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Gender differences in manifestations of antisocial personality disorder among residential drug abuse treatment clients.

We examined gender differences in manifestations of DSM-III-R antisocial personality disorder in 106 male and 34 female drug abusers enrolled in residential relapse prevention/health education treatment. In childhood, compared to males, females had more often run away but less often used weapons in fights, been cruel to animals, and set fires. Females also reported less vandalism. In adulthood, women had more often been irresponsible as parents and in financial matters, engaged in prostitution, made money finding customers for prostitutes, been physically violent against sex partners and children, failed to plan ahead, and lacked remorse. Our findings suggest that addiction treatment programs need to consider gender differences in antisocial symptomatology in the development of individualized treatment programs for both male and female clients.

Adult↗

The level of knowledge and views of the street children/youth about AIDS in Turkey.

The purpose of this study was to discover the level of knowledge and views of the street children and youth in Turkey about AIDS. Five focus group discussions were held with 44 children. On the data collection form there were questions about their age, status of working and living status on the streets, gender, source of information about AIDS, high-risk groups, and knowledge on the ways of transmission and getting protected from AIDS. According to the study results, more than half of the participants (56.8%) did not have any knowledge about AIDS. 63.6% stated that they received their information about AIDS from public media. In addition, the participants of this study listed the main causes of transmission of AIDS as having sexual relationship with prostitutes (22.3%) and sharing razors, toothbrushes, footwear, food (27.6%). When asked the ways to protect oneself from AIDS, 28.9% stated that individual hygiene was very important while 21.0% stated not sleeping with prostitutes, single marriages, and condom use were very important ways to protect oneself from AIDS. 37 children of the total participants stated they were also at risk for AIDS. The main reasons of defining themselves at risk were being substance addicts (24.3%) and unhygienic practices (21.6%). The main conclusion of this study is that street children/youth have insufficient and incorrect knowledge about transmission and protection from AIDS and risk groups.

Adolescent↗

Female sex workers as health educators with men who buy sex: utilising narratives of rationalisations.

This paper reports on findings from an ethnographic study of female sex workers who work in the indoor sex markets in a British city. An unexpected finding was the collective narratives that sex workers construct to rationalise their involvement in the sex industry. Fifty-five respondents who took part in in-depth interviews maintained that prostitution is a useful occupation and function in society. Narratives included providing emotional support to male clients; a service for men who are socially or physically disabled; preventing men having adulterous affairs; and health education, disease prevention and as therapists for sexual dysfunction. This paper evaluates how the latter narrative of sexual health promotion is an example of how sex workers are ideally placed to work as health educators with men who buy sex. Arguing against gender specific sexual health policies, men who buy sex are described as a 'high risk' group who are also a hidden population. Limitations posed by ideological, ethical and practical concerns relating to the specific conditions of the sex industry suggest that this proposal could be partially successful. In conclusion, I suggest the sexual health of the nation and the place of sex workers in society must be considered with regard to recent policy debates on the management of prostitution and the cultural construction of the sex worker.

Adolescent↗

Violence against women: global scope and magnitude.

An increasing amount of research is beginning to offer a global overview of the extent of violence against women. In this paper we discuss the magnitude of some of the most common and most severe forms of violence against women: intimate partner violence; sexual abuse by non-intimate partners; trafficking, forced prostitution, exploitation of labour, and debt bondage of women and girls; physical and sexual violence against prostitutes; sex selective abortion, female infanticide, and the deliberate neglect of girls; and rape in war. There are many potential perpetrators, including spouses and partners, parents, other family members, neighbours, and men in positions of power or influence. Most forms of violence are not unique incidents but are ongoing, and can even continue for decades. Because of the sensitivity of the subject, violence is almost universally under-reported. Nevertheless, the prevalence of such violence suggests that globally, millions of women are experiencing violence or living with its consequences.

Adult↗

Prevalence of human T-lymphotropic retroviruses type III (HIV) and type IV in Ivory Coast.

