗
PubMed1993

Low risk of sexual transmission of hepatitis C virus.

Sexual transmission of hepatitis C virus (HCV) was studied between 104 anti-HCV positive index cases (99 haemophilic men, five women) who have attended the Oxford Haemophilia Centre and 104 (98 female, 6 male) longstanding sexual partners. Ninety-one percent of the index cases were HCV RNA positive by the polymerase chain reaction (PCR) and 56% were anti-human immunodeficiency virus (HIV) positive. Three (2.9%) sexual partners (each a female partner of a different HCV RNA positive haemophilic man) were anti-HCV, and HCV RNA, positive. All had other risk factors for HCV infection. Of 59 partners who were tested for anti-HIV four (7%) were positive and only one of these was also anti-HCV positive. There was no association between HIV positivity in the index cases and HCV positivity in their partners. Our results confirm a low risk of sexual transmission of HCV.

Adult↗
PubMed2006

Intoxication before intercourse and risky sexual behavior in male veterans with and without human immunodeficiency virus infection.

BACKGROUND: Male veterans represent a large population at risk for acquiring or transmitting human immunodeficiency virus (HIV) infection. We sought to determine the prevalence of risky sexual behavior among veterans with and without HIV infection and to assess the relationship of intoxication before intercourse and other measures of drug and alcohol use to risky sexual behavior in this population. METHODS: We analyzed baseline data on 1009 HIV-positive (mean age 49 years) and 710 HIV-negative male veterans (mean age 55 years) who were participating in the Veterans Aging Cohort 5-Site Study (VACS 5). Participants completed a written questionnaire that included measures of alcohol and drug use and risky sexual behavior. RESULTS: Compared with HIV-negative veterans, HIV-positive veterans were more likely to report 5 or more sexual partners in the past year (14% vs. 4%, P < 0.01), less likely to report not using a condom at last intercourse (25% vs. 75%, P < 0.01), and similarly likely to report having 2 or more partners and inconsistent condom use (10% vs. 10%). Among sexually active HIV-positive veterans, intoxication before intercourse was significantly associated with having 5 or more sexual partners in the past year (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.1-2.8), inconsistent condom use (OR 1.8, 95% CI 1.2-2.7), and the combined measure of 2 or more partners and inconsistent condom use (OR 1.8, 95% CI 1.1-3.0). Intoxication before intercourse was not significantly associated with these behaviors in HIV-negative veterans, although similar trends were noted. CONCLUSION: Risky sexual behavior was common among male veterans attending outpatient clinics and is more common among HIV-positive veterans who use alcohol and drugs in sexual situations. Asking HIV-positive men a single question about intoxication before intercourse could help to identify men at increased risk of engaging in risky sexual behavior, and specific advice to avoid intoxication in sexual situations could help to reduce risky sexual behavior.

Cohort Studies↗
PubMed1988

Impact of HIV antibody testing on changes in sexual behavior among homosexual men in The Netherlands.

Between October 1984 and May 1986, 746 homosexual men, living in and around Amsterdam, The Netherlands, were surveyed at three consecutive six months periods regarding their sexual behavior. At the start of the study all subjects, of whom 234 (31 per cent) were HIV-Ab seropositive, were informed about their HIV antibody status. Seropositives initially reported more sexual partners than seronegatives; they also showed a greater reduction in the number of sexual partners and the number of partners with whom all forms of sexual practices were performed than did seronegatives. In both groups subjects were more likely to terminate orogenital intercourse than anogenital intercourse and masturbation.

AIDS Serodiagnosis↗
PubMed1998

Sexual behaviour and condom use in the general population of Spain, 1996.

A national household survey of a representative sample of 9,984 individuals aged 15 years or over, carried out in 1996 using a combination of face-to-face interviews and self-completion questionnaires, was analyzed in order to describe the frequency of HIV sexual risk behaviours and condom use in Spain. Of a total of 8,101 persons (81%) who completed the questionnaire, 37% reported no sexual partner during the previous 12 months, 57% reported one partner and 6% reported more than one partner. Three per cent reported engaging in HIV sexual risk behaviour (i.e. more than one partner and failure to use a condom systematically), a pattern of behaviour which showed independent positive association with the male sex, an age of 20-59 years and being unmarried. Among those who had casual sexual partners during the preceding 12 months, 38% had always used condoms. In the multivariate analysis, failure to use a condom systematically with casual partners was associated with a higher age and being married. Of those who had regular partners during the previous 12 months, 26% had always used condoms, a finding associated with a lower age, higher educational level, unmarried status and non-cohabitation with the sexual partner. This survey has furnished some useful indicators for prevention purposes. Periodic repetition of this survey would enable possible changes in sexual risk behaviours to be detected.

