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PubMed1980

Epidemiology of infection by serotypes D to K of chlamydia trachomatis.

Non-specific urethritis (NSU) is a sexually transmitted disease; 50% of cases are due to Chlamydia trachomatis, so that this is the commonest sexually transmitted infection in the developed world. Chlamydial infection is now readily diagnosable and the evidence increasingly suggests that it is underdiagnosed. Chlamydial conjunctivitis (in the newborn baby or the adult) in the developed world is a complication of sexually transmitted genital infection by C trachomatis and it indicates a large reservoir of such infections. Because of the association of sexually transmitted diseases, systemic treatment for such chlamydial conjunctivitis should not be given until full genital and serological investigators have been carried out. Chlamydial infection causes serious complications (that were formerly often thought to be gonococcal), such as epididymitis in young men and salpingitis on young women. It may cause local complications in the eye of the newborn baby and even pneumonia in babies and fatal endocarditis in adults. The diagnosis of NSU should lead to the correct treatment of the male patient and of his sexual partners. It is the promiscuous woman, who does not have a regular sexual partner to report back to her that he has NSU, who is at particular risk of undiagnosed chlamydial infection. Routine genital investigations for chlamydia are particularly indicated in her case. Following the parallel of gonorrhoea, it seems that the use of contact tracers may be an effective method for controlling chlamydial infection.

Adult↗
PubMed2001

Sexuality in patients with noninvasive mechanical ventilation due to chronic respiratory failure.

In patients with chronic respiratory failure (CRF) noninvasive mechanical ventilation (NMV) improves quality of life. We studied some basic issues concerning sexuality in patients with NMV. In 383 patients with NMV for CRF (age, > 40 yr) physiologic data (lung function, blood gases, and exercise) were taken from within the 6 mo period before enrollment. The questionnaire was focused on sexuality after initiation of NMV. Of the patients, 54.3% sent back the questionnaire. NMV was used for 41.1 +/- 27.0 mo. A total of 34.1% of patients were sexually active. Compared with patients receiving NMV, control persons had a higher rate of sexual activity (84%, p < 0.0001) and masturbation rate (13 versus 40%). Sexually active patients had greater VC (2.1 versus 1.8 L), higher FEV(1) (1.4 versus 1.1 L), higher Pa(O(2)) at rest (64.0 versus 60.4 mm Hg), a higher maximal work load (72.0 versus 58.8 W), were younger, and most of them were married or had sexual partners. Changes in sexual activity after NMV initiation were reported to be as follows: "Nothing changed," 46.3%; "less active," 35.8%; "more active," 12.6%; and "fantasy increased," 10.5%. Increased sexual fantasy predominated in men. "Sexually active" patients with NMV had sexual intercourse 5.4 +/- 4.8 times per month. Sexuality in patients receiving NMV for CRF is markedly reduced compared with normal subjects. In half of the patients, sexual activity is influenced by initiation of NMV.

Analysis of Variance↗
PubMed1995

Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior.

Two studies are presented that evaluate newly developed scales of sensation seeking and sexual compulsivity. Results showed that the scales were reliable and correlated with convergent and divergent measures in expected directions in samples of both gay men (N = 296) and inner city low-income men and women (N = 158). Consistent with theories of sensation seeking, the scales corresponded to an attraction toward a range of sexual practices, including increased frequencies of unprotected intercourse and a greater number of sexual partners. As expected, sexual compulsivity was not related to variety and novelty in sexual practices, but was associated with lower levels of self-esteem and resistance to adopting sexual risk-reducing strategies. However important differences were observed between the gay men and heterosexual samples; scales correlated with substance use only among gay men, and sexual compulsivity was related to a range of sexual practices only among heterosexuals. The sensation seeking and Sexual Compulsivity Scales were therefore reliable, appeared valid, and useful in predicting sexual risk behaviors.

Adolescent↗
PubMed2006

A case control study of active genital Chlamydia trachomatis infection among patients with tubal infertility in northern Nigeria.

A case-controlled study of the prevalence of genital Chlamydia trachomatis infection in 120 patients with tubal infertility (study group) and 120 clients of the family planning clinic (control group) attending the Ahmadu Bello University Teaching Hospital, Zaria in northern Nigeria is reported. The prevalence was 38.3%, 95% confidence interval (CI) (29.6-47.6%) in the study group and 13.3%, 95% CI (7.8-20.7%) in the control group. There was a fourfold risk of having genital Chlamydial infection among the cases compared to the controls (odds ratio [OR] = 4.04, 95% CI (2.04 < OR < 8.09). Tubal infertility was found to be significantly associated with genital C. trachomatis infection (P < 0.001). Out of the 58 cases of primary infertility, 22(37.9%) tested positive for genital C. trachomatis compared with 24 of the 62 (38.7%) that had secondary infertility. The infection was not found to be significantly associated with a particular type of infertility (primary or secondary), number of sexual partners or previous sexually transmitted disease (P < 0.05). There is need for provision of facilities to enable screening for genital C. trachomatis infection in view of its high prevalence in the study population.

Adult↗
PubMed2006

Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students.

OBJECTIVE: The purpose of this study was to examine whether depressive symptoms are predictive of subsequent sexual risk behavior in a national probability sample of US middle and high school students. METHODS: Sexually active, unmarried, middle and high school students (n = 4152) participated in home interviews in waves I and II of the National Longitudinal Study of Adolescent Health, at an approximately 1-year interval. Associations between baseline depressive symptoms and sexual risk behaviors over the course of the following year were examined separately for boys and girls, adjusting for demographic variables, religiosity, same-sex attraction/behavior, sexual intercourse before age 10, and baseline sexual risk behavior. RESULTS: In adjusted models, boys and girls with high depressive symptom levels at baseline were significantly more likely than those with low symptom levels to report > or = 1 of the examined sexual risk behaviors over the course of the 1-year follow-up period. For boys, high depressive symptom levels were specifically predictive of condom nonuse at last sex, birth control nonuse at last sex, and substance use at last sex; these results were similar to those of parallel analyses with a continuous depression measure. For girls, moderate depressive symptoms were associated with substance use at last sex, and no significant associations were found between high depressive symptom levels and individual sexual risk behaviors. Parallel analyses with the continuous depression measure found significant associations for condom nonuse at last sex, birth control nonuse at last sex, > or = 3 sexual partners, and any sexual risk behavior. CONCLUSION: In this study, depressive symptoms predicted sexual risk behavior in a national sample of male and female middle and high school students over a 1-year period.

Adolescent↗
PubMed1991

Knowledge and attitudes relating to condoms on the part of African high school children around Johannesburg.

Senior high school children completed a self-administered questionnaire on sexual activity, knowledge of family planning methods, condoms and use of condoms. The study highlighted some useful and interesting information though its value is limited by a poor response rate. The results suggest that at least 50% of the scholars are sexually active, but only about 20% reported sexual intercourse during the month preceding the survey. This small group reports more than 1 sexual partner and unprotected sexual intercourse in over 50% of the cases. Knowledge of condoms was poor and a number of factors relating to resistance to condoms are identified. These must be addressed by a combination of social marketing and educational strategies. The most important finding is that half of the children were still not sexually active. Education programmes therefore should support the development of safe and responsible sexual lifestyles.

Adolescent↗
PubMed1999

Amphetamine use and its correlates among youths living with HIV.

Amphetamine use and its correlates are examined among youths living with HIV (YLH) to determine whether its use is associated with increased transmission acts and poor health. Amphetamine use, other HIV-related risk acts, T-cell counts, emotional distress, coping style, and symptoms of HIV are examined in 337 YLH. One third of YLH engaged in amphetamine use in their lifetime, and 21% of youths reported current use (i.e., in the last 3 months). Compared with those who never used, users initiated other drug use at younger ages, used more types of drugs, reported more emotional distress, and employed escape coping significantly more often. Compared with those who have never used (never-users), users also had more sexual partners and more sexual encounters. Although users and never-users do not differ on physical symptoms or whether they have been diagnosed with AIDS, users of amphetamines report significantly higher T-cell counts than never-users. Despite poor psychosocial functioning, amphetamine users have higher T-cell counts than other YLH; future research must examine longitudinally if a quadratic relationship exists between amphetamine use and health status. The continued high-risk profile of transmission acts among users suggests that preventive interventions must target specific drugs used by YLH.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Seropositivity to human herpesvirus 8 in relation to sexual history and risk of sexually transmitted infections among women.

