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Workplace and HIV-related sexual behaviours and perceptions among female migrant workers.

Data from 1,543 female migrants working in eight occupational clusters in Beijing and Nanjing, China were analysed to examine the association of workplace with HIV-related behaviours and perceptions. For sexually experienced women (n = 666, 43.2%), those working in entertainment establishments or personal service (e.g., nightclubs, dancing halls, barbershops, beauty salons, massage parlours, etc.) engaged in risky sexual practices twice as frequently as those working in non-entertainment establishments (e.g. restaurants, stalls, domestic service, factories, etc.). About 10% of women in the entertainment establishments reported having sold sex, 30% having multiple sexual partners and 40% having sex with men with multiple sexual partners. The rate of consistent condom use was less than 15%. They also tended to have a higher level of perceptions of both peer risk involvement and positive expectancy of risk behaviours, and lower perceptions of severity of STDs and HIV. For women who were not sexually experienced, those working in 'stalls' or 'domestic service' tended to perceive higher peer risk involvement, less severity of HIV infection, and less effectiveness of protective behaviour. The occupational pattern of sexual risk behaviours and perceptions observed in the current study indicates employment conditions are associated with HIV risk. Intervention strategies should be tailored to address occupational-related factors.

Adolescent↗

Sexual behaviors and safer sex practices of college students on a commuter campus.

The sexual behaviors and safer sex practices of college students at a midwestern commuter university are described. Responses from a student sample of 1,919 indicated that slightly more than 10% used condoms consistently. The most frequently cited reasons for not using condoms were monogamy (83%) and preferring other forms of birth control (31%). The leading reason for consistent condom use was fear of HIV infection (72%). Approximately 75% indicated they talked with their sexual partners about HIV prevention; women reported communicating significantly more often than men did (p < 0.0001). Seventy percent of the sample reported they had only one sexual partner during the past year. Students who had multiple partners during the past year were more likely to practice such unsafe sexual practices as not using condoms and not communicating about HIV prevention. Unsafe sexual practices occur on nontraditional university campuses just as frequently as they do on more traditional campuses, thus supporting the need for HIV prevention programs on every college and university campus.

Adolescent↗

Incidence and reinfection rates of genital chlamydial infection among women aged 16-24 years attending general practice, family planning and genitourinary medicine clinics in England: a prospective cohort study by the Chlamydia Recall Study Advisory Group.

BACKGROUND: In England, screening for genital chlamydial infection has begun; however, screening frequency for women is not yet determined. AIM: To measure chlamydia incidence and reinfection rates among young women to suggest screening intervals. METHODS: An 18-month prospective cohort study of women aged 16-24 years recruited from general practices, family planning clinics and genitourinary medicine (GUM) clinics: baseline-negative women followed for incidence and baseline-positive women for reinfection; urine tested every 6 months via nucleic acid amplification; and behavioural data collected. Extra test and questionnaire completed 3 months after initial positive test. Factors associated with infection and reinfection investigated using Cox regression stratified by healthcare setting of recruitment. RESULTS: Chlamydia incidence was mean (95% CI) 4.9 (2.7 to 8.8) per 100 person-years (py) among women recruited from general practices, 6.4 (4.2 to 9.8) from family planning clinics and 10.6 (7.4 to 15.2) from GUM clinics. Incidence was associated with young age, history of chlamydial infection and acquisition of new sexual partners. If recently acquiring new partners, condom use at last sexual intercourse was independently associated with lower incidence. Chlamydia reinfection was mean (95% CI) 29.9 (19.7 to 45.4) per 100/person-year from general practices, 22.3 (15.6 to 31.8) from family planning clinics and 21.1 (14.3 to 30.9) from GUM clinics. Factors independently associated with higher reinfection rates were acquisition of new partners and failure to treat all partners. CONCLUSIONS: Sexual behaviours determined incidence and reinfection, regardless of healthcare setting. Our results suggest annual screening of women aged 16-24 years who are chlamydia negative, or sooner if partner change occurs. Rescreening chlamydia-positive women within 6 months of baseline infection may be sensible, especially if partner change occurs or all partners are not treated.

Adolescent↗

Differences in sexual risk behaviors between college students with same-sex and opposite-sex experience: results from a national survey.

