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PubMed2005

Risk factors for sexually transmitted disease among rural-to-urban migrants in China: implications for HIV/sexually transmitted disease prevention.

The objective of the study was to identify risk factors associated with sexually transmitted diseases (STDs) among rural-to-urban migrants in Beijing in 2002. Migrants with STDs consisted of 432 migrants who sought STD care in two public STD clinics. Migrants without STDs included 892 migrants recruited from 10 occupational clusters. Multiple logistic regression was used for data analysis. Compared to migrants without STDs, migrants with STDs were more likely to report having engaged in commercial sex (selling or buying sex) (odds ratio [OR] = 2.70, 95% confidence interval [CI]: 1.71-4.25), multiple sex partners in the previous month (OR = 6.50, 95% CI: 3.73-11.32) and higher perceived HIV-related stigma (OR = 1.89, 95% CI: 1.30-2.75). Being a migrant with an STD was also associated with female gender (OR = 4.10, 95% CI: 2.89-5.82), higher education (OR = 2.92, 95% CI: 1.40-6.06), and higher monthly salary (OR = 1.68. 95% CI: 1.23-2.29). Migrants with STDs visited their hometowns more frequently and had more stable jobs than migrants without STDs. Approximately 10% of the migrants with STDs and 7.7% of the migrants without STDs always used condoms. This study suggests that among migrants, acquisition of an STD is associated with higher participation in risk behaviors as would be expected, but also with higher perceived stigma, education, stable jobs, salary, and with female gender. Appropriate behavioral intervention programs are advocated to reduce the risk and stigma among the special population.

Adult↗
PubMed2005

Antiretroviral therapy and sexual behavior: a comparative study between antiretroviral- naive and -experienced patients at an urban HIV/AIDS care and research center in Kampala, Uganda.

We examined whether use of antiretroviral (ARV) therapy is associated with increased sexual risk behavior in a cross-sectional study of patients undergoing ARV therapy (ARV experienced) compared to patients not undergoing ARV therapy (ARV-naïve) attending an urban HIV clinic in Kampala, Uganda. Sexual behavior during the prior 6 months and sexually transmitted disease (STD) treatment was determined by face-to-face structured interviews. Multiple logistic regression was used to identify independent correlates of sexual activity, multiple sexual partners, inconsistent condom use, and STD treatment during the prior 6 months. Three hundred forty-seven (48%) of the 723 respondents reported a history of sexual intercourse in the 6 months prior to the interview (sexually active). Receipt of ARV therapy was not associated with a significantly higher likelihood of being sexually active (adjusted odds ratio [AOR], 2.0 95% confidence interval [CI], 0.3-9.9). Among both ARV-experienced and ARV-naïve persons who were sexually active, 35% (120) reported one or more casual sexual partners in addition to a main partner (no difference by ARV status). Consistent condom use with spouse, regular, casual, and commercial partners was reported by 57%, 65%, 85%, and 85% of the sexually active respondents, respectively. The ARV-experienced respondents were more likely to report consistent condom use with their spouses than were ARV-naïve respondents (OR 2.82 95% CI 1.74-4.6). ARV-experienced respondents were more likely than ARV-naïve respondents to have disclosed their HIV status to their spouses (OR 1.57 95% CI 1.07-2.30).The ARV-experienced group was more likely to report STD treatment in the prior 6 months (AOR 2.62 95% CI 1.8-3.83) than the ARV-naïve group. The findings suggest that in this population, use of ARV therapy was not associated with risky sexual behavior in the prior 6 months. Still, recall and social desirability biases remain important limitations in interpreting these conclusions.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Nucleus-vacuole junctions in Saccharomyces cerevisiae are formed through the direct interaction of Vac8p with Nvj1p.

