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PubMed1994

HIV infection and risk behaviors among heterosexuals in alcohol treatment programs.

OBJECTIVE: To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcohol treatment. DESIGN: Cross-sectional survey. SETTING: Five public alcohol treatment centers. SUBJECTS: Consecutive sample of 888 heterosexual clients entering treatment between October 1990 and December 1991. Respondents were 51% black, 10% Hispanic, 33% white, and 76% male. The overall response rate was 68%. MEASUREMENTS: Structured interview and serotesting for HIV antibodies. RESULTS: The overall seroprevalence of HIV infection was 5% (95% confidence interval, 3% to 6%). There were no significant differences in rates of infection by age, gender, or race. The prevalence of infection in heterosexual respondents without a history of injection drug use was 3% in men and 4% in women, several times higher than published estimates from a similar community-based heterosexual sample. Unsafe sexual practices were common: 54% of respondents reported multiple sexual partners in the previous year, 97% of nonmonogamous respondents did not use condoms during all sexual encounters, and few respondents consistently asked new sexual partners about previous high-risk behaviors. CONCLUSIONS: There is a substantial prevalence of HIV infection among heterosexual clients in San Francisco (Calif) alcohol treatment programs, much of which is not associated with injection drug use. Because of this and the high prevalence of unsafe sexual behaviors, there is a relatively high likelihood of heterosexual spread of HIV among the large population of clients seeking treatment for alcohol dependency. Interventions to prevent HIV spread should become a standard part of alcohol treatment programs.

AIDS Serodiagnosis↗
PubMed1993

Search for intrafamilial transmission of hepatitis C virus in hemophilia patients.

This study was performed to determine the risk of family members of anti-hepatitis C virus (HCV)-positive hemophilia patients (index patients) for infection with HCV compared with the risk of acquiring hepatitis B virus (HBV), human immunodeficiency virus (HIV), and hepatitis A virus (HAV) infection. All index patients (n = 141) were found to be positive by first and second generation anti-HCV enzyme immunoassays (EIAs). Among their household contacts (n = 228), 224 were negative and 1 positive by both assays. Three contacts gave positive results in first generation anti-HCV EIA and negative results in second generation assay. This latter result was confirmed by further tests (neutralization test, synthetic peptides, and supplemental assay). Percent positivity for anti-HBc was about the same in non-sexual household contacts and sexual partners (13 of 109 [12%] and 7 of 54 [13%], respectively). Percent prevalence of anti-HBc was higher in contacts of index patients with chronic hepatitis B than in those of index patients who had recovered from that disease (6 of 20 [30%] and 14 of 133 [10%], respectively; P < .05). The HBV infection rate of contacts participating in controlled self-treatment was not higher than that of controls (3 of 57 [5%] and 10 of 98 [10%], respectively). Of 44 sexual partners, 5 (11%) were found to be positive for anti-HIV. Prevalence of anti-HAV matched with the age-related distribution in the German population. These findings suggest that intrafamilial transmission of HCV to family members of hemophilia patients is uncommon. In contacts of hemophilia patients, the risk of acquiring HBV infection seems to be as high in household contacts as in sexual contacts. Participation in controlled self-treatment does not appear to be an additional risk for HCV and HBV infection. There is no doubt that sexual transmission of HCV is less common than that of HBV and HIV.

Adolescent↗
PubMed2006

Can chlamydial conjunctivitis result from direct ejaculation into the eye?

The majority of cases of chlamydial conjunctivitis are thought to result from autoinoculation by the patient of infected genital secretions from themselves or their sexual partners. We noted that some patients had developed symptoms following direct ejaculation into the affected eye. We describe four cases of chlamydial conjunctivitis following ejaculation of semen directly into the eye, which have not been previously described. In only one case was chlamydia detected in the genital tract. In three cases, there was no evidence of genital chlamydial infection; the sources of the eye infection being either from infected genital material of their sexual partners transferred by hands to the eyes, or more likely from direct ejaculate inoculation. It is likely that this mode of transmission is underestimated as a history of ejaculation into the conjunctiva is not normally asked for.