The mode of transmission of human herpesvirus 8 (HHV8) was investigated in two seroepidemiological studies of Swedish women who completed a questionnaire about sexual behavior. Seropositivity for HHV8 antibodies, measured using an indirect immunofluorescence assay, was linked to a high number (>10) of sexual partners (P < 0.004). It also correlated strongly with a history of other sexually transmitted diseases (STD; P < 0.0001), in particular with a history of Chlamydia trachomatis infection and condyloma acuminata. There was appreciable HHV8 seropositivity already among virginal or monogamous women (9%). In summary, HHV8 transmission to women in Sweden may occur nonsexually. When sexual transmission occurs, it appears to be associated with high risk-taking sexual behavior.

Adolescent↗
PubMed2001

Knowledge, attitude and practice about sexually transmitted diseases among university students in Kampala.

BACKGROUND: Sexually transmitted diseases (STDs) remain an important cause of morbidity and mortality among women in the child-bearing age. In order to institute appropriate preventive measures there is need to establish the profile of knowledge of the predisposing factors and causation of STDs, attitude to sexual practice and sexual patterns among the susceptible young people, such as university students. STUDY POPULATION: Non medical university students, Makerere University. DESIGN: Descriptive cross sectional study. METHODS: A detailed questionnaire identifying socio-demographic characteristics, sexual patterns, knowledge of STDs as well as attitudes towards prevention of STDs was administered to 400 non medical university students of Makerere University. RESULTS: Knowledge of the clinical features of gonorrhoea and AIDS was high; most knew the predisposing factors for STDs (multiple sexual partners 90%; unprotected sexual intercourse 93%; rape 81%; sex outside marriage 78%, and sex under the influence of alcohol 73%) but not so for syphilis. Males were three times more likely to contract STDs (27%) than their female (9%) counterparts. Whereas knowledge on methods of prevention was high (>90%) it was not followed by appropriate behavioural patterns. More female (33.5%) students had heard about Trichomonas vaginalis than males (23%); (((2) = 17.1; < 0.0001). This study has shown that more female than male students got information from their parents (((2) = 25.3; p < 0.001) while more male students had their source of information from previous sexual intercourse (((2) = 12.9; p = 0.001). CONCLUSION: The level of knowledge about STDs and their prevention is not matched by sexual behavioural patterns, and male students undertake more risky sexual behaviour. Sexual education should be introduced at the university as a means of increasing students' awareness about the problem and prevention of sexually transmitted diseases including HIV/AIDS.

Adolescent↗
PubMed1992

Demographics of adolescent sexual behavior, contraception, pregnancy, and STDs.

The demographics of fertility-related behavior of youth ages 10-18 are reviewed. Data were collected from U.S. vital statistics, and birth rates, contraceptive use, sexual behavior, number and types of sexual partners, patterns of sexual initiation and sexual intercourse, and sexually transmitted diseases were examined. Despite data limitations, the demographic profile of adolescent sexual intercourse is striking. Age clearly is the single most important predictor of sexual debut.

Adolescent↗
PubMed2005

[Acceptability of a test for antibodies against HIV in a group of pregnant women in Yucatan, Mexico].

OBJECTIVE: To evaluate the acceptability of a test for antibodies against HIV (Ab-HIV) in a group of pregnant women in Yucatan, Mexico. PATIENTS AND METHODS: A clinical and epidemiological study was carried out on 310 pregnant women at different health centers in Yucatan Mexico, from January 2000 to March 2001. A questionnaire was applied to determine information in relation to HIV infection and acceptability of the test. Prior counselling was given to all those who accepted being tested. RESULTS: The median age was 24 (range 14 to 42). A 64.5% had a basic education, 91.6% were homemakers; 38% of the sexual partners worked away from home; 15% said they had more than one sexual partner; 31% had leukorrhea at the time of testing and 69% at some time in the past. Ninety percent of the women accepted being tested for HIV and all of them showed negative results. CONCLUSION: The acceptability of the test was similar to that reported in the international literature. The cost benefits of such a test must be considered, but always within the values of prevailing normative and respect of human rights of women. Despite zero prevalence, we found factors favourable for HIV infection.

AIDS Serodiagnosis↗
PubMed2004

Epidemiology of hepatitis C infection and its public health implications in Puerto Rico.