The goal of this study was to identify differences in the sexual health behaviors (condom use and number of sexual partners) between college students with same-sex sexual experiences and those with only opposite-sex partners. Data from a random sample of American university students were gathered as part of the 1997 College Alcohol Study. Odds ratios were estimated for consistent condom use and multiple sex partners for students with same-sex or both-sex sexual partners compared to those with exclusively heterosexual contacts. Five percent of respondents reported ever having a same-sex partner. Significant differences in safer-sex practices were found between groups. Females with both-sex experience and males with both-sex or only same-sex experiences were more likely to report multiple recent sexual partners than their peers with only opposite-sex partners. Odds ratios of consistent condom use were lower for men with only same-sex experience than among those with only opposite-sex partners. Findings have implications for sexual health education on the college campus. Consistent condom use remains low among college students. Education programs should emphasize the importance of limiting the number of lifetime sex partners, especially among students with same-sex experiences.

Adolescent↗

Social and sexual risk factors for bacterial vaginosis.

BACKGROUND: A number of sexual and social risk factors for bacterial vaginosis (BV) have been identified. However, many previous studies have used small numbers of patients, or highly selected or convenience samples, or poorly defined populations. This study aims to clarify potential sexual and non-sexual risk factors for BV. METHODS: Women attending the Sydney Sexual Health Centre with BV, between March 1991 and July 1999, were included. Controls were randomly selected women without BV. Information on the demographics, clinical findings, and sexual and non-sexual risk behaviours were extracted from the clinic database and analysed using SPSS and SAS. A logistic regression model was used to establish which associations with BV persisted. RESULTS: 890 women with BV and 890 controls were studied. Factors that were independently associated with BV were > or =3 male sexual partners in the past 12 months (OR = 1.60, 95% CI: 1.19 to 2.04), at least one female sexual partner in the past 12 months (OR = 2.1, p = 0.003), a past pregnancy (OR = 1.5, p<0.0006), and smoking. In contrast, women with BV were significantly less likely to have used hormonal contraception (OR = 0.60, 95% CI: 0.51 to 0.81) or to have used condoms consistently (OR = 0.5, 95% CI: 0.31 to 0.71) than controls. CONCLUSION: Our findings may be important for planning a preventive strategy for BV by discouraging smoking and increasing condom use and hormonal contraception among women.

Adolescent↗

Partner influences and gender-related factors associated with noncondom use among young adult African American women.

We examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likely to receive AFDC, twice as likely to be sexually nonassertive, three times more likely to believe that it was not difficult to find an "eligible" African American man, and three times as likely to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.

Adult↗

Personal risk perception, HIV knowledge and risk avoidance behavior, and their relationships to actual HIV serostatus in an urban African obstetric population.

One quarter of pregnant women in Zambia are infected with HIV. Understanding how knowledge of HIV relates to personal risk perception and avoidance of risky behaviors is critical to devising effective HIV prevention strategies. In conjunction with a large clinical trial in Lusaka, Zambia, we surveyed postpartum women who had been tested for HIV but did not know their status before undergoing the questionnaire. Of 858 women for whom complete data were available, 248 (29%) were HIV infected. Women 22 years of age or older (adjusted odds ratio [AOR], 1.7; 95% confidence interval [CI], 1.1-2.5), women reporting > or =2 sexual partners in their lifetime (AOR, 1.8; 95% CI, 1.3-2.5), and women reporting a history of a sexually transmitted infection (AOR, 2.7; 95% CI, 1.7-4.3) were more likely to be HIV infected. Having had > or =2 lifetime sexual partners was a marker for perception of high personnel risk for HIV infection (AOR, 1.5; 95% CI, 1.1-2.1). However, there was no relationship between perceived risk of HIV infection and actual HIV status. In fact, 127 (52%) of 245 women who stated that they were at no or low risk for HIV infection were HIV infected. Living in an area of high HIV seroprevalence like Zambia seems to be the greatest risk factor for infection in unselected pregnant women. Before significant inroads can be made in decreasing the incidence of HIV infection among pregnant women, population-based strategies that involve men must be implemented.

Adult↗

Risk factors for hepatitis C virus seropositivity in heterosexual couples.