Vac8p is a vacuolar membrane protein that is required for efficient vacuole inheritance and fusion, cytosol-to-vacuole targeting, and sporulation. By analogy to other armadillo domain proteins, including beta-catenin and importin alpha, we hypothesize that Vac8p docks various factors at the vacuole membrane. Two-hybrid and copurfication assays demonstrated that Vac8p does form complexes with multiple binding partners, including Apg13p, Vab2p, and Nvj1p. Here we describe the surprising role of Vac8p-Nvj1p complexes in the formation of nucleus-vacuole (NV) junctions. Nvj1p is an integral membrane protein of the nuclear envelope and interacts with Vac8p in the cytosol through its C-terminal 40-60 amino acids (aa). Nvj1p green fluorescent protein (GFP) concentrated in small patches or rafts at sites of close contact between the nucleus and one or more vacuoles. Previously, we showed that Vac8p-GFP concentrated in intervacuole rafts, where is it likely to facilitate vacuole-vacuole fusion, and in "orphan" rafts at the edges of vacuole clusters. Orphan rafts of Vac8p red-sifted GFP (YFP) colocalize at sites of NV junctions with Nvj1p blue-sifted GFP (CFP). GFP-tagged nuclear pore complexes (NPCs) were excluded from NV junctions. In vac8-Delta cells, Nvj1p-GFP generally failed to concentrate into rafts and, instead, encircled the nucleus. NV junctions were absent in both nvj1-Delta and vac8-Delta cells. Overexpression of Nvj1p caused the profound proliferation of NV junctions. We conclude that Vac8p and Nvj1p are necessary components of a novel interorganelle junction apparatus.

Cell Fractionation↗
PubMed2002

Association of sexual activity with colonization and vaginal acquisition of group B Streptococcus in nonpregnant women.

In a longitudinal cohort study of 1,248 nonpregnant young women recruited from three Pittsburgh, Pennsylvania, health clinics in 1998-2000, the authors investigated risk factors associated with vaginal acquisition of group B Streptococcus (GBS). Rectal and vaginal swabs for GBS culture and demographic and behavioral interview data were obtained from the women at enrollment and at three 4-month intervals. Cox proportional hazards models were used to evaluate risk factors for GBS acquisition among the 1,089 women with follow-up data. At enrollment, 365 (29.2%) of the 1,248 study participants were vaginally colonized with GBS. Of 767 women who were GBS-negative at enrollment, 344 (44.9%) acquired vaginal GBS colonization during follow-up. The following factors were independently associated with vaginal acquisition of GBS at the 0.05 significance level: African-American race (hazard ratio (HR) = 1.5, 95% confidence interval (CI): 1.2, 1.9), having multiple sex partners during the past 4 months (HR = 1.7, 95% CI: 1.1, 2.5), having frequent sexual intercourse during the past 4 months (HR = 1.5, 95% CI: 1.1, 2.2), and having sexual intercourse within the 5 days prior to the follow-up visit (HR = 1.6, 95% CI: 1.3, 2.0). These results show that sexual activity is an important risk factor for vaginal acquisition of GBS.

Adolescent↗
PubMed1991

Patients with sexually transmitted disease: a well-defined HIV risk group in general practice?

Since patients with sexually transmitted disease (STD) form the most apparent risk group for HIV infection in general practice, differences in sexual behaviour in patients with and without STD were studied. Patients fulfilling at least one of four clinical criteria for suspicion of STD were offered four microbiological tests and a serological HIV test and were asked to complete a questionnaire concerning possible HIV exposure. Control patients were selected from a sample of ordinary consulting patients in general practice, without clinical suspicion of STD. The answers to the questionnaires given by six male and 52 female patients with a positive microbiological test for STD were compared with answers given by control patients matched for sex, age, education and geographical region. Females with STD had multiple male partners more often than controls. STD patients were more uncertain whether they had had sex with a HIV-positive person, and they reported more previous gonorrhea than the control patients. The proportion of patients who reported practicing oral sex was the same in both groups, while data for anal sex were insufficient. There were no significant differences in the use of condoms with a new partner, although there was a higher proportion of never-users of condoms among the STD patients. Identifying STD patients on clinical grounds is difficult in general practice. Clinical criteria have limited sensitivity because of asymptomatic infections, and the specificity is low. Patients with microbiologically confirmed STD should receive HIV-related attention, but attention to STD patients alone is not enough. Many people without STD have sexual behaviour which may exposure them to the HIV virus. The only means to a selective approach is increased attention to an appropriate sexual medical history.

