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PubMed1999

Acceptability of female condom use among women exchanging street sex in New York City.

Greater access to alternative female-initiated barrier methods, such as the female condom, is needed among women exchanging street sex. This study describes knowledge of and experience with the female condom among 101 women exchanging sex for money and drugs on the streets of New York City, and examines the acceptability of female condom use as an alternative barrier method for HIV/STD prevention among this population. Female condom use among this sample of sex workers was found to be related to having a regular sexual partner, living with someone who is a drug or alcohol abuser, not being homeless, using alcohol or intravenous heroin, having heard of the device, and having discussed the device with other women or with a regular sexual partner. Despite decreased acceptability post-use, most sex workers indicated an intention for future female condom use.

Adult↗
PubMed2000

Risk factors for HIV-2 seropositivity among older people in Guinea-Bissau. A search for the early history of HIV-2 infection.

Because the seroprevalence of HIV-2 has been shown to be high in older age groups, we conducted a survey of all persons aged 50 years or over in two districts in Bissau, investigating the presence of HIV antibodies and possible risk factors for HIV infection with a particular emphasis on age, the impact of the war of independence (1963-74), traditional marital and extramarital sex patterns, blood contact and contact with monkeys. In 670 participants, the HIV-2 prevalence was 14.3%; 16.1% in women and 12.3% in men. The HIV-1 prevalence was only 0.5% (3/670). The HIV-2 prevalence peaked for men in the 60-69 years age group, and for women in the 50-59 years age group, declining markedly in the following age group for both men and women (OR = 0.09 (0.01-0.51), OR = 0.37 (0.15-0.82), respectively). This pattern could be due to differential mortality for HIV-2 infected individuals or to a cohort effect for a generation who were sexually active at the time of the war of independence in the 1960s and early 1970s in Bissau. Supporting the link with the colonial army, women who had had sex with a white man had a higher seroprevalence (OR = 3.63 (1.12-11.24)). The ethnic group indigenous to Bissau city had a much lower prevalence, but demographic and cultural risk factors such as marital status, religion, education and having lived outside Bissau were not associated with HIV-2. In the multivariate analyses for women, variables related to extramarital sex or prostitution (having sex with a white man, having lived in Senegal, not living with husband, and not marrying first sexual partner) were associated with higher risk. For men, previous spouses who had died or had divorced were associated with higher prevalence. Having married the first sexual partner was protective against HIV-2 infection for both men (OR = 0.29 (0.09-0.76)) and women (OR = 0.19 (0.04-1.00)). Hospitalizations, possibly due to transfusions, tended to be associated with higher risk, but only for women (OR = 1.83 (0.97-3.48)). The focus of the HIV-2 epidemic in Guinea-Bissau is likely to be endogenous, and the war of independence and the colonial army with its associated prostitution may have played an important part in propagating the virus.

Aged↗
PubMed1996

Measuring vaccine efficacy for both susceptibility to infection and reduction in infectiousness for prophylactic HIV-1 vaccines.

Current Phase III trials are designed to assess only a vaccine candidate's ability to reduce susceptibility to infection or disease, that is, vaccine efficacy for susceptibility (VES). Human immunodeficiency virus (HIV) vaccination, however, may reduce the level of infectiousness of vaccinees who become infected, producing an important indirect reduction in HIV transmission even if the vaccine confers only modest protection against infection. We propose two approaches for augmenting the information of a classic trial for estimating protective efficacy that enable the additional estimation of the vaccine's effect on infectiousness, that is, vaccine efficacy for infectiousness (VEI). In the first augmentation, steady sexual partners of trial participants are recruited but not randomized to vaccine or placebo. Their infection status is monitored throughout the trial. In the second augmentation, the sexual partners are randomized. Through computer simulations and analytic methods, we investigate the feasibility and statistical properties of the augmented designs. Phase III prophylactic HIV-1 vaccines trials are currently being planned. Employment of the augmented designs described in this paper would not only provide estimation of VEI but also increase the precision of the VES estimator and the power to reject the null hypothesis of no vaccine effect.

AIDS Vaccines↗
PubMed2001

Adolescents with ASCUS: are they a high risk group?