OBJECTIVES: To determine the risk of heterosexual transmission of hepatitis C virus (HCV) and to identify other risk factors for HCV seropositivity in heterosexual couples. DESIGN: Retrospective cross-sectional study comparing HCV-seropositive and HCV-seronegative heterosexual men and women. SETTING: Couples recruited from the community and screened for participation in a study of the heterosexual transmission of human immunodeficiency virus. PARTICIPANTS: A total of 340 subjects, 170 men and 170 women in sexual partnerships, aged 18 through 61 years. MAIN OUTCOME MEASURE: Seropositivity for HCV antibodies. RESULTS: Overall, 31 (18%) of the 170 women and 56 (33%) of the 170 men were positive by a four-antigen HCV immunoblot. Injection drug use and hemophilia were strongly associated with HCV seropositivity. Sixty-four percent of injection drug users were positive (odds ratio [OR], 27.0; 95% confidence interval [CI], 13.4 to 56.1; P < .0001), as were all four hemophiliacs in the study. History of blood transfusion was significantly associated with HCV seropositivity (OR, 2.7; 95% CI, 1.1 to 7.0; P = .02). Positivity for HCV was not associated with measures of sexual behavior within couples or with numbers of other sexual partners, history of sexually transmitted diseases, or human immunodeficiency virus seropositivity. However, two of the 31 women without parenteral risk but with a long-term HCV-positive male partner were HCV seropositive compared with none of 81 women with an HCV-negative male partner (P = .07). CONCLUSIONS: These results provide little evidence of HCV sexual transmission but are consistent with infrequent sexual transmission. They corroborate the importance of injection drug use and transfusion of blood or blood products in transmitting HCV and underscore the importance of ascertaining parenteral exposures when examining sexual transmission of HCV.

Adult↗

Sexual risk behavior among injection drug-using human immunodeficiency virus positive clients.

This study examined sexual risk behavior of 154 seropositive Hispanic injection drug-using clients who were a subsample of a larger study. The results revealed that while nearly 71% followed safe sex practices at a 6-month follow-up, the other 29% were following risky sexual behaviors. Among males who were 25 years of age or younger, slightly over 58% were practicing unsafe sex. Among females, those in the 31-35 age group were all following risky sexual behaviors. Generally, those who lived with their sexual partners, females, and younger clients tended to follow risky sexual behaviors. These findings are very significant in the light of the heterosexual transmission of Human Immunodeficiency Virus (HIV). Educational and case management programs are needed to provide such clients with an understanding of the possibility of HIV transmission to their sexual partners and to their children in case of pregnancies.

Adult↗

Predictors of cervical coinfection with multiple human papillomavirus types.

Women infected with multiple human papillomavirus (HPV) types seem to be at higher risk of cervical intraepithelial neoplasia, although there is controversy about whether coinfections are associated with lower or higher grades of dysplasia. There is no established risk factor profile for infection with multiple HPV types. We analyzed data from a prospective cohort of 2,075 Brazilian women to identify determinants of HPV coinfection. Cervical specimens were collected for cytology and HPV DNA detection. Data on baseline and time-dependent putative risk factors were obtained by interview. Baseline predictors of HPV coinfection included younger age, greater number of recent sexual partners, a history of condyloma but not of other sexually transmitted diseases, and younger age at first sexual intercourse. In repeated measures analyses, there was a weak positive association between the number of sexual partners in the time interval between two study visits and the risk of coinfection. Our results suggest that the risk factor profile for HPV coinfection among HPV-infected women shares several similarities with risk factors for any HPV infection.

Adolescent↗

Effects of counselling on knowledge about HIV-1 among transfusion recipients and their partners. Transfusion Safety Study Group.

The present study determined how much HIV-1-positive persons knew about AIDS, and HIV-1 transmission and prevention, in comparison with HIV-1-negative controls in a predominantly heterosexual cohort. The subjects were blood donors, blood recipients, hemophiliacs, and their sexual partners. A 16-item questionnaire about AIDS, HIV-1 transmission, and knowledge of safe sexual practices was administered to 228 subjects to determine background information. The HIV-1-positive cohort answered more questions correctly (mean = 8.5) than did the HIV-1-negative cohort (mean = 6.5), largely as a result of general information about AIDS among those with steady sexual partners. All persons, however, were poorly informed about HIV-1 transmission and safe sexual practices. Thus, there is a great need for effective counselling.

Acquired Immunodeficiency Syndrome↗

Bladder and sexual function among women with multiple sclerosis.