Adolescent↗
PubMed2001

Prevalence of HIV infection among former commercial plasma donors in rural eastern China.

BACKGROUND: Sporadic reports of HIV-1 infection among commercial plasma donors in China between 1994 and 1995. OBJECTIVES: (1) To determine the prevalence of HIV infection among repeat plasma donors; (2) to identify factors associated with HIV infection; and (3) to describe characteristics associated with secondary transmission. METHODS: Plasma/blood donors who had a history of donating plasma/blood before March 1, 1995, their spouses, and their children under 5 years were recruited for a cross-sectional study. A questionnaire and an HIV test were collected anonymously. Information collected included demographic characteristics, sexual behaviour, recreational drug use and history of medical care and blood/plasma donation. HIV antibody was identified by the Hema-Strip rapid test and confirmed by Western blot. The prevalence of HIV infection was calculated and risk factors associated with infection determined by univariate analyses followed by multivariate modelling. RESULTS: A total of 1517 individuals were interviewed and tested, of whom 1043 adults admitted to donating plasma. The prevalence of HIV infection among plasma donors was 12.5% and among their non-donor spouses was 2.1%. Prevalence was inversely related to educational level and was higher in married participants, but was not associated with medical care, drug abuse or multiple sexual partners. A higher frequency of plasma donation was directly associated with a higher risk of HIV infection. Multivariate analyses demonstrated that being HIV-positive was associated with being 30 to 49 years old [odds ratio (OR) = 1.9], donating both plasma and blood (OR = 2.5), and the frequency of plasma donation (OR = 14 for >10 donations per month). CONCLUSION: The study demonstrated that the prevalence of HIV infection in the commercial plasma donor population was alarmingly high. Many married individuals and those getting married in the future will transmit the virus to their spouses and future children. Plasma donors need to be alerted to the risk of being infected with HIV and of transmitting HIV to their families and others. Other countries can benefit from the experience of China in reducing the risk of HIV transmission from plasma donating.

AIDS Serodiagnosis↗
PubMed1994

Risk-taking behaviors and AIDS knowledge: experiences and beliefs of minority adolescent mothers.

Using a qualitative focus-group methodology, this study investigated risk-taking behaviors and AIDS knowledge among minority pregnant and parenting adolescents at risk for heterosexual and perinatal transmission of HIV. Seven focus groups were conducted with a total of 48 young women recruited from alternative schools and residential facilities for pregnant adolescents and young mothers in Southern California. Participants also completed a background questionnaire soliciting sociodemographic information and an AIDS knowledge test. The sample included 33 Latinas and 15 African-Americans, ranging in age from 12 to 19 years. There were bipolar findings regarding risk-taking behaviors. At one end of the continuum were young women with a history of one of more of the following behaviors: multiple sex partners, drug and alcohol use, carrying weapons, and participating in gang-related activities. Contrasting with these, were those who had one or two sex partners and no history of alcohol or drug abuse. A majority of the participants were having unprotected sex. A variety of factors affected condom use, including gender inequality, embarrassment, and personal preferences and values. Risk-taking was also influenced by lack of security and safety in daily living, emotion-focused coping and peer pressure.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Associates of self-reported fertility status and infertility treatment-seeking in a rural district of Malawi.