Population demographics, risk behaviors, and compliance rates for the management of an ASCUS (atypical squamous cells of undetermined significance) diagnosis are not well studied in the adolescent population. From June 1994 to December 1996, 1,175 Papanicalou (pap) smears were performed in an urban adolescent clinic on patients age 12 to 18. Of these, 124 (10.5%) were diagnosed with ASCUS or ASCUS with a qualifying statement. A retrospective chart review (n=83) and telephone interview was performed on patients with ASCUS. Ninety-nine percent of enrollees were African American. Comparisons were made between those patients with normal pap smears and those with ASCUS. No statistically significant difference existed pertaining to age at pap smear, age at menarche, age at first coitus, and education level. A positive association was found in the ASCUS group for the presence of sexually transmitted diseases (P < 0.001), number of sexual partners (P < 0.0007), and pregnancy (P < 0.001). Of the 80% of patients who had an ASCUS diagnosis and were referred for colposcopy (n = 62), only 61% attended their appointment (n = 38). Thirty-nine percent of these patients were aware of an abnormal diagnosis after colposcopy. For those that attended colposcopy, 56% were accompanied by a parent. For those who were not compliant with attendance, none cited parental consent for the procedure as a barrier to obtaining treatment. Adolescent females in an urban setting with multiple sexual partners, history of sexually transmitted diseases, and prior pregnancy are at a greater risk for ASCUS on cervicovaginal smear when compared to their age-matched controls. In addition, the adolescent compliance rate for colposcopy is low. We, therefore, recommend that these adolescent females be observed diligently.

Adolescent↗
PubMed2006

The changing risk profile of the American adolescent smoker: implications for prevention programs and tobacco interventions.

PURPOSE: To determine how the association between cigarette smoking and other risky behaviors, such as substance use, violence, and risky sexual practices, has changed between 1991 and 2003. METHODS: Youth Risk Behavior Surveys (YRBS) from 1991 to 2003 were analyzed. For each cohort, logistic regression models controlling for gender, race/ethnicity, and school grade were used to describe the associations between smoking and other risky behaviors. Changes in the odds ratios over time were confirmed with a trend analysis. RESULTS: The strength of the relationship between smoking and other risky behaviors increased for lifetime number of sexual partners (1991 odds ratio [OR] 1.49; 2003 OR 1.61 (p < .001)), sexual partners in the past 3 months (1991 OR 1.77; 2001 OR 2.05 (p < .001)), and never wearing a bicycle helmet 1991 OR 1.40; 1997 OR 5.94 (p < .001). Increases were also seen for binge drinking, and physical fighting. The association between cigarette smoking and marijuana use decreased slightly. CONCLUSIONS: Future prevention efforts and tobacco intervention programs should recognize that current adolescent smokers are even more likely to engage in risky sexual behavior, risky alcohol-related behaviors, and to not use a seatbelt or bicycle helmet than were adolescents in the early nineties.

Adolescent↗
PubMed1993

Factors controlling the spread of HIV in heterosexual communities in developing countries: patterns of mixing between different age and sexual activity classes.

The paper describes the development and analysis of a mathematical model of the spread and demographic impact of HIV in heterosexual communities in developing countries. The model extends previous work in this area by the representation of patterns of mixing between and within different age and sexual activity classes in a two sex structure. Summary parameters are derived to represent different mixing patterns, ranging from assortative via random to disassortative, as are methods to ensure that particular mixing patterns between different age and sexual classes (stratified on the basis of rates of sexual partner change) meet constraints that balance the supply and demand for sexual partners as AIDS induced mortality influences the demographic structure of a population. Analyses of model behaviour rely on numerical methods due to the complexity of the mathematical framework, and sensitivity analyses are conducted to assess the significance of different assumptions and different parameter assignments. Simulated patterns of HIV spread across the two sexes and various age classes are compared with observed patterns in Uganda. The principle conclusion of the study is that the pattern of mixing between age and sexual activity classes, combined with the assumptions made to balance supply and demand between the sexes have a very major influence on the predicted pattern of HIV spread and the demographic impact of AIDS. The paper ends with a discussion of future needs in model development and data acquisition.

Acquired Immunodeficiency Syndrome↗
PubMed2002

A review of studies of sexual behaviour of school students in sub-Saharan Africa.