Serological investigations in the Ivory Coast indicate that, despite the rarity of overt acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV) is widely prevalent. So also is human T-lymphotropic virus type IV (HTLV-IV). The highest rates of HIV and HTLV-IV seropositivity were observed in female prostitutes. These findings suggest that, like HIV, HTLV-IV can be transmitted by heterosexual contact, and that the mobility of prostitutes may be an important factor in spread of the retroviruses in Africa. The incidence of HIV-associated AIDS in the Ivory Coast is likely to rise sharply in the next few years.

Acquired Immunodeficiency Syndrome↗

[Prevalence of the HIV infection in patients seen at specialized diagnosis centers in 9 cities in Spain from 1992 to 2001].

OBJECTIVE: To describe the prevalence of HIV infection in persons tested between 1992 and 2001. DESIGN: Descriptive, cross-sectional epidemiological study. SETTING: 10 ambulatory centers specialized in diagnosing HIV, located in 9 cities in Spain. PARTICIPANTS: 53,183 persons older than 12 years, tested for the first time for HIV. MAIN MEASURES: Number of persons tested per year, number of persons diagnosed as seropositive for HIV according to sex, age group and category of exposure. RESULTS: The number of persons tested increased from 4401 in 1992 to 6407 in 2001. Approximately half reported heterosexual risk exposure/exposure through high-risk heterosexual behaviors, excluding prostitution. Intravenous drug users (IVDU) increased from 15.3% in 1992-1993 to 1.4% in 2000-2001, and women prostitutes/female sex workers increased from 6.7% to 25.1%. A total of 2898 persons were diagnosed as having HIV infection; 78% of them were men. The number of diagnoses decreased from a high of 1058 in 1992-1993 to 304 in 2000-2001, and this trend was seen for all categories of exposure except female prostitutes and men with heterosexual risk factors. The prevalence decreased from 14% in 1992 to 2% in 2001. There were decreases in all categories of exposure, especially during the first years of the study, with a tendency to level off. In 2001 the prevalence figures were 23.8% for IVDU, 7.9% for homosexual men and women, 0.8% for female sex workers and 1% for other heterosexual men and women. CONCLUSIONS: The specialized diagnostic centers play an important role in diagnosing HIV, and this service complements primary care services. Greater efforts are needed in the prevention of HIV infection.

Adult↗

[Jails and AIDS. Risk factors for HIV infection in the prisons of Madrid].

The spread and risk factors for HIV infection were studied in 288 men and 95 women at the prisons of Carabanchel and Yeserias, Madrid. These men and women requested care at the AIDS prevention program in the jails of Madrid, from April to December 1987. Among the men studied at Carabanchel, 55% were positive to HIV (77% seropositivity among intravenous drug users, IVDU). Tattooing (OR = 2.8), and number of times in prison (OR = 4.5 comparing those who had been 8 or more times in prison with those who had been in prison only once) were independent risk factors for infection, after controlling for IVDU. No association was found between seropositive status to HIV and reported anal intercourse. Among the women studied at Yeserias, the proportion of HIV seropositive women was 26% (70% of the IVDUs were seropositive). Tattooing, number of times in prison, history of prostitution and history of syphilis were associated with HIV infection. When controlling for IVDU, number of times in prison and history of prostitution were not independent risk factors for infection. These data indicate that there is a need for control measures to avoid further spread of the HIV infection among the inmate population, in particular through the use of contaminated needles while in prison.

Female↗

STDS in women attending family planning clinics: a case study in Addis Ababa.