Adult↗
PubMed1997

Relationship between cigarette smoking and health risk and problem behaviors among US adolescents.

OBJECTIVE: To examine whether sociodemographic factors and health risk and problem behaviors explain the prevalence of cigarette smoking among US adolescents. DESIGN: Probability survey. PARTICIPANTS: A nationally representative sample of US adolescents. MAIN OUTCOME MEASURES: Weighted prevalence, adjusted odds ratio (OR), and 95% confidence intervals (CIs) for current smoking status by health risk and problem behaviors. RESULTS: The prevalence of smoking was highest among adolescents who were white, older, and who had a high school education or lived in the Northeast. When we adjusted for sociodemographic factors and health risk and problem behaviors, smoking was associated with marijuana use (OR, 3.7; 95% CI, 2.7-5.1), binge drinking (OR, 2.1; 95% CI, 1.6-2.8), and fighting (OR, 1.4; 95% CI, 1.1-1.7) among white adolescent males. Similar associations between each of these 3 behaviors and cigarette smoking were found among white adolescent females and African American and Hispanic adolescent males and females. Cigarette smoking was also associated with using smokeless tobacco, having multiple sexual partners, and not using bicycle helmets among white adolescent males and females, having multiple sexual partners among Hispanic adolescent females, and carrying weapons among Hispanic adolescent males. CONCLUSIONS: Marijuana use, binge drinking, and fighting are correlates of cigarette smoking among US adolescents. These associations, which vary by sex and race or ethnicity, suggest clustering to form a risk behavior syndrome.

Adolescent↗
PubMed1991

HIV-related practices and ethics--survey of opinions in a paediatric department.

Seventy-five doctors working in an academic paediatric department each completed an anonymous self-administered questionnaire. Questions were posed relating to the need for consent before human immunodeficiency virus (HIV) testing and the informing of sexual partners of HIV-infected mothers. Only 9% of the doctors thought that the sexual partner of an HIV-infected mother should never be informed if the mother refused to do so. Sixty-one per cent of the doctors thought that pre-test consent was never necessary when screening hospital admissions. This opinion conflicts with the view of the South African Medical and Dental Council that pre-test consent is mandatory.

AIDS Serodiagnosis↗
PubMed1995

[Seroprevalence of HTLV-I in relatives of patients with spastic paraparesis (HAM/TSP and PEP)].

The seroprevalence of HTLV-1 was studied in parents, brothers, siblings and sexual partners of 147 patients with spastic paraparesis associated to HTLV-1 (HAM/TSP) and 84 patients with HTLV-1 negative spastic paraparesis (SP). Seroprevalence was 29.1% for HAM/SP and 0% for SP relatives (p < 0.001); the last figure is similar to that of the general population. Seroprevalence in sexual partners was 65%, suggesting that sexual intercourse is the principal route of transmission. Likewise, seroprevalence in siblings of mothers with HAM/TSP or HTLV-1 positive was 17.6%, suggesting a high maternal transmission.

Adolescent↗
PubMed1991

Seroepidemiological study of gonorrhoea in Ethiopian women. 2. Socioeconomic picture.

OBJECTIVES: To determine aetiological factors associated with the prevalence of gonorrhoea in Ethiopian women to enable subsequent formulation of intervention policies. SUBJECTS: 1851 Ethiopian women: 50% symptomatic, 50% asymptomatic. SETTING: Gynaecological outpatient departments, antenatal, postnatal and family planning clinics (Ethiopian Family Guidance Association (EFGA)), in two teaching hospitals and a mother and child health centre in Addis Ababa, Ethiopia. METHODS: Using the indirect haemagglutination test with gonococcal pilus antigen, sera were tested for the presence of gonococcal antibodies indicating past or present infection. The socioeconomic facts were analysed against gonococcal seropositivity of these women. RESULTS: Gonococcal infection was associated with very early age at first marriage and first coitus, more than one sexual partner and marital status/profession. The highest prevalence and titres were found in bargirls (100%) prostitutes (89%) and sellers of local beer (85%). The lowest prevalence and titres were found in the highest income group, those married over the age of 18 years, those with only one husband or sexual partner, and those with a sexual life of less than 5 years duration. CONCLUSIONS: National measures which could contribute to reduction and control of gonorrhoea include effective raising of the age of first marriage and first coitus, as has already been defined by law; the education of all girls up to fifth grade or equivalent; the provision of financial support to prevent widows and divorcees from drifting into prostitution; regular health checks and treatment of prostitutes; and education of men. While gonorrhoea per se is a major public health problem, our findings must have serious implications in the wider context of possible transmission of HIV through the community.