BACKGROUND: This study examines the demographic, fertility preference, health/infection and behavioural factors associated with self-reported fertility problems and infertility treatment-seeking in a rural district of Malawi. METHODS: Data come from a population-based survey of 678 women and 362 men. RESULTS: Having a higher ideal number of children than actual number of children, i.e. a 'child deficit', is highly associated with women's reported fertility impairment and treatment-seeking. Other factors associated with women's infertility treatment-seeking are being educated and reporting infertility in self or spouse. In contrast, being in a polygamous union, having exchanged money or goods for sex, and having multiple sex partners are significantly associated with men's reported fertility impairment. Significant factors associated with men's infertility treatment-seeking are having no education, having a long waiting time to pregnancy and having a 'child deficit'. CONCLUSIONS: There is a sex difference in which factors are associated with reported fertility impairment. Fertility preference variables are more often significantly related to women's reported fertility impairment, whereas sexual behaviours are more often significantly related to men's reported fertility impairment.

Adolescent↗
PubMed1991

Sexual contact patterns between men and women and the spread of HIV-1 in urban centres in Africa.

A simple model of the transmission of HIV-1 by heterosexual contact and from mother to unborn infant is developed to assess the influence of patterns of mixing between low and high sexual activity classes of the two sexes on the pattern of spread of the virus and the demographic impact of AIDS. Numerical studies of model behaviour are based, where possible, on parameter estimates derived from epidemiological studies of HIV-1 spread in Africa. Analyses reveal that the assumed pattern of mixing, ranging from assortative (like with like) through random (proportional) to disassortative (like with unlike), has a very major impact on the predicted spread of the virus and the concomitant demographic impact of AIDS. Patterns of strong assortative mixing are predicted to generate the least spread and demographic impact, by comparison with proportional or disassortative mixing. Analyses also reveal that the rules governing behaviour changes, once AIDS-induced mortality changes the structure of the population (i.e. the numbers in the low and high sexual activity classes of the two sexes), have a very significant influence on the course of the epidemic. Where possible, predicted patterns are compared with observed trends in Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1978

Hepatitis A virus infection: new insights from seroepidemiologic studies.

The prevalence of exposure to hepatitis A virus (HAV) increases with increasing age; decreases with increasing socioeconomic class; increases with increasing serologic evidence of prior hepatitis B virus (HBV) exposure but is much more common than HBV exposure; is independent of sex and race; varies in different parts of the world as a function of hygienic, developmental, and unrecognized geographic factors; and is not affected by immune deficiency or immaturity. Transmission of type A hepatitis is enhanced by poor personal hygiene such as that seen in institutions for the mentally retarded. On the other hand, there is no increased exposure to HAV among homosexuals, who have frequent and intimate contact with multiple sexual partners; among hemodialysis patients and staff; or among multiply transfused individuals, all of whom are at significantly increased risk of exposure to HBV. No epidemiologic evidence has confirmed the existence of viremic or intestinal carriers of HAV, and the virus is rarely, if ever, spread by parenteral mechanisms. Finally, HAV appears to play no role in chronic liver disease and a very minor role in fulminant hepatitis; however, HAV is responsible for a sizable proportion (approximately 20%--40%) of sporadic hepatitis among urban adults.

Age Factors↗
PubMed1990

Epidemiology of genital herpes in Pittsburgh: serologic, sexual, and racial correlates of apparent and inapparent herpes simplex infections.

Women attending family planning clinics in western Pennsylvania were enrolled into a prospective epidemiologic study of herpes simplex virus (HSV) infection. Detection of antibodies to HSV-1 and HSV-2 was based on an immunodot assay using type-specific glycoproteins gG-1 and gG-2. Serologic and historical data at enrollment were analyzed for 4527 subjects; the seroprevalence of HSV-2 was 21.6%. By multivariate analysis, HSV-2 infection as determined by seroprevalence was significantly and independently associated with age, years of sexual activity, race, one or more episodes of other genital infections, lower annual family income, and multiple sexual partners. The presence of antibody to HSV-1 was associated with a lower frequency of antibody to HSV-2, suggesting that developed immunity to HSV-1 protected against HSV-2 infection. Of 926 participants who had antibody to HSV-2, only 117 (12.6%) reported a history of genital herpes. Hence the vast majority of HSV-2 infections were inapparent. Although seroprevalence of HSV-2 was higher among black (35.4%) than white (18.5%) women, black women appeared to have significantly less symptomatic genital herpes than white women (7.7% vs. 14.7%, P less than .01).