For cultural reasons modern contraception has been slow to gain acceptance in Ethiopia. Knowledge about contraception and abortion is still limited in many family and community settings in which it is socially disapproved. By 1990 only 4% of Ethiopian females aged 15-49 used contraception. Little is known of sexually transmitted disease (STD) prevalence in family planning (FP) attenders in Africa in general and Ethiopia in particular, even though attenders of family planning clinics (FPCs) are appropriate target groups for epidemiological studies and control programmes. A study of 2111 women of whom 542 (25.7%) attended FPCs in Addis Ababa showed utilisation rates to be highest in women who were: Tigre (33%) or Amhara (31%), aged 20-34 years (30%), age 16 or older at first marriage/coitus (28%:38% in those first married after 25 years); who had a monthly family income of 10 Ethiopian Birr (EB) or more (33%:36% for those with income 100-500 EB), three or more children (37%), more than five lifetime husbands/sexual partners (39%); or were bargirls (73%) or prostitutes (43%). The seroprevalence rates for all STDs, higher in FPC attenders compared with other women, were syphilis (TPHA) 39%, Neisseria gonorrhoeae 66%, genital chlamydia 64%, HSV-2 41%, HBV 40% and Haemophilus ducreyi 20%. Only 4% of FPC attenders had no serological evidence of STD: 64% were seropositive for 3 or more different STD. Clinical evidence of pelvic inflammatory disease (PID) was also more common in the FPC attenders (54%), 37% having evidence of salpingitis. The FPC provides a favourable setting for screening women likely to have high seroprevalence of STD, who for lack of symptoms will not attend either an STD clinic nor a hospital for routine check up. We recommend that measures be taken to adequately screen, treat and educate FPC attenders, their partners, and as appropriate and when possible their clients, in an attempt to control STDs and ultimately HIV in the community. Social, economic and cultural factors in the occurrence of STDs, prostitution, family planning and modern contraception coverage in Ethiopia are identified and deficiencies of current programmes briefly discussed with the objective of targeting services more effectively.

Cultural Characteristics↗

Low prevalence of infection by HTLV-I in populations at risk for HIV in Djibouti.

In order to determine whether HTLV-I (a recently discovered retrovirus causing T-cell leukaemias and lymphomas, as well as tropical spastic paraparesis) was present in Djibouti in 1988, we investigated 576 subjects belonging to various groups at risk of acquiring HIV, a related retrovirus transmitted analogously to HTLV-I. Sera were screened by a commercial agglutination assay and confirmation of repeatedly reactive sera was performed by specific Western blot analysis. Four sera were strongly positive for HTLV-I by Western blotting, while one serum displayed equivocal reactivity. All positive sera came from young women who engaged in prostitution. This accounted for an HTLV-I seropositivity rate of 0.7% (95% CI, 0.03-1.4%) in the total study population and 1.2% (95% CI, 0.02-2.4%) in the population engaged in prostitution. We concluded that in Djibouti in June 1988, HTLV-I was present but that the prevalence of infection in high risk individuals was very low.

Acquired Immunodeficiency Syndrome↗

Toronto street youth and HIV/AIDS: prevalence, demographics, and risks.

PURPOSE: The purposes of this study were: (a) to identify human immunodeficiency virus (HIV) prevalence in Toronto street youth through paired blood and saliva specimens; (b) to identify the HIV risk and prevention behaviors of street involved youth; and (c) to identify demographic or other factors that may contribute to the risk of street youth becoming infected with HIV/acquired immunodeficiency syndrome (AIDS) in the future. METHODS: This was a cross-sectional convenience study of street-involved youth aged 14-25 years. The youth participated in interviews to identify HIV-related knowledge and personal risk and preventive behaviors. Following interviews, they were asked to provide a saliva sample, blood spot, or both. They could refuse one or both samples without jeopardizing their involvement or receiving an honorarium. Two males were the only participants who declined to provide a sample. RESULTS: Fifteen of 695 (2.2%) youth tested positive for HIV infection. All were male, ranging in age from 18 to 25 years. Same and opposite sex, intravenous (IV) drug use, prostitution, and incarceration were risk factors associated with positive HIV test results. The rate of HIV infection was seven times greater for the group 20 years of age and older (20-25) compared to the younger group aged 14-9 years. The proportion testing positive for HIV from small cities, towns, and rural communities in Ontario was 40%; yet, they represented 21% of the study population. Most (57%) youth had been on their own for no more than 3 years and had moved frequently. Nearly two thirds (60%) had stayed in hostels or homeless shelters in the previous 6 months. CONCLUSION: Street youth in Canada are at high risk of HIV infection with their risk increasing with age. Unprotected (same and opposite) sex, IV drug use, prostitution and incarceration were linked to their HIV infections. The high level of mobility identified by street youth challenges governments, communities, and public health officials to develop appropriate prevention strategies and to carefully monitor the spread of HIV infection in this vulnerable population.