Adolescent↗
PubMed1993

Psychosocial predictors of high-risk sexual behavior among HIV-negative homosexual men.

Despite general awareness that human immunodeficiency virus (HIV) is transmitted sexually, people continue to engage in high-risk behavior. As part of a larger HIV project, the Coping in Health and Illness Project (CHIP), we studied the association of psychosocial factors with sexual risk taking behaviors in 53 HIV-negative gay men residing in a HIV non-epicenter. Risk behavior was measured on a 3-point scale, taking into account condom use, number of sexual partners, and type of sexual activity. Independent variables included mood, coping, history of substance dependence, social support, and acceptance of sexual orientation. Sixty percent of the subjects practiced lower-risk, 17.3% practiced moderate-risk, and 23.1% practiced high-risk behavior. We found that risk behavior was positively correlated with optimism (Life Orientation Test) (OR = 2.7; 95% CI = 1.3-5.5), anger (POMS) (OR = 2.6; 95% CI = 1.2-5.7), and negatively related to emotional control (Courtauld) (OR = 0.5; 95% CI = 0.3-1.0), and gay self-acceptance (OR = 0.35; 95% CI = 0.2-0.8). Further study is needed to determine if sexual risk-taking behavior in HIV-negative gay men will be reduced by enhancing gay self-esteem, increased understanding and adaptive use of anger, and modifying overly optimistic attitudes to increase realism.

Adaptation, Psychological↗
PubMed1998

[Use of condoms among the population of the Czech Republic: results of a national study].

Based on an anonymous survey, using questionnaires, in a representative group of the population of the Czech Republic above 15 years of age (862 men and 857 women) the authors investigated the use of condoms at the onset of sex life and with a steady and casual sexual partner. From the results ensues that the use of condoms in our population is lower than in advanced western European countries and the USA. During the first intercourse it was used only by 19% men and 14% women, in particular those of younger age groups. In a steady partnership two thirds of the respondents have experience with a condom, however, only one fifth uses it regularly. The position is similar during intercourse also with casual sexual partners, though the respondents use it more frequently. However not even then one third of men and almost half the women do not use protection by condoms. The most important influence on the reported use of condoms is exerted by the factors of sex (men, probably to appear socially in the most favourable light report its more frequent use) and age (condoms are used more frequently by younger men and women). In the Czech population the effect of religion and education is not important in this respect.

Adolescent↗
PubMed1998

Risk factors for cervical neoplasia in Denmark.