Adolescent↗
PubMed2005

HIV prevalence and risk factors in women of Accra, Gghana: results from the women's health study of Accra.

The Women's Health Study of Accra is a cross-sectional study designed to measure the burden of communicable and noncommunicable diseases in adult women residing in Accra, Ghana. This study assessed the prevalence rate of HIV and risk factors associated with HIV infection in 1,328 women age 18 years and older. The weighted overall HIV prevalence rate for women residing in Accra is 3.1%. The highest prevalence rate of HIV infections was identified in women age 25 to 29 years at 8.3%, OR (95%CI) 3.8 (1.68-8.33), P = 001. In addition to young age, other significant risk factors included sexually transmitted infection (STI) symptoms (OR 1.81 [1.14-2.87], P = 0.012) and mean number of lifetime sexual partners (P < 0.001). All HIV-positive women were sexually active. Other findings significantly associated with HIV-positive status included chills, oral lesions, tuberculosis, bloody sputum production, and intestinal parasite infections. There was a significant association with HIV-positive status and locality of residence in the city. There was no association with reported use of condoms, blood transfusions, surgery, reproductive health history including pregnancy or number of sexual partners, symptoms suggestive of AIDS, or self-perception of health. There was also no association with education level, religion, ethnicity, marital status, or socioeconomic level. This community-based study confirms the need to target young, sexually active women for HIV educational and preventive initiatives. A strong Ghanaian public health initiative to increase awareness of the risks of HIV and the link to STIs is critical at this time to prevent the further increase in HIV prevalence and the resultant HIV-associated illnesses.

Adolescent↗
PubMed2005

Sexual risk behaviour among young people in Osogbo, Osun state Nigeria.

By analysing data randomly collected via administration of questionnaire by interview of individuals on sexual risk behaviour to 628 young people living in Osogbo, Nigeria, the results of the questionnaire revealed that the mean age of first sexual encounter was 17.4 years for men and 16.5 years for women. Men tended to have multiple sexual partners more than the women (74.4% and 25.1%, respectively), while there was a highly significant relationship between sexually transmitted disease and multiple sexual partners among singles with P<0.001 and P= 0.000. We concluded that parents and government alike should teach sex education at home, and in schools involving intensive counselling.

Adolescent↗
PubMed2005

Sexual health behaviours among Pacific Island youth in Vanuatu, Tonga and the Federated States of Micronesia.

ISSUES ADDRESSED: This study was conducted to describe the sexual risk behaviours of youth within the Pacific Island nations of Vanuatu, Tonga and the Federated States of Micronesia. METHODS: General health behaviour surveys were conducted with youth aged 15-19 years and not attending school in the three countries. A sample of 390 Ni-Vanuatu youth from the Shefa Province, 934 youth from three island provinces of Tonga and 92 youth from Pohnpei, the main island of the four island states of the Federated States of Micronesia, were interviewed in gender-specific groups. Questions were asked about sexual behaviours that may contribute to unintended pregnancy or sexually transmitted infections (STIs). RESULTS: Moderate to high percentages of youth were sexually active (had a least one sexual partner) in the Pacific island nations of Vanuatu (49.7%), Tonga (35.5%) and the Federated States of Micronesia (76.1%). Young men were more likely to engage in sexually risky behaviour than young women. They were more likely to be sexually active, have had multiple sexual partners and have had sex when drunk or high. Of those sexually active, more young men than women in Vanuatu (36.1% compared with 30.6%) and Micronesia (54.2% compared with 50%) never used protection against STIs. However, of the sexually active Tongan youth, the proportion of females (61.1%) who reported never using protection against STIs was nearly double the proportion reported by Tongan males (32.2%). CONCLUSION: A high percentage of young people not attending school in the Pacific island nations of Vanuatu, Tonga and the Federated States of Micronesia are at risk of unintended pregnancy and STIs, including HIV, because of patterns of sexual risk behaviour.

Adolescent↗