Adolescent↗

A demographic and health survey of Spanish female sex workers: HIV prevalence and associated risk factors.

In order to examine the prevalence of HIV infection and associated risk factors amongst Spanish female prostitutes a multicentre (n = 22) cross-sectional study was conducted between November 1989 and January 1991. Data collected included socioeconomic characteristics, sexual behavior and health status together with blood samples. A total of 1633 prostitutes were recruited into the study. Of these, 1433 (87.8%) consented to blood samples being taken and 180 (12.6%) were HIV positive. HIV seroprevalence was 54.7% for intravenous drug users (IVDUs) versus 3.7% for non-IVDUs. Previous imprisonment, hepatitis B and a partner who was an IVDU were significant predictors of HIV infection according to multivariate logistic regression models.

Adolescent↗

Epidemiology of genital herpes (HSV-2) among brothel based female sex workers in Bangladesh.

A prospective study was carried out to determine the prevalence of herpes simplex type 2 (HSV-2) in Bangladeshi female sex workers. Serum samples were collected from 463 female prostitutes and tested by ELISA using type specific antigens (gG1 and gG2). There were 405 (87.5%) samples seropositive for both HSV-1 and HSV-2, 24 (5.2%) samples were seropositive for only HSV-1, a further 33 (7.1%) samples were seropositive for HSV-2 only and one sample was found to be negative. Human immunodeficiency virus (HIV) testing was also performed and all samples were found to be negative. Surveillance studies are needed for development and application of control and preventative measures. The prostitute population in Bangladesh is particularly at risk of acquiring and transmitting HSV-2 and other sexually transmitted diseases (STDs).

Adolescent↗

Evidence for terror management theory: I. The effects of mortality salience on reactions to those who violate or uphold cultural values.

On the basis of terror management theory, it was hypothesized that when mortality is made salient, Ss would respond especially positively toward those who uphold cultural values and especially negatively toward those who violate cultural values. In Experiment 1, judges recommended especially harsh bonds for a prostitute when mortality was made salient. Experiment 2 replicated this finding with student Ss and demonstrated that it occurs only among Ss with relatively negative attitudes toward prostitution. Experiment 3 demonstrated that mortality salience also leads to larger reward recommendations for a hero who upheld cultural values. Experiments 4 and 5 showed that the mortality salience effect does not result from heightened self-awareness or physiological arousal. Experiment 6 replicated the punishment effect with a different mortality salience manipulation. Implications for the role of fear of death in social behavior are discussed.

Arousal↗

Sampling hard to reach populations.

Studies on 'hidden populations', such as homeless people, prostitutes and drug addicts, raise a number of specific methodological questions usually absent from research involving known populations and less sensitive subjects. This paper examines the advantages and limitations of nonrandom methods of data collection such as snowball sampling. It reviews the currently available literature on sampling hard to reach populations and highlights the dearth of material currently available on this subject. The paper also assesses the potential for using these methods in nursing research. The sampling methodology used by Faugier (1996) in her study of prostitutes, HIV and drugs is used as a current example within this context.

England↗

Sexual behaviour, STDs and risks for prostate cancer.