With the overall goal of elucidating the risk factor pattern for cervical neoplasia, two case-control studies and a prospective cohort study were conducted. The first case-control study focused on female lifestyle risk factors. It was designed to include all women (aged 20-49 years) in Greater Copenhagen, diagnosed with invasive cervical cancer or carcinoma in situ (CIS) from January 1985 to December 1986. They were identified from the Danish Cancer Registry. An age-stratified control group was randomly selected from the study area by means of The Danish Central Population Register. Information on risk factors was collected using a self-administered questionnaire. The study, which included 586 women with CIS, 59 women with cervical cancer, and 614 control subjects, confirmed that CIS and invasive cervical cancer share similar risk factors. Both disease entities were strongly associated with sexual and venereal factors. This applied especially to lifetime number of sexual partners and age at first episode with genital warts (proxy measure for human papillomavirus (HPV)), supporting that HPV infection in the adolescent cervix is associated with a higher risk of cervical neoplasia compared with such an infection later in life. Our results also suggested that parity, oral contraceptive use, and smoking may be important risk factors. In the second case-control study, we identified all women with one lifetime sexual partner based on the questionnaire information obtained in the first case-control study. To investigate the role of the "male factor", the women were invited to participate in the study together with their husband. In all, 41 case couples and 90 control couples were enrolled. Data collection included a personal interview, blood samples, and penile swabs from the males. The most significant risk determinants of cervical neoplasia were a history of genital warts in the male and non-use of condoms, emphasizing the venereal nature and pointing to HPV as an important agent. Genital warts are usually associated with the low-risk HPVs (types 6 and 11) rather than with the high-risk HPV types. However, an explanation for the observed relationship between risk of cervical neoplasia and genital warts in the woman herself and in her male partner could be, that they are more likely also to harbour the high-risk HPV types. Only 2 case husbands and no control husbands had HPV DNA detected in the penile swabs (ViraPapR, ViraTypeTM). As the number of cells in the swab always exceeded 3 x 10(4), the result may reflect shortcomings in the test kit used. From our population-based prospective cohort study of 11,088 women, we selected the prevalent cases (199 women with LSIL/HSIL(low-grade/high-grade squamous intraepithelial neoplasia), 131 women with ASCUS (atypical squamous cells of undetermined significance)), and 1000 random controls (women and normal cervical cytology). At enrollment, the women were personally interviewed and had a gynecological examination including cervical swabs for HPV testing and a Pap smear. HPV DNA detection was done using polymerase-chain-reaction methods. Cervical HPV infection (especially with the high-risk types) was the out-standing risk factor for all grades of neoplasia, the association being strongest for HSIL. Women with high-risk HPV infection had a nearly 33-fold increased risk of HSIL compared to HPV-negative women. Possible risk factors for cervical neoplasia in HPV-positive women included smoking, non-use of barrier contraceptives and parity. If analysis was restricted to histologically confirmed high-grade lesions, the proportion of cases that could be attributed to HPV infections was 80%. The importance and urgent need for studies which include HPV as an adjunct to cervical cytology is emphasized. Greater effort should be made to determine the usefulness of this modality (HPV diagnostics) in cervical cancer screening or in the management of cervical neoplasia, especially ASCUS and LSIL.

Adult↗
PubMed1994

A comparison of HIV risk between women and men who inject drugs.

Although there is growing evidence of differences between women and men who inject drugs (IDUs) in terms of level of risk for HIV infection, very little research has been conducted specifically addressing the risk practices of women IDUs. This study formed part of a national study of HIV infection risks in IDUs and the purpose of the present analysis was an exploration of gender differences in HIV risk practices, focusing on the HIV risk practices of IDU women. 1,245 IDUs from the inner city area of Sydney took part in this study. Of these, 908 were men and 331 were women. Notable results were that female respondents were more likely to report sharing needles, they injected heroin more times in a typical using month and were more likely to have shared with someone they later found out was HIV seropositive. Female respondents also reported more sexual partners than men, were more likely to engage in prostitution, and were more likely to have sexual partners who were themselves IDUs. The results provide support for the proposition that women who inject drugs may be at greater risk of HIV infection through both their drug taking and their sexual practices. Further research is needed to explore the reasons underlying the risk practices of women who inject drugs and an understanding of these factors needs to be incorporated into HIV risk-reduction and drug harm-reduction policies and programs.

Adolescent↗
PubMed1990

Effect of health education and condom promotion on behavioral change among low socioeconomic prostitutes in Mae Sot, Tak, Thailand.