AIMS: This is a review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999. The objective was to describe what is known in this regard and identify gaps in knowledge. METHODS: Literature search using electronic databases and a thumb search of relevant journals identified 47 articles reporting sexual behaviours of school-based young persons aged between 14 and 24 years. RESULTS: The findings indicate a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region; high prevalence rates of sexual intercourse; infrequent use of condoms and other contraceptives; and significant proportions of adolescents who have two or more lifetime sexual partners. More data are needed on the extent to which adolescents engage in non-penetrative sexual behaviour and penetrative sex other than heterosexual vaginal intercourse; characteristics of the sexual partners of adolescents; and proximal psychosocial antecedents of sexual behaviour and consistent risk-reduction behaviours. CONCLUSIONS: Cultural influences on sexual behaviour, the sensitivity of such research in adolescent populations, and the opportunity afforded by school systems for intervention suggest a need for additional exploratory and methodological studies. Placing such information firmly within sociocultural contexts in which young people are raised will better inform effective interventions that both delay the onset of sexual intercourse and encourage use of risk reduction strategies.

Adolescent↗
PubMed2002

Opportunities for prevention: hepatitis C prevalence and incidence in a cohort of young injection drug users.

The objective of this study was to compare sociodemographic, drug, and sexual risk characteristics between hepatitis C virus (HCV) baseline positive and negative young (13-24 years) injection drug users (IDUs) and to determine prospective risk factors for HCV seroconversion among the youth. Data were collected through the Vancouver Injection Drug Users Study (VIDUS). To date, more than 1,400 Vancouver-area IDUs have been enrolled and followed up; 234 were aged 24 years and younger. Semiannually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for human immunodeficiency virus (HIV) and HCV. Univariate and multivariate logistic regression analyses were undertaken to investigate predictors of baseline HCV positivity. In the multivariate analyses, Cox regression models with time-dependent covariates were used to identify predictors of HCV seroconversion. Of the 232 young injectors, 107 (46%) were HCV positive at baseline and a further 37 HCV seroconverted during the study period for an incidence rate of 37.3 per 100 person-years. Baseline positivity was associated with Aboriginal ancestry, older age, greater number of years injecting drugs, recent incarceration, sex trade work, more than 100 lifetime sexual partners, a previous sexually transmitted disease, living in the IDU epicenter, and injection more than once per day of heroin, cocaine, and speedball. Factors independently associated with HCV seroconversion were having a partner who uses injection drugs, requiring help to inject, and injection of cocaine more than once daily. In conclusion, unlike older IDUs, more than one half of young injectors were HCV negative at recruitment. Thus, there is a window of opportunity for prevention. However, the incidence rate of HCV among these young IDUs is alarming, suggesting that the opportunity to intervene is exceedingly small.

Adolescent↗
PubMed1999

[Factors associated with survival in Kaposi's sarcoma in patients infected with the human immunodeficiency virus. Clinical Epidemiological Group for AIDS in Aquitaine].

BACKGROUND: To study behavioral risk factors of Kaposi's sarcoma (KS) among HIV infected homosexuals in Bordeaux, southwest France. METHODS: A case-control study was performed within the Aquitaine Cohort. Cases of KS surviving in 1995 and homosexuals were systematically enrolled. For each case, two controls were selected among homosexuals surviving in the cohort. Cases and controls were matched on year of diagnosis of HIV infection. Data collection was based on a self administered questionnaire focusing on use of recreational drugs, detailed sexual practices and sexually transmitted diseases in the year preceeding the diagnosis of HIV infection, in the year after the HIV diagnosis and in the year preceeding the diagnosis of KS (or an equivalent period of time for controls). RESULTS: Twelve cases were matched to 2 controls, 15 cases to one control and 13 cases remained unmatched. Matched analysis identified an association between KS and regular sexual partner (odds ratio = 0.07; 95% confidence interval: 0.01-0.52 and p < 0.001) and active and passive oro-anal intercourse before HIV diagnosis and before KS diagnosis (p = 0.01). In the unmatched analysis including all cases, we found an association between KS and the overall number of sexual partners (p < 0.03) for all periods of interest. CONCLUSIONS: This case-control study identified sexual practices in favor of a sexually transmitted agent of KS.

Case-Control Studies↗
PubMed1997

Establishing a link between cultural evolution and sexually transmitted diseases.