A population-based case-control study was carried out among 981 men (479 black, 502 white) with pathologically confirmed prostate cancer and 1315 controls (594 black, 721 white). In-person interviews elicited information on sexual behaviour and other potential risk factors for prostate cancer. Blood was drawn for serologic studies in a subset of the cases (n = 276) and controls (n = 295). Prostate cancer risk was increased among men who reported a history of gonorrhoea or syphilis (odds ratio (OR) = 1.6; 95% confidence internal (CI) 1.2-2.1) or showed serological evidence of syphilis (MHA-TP) (OR = 1.8; 95% CI 1.0-3.5). Patterns of risk for gonorrhoea and syphilis were similar for blacks (OR = 1.7; 95% CI 1.2-2.2) and whites (OR = 1.6; 95% CI 0.8-3.2). Risks increased with increasing occurrences of gonorrhoea, rising to OR = 3.3 (95% CI 1.4-7.8) among subjects with three or more events (Ptrend = 0.0005). Frequent sexual encounters with prostitutes and failure to use condoms were also associated with increased risk. Syphilis, gonorrhoea, sex with prostitutes and unprotected sexual intercourse may be indicators of contact with a sexually transmissible factor that increases the risk of prostate cancer.

Adult↗

A strategy of clinical tolerance for the prevention of HIV and AIDS in China.

HIV infection and AIDS create many dilemmas in Chinese AIDS/HIV prevention policy. A strategy of clinical tolerance is proposed to address these dilemmas. The immediate purpose of the strategy of clinical tolerance is to win the cooperation of members of stigmatized groups at high risk for contracting HIV infection and AIDS, which occurs as a result of acts done in private and thus beyond the reach of regulation. The strategy of clinical tolerance differs from both tolerance as liberal tolerance and tolerance as a moral ideal of tolerance. A strategy of clinical tolerance does not ask the government, health worker, health official or the public to change either laws or the disapproval of prostitution, homosexuality and drug use. A strategy of clinical tolerance asks, instead, that we weigh what we may regard as the wrong involved in prostitution, homosexuality, and drug use against the greater evil of an HIV/AIDS epidemic. A strategy of clinical tolerance offers the most effective and practical way to confront a growing and significant public health problem in China.

China↗

Prevalence of infection with hepatitis G virus among various groups in Thailand.

Two research groups recently and independently, isolated a hepatotropic flavivirus from human sera. The two viruses, named GB virus C and hepatitis G virus (HGV), were subsequently discovered to represent the same virus, which was associated with acute and chronic hepatitis of the non-A-E type. The prevalences of infection with HGV have now been investigated in various groups of the Thai population, some of which [e.g. thalassaemic children, patients with chronic liver disease, carriers of antibodies to hepatitis B virus and/or hepatitis C virus (HCV), prostitutes and intravenous-drug users (IVDU)] were assumed to be at high risk. Samples of sera were investigated by reverse-transcriptase PCR, using four primers created from the 5' untranslated region of HGV. The prevalence of HGV infection among the healthy controls (1%-5%) was found to be much less than that among thalassaemic children (32.6%), asymptomatic carriers of anti-HCV (20.4%), IVDU (18.2%), aplastic anaemia patients (14.3%) and prostitutes (10%), although similar to that in patients with chronic liver disorders. These results confirm a parenteral route of transmission for HGV and emphasise the need for further research to determine the clinical significance of this virus.

Adolescent↗

Big sister is watching you! Gender interaction and the unwritten rules of the Amsterdam red-light district.

It is generally accepted that in sexual interaction men are the hunters and women the gatherers. An expressly sexual environment such as a red-light district would be expected to only reinforce this image. Strikingly enough, however, it is precisely prostitutes who seem able to break with these established gender roles. This ethnographic study uses participant observation to demonstrate how assumptions about sexual interaction may be specious: female prostitutes are frequently not the passive victims and male clients not the active sex-hunters they are taken for. Both the communicative function and protection of privacy play an important role in these processes in a red-light district. In the red-light district, gender interaction is bound by social regulation and unwritten rules that greatly exceed the influence of formal institutions. In this paper, the case of the red-light district "De Wallen" in Amsterdam, The Netherlands, is discussed in the context of several disciplines including urban anthropology, social psychology, geography, gender studies, and urban sociology.

Erotica↗