A study was conducted to determine the effect of preventive educational efforts among 621 female prostitutes in Mae Sot, Tak Province, in 1989. The intensive health education program at a personal level and free condom distribution to the prostitutes began in March and June 1989, respectively. The proportion of prostitutes' sexual partners using condoms increased from 13.5% in January 1989 to 50.4% by December 1989. The reported increase in condom use was supported by the decline in the incidence rate of gonorrhea among the prostitutes during the same period. Anal intercourse was not commonly practised in these women and decreased from 9.7% in January to 1.8% in December 1989. None of the prostitutes interviewed throughout the year reported using intravenous drugs, nor reported having a steady sexual partner who was an intravenous drug user. None out of 248 prostitutes tested in January 1989 were HIV-1 seropositive. After that throughout the year, 15 of 373 (4.0%) additional prostitutes in this area were found to be seropositive on their first test. Ten out of 405 (2.5%) initially-seronegative prostitutes who were subsequently tested at 3-month intervals became seropositive. The effect of health education and condom promotion among our study prostitutes was modest. Similar studies are needed to evaluate the programs in other settings of Thailand, particularly in areas with high prevalence of HIV-1 infection.

Adolescent↗
PubMedDate not supplied

[The role of human papillomaviruses among the risk factors for cervical carcinoma].

In a prospective study, risk factors of the development of cervical carcinoma in 210 diseased and 100 healthy subjects were investigated. Special attention was paid to metaplastic changes in the portio vaginalis cervics and to human papilloma virus which are considered responsible for the development of these changes. It has been found that metaplasias are favoured by adolescence, chronic irritative processes in the cervix (pathologic discharge recorded in 51.9% of the diseased and 38% of the healthy), cervical lacerations (33.8%:9%), and a prolonged use of hormonal contraception (37.1:15%), all relationships being statistically significant. The factors statistically significant for the development of infection with human papilloma virus proved to be early sexual life (16.2% of the diseased and 6% of the healthy), a great many changes in sexual partners (6.7%:1%), unreliable sexual devotion of the male partner (56.2%:42%), the use of non-barrier contraception methods, and inadequate sexual hygiene. It has not been found that some other factors (profession, number of marriages, nationality, and the like) have an important effect on cervical changes.

Adult↗
PubMed1991

Sexual behaviour and use of the condom among Ugandan students.

HIV infection is widespread in Uganda. Have its university students, the country's leaders of tomorrow, taken appropriate action? A questionnaire was completed by 661 men and 270 women in a one-in-four sample of Makerere University undergraduates (93% response rate). More than 60% of the men and 36% of the women reported at least two sexual partners in the past year. Over 18% of respondents reported at least one episode of sexually transmitted disease in the past year. Most respondents correctly identified the main routes of HIV transmission but risk was also often incorrectly associated with non-penetrative sex. Only a minority saw the condom as an effective preventive method: most saw it as unsafe or an encouragement to promiscuity. Condoms had been used by 35% of men and 24% of women but were currently always used by only 9% of men and 11% of women. The condom was approved of by only one quarter of respondents. Condom use increased with the number of sexual partners but was less likely if the respondent had seen official publicity about the condom. Whilst there were some encouraging signs of behaviour change, opportunities for the spread of HIV continued to abound in this important group. More positive promotion of the condom is urgently required.

Adult↗
PubMed1982

A modern perspective on nymphomania.

There is a stark contrast between the widespread myth of nymphomania and women who actually experience disruptive increases in sexual desire. Nymphomania can be defined in terms of three distinct elements: marked increase in sexual drive; extremely frequent partner sexual behavior; promiscuity. The essence of the problem, however, is the disruptive increase in desire. Causes often involve one or more of the following: acting out; atypical psychoses; alcohol and/or drug abuse; temporal lobe disorders; involvement with an inappropriate partner; response to another sexual dysfunction. Many of these women are unable to derive emotional satisfaction from sex.

Acting Out↗
PubMed1990

HIV infection surveillance in Mogadishu, Somalia.