It is argued that archaic sexually transmitted diseases influenced cultural traditions by reducing multiple sexual partners within communities. In this article, the adverse consequences of current sexually transmitted diseases are surveyed: Such infections decrease fertility of women and increase infant mortality; those adverse consequences are especially potent when antibiotics are not readily available. Cultural (cross-generational transmission of learned) responses to the threat of widespread infertility and elevated infant mortality rates are hypothesized to include the implementation of expectations for restricted numbers of sexual partners. These expectations, formal or informal, have been instituted within the context of biological predispositions, the "certainty of paternity" model, already-established traditions, and the need for a social father to be aligned with the mother-child dyad. A case study of the contemporary United States is offered as a heuristic example of how and why cultural choices may be developed and sustained.

Cultural Evolution↗
PubMedDate not supplied

[Key aspects of sexual behavior and safer sex practice among men in the city of São Paulo].

Heterosexual relations currently constitute the predominant route of HIV transmission to women in Brazil. Few studies have approached male sexual behavior taking women into account. This study included 597 men ages 21 to 50 in São Paulo city and explored several aspects pertaining to safer sex, such as sexual partners, knowledge of sexually transmitted diseases (STDs)/AIDS, risk perception, and protective practices aimed at AIDS prevention. The results showed that, similar to other countries, the proportion of men who have sex with men is low (5%), that younger men adopt more protective behavior than older men regarding multiple partners and condom use, that knowledge of AIDS is widespread (but that there is still a lack of knowledge concerning STDs in general), and that although risk perception increases protective behavior, presumption of the partner's behavior influences this perception, placing men and women in a vulnerable situation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Timing of alcohol and other drug use and sexual risk behaviors among unmarried adolescents and young adults.

CONTEXT: Although alcohol and drug use by young people has been associated with sexual risk behavior in some research, detailed data are lacking on the timing of substance use in relationship to sexual risk-taking. METHODOLOGY: Cross-sectional data on 7,441 unmarried young people aged 14-22 from the 1992 Youth Risk Behavior Survey (household supplement) were used in the analysis. Alcohol and other drug use at last sexual intercourse, substance use in the past 30 days (recent use), the number of different substances ever used (lifetime use) and age at initiation of alcohol use are examined here. The outcome variables assessed through multivariate regression analyses were condom use at last intercourse and more than one sexual partner in the past three months. RESULTS: Failure to use a condom was strongly associated with the lifetime substance-use scale or, alternatively, with age at initiation of alcohol. Once the number of substances ever used was controlled for, neither substance use at last sexual intercourse nor recent use was associated with the likelihood of using a condom at last coitus. Among young men and women, recent substance use and use of either alcohol or drugs at last intercourse were both strongly associated with having had more than one sexual partner in the past three months. For females only, lifetime use also increased the probability of recent multiple partners. CONCLUSIONS: The relationships between alcohol and other drug use and two sexual behaviors--condom use and multiple partners-suggest distinct mechanisms of influence and the need for different prevention strategies.

Adolescent↗
PubMed1988

Subclinical penile human papillomavirus infection and dysplasia in consorts of women with cervical neoplasia.

Fifty men whose sexual partners were 50 women with histologically proved cervical intraepithelial neoplasia (CIN) grade III (severe dysplasia or carcinoma in situ) were studied. A further 25 men whose current regular sexual partners were 25 women with chlamydial cervicitis were recruited as controls. If either of the partners in either group had genital condylomata acuminata or a known history of similar lesions, the couple was excluded from the study. Abnormal penile epithelium, which was detected by colposcopy after application of 5% acetic acid to the penile skin, was reported in 25 men in the study group compared with three in the control group. Histologically proved subclinical penile infection with human papillomavirus (HPV) was present in 23 men in the study group compared with three in the control group (p less than 0.01). Of the 50 men in the study group, four had histologically proved severe penile dysplasia or carcinoma in situ with evidence of HPV infection, the disease being subclinical in each case and diagnosed on histology of a specimen obtained by colposcopically directed biopsy. HPV DNA was detected on filter hybridisation of penile scrapes from 15 of the 23 men in the study group with histologically proved penile HPV infection, HPV16 DNA being detected in 10 of them. HPV DNA was detected on DNA-DNA hybridisation of biopsy material in seven of 18 men with histologically proved penile HPV infection. Five of these biopsy specimens were positive for HPV16 DNA. Only one man in the control group had HPV DNA detected in a penile scrape. This patient had histologically proved subclinical penile HPV infection. Such lesions may represent an important male reservoir of HPV types implicated in genital squamous carcinogenesis in both sexes.