OBJECTIVE: Genitourinary dysfunction is common in women with multiple sclerosis (MS), yet few studies have evaluated the association between bladder and sexual dysfunction in these women. The aim of this study was to determine factors, including demographic and bladder function, associated with sexual dysfunction in a sample of women with MS. METHODS: One hundred and thirty-three women with MS completed questionnaires related to overall heath status, bladder function and sexual function. Response frequencies and percentages were calculated for questionnaire responses. Multivariate logistic regression analyses were performed to determine predictors of sexual dysfunction. RESULTS: Sixty-one per cent of the sample indicated that they had a problem with bladder control. Forty-seven per cent of respondents indicated that their neurological problems interfered with their sex life. Over 70% of the sample reported that they enjoyed, felt aroused and experienced orgasm during sexual activity. Not having a sexual partner and the indication of bothersome neurological problems were the best predictors of sexual dysfunction. Interestingly, patients bothered by their urge incontinence had higher levels of orgasm compared to women not bothered by urge incontinence. CONCLUSIONS: Although over half of the women reported voiding symptoms, most still enjoyed, felt aroused and could experience orgasm. Neurological symptoms and lacking a sexual partner emerged as the best predictors of sexual dysfunction. Urge incontinence may not be a risk factor for an orgasm. Our findings elucidate the complex nature of sexual dysfunction in women with MS.

Adult↗

Has the HIV/AIDS epidemic changed sexual behaviour of high risk groups in Uganda?

BACKGROUND: Uganda, was the first country in sub-Saharan Africa to reverse its HIV/AIDS epidemic. Long distance drivers, prostitutes and barmaids have been identified as the groups that engage in risky sex, which promotes HIV transmission in Uganda and other countries across the continent. This paper investigates whether and why there were changes of sexual behaviour and practices among five risky groups in Uganda as a consequence of HIV/AIDS epidemic. METHODOLOGY: The paper is based on data generated from a survey on 'resistance to sexual behaviour change in the African AIDS epidemic', which was conducted in the districts of Kabale, Kampala and Lira in 1999. For purposes of this paper, only data from the focus group discussions with high-risk groups have been analysed. These include commercial sex workers, street children, long haul truck drivers, bar maids and adolescents in three towns of Uganda (Kabale, Kampala, Lira). RESULTS: Results indicate that despite the HIV/AIDS epidemic, these groups had only changed their sexual behaviour a little, and they reported to be continuing with multiple sexual partners for a variety of reasons. The adolescents and street children were under peer pressure and a lot of sexual urge; commercial sex workers and bar maids attributed their risky behaviour to the need to survive due to the existing poverty; and the truck drivers reflected on the need for female company to reduce their stress while on the long lonely travels across Africa. Nevertheless, they are all aware and perceive people with multiple sexual partners as being highly vulnerable to contracting HIV and they all reported to have adopted condom use as an HIV preventive strategy. They also observed that married people were at a high risk of contracting HIV due to non-use of condoms in marital relationships and unfaithfulness of spouses. CONCLUSIONS Females engage in high-risk sexual relations as a means of economic survival, and perceive their acts as a strategy to improve their socio-economic well being. On the contrary, men in these high-risk categories do such acts out of pleasure and as avenues for attaining fulfilled sexual lives. The search for money among women and the constant desire for men to have sexual pleasure, which are greatly facilitated by their financial status are the forces behind reckless sexual behaviour among high-risk groups.

Acquired Immunodeficiency Syndrome↗

Positive, negative, unknown: assumptions of HIV status among HIV-positive men who have sex with men.

Serosorting (i.e., engaging in unprotected sex with partners known to be of the same serostatus) can be a difficult process for men who have sex with men (MSM) who frequently make assumptions about their partners' serostatus. This process can be further complicated by a partner's dishonesty as well as other individual and contextual factors. The present study specifically examined how assumptions of serostatus made about unknown serostatus partners impact on the sexual behavior of 110 alcohol-abusing HIV-positive MSM. Although previous research has shown that HIV-positive MSM are more likely to serosort with other known HIV-positive men than with known HIV-negative men, our data suggest that unprotected sex behavior may not be specifically driven by whether or not they made assumptions of seroconcordance or serodiscordance. The types of assumptions these HIV-positive MSM made about their unknown status sexual partners and the basis for such assumptions were also examined. Owing to the ambiguities involved in assumptions of a partner's serostatus in sexual encounters, the 'unknown status' partner category is analytically distinct from 'known status' categories, and needs to be more fully explored because of its impact on perceived serosorting, rather than actual serosorting, among HIV-positive men.