Hepatitis C infection is the most common chronic blood-borne pathogen in the United States associated with liver cirrhosis and hepatocellular carcinoma and is the leading reason for liver transplantation. It has been estimated that hepatitis C infection may lead to a substantial health and economic burden over the next 10 to 20 years. The prevalence of hepatitis C virus (HCV) infection varies worldwide, with an estimated overall prevalence of 3%. However, the only available data of hepatitis C in the general population of Puerto Rico suggest an elevated prevalence of hepatitis C infection in the municipality of San Juan (6.3%) in comparison with estimates for the adult population residing in the United States (0.9%-3.9%). Much of the inter-region variability in the prevalence of hepatitis C can be attributable to the frequency and extent to which different risk factors have contributed to the transmission of the virus. Established risk factors for infection include injection drug use, transfusion of blood and solid organ transplantation from infected donors prior to July 1992 and blood clotting products before 1987, occupational injury, vertical transmission, sex with an HCV infected partner, and multiple sexual partners. Other potential exposures for infection that have been investigated in epidemiologic studies include history of intranasal cocaine use, sharing of contaminated equipment and personal care items, tattooing, body piercing, imprisonment, acupuncture, and use of contaminated healthcare instruments. The high incidence of AIDS in Puerto Rico and the large prevalence observed in Puerto Rican inmates and in adults residing in the municipality of San Juan indicate that HCV infection is an emerging public health concern. From a public health perspective, potential targets for intervention to decrease the spread of HCV infection, ongoing surveillance, increased clinician awareness of disease reporting systems and the epidemiology and management of hepatitis C, availability of diagnosis and treatment facilities, and recognition of the need for local resources will be of paramount importance to face this silent infection in Puerto Rico.

Hepatitis C↗
PubMed1992

Characteristics associated with HIV-1 infection in pregnant women in Brazzaville, Congo.

Maternal human immunodeficiency virus type 1 (HIV-1) infection in sub-Saharan Africa is a major public health concern because of the high prevalence among women of childbearing age and the poor prognosis for perinatally infected children. Characteristics associated with HIV seroprevalence were studied in a population of 1,833 pregnant women seen in two large mother-child clinics in Brazzaville, Congo. The prevalence of HIV infection was 3.9% (95% confidence interval, 3.0-4.9%) and differed significantly according to the district of residence, marital status, duration of the relationship with the current partner, number of sexual partners in the year prior to pregnancy, number of living and dead children, and history of blood transfusion and/or hospitalization. Logistic regression analysis identified six significant factors independently associated with seropositivity; age, history of blood transfusion and/or hospitalization, district of residence, duration of the relationship, number of living children, and number of decreased children. However, the predictive value of the model was poor: while 80% of the truly positive women were correctly predicted positive by the model, 50% of the truly negative women were misclassified. Among pregnant women attending these clinics it is therefore difficult to identify a subgroup at risk toward which specific actions could be targeted.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Seroprevalence of HTLV-I/II and HIV-1 infection among male intravenous drug abusers in Chicago.

We surveyed for serologic evidence of either HIV-1 or HTLV-I/II infection in 387 male veterans who entered into an inpatient drug treatment center. Serum was obtained after receiving written informed consent. Serum specimens were tested by enzyme-linked immunosorbent assay for antibody to HIV-1 and for antibody to HTLV-I/II; sera that were repeatedly reactive were then tested by Western blot (HIV-1/HTLV-I/II) and radioimmunoprecipitation assay (HTLV-I/II). Sixty-five of 387 (16.79%) patients were tested and confirmed as positive for HTLV-I/II only antibodies and 30 of the 387 (7.75%) were positive for HIV-1 only antibodies. An additional nine patients (2.32%) were seropositive for antibodies to both viruses. A statistically significant difference in the CD4/CD8 lymphocyte ratio was associated with HIV-1 seropositivity. HTLV-I/II seropositivity was strongly associated with black race, age, and duration of i.v. drug use, but not with sexual intercourse as determined by lifetime history of number of sexual partners, incidence of sexually transmitted diseases, type of drug used, or needle-sharing practices.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Family characteristics of youngsters attempting suicide in Campinas, Brazil: a comparative study with normal and psychiatric youngsters].