Adult↗
PubMedDate not supplied

Spectrum of genital human papillomavirus infection in a female adolescent population.

BACKGROUND: Human papillomavirus infection is a sexually transmitted disease associated with cervical dysplasia and carcinoma. GOAL OF THIS STUDY: To determine prevalence rates of cervical human papillomavirus infection compared with other sexually transmitted diseases and risk factors associated with human papillomavirus infection among adolescent women, we evaluated 634 patients attending three urban adolescent clinics. STUDY DESIGN: Patient evaluation included Pap smears; screening for chlamydia, gonorrhea, and trichomoniasis; and testing of cervical swab samples for human papillomavirus DNA. RESULTS: Cervical human papillomavirus was the most common STD in our population (15.6%), followed by infection with Chlamydia trachomatis (11.0%), Neisseria gonorrhoeae (7.1%), and Trichomonas vaginalis (5.4%). The most prevalent human papillomavirus types were 16/18 (7.3%), followed by 31/33/35 (4.7%) and 6/11 (3.5%). When genital warts on exam, low-grade squamous intraepithelial lesions on cytology, or cervical human papillomavirus DNA were considered as indicators of genital human papillomavirus infection, 24% of patients had any manifestation of infection, including 15% with clinically apparent infection (genital warts), 36% with cytologically apparent infection without warts, and 49% with subclinical infection only (cervical human papillomavirus DNA without low-grade squamous intraepithelial lesions or warts). Factors associated with detection of cervical human papillomavirus DNA by multivariate analysis included number of lifetime sexual partners and genital warts on exam. CONCLUSION: Cervical human papillomavirus infection was the most prevalent sexually transmitted disease among an ethnically diverse group of urban adolescent females, with a large proportion of infections neither clinically nor cytologically apparent. The strong association with lifetime sexual partners substantiates that cervical human papillomavirus is acquired predominantly by sexual contact and often soon after the onset of sexual activity.

Adolescent↗
PubMed2004

Monogamous networks and the spread of sexually transmitted diseases.

Patterns of sexual mixing and heterogeneity in the number of sexual partners can have a huge effect on the spread of a sexually transmitted disease (STD). The sexual mixing network identifies all partnerships within a population over a given period and is a powerful tool in the study of such infections. Previous models assumed all links within the network to be concurrent active partnerships. We present a novel modelling approach in which we adapt the notion of a sexual contact network to a monogamous population by allowing the nature of the links to change. We use the underlying network to represent potential sexual partnerships, only some of which are active at any one time. Thus serial monogamy can be modelled while maintaining the patterns of mixing displayed by the population.

Contact Tracing↗
PubMed1995

Prevalence of hepatitis B virus (HBV) infection in Singapore men with sexually transmitted diseases and HIV infection: role of sexual transmission in a city state with intermediate HBV endemicity.

STUDY OBJECTIVES: To describe the prevalence of hepatitis B virus (HBV) infection in patients with sexually transmitted diseases (STD) and human immunodeficiency virus (HIV) infection, and to determine the role of sexual transmission of HBV infection in Singapore. DESIGN: A cross sectional study of all consecutive men presenting with a new episode of STD at a government outpatient clinic and all men with HIV infection on routine follow up at a government hospital. The prevalence of various HBV markers was compared with that of healthy males aged 15 years and above (controls). SETTING: Singapore, a city state of intermediate HBV endemicity. SUBJECTS: These comprised 497 STD patients, 47 HIV infected patients, and 418 controls. MAIN RESULTS: The overall seroprevalences of HBV infection in STD patients, HIV infected patients, and control subjects were 41.2%, 61.7%, and 33.3%, respectively (p < 0.001). The seroprevalences of hepatitis B surface antigen (6.2%, 8.5%, and 4.5%, respectively) were comparable in the three groups. Using stepwise logistic regression analysis, the adjusted seroprevalences of HBV infection in STD and HIV infected patients were respectively 2.4 times (95% confidence interval (CI), 1.7, 3.3) and 3.3 times (95% CI 1.7, 6.3) higher than in controls. HBV infection rates were higher among Chinese (odds ratio (OR), 1.9; 95% CI 1.6, 3.4) than non-Chinese, and among those aged 25-34 years (OR 2.4; 95% CI 1.6, 3.4), 35-44 years (OR 3.9; 95% CI 2.5, 5.9), and 45+ years (OR 6.2; 95% CI 3.8, 10.2) than in those aged 15-24 years. Sex related factors significantly associated with higher infection rates, independent of age and ethnic group, were reactive VDRL test (OR 2.4; 95% CI 1.2, 4.7), participation in anal intercourse (OR 2.3; 95% CI 1.2, 4.3), and having 10 or more lifetime sexual partners (OR 1.5; 95% CI, 1.0, 2.1). CONCLUSION: The importance of sexual transmission of HBV in an area of intermediate HBV endemicity was confirmed. Patients attending STD clinics should be routinely screened for HBV markers and those found to be seronegative should be strongly advised to be immunised against this virus.

Adolescent↗
PubMed2003

Sexually-transmitted infections in adolescents and young adults in a large city of Northern Italy: a nine-year prospective survey.

To determine demographic, epidemiological, clinical features and risk factors of sexually-transmitted diseases (STD) in adolescents and young adults referring to a STD centre in Northern Italy, patients diagnosed with a STD and aged 13-20 years, were prospectively evaluated from the year 1991. Teenagers showed an appreciable and increasing risk of a broad spectrum of STD, and represented 3.6-13.3% of patients yearly diagnosed with a STD in a nine-year period. More than 10% of patients were under the age of 18, and did not report condom use in the six months preceding diagnosis in 96.7% of cases. A significant increase in the female gender was found since 1993 (but our series was massively influenced by the recent immigration of female sex workers, who declared frequent condom use), while male homosexuals and drug addicts represented a minority. When excluding subjects engaged in prostitution, over 50% of patients declared only 0-1 sexual partners during the last six months, but a significant increase in sexual promiscuity was observed over time (1997-1999 versus 1991-1996) (p<.02). Over two thirds of our teenagers never used a condom prior to the diagnosis of STD, and the apparently increased temporal trend to condom utilization proved related only to the recent immigration of sex workers; lack of condom use proved significantly related to the male gender, and a lower education. Non-gonococcal STD and human Papillomavirus infection accounted for over 60% of overall diseases, while the frequency of molluscum contagiosum, gonorrhea, HSV genital ulcer, and Chlamydia disease ranged from 6.1 to 7.4%, and that of syphilis, phthiriasis, trichomoniasis, and HIV infection varied from 1.3 to 4.7%. Non-gonococcal STD and syphilis were increasingly diagnosed over time, especially in immigrant prostitutes (and despite their frequent condom use). According to our surveillance study of teenagers, a number of demographic, epidemiological, and clinical features of STD showed significant variations over time: recent immigration, spread of prostitution, increased sexual promiscuity, and infrequent condom use, are relevant and/or persisting risk factors. A permanent monitoring of STD in young adults and adolescents is strongly warranted, to allow a timely diagnosis and an appropriate treatment, and to plan preventive strategies specifically addressed to this target population, with special attention to immigrants and sex workers.

Adolescent↗
PubMed1997

Correlation between self-reported cocaine use and urine toxicology in an inner-city prenatal population.

To determine the prevalence of recent cocaine use and the accuracy of self-reported use, the results of a urine assay for the major cocaine metabolite benzoylecgonine were compared with self-reported cocaine use in an inner-city prenatal population offered routine voluntary urine toxicology screening at the time of registration for prenatal care. During a 1-year period, 6866 women registered for prenatal care and 5200 (76%) consented to urine assays for cocaine metabolites. Of the women consenting to urine assays, 253 (5%) had positive assays for benzoylecgonine. Women with positive assays were significantly more likely than those with negative assays to be older (mean [SD] 27 [5] versus 23 [6] years), black, single, and unemployed. In addition, women with positive assays were significantly more likely to be multiparous, report > two sexual partners in the previous year, and acknowledge a history of a sexually transmitted disease (STD). Forty-seven percent of women with positive assays acknowledged cocaine use in the 6 months prior to sampling. Women with positive assays who denied cocaine use were significantly more likely than those who admitted use to be younger (mean [SD] 26 [5] versus 28 [4] years), to report > or = two sexual partners in the past year, and acknowledge a history of an STD. This analysis revealed a poor correlation between self-reported cocaine use and the results of urine assays for cocaine metabolites among women seeking prenatal care in an inner-city institution.

Cocaine↗