Adolescent↗
PubMed2026

Chlamydia trachomatis incidence in relation to vaginal microbiota dynamics, immunogenetics and exposures in a cohort of young student women in France.

BACKGROUND: Given the potential role of the vaginal microbiota in the acquisition of Chlamydia trachomatis infections, we aim to investigate its contribution together with immunogenetics and epidemiological exposures to the incidence of C. trachomatis in young women. METHODS: This study involved 313 female students aged 18-24 years from the i-Predict prevention trial in France. Participants provided four self-collected vaginal samples and filled four self-administered questionnaires every 6 months for 18 months. C. trachomatis-positive participants and negative controls with complete follow-up were selected for this analysis and submitted to chlamydia testing and to vaginal microbiota characterization using 16S rRNA amplicon sequencing. Thirteen human single nucleotide polymorphisms (SNPs) related to C. trachomatis susceptibility and severity were also assessed. RESULTS: Compared to 260 non-infected participants, Gardnerella spp., Fannyhessea vaginae and Prevotella timonensis were more abundant in C. trachomatis-incident participants (n=24) before infection. Having a CST IV at the preceding sample compared to a CST I (3.56 [1.08-11.70], p=0.037) was associated with increased risk of C. trachomatis acquisition, as well as having had multiple concomitant partners in the last 6 months (4.33 [1.19-15.72], p=0.028). Lifetime condom use was associated with decreased incidence (OR 0.38 [0.16-0.94], p=0.037). None of the tested human SNPs was associated with C. trachomatis infection. CONCLUSIONS: In this low-risk for C. trachomatis population, having a CST IV-AB vaginal microbiota and associated bacterial anaerobes was a risk factor for C. trachomatis acquisition after adjustment for other exposures. Condom use remains one of the main tools to prevent incidence.

C. trachomatis↗
PubMed2002

Incidence of violence against HIV-infected and uninfected women: findings from the HIV Epidemiology Research (HER) study.

The effect of human immunodeficiency virus (HIV) infection on the incidence of violence against women was addressed in a prospective cohort of HIV-infected and uninfected women. Participants were enrolled between 1993 and 1995 in four US cities and followed up semiannually through 1998. Among 1,087 women with a total accrual of 2,988 person-years (PY) of follow-up, there were 185 reports of abuse (incidence rate = 6.19 per 100 PY). The rate of abuse among HIV-infected women with a CD4+ count less than 350 cells/ micro L was lower than that among HIV-infected women with more CD4+ cells/ micro L or among uninfected women (4.87, 6.92, and 6.44 per 100 PY, respectively). In multivariate analysis, being separated or divorced, having a history of abuse in adulthood, using marijuana, using crack, and having multiple sex partners were each significantly associated with an elevated abuse rate; being older was inversely associated with abuse. Among HIV-infected women, those with fewer CD4+ cells/ micro L continued to show a decreased abuse rate (hazard ratio = 0.55, 95% CI = 0.36, 0.82) after adjustment for these factors. It is important to complement existing and future HIV prevention and intervention strategies with efforts to reduce violence against women.

Adult↗
PubMed1991

Visualization of novel simian virus 40 DNA recombination intermediates induced by ultraviolet light irradiation.