A group of 89 prostitutes and 45 patients attending sexually transmitted disease clinics in Mogadishu, Somalia were examined for evidence of HIV infection. Both groups reported more than 1 sexual partner routinely and had sexual contacts with prostitutes. There was a significant amount of sexually transmitted diseases (STDs) in these two groups, with 11.2% and 6.7% respectively being culture positive for N. gonorrhoea. Among the prostitutes, 28.1% were positive for antibodies to T. pallidum while only 4.4% of the STD patients were positive. One isolate of N. gonorrhoea was resistant to penicillin. All study participants were negative for antibodies to HIV suggesting an extremely low prevalence of HIV in high risk behaviour groups in the capital city of Somalia.

Adult↗
PubMed2006

Relationship between sexual behavior classifications of rams and lambs sired in a competitive breeding environment.

The objectives for this study were to 1) determine the relationship between sexual performance class and lambs sired in a competitive mating environment, and 2) determine whether the male-oriented ram test is valid. Fifteen 2- to 3-yr-old whitefaced rams classified as female-oriented, with high or low sexual performance, or classified as male-oriented were used in a multiple-sire breeding arrangement. Five groups of approximately 200 ewes each were exposed for 21 d to 3 rams per group consisting of 1 ram from each class. Rams were blocked for sexual class, and those with close genetic relationship were assigned to different pens. Genomic DNA was prepared from blood collected from 15 rams, 934 ewes, and 1,757 lambs. Up to 4 microsatellite markers were used to determine a lamb's sire. Of 884 ewes with identifiable lambs (known sires), 178 ewes had single lambs, 408 had multiples sired by 1 ram, and 298 had multiples sired by more than 1 ram. The sexual partner preference test used to identify male-oriented rams did not absolutely reflect their sexual performance during competitive breeding. In contrast to only mounting and servicing males in preference tests before breeding, male-oriented rams sired 480 lambs from 330 ewes. Serving capacity tests predicted sexual performance of high and low sexual performance rams. High performance rams impregnated more ewes (499 vs. 258; P < 0.05) and sired more lambs (756 vs. 357; P < 0.05) than did low performance rams, respectively. Low performance and male-oriented rams did not differ for ewes impregnated or lambs sired. We conclude that 1) sexual partner preference tests used to classify male-oriented rams were not absolute in reflecting their breeding performance in a competitive breeding environment; 2) serving capacity tests predicted that high performance rams would breed more ewes than low performance rams and sire more lambs than either low performance or male-oriented rams; and 3) under the conditions of this study, low performance and male-oriented rams did not have an adverse impact on the overall breeding outcome. Combined, low performance and male-oriented rams sired 81 more lambs than did high performance rams, but this required twice as many rams to obtain approximately equal breeding results. Therefore, we suggest that serving capacity tests should be used to select high performance rams, reduce number of rams with marginal sexual performance, and make decisions on ram numbers needed.

Animals↗
PubMed1989

Risk factors for human immunodeficiency virus (HIV) infection among homosexual and bisexual men in a region at low risk for AIDS: the northeastern part of Italy. AIDS and Related Syndromes Study Group.

Prevalence and determinants of HIV infection were assessed in 127 homosexual and bisexual men in the northeastern part of Italy. The overall prevalence of HIV seropositivity was still rather low: 20% (95% confidence interval -CI- 13-27%). The most important risk factor for acquiring HIV infection turned out to be having has sexual intercourses in high-risk areas. Relative risks (RRs) for those who have travelled and had sex in North Europe and in the U.S., were, respectively, 2.7 (95% CI: 1.0-7.3) and 5.6 (95% CI: 1.2-25.9). A significantly increased risk was also seen for having a steady sexual partner (RR = 3.1, 95% CI: 1.3-7.5). Use of nitrite inhalants, high number of occasional sexual partners and habitual receptive anal intercourses were also associated with elevation of risk, whereas prostitution was not. The present study confirms the patterns of HIV spread among homosexual and bisexual men from high-risk areas to low-risk areas and prompts urgent educational intervention, in order to prevent the epidemics of AIDS among Italian homosexuals from reaching the size documented in other countries.

Acquired Immunodeficiency Syndrome↗