Adult↗

Personality differences between endometrial and cervical cancer patients in relation to sexual behavior.

Possible differences in personality were investigated in a sample of endometrial (n = 30) and cervical (n = 30) cancer patients and related to sexual behavior. The assessments were based on the Karolinska Scales of Personality (KSP) and semistructured interviews. The endometrial group reported both a higher age at sexual debut and a lower number of sexual partners whereas the corresponding figures for the cervical group were within the range of representative data from the general population. Strikingly, numerous significant correlations between personality characteristics and behavioral aspects appeared in the cervical group. In a discriminant analysis between the two cancer groups, verbal aggression, number of sexual partners, irritability, use of alcohol, age at sexual debut, impulsivity and social desirability appeared to be the most powerful variables. In view of the similarity of cervical cancer women in terms of personality and sexual behavior to normative data the elaboration of adequate and large-scale preventive measures aimed at young age groups is warranted.

Adult↗

Sexual behaviour in Zulu men and women with genital ulcer disease.

OBJECTIVE--To investigate patterns of sexual behaviour in men and women with genital ulcer disease (GUD) and their relevance to HIV-1 transmission. METHODS--A sexual behaviour questionnaire was administered by the same interviewer to all participants who were also entered into a study of the microbial aetiology of GUD. SETTING--City Health Sexually Transmitted Diseases Clinic, King Edward VIII Hospital, Durban, South Africa. PARTICIPANTS--100 Zulu men and 100 Zulu women. RESULTS--36 (%) of men and 36 (%) of women had continued with sexual intercourse despite GUD. Patients with donovanosis and secondary syphilis were more likely than those with other causes of GUD to have intercourse despite ulcers. During swab collection bleeding was observed from ulcers in 59 women and 26 men. Prostitutes were not identified and were rarely named as source contacts. Men had more sexual partners (190) than women (122) during the previous three months. Condom use was minimal. Men who migrated between urban and rural areas appeared to have the most sexual partners. Urban women had more partners than women from rural areas. CONCLUSIONS--Men and women with GUD are practising riskful sexual behaviour and could benefit from behaviour modification programmes. In this community men who travel between urban and rural areas and who present late with GUD that bleeds easily are probably the most important high-frequency HIV transmitter core group. A significant potential risk of blood to blood contact during sexual intercourse exists in patients with GUD.

Black People↗

Gender and the stolen kiss: the social support of male and female to violate a partner's sexual consent in a noncoercive situation.

Although the literature on gender and status consistently asserts that men receive greater support for sexual self-determination than women do, this study found the contrary to be true in the case of noncoercive kissing. College students assessed a vignette in which one dating partner says he/she does not want to be kissed, but the other partner does not listen, and kisses him/her anyway. There was significantly more support for the female to violate the male's consent in this situation than vice versa, and there was significantly less support for the male to withhold sexual consent. The paper concluded by suggesting that men received less support to violate a partner's sexual consent than women did because men are seen as more threatening than women. Correspondingly, men received less support to withhold sexual consent because the appearance of diffidence conflicts with the cultural norm of male aggressiveness.

Adult↗

Isolation of Mycoplasma pneumoniae from the human urogenital tract.

Mycoplasma pneumoniae is a common etiologic agent of lower respiratory tract infections in humans. However, it has been reported previously that the organism has occasionally been isolated from sites other than the oropharynx and respiratory tract. We report the isolation of 24 strains of M. pneumoniae from urogenital specimens obtained from 22 female patients. Most isolates were of cervical origin from patients attending several local gynecological clinics over a 2-year period. Strains were also isolated from the urethra of one of three healthy male sexual partners of female patients positive for the organism. Single serum specimens obtained from three female patients and three different male sexual partners showed antibody levels suggestive of either recent respiratory infection or genital tract colonization with M. pneumoniae. Although there is no apparent definitive explanation for the localized outbreak of the organism at these unusual sites, the possible transfer through sexual and/or orogenital contact remains the most likely mode of transmission. The occurrence of an organism with obvious pathogenicity for human epithelial tissue in the urogenital tract suggests such transfer could play a role in genital tract infection.

Adult↗