Electron microscopic technique was used to examine the structures of SV40 DNA recombination intermediates induced by ultraviolet irradiation as an approach for understanding recombination mechanisms in animal cells. Putative recombination intermediate with the characteristic Holliday junction was observed in both SV40 and CV-1 monkey kidney cell DNA. These results suggest that Holliday recombination intermediate is a common intermediate in eukaryotic as well as prokaryotic recombination pathways. In UV irradiated cells, putative SV40 DNA recombination intermediates with multiple recombining partners were observed. In addition, UV irradiation induced two types of novel joint molecules of SV40 DNA. The first type contains replication intermediates as one of the joint molecules with the putative recombination junction located in the newly replicated DNA arms. The second type of novel joint molecules is represented by of the 'dumbbell' structures with two circular SV40 DNA linked by a linear DNA of varying lengths. The structures of these novel recombination intermediates suggest a strand-invasion mechanism for UV-induced DNA recombination.

Animals↗
PubMed1983

Sexual and socioeconomic factors affecting the risk of past infections with herpes simplex virus type 2.

Between November 1978 and May 1980, a cross-sectional survey of 566 females and 391 males, aged 35 to 50 years, living in metropolitan Toronto, was conducted to examine the influence of socioeconomic status and sexual behavior on the occurrence of antibodies to herpes simplex virus type 2. Antibodies to the virus were detected in 17.5% of females and 12.8% of males. Lower socioeconomic status was associated with an increased risk of herpes simplex virus type 2 seropositivity for females but not for males. An increased risk of seropositivity was associated in both sexes with young age at first intercourse, multiple sexual partners, and renting rather than owning their residence. The risk associated with each of these attributes remained when the effects of the other attributes including socioeconomic status and age at interview were controlled. The greatest risk was associated with renting. If the renting effect is real, it suggests that there is some determinant of risk not measured by this study, which is more important than socioeconomic status or sexual behavior.

Adult↗
PubMed1987

Risk factors and prevalence of HIV antibodies in homosexual men in the Netherlands.

As part of the prospective AIDS study in Amsterdam, blood samples were collected from 741 healthy homosexual men with multiple sexual partners, between October 1984 and May 1985. Samples were analyzed for the presence of antibodies to the human immunodeficiency virus (anti-HIV). Anti-HIV was demonstrated in 233 (31%) of the respondents. Seropositive respondents engaged in anal receptive sexual techniques with more sexual partners than did seronegative respondents, whereas seronegatives engaged in manual sexual techniques with more sexual partners than did seropositives. As far as it was possible to control for the interrelations between the measured variables, a direct relation with anti-HIV was established. This leads to the conclusion that when the number of sexual partners is considered a risk factor for HIV, a clear distinction should be made between the sexual techniques practiced with these partners. Two other risk factors for the presence of anti-HIV were the use of cannabis and of nitrite.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Risk factors for human immunodeficiency virus type 1 (HIV-1) infection in patients at a sexually transmitted disease clinic in New York City.

Patients who attended a sexually transmitted disease clinic in New York City in 1987 were offered enrollment in a nonblinded study to estimate human immunodeficiency virus type 1 (HIV-1) seroprevalence in adults with multiple sexual partners and to determine risk factors associated with HIV-1 infection. In addition, a blinded serosurvey of a representative sample of patients was performed to obtain an unbiased estimate of seroprevalence in clinic attendees. The seroprevalence in the blinded serosurvey was 7.5% (26/348), while the seroprevalence of the 1,201 volunteers for the nonblinded study was 11.2%. For men in the nonblinded study, the risk behaviors most strongly associated with HIV-1 infection were intravenous drug use, sexual contact with another man, and sexual contact with a female intravenous drug user. For women, intravenous drug use and sexual contact with a man at risk for HIV-1 infection (an intravenous drug user or a bisexual) were most important. The seroprevalence among persons who denied all high-risk behavior was 1% (7/723). The results of this study, conducted in a city with one of the nation's highest reported cumulative incidences of acquired immunodeficiency syndrome, suggest that HIV-1 infection in clinic attendees was primarily limited to intravenous drug users, homosexual/bisexual men, and the sexual partners of these two groups.

Acquired Immunodeficiency Syndrome↗