A clinical-epidemiological study of the type of case-control, in which the group of cases was made up of 50 youngsters, between 12 and 27, who had attempted suicide some days before, was carried out. This group was matched by age, sex and social-economic level with two control groups. One was made up of 50 normal youngsters (each pair selected at random, in the same district where the case lived), and the other one made up of 50 youngsters who had come for their first psychiatric visit, and had no suicidal antecedents. When the three groups were compared, it was noticed that the suicidal group revealed: a deeper parental gap, these gaps manifested earlier, the relationship between parents was worse. There was a higher rate of somatic and mental diseases and alcoholism, and the family had more legal problems. Three criteria for broken homes were used, and in all of them the proportion of the suicidal groups was much higher. These data were discussed together with clinical results with the finality of suggesting that such family traits hinder the normal separation-individuation phase, keeping the patient at symbiotic regressive phases, which are intensified at adolescence. The breaking up or threat of breaking up of these symbiotic connections (commonly with sexual partners) leads to sexual acting out and suicidal attempts.

Adolescent↗
PubMed1983

Immunological characterization of homosexual males.

To help clarify the nature and pathogenesis of the syndrome of severely opportunistic infection associated with immune deficiency in young homosexual males, we investigated the immunological characteristics of a group of 33 young homosexual men. These young men all had the prodrome to the syndrome which included a history of multiple sexual partners and multiple sexually transmitted diseases. In addition, they all had a past history of mild to moderate viral, bacterial, parasitic, or fungal infections and had used recreational drugs. Within this group of patients, there were five men who had Kaposi's sarcoma. Compared to the 21 normal heterosexual individuals, the homosexual men were found to be anergic to a battery of recall antigens (52% versus 19%); to be hyporesponsive to mitogen stimulation (pokeweed, 30.7 x 10(-3) versus 65.3 x 10(-3) cpm, p less than or equal to 0.005; concanavalin A, 32.2 x 10(-3) versus 60.1 x 10(-3) cpm, p less than or equal to 0.006); and to have lower helper T-cells (18% versus 34.6%, p less than or equal to 0.01), inverted helper:suppressor T-cell ratios (0.85 versus 1.92, p less than or equal to 0.01), and an elevated serum thymosin alpha 1 level (1473 versus 524 pg/ml, p less than or equal to 0.001). These data suggest that the immunological defect precedes the syndrome. The mechanism of this phenomenon is unclear; however, the repeated viral infection combined with drug usage may be responsible. The five patients with Kaposi's sarcoma were compared as a group to the other patients without cancer and found to be more severely immunodeficient. This suggests that the immune suppression by the malignant disease is superimposed on the preexisting deficiency.

Adult↗
PubMedDate not supplied

Epidemiology of Mycoplasma hominis.

Mycoplasma hominis colonizes the vagina of women and the urethra of men. The organism is also isolated from beneath the foreskin of uncircumcised men. It is sexually transmitted. M. hominis is isolated from a small proportion of children and sexually inexperienced adults. Among sexually experienced adults, rates of colonization rise in relation to the lifetime number of sexual partners. Even with sexual experience taken into account, the organism is more prevalent among young individuals and among blacks. The use of barrier methods of contraception (condom and diaphragm) reduces the likelihood of colonization with M. hominis.

Adolescent↗
PubMedDate not supplied

Evaluation of two AIDS prevention interventions for inner-city adolescent and young adult women.

Two hundred and fourteen young women received acquired immunodeficiency syndrome (AIDS) prevention interventions at an inner-city family health center serving minority patients predominantly. The community in which the health center is located has a high incidence of intravenous (IV) drug abuse. Either a peer or a health care provider delivered the intervention. In the peer-delivered intervention, a trained peer educator reviewed with patients an AIDS "Rap" videotape and several AIDS brochures, which imparted information about human immunodeficiency virus (HIV), its transmission, and prevention. In the provider-delivered intervention, family practice residents, attending physicians, and nurse practitioners used a patient-centered counseling approach to convey the same information. Questionnaires administered immediately before and after the intervention and at one month follow-up evaluated changes in knowledge, attitudes, and behavior. Analyses of data from both combined intervention groups revealed significant improvements in several areas of knowledge, including the effectiveness of using a condom and cleaning IV drug implements with bleach to prevent transmission of HIV. Many improvements were retained at the one-month follow-up. In addition, subjects in both groups who were sexually active stated immediately after the intervention that asking a sexual partner about past sexual experience would now be less difficult, and at one-month follow-up they reported a significant decrease in the frequency of vaginal sex. Our findings suggest that counseling by physicians can achieve more changes in knowledge of sexual risks, whereas peer education can achieve greater changes in knowledge about IV drug use. Results show that both approaches to AIDS prevention used in this study can significantly affect knowledge, attitudes, and sexual behavior.

Acquired Immunodeficiency Syndrome↗