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PubMed1995

Risk factor exposure among hepatitis C virus RNA positive Swedish blood donors--the role of parenteral and sexual transmission.

The potential modes of transmission for hepatitis C virus (HCV) infections were studied using a multivariate analysis of risk factor exposure among 51 2nd generation anti-HCV and HCV-RNA positive and matched anti-HCV negative blood donors. The following variables were found to be independently associated with anti-HCV and HCV-RNA positivity: intravenous drug use (IVDU) (p < 0.001), blood transfusion (p < 0.01), tattoos (p < 0.001), previous hospitalization (p < 0.05), history of sexually transmitted disease (STD) (p < 0.001) and lack of travels outside of Europe (p < 0.05). Among the 23 HCV-RNA positive donors without a history of IVDU or blood transfusion, an increased frequency of hospitalization (p = 0.017) and history of STD (p = 0.023) were found. Five of 22 sexual partners of the 51 index blood donors were HCV-RNA positive and in one of these couples sexual transmission was suspected. Anti-HCV and HCV-RNA positive donors were more often seropositive for herpes simplex virus type 2 (HSV-2) antibodies than were HCV-negative controls (p = 0.015). Sexual transmission of HCV may occur, but the possible role of HSV-2 requires further investigation.

Adult↗
PubMed1996

Mixing matrices: Necessary constraints in populations of finite size

This paper analyses the constraints used to define the elements of mixing matrices employed in deterministic models of the transmission dynamics of sexually transmitted infections. These matrices define the degree to which the choice of sexual partners in a population is assortative (like with like) or dissassortative (like with unlike) in populatiions stratified by sexual activity (i.e. the number of different sexual partners per unit of time). An expanded set of constraints is described which defines patterns of mixing on the assortative to disassortative spectrum in populations of finite size. The relevance of these new constraints to past work in this area is assessed. Keywords: mixing matrices

Journal Article↗
PubMed1998

Sexual HIV risk behaviour among men who have sex with both men and women.

The aim of this study was to describe the sexual behaviour of men who had sex with both men and women in the preceding five years (behaviourally bisexual men), specifically to examine their needs in relation to HIV prevention. Anonymous telephone interviews were carried out with respondents recruited though advertisements in UK newspapers and magazines with (sexual) 'personal' or 'contact' sections. Data are reported from 745 respondents. Respondents report relatively high and approximately equal numbers of male and female sexual partners in the year preceding interview. There is a clear patterning of sexual activity by type of partner (regular or casual). A high proportion report anal intercourse with female and male partners. A third disclose their homosexual practices to regular female partners. Although self-reported HIV seroprevalence is low (less than 1%), the levels of unprotected sex with multiple sexual partners indicate substantial potential for transmission of sexually transmitted infections, including HIV. While low seroprevalence suggests that there is little overlap with existing core groups of HIV infection, the study provides information to judge the priority of targeting HIV prevention initiatives and suggests ways in which initiatives could be undertaken.

Adolescent↗
PubMed2005

High risk health behaviours among adult Jamaicans.

The purpose of this study was to assess the prevalence of high risk health behaviours among adult Jamaicans aged 15-49 years in 2000, and to compare the results with the 1993 survey. A nationally representative sample of 2013 persons aged 15-74 years was surveyed in 2000 using cluster sampling in the Jamaica Healthy Lifestyle Survey (Wilks et al, unpublished). Interviewer administered questionnaires and anthropometrical measurements were done. Data for a sub-sample of adults aged 15-49 years were analyzed The sub-sample included 1401 persons (473 men and 928 women). Significantly more men (18.6%) than women (4.3%) reported never having had a blood pressure check (p = 0.0001). Approximately one-third of the women reported that they had never had a Pap smear (36.0%) or a breast examination (31.2%). Current cigarette smoking was reported in 28.6% of men and 7.7% of women (OR 3.73 CI 2.71, 5.15), while 49.0% of men and 15.0% of women ever smoked marijuana (OR 3.28 CI 2.56, 4.20). Significantly more men (28.0%) than women (11.7%) reported ever having a sexually transmitted disease (OR 2.93 CI 2.16, 3.97); having more than one sexual partner in the past year (49.1% vs 11.4%, OR 4.31 CI 3.22, 5.76) and usually using a condom during sexual intercourse (55.3% vs 40.5%, OR 1.3 CI 1.11, 1.68). Between 1993 and 2000, significant trends include: more persons reported having a blood pressure check, a reduction in multiple sexual partners, increased condom use at last sex (women), reduced crack/cocaine use (males) and increased marijuana smoking. Although there were some significant positive lifestyle trends between 1993 and 2000, high risk behaviours remain common among Jamaican adults. Comprehensive health promotion programmes are needed to address these risk behaviours.

Adolescent↗
PubMedDate not supplied

Characteristics of the ideal sex partner: gender differences and perceptions of the preferences of the other gender.

The objective of the current study was to further examine gender differences in preferences for particular characteristics in a sexual partner and to investigate the extent to which men and women accurately estimate the preferences of the other gender. Heterosexual college students (185 men, 244 women) rated a diverse set of characteristics in a hypothetical sexual partner with whom they were presumed to be involved in an ongoing relationship. Participants also responded to the same set of items with regard to estimates of the ratings of the other gender (order of presentation was counter-balanced). Although there was notable similarity in what men and women most valued in a potential long-term sex partner, there were gender differences with regard to ratings of several of the items. Also, men and women under- or overestimated the ratings of the other gender with regard to several characteristics. Results are discussed with regard to implications for intervention as well as directions for future research.

Adolescent↗
PubMed2005

Women's preference for dominant male odour: effects of menstrual cycle and relationship status.

Body odour may provide significant cues about a potential sexual partner's genetic quality, reproductive status and health. In animals, a key trait in a female's choice of sexual partner is male dominance but, to date, this has not been examined in humans. Here, we show that women in the fertile phase of their cycle prefer body odour of males who score high on a questionnaire-based dominance scale (international personality items pool). In accordance with the theory of mixed mating strategies, this preference varies with relationship status, being much stronger in fertile women in stable relationships than in fertile single women.

Analysis of Variance↗
PubMed2004

Contribution of sexually transmitted diseases and socioeconomic factors to perinatal mortality in rural Ghana.

BACKGROUND: The infant mortality rate is higher in sub-Saharan Africa than in other developing regions. The purpose of this study was to evaluate the association of sexually transmitted diseases (STDs) and socioeconomic and obstetric factors with perinatal mortality in rural Ghana. METHODS: Perinatal mortality data were collected from 154 patient records of the outpatient and inpatient gynecology department of a rural Ghanaian setting in 1997. All women attended the antenatal care unit of the hospital at least once before delivery, where they were screened for common STDs, including syphilis, gonorrhea, and trichomoniasis. Patients' socioeconomic characteristics and previous obstetric complications were recorded. RESULTS: The rate of perinatal mortality at the Holy Family Hospital in the Berekum district of Ghana was 13.7% in 1997 (154 of 1123 documented births). Characteristics of mothers whose infants died in the perinatal period and who had attended antenatal care at least once were as follows: prior obstetric complications, 108 patients (70.1%); average age, 25 years (range: 16-42 years); average number of previous sexual partners, three; prevalence of STDs, including gonorrhea, trichomoniasis, or syphilis, 83 patients (53.8%); history of other chronic diseases, 13 patients (8.5%); and illiteracy, 66 patients (42.8%). The number of previous sexual partners and illiteracy were higher in the STD-positive women. CONCLUSIONS: Sexually transmitted diseases and previous obstetric complications seemed to contribute considerably to perinatal mortality in rural Ghana.

Adolescent↗
PubMed2004

Determinants of human papillomavirus 16 serological conversion and persistence in a population-based cohort of 10 000 women in Costa Rica.

Determinants of human papillomavirus (HPV)-16 serological conversion and persistence were assessed in a population-based cohort of 10 049 women in Guanacaste, Costa Rica. Serologic responses to HPV-16 were measured in 7986 women by VLP-based enzyme-linked immunosorbent assay at both study enrollment (1993/94) and at 5-7 years of follow-up. Seropositive women were defined as >/=5 standard deviations above the mean optical density obtained for studied virgins at enrollment (n=573). Seroconnversion (n=409), persistence (n=675), and clearance (n=541) were defined based on enrollment and follow-up serology measurements. Age-specific distributions revealed that HPV-16 seroconversion was highest among 18- to 24-year-old women, steadily declining with age; HPV-16 seropersistence was lowest in women 65+ years. In age-adjusted multivariate logistic regression models, a 10-fold risk increase for HPV-16 seroconversion was associated with HPV-16 DNA detection at enrollment and follow-up; two-fold risk of seroconversion to HPV-16 was associated with increased numbers of lifetime and recent sexual partners and smoking status. Determinants of HPV-16 seropersistence included a 1.5-fold risk increase associated with having one sexual partner during follow-up, former oral contraceptive use, and a 3-fold risk increase associated with HPV-16 DNA detection at both enrollment and follow-up. Higher HPV-16 viral load at enrollment was associated with seroconversion, and higher antibody titres at enrollment were associated with seropersistence.

Adolescent↗
PubMed1994

Sexually transmitted diseases as major causes of ectopic pregnancy: results from a large case-control study in France.

OBJECTIVE: To evaluate the current impact of sexually transmitted diseases (STDs) and their consequences on the occurrence of ectopic pregnancy (EP). DESIGN: Case-control study. SETTING: Fifteen maternity hospitals in the Rhône-Alpes region, France. SUBJECTS: Six hundred twenty-four women with EP diagnosed from October 1988 to December 1991 and 1,247 controls who delivered liveborn children during the same period. MAIN OUTCOME MEASURES: Information on risk factors included behavioral, clinical, and serological indicators of STDs and other known risk factors of EP. RESULTS: Logistic regression identified several indicators of STDs as strong and independent risk factors for EP: previously treated STD without history of salpingitis; history of probably pelvic inflammatory disease (PID) and, especially, history of confirmed PID; previous STDs of the sexual partner; and Chlamydia trachomatis seropositivity. The adjusted attributable fractions of EP for previous symptomatic STDs, symptomatic STDs of the sexual partner, and C. trachomatis seropositivity were 20%, 3.5%, and 25.2%, respectively, giving a total of 43% of EP cases attributable to infectious factors. CONCLUSIONS: Our findings and previous epidemiological and biological evidence suggest that STD is a major cause of EP. The evidence is particularly strong in the case of C. trachomatis infection. An effective way of dramatically reducing the EP rate would be to prevent STD through education programs sensitizing young women to the complications of STD and public health measures promoting the use of protective methods such as condoms.

Adolescent↗
PubMed1998

Assessment of behavioural risk factors associated with HIV infection among youth in Moshi rural district, Tanzania.

To determine behavioural risk factors associated with human immunodeficiency virus (HIV) seropositivity among 1104 youth aged 15-24 years we conducted a cross-sectional survey in Moshi rural district in northern Tanzania. Information was obtained about sociodemographic characteristics as well as sexual and reproductive health behaviour. Anonymous blood samples were taken for HIV testing. Positive HIV antibodies were determined and confirmed by two Enzyme-Linked Immunosorbent Assays (ELISA). Of 1104 youth interviewed, 91% (1003) consented for blood specimen taking. Seven out of ten youth volunteered to have had sexual intercourse at least once in their lifetime; 60% reported to consume alcohol and 50% of the sexually experienced females reported to have received a gift for their sexual encounter. The overall HIV seroprevalence was 7.5% (75/1003); females compared to males were twice as likely to be HIV positive, 9.7% and 5% respectively. Behavioural risk factors associated with HIV seropositivity were different in male compared to female youth. Among male subjects, cigarette smoking, ever use of marijuana and having a past history of sexually transmitted diseases (STDs) were significant risk factors associated with increased risk of HIV seropositivity. On the other hand, in females, those with a past or current history of STDs, those who volunteered that they practiced oral sex and subjects with four or more lifetime sexual partners were more likely to be HIV positive than subjects without a history of an STD, those with single sexual partner or had never practiced oral sex. A four fold increased risk of HIV seropositivity was also observed among female subjects with a history of blood transfusion in the previous 10 years compared to having received none, the Odds ratio was 4.1 (95% CI = 1.5, 11.1). The profile of risk behaviour associated with HIV seropositivity calls for an urgent need to target health information and education interventions to bring about a change in behaviour among the youth and hopefully help to reduce the rate of transmission of HIV infection.

Adolescent↗
PubMedDate not supplied

Bacterial vaginosis is not important in the etiology of cervical neoplasia: a survey on women with dyskaryotic smears.

BACKGROUND AND OBJECTIVES: It has been suggested that bacterial vaginosis may play a role in the etiology of cervical neoplasia. The authors analyzed the prevalence, risk factors, and impact on histologic changes of bacterial vaginosis in women with cytological abnormalities of the uterine cervix. METHODS: Two-hundred-eighty women with dyskaryotic smears were surveyed. Using a questionnaire, data were obtained on smoking habits and sexual history. Bacterial vaginosis was the diagnosis if the vaginal discharge produced a fishy odor upon alkalinization and if clue cells were seen in the wet smear. Cervical scrapes were analyzed for the presence of human papillomavirus DNA, and cervical tissue specimens were analyzed for the presence and severity of (intraepithelial) neoplasia and the proliferation rate (mitotic index) of the lesion. Chlamydia trachomatis was identified by culture of an endocervical swab. RESULTS: Bacterial vaginosis was found in 56 (20%) out of the 280 women. The presence of bacterial vaginosis was significantly associated with the number of cigarettes smoked per day, age at first sexual intercourse, the lifetime number of sexual partners, and current Chlamydia trachomatis infection. The number of cigarettes currently smoked per day and the lifetime number of sexual partners were independent significant risk factors for the presence of bacterial vaginosis. There was no relation between the presence of bacterial vaginosis and the human papillomavirus infection. Bacterial vaginosis did not influence the severity of the (intraepithelial) neoplasia or the mitotic index. CONCLUSION: In women with dyskaryotic cervical smears, the prevalence of bacterial vaginosis did not seem to be increased, and bacterial vaginosis did not influence the histologic changes. Therefore, bacterial vaginosis is unlikely to be important in the etiology of cervical neoplasia, despite the similarity between its epidemiologic features and those of cervical human papillomavirus infection and cervical neoplasia.

Adult↗
PubMed1995

Are Israeli women in a low risk group for developing squamous cell carcinoma of the uterine cervix?

OBJECTIVE: Invasive cervical squamous cell carcinoma is not a common disease among Jewish women. In the present study an attempt was made to find what is the distribution of the known risk factors in this population. METHODS: Three hundred and ninety-one patients with various cervical cytological abnormalities comprised the study group. They were compared to 350 Israeli women with negative cytology. The risk factors were extracted from an anonymous questionnaire. The results were statistically analyzed and compared to the equivalent figures published in the literature pertaining to non-Jewish women. RESULTS: The prevalence of abnormal cytology among the Israeli women was almost the same as that of the non-Jewish group: 24/1000 and 26/1000, respectively. Significant statistical differences were found between the following risk factors: number of sexual partners, age at first intercourse, age at first pregnancy. Women in the study group were younger when they became sexually active and at first pregnancy, they had a larger number of sexual partners, fewer of them were married and fewer of them were observant of Jewish ritual practices. In addition, they had achieved higher academic levels than the women in the control group. CONCLUSIONS: It was found that the distribution of the known risk factors among the study group was practically the same as those in the non-Jewish population. Moreover, it was found that there was an increase of 29.2% (from 17/1000 to 24/1000) in the prevalence of cervical premalignant lesions among the Israeli women. We believe that this population can no longer be considered as being at low risk for this disease.

Adolescent↗
PubMed1986

Sexual experience and drinking among women in a U.S. national survey.

A 1981 national survey of 917 women provided rates of major sexual experiences and dysfunctions for the entire sample and across alcohol abstention/consumption categories. Most women drinkers (heavier drinkers most often) reported that drinking lessens sexual inhibition and helps them feel close to others; only 8% reported becoming less particular in sexual partner choice, 22% more sexually assertive, but over half (60%) had been targets of other drinkers' sexual aggression. On a sexual dysfunction index combining lifetime lack of sexual interest, lifetime lack or low frequency of orgasm with a partner, and vaginismus, moderate drinkers scored significantly lower than lighter and heavier drinkers. The heaviest drinking women had the highest rates of lifetime sexual disinterest and lack of orgasm with a partner. "Temporary abstainers" (who drank in the past 12 months but not the last 30 days) also had elevated sexual dysfunction rates, particularly those with substantial drinking histories. Several nontraditional sexual behaviors were correlated with heavier drinking, which was also related to morally liberal sexual attitudes. The study's findings may show the effects of a generalized moral value framework in which one large portion of the nation's population, especially females, is subject to pervasive proscriptions of behavioral, including their drinking and sexuality, while others vary in the freedom they find to drink and be sexual. More suppressed traditional sexuality occurs more frequently with lighter drinking and abstention, as is also true of sexual dysfunction. At heavier drinking levels suppressed and dysfunctional sexuality and heavy drinking may be both cause and consequence in a vicious circle, sometimes escaped by temporary or lasting abstention.

Alcohol Drinking↗
PubMedDate not supplied

The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions?

The aims of this prospective study were to compare sexual functioning between women with male partners who have erectile dysfunction (ED) and women without partners with ED and also to investigate the effect of the treatment of male ED on female partner's sexual function. The study included 87 women and their male partners. We divided the women into two groups: 38 women with male partners complaining of ED (ED group) and 49 women with male partners who have no ED (control group). Of the men with ED, 30 were treated with penile prosthesis implantation (n = 17) or oral sildenafil citrate (n = 13). We evaluated all the men with the International Index of Erectile Function (IIEF; Rosen, Cappelleri, Smith, Lipsky, & Pena, 1999), physical examination, and color penile Doppler ultrasound. We evaluated female sexual function with the Female Sexual Function Index (FSFI; Rosen et al., 2000) to assess sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. We compared female sexual function scores between the women of the male partners with and without ED and also compared before both groups and after the treatment of male partners in the ED group. Additionally, we compare the scores according to the type of treatment given to the male partners. Sexual arousal (p = 0.009), lubrication (p = 0.001), orgasm (p = 0.006), satisfaction (p = 0.000), pain (p = 0.039), and total score (p = 0.003) were highly significantly lower in the ED group than in the control group, although sexual desire did not differ between the two groups (p = 0.515). We investigated the effect of male ED on female sexual functions and found no statistically significant differences in the presence of organic type impotence, older age, and lower erection scores on the IIEF (p = 0.53, p = 0.15, and p = 0.1, respectively). After the treatment of male ED, we observed significant improvement in sexual arousal (p = 0.001), lubrication (p = 0.002), orgasm (p = 0.000), satisfaction (p = 0.000), and pain (p = 0.002) in the women. These findings suggest that female sexual function is affected by male erection status and may improve after the treatment of male sexual dysfunction.

Adult↗
PubMed1999

Sexual attitudes and their relation to cervical intraepithelial neoplasia in Maiduguri, Nigeria.

Five hundred randomly selected sexually active women attending antenatal, postnatal, family planning and gynaecological clinics in the Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, had questionnaires administered on their sexual attitudes/ behaviour and their 'pap'smears taken for cytological assessment. The aim was to identify any significant association between sexual attitudes/behaviour and cervical intraepithelial neoplasia (CIN) for the purpose of targeting the population most at risk. Ninety-one women had varying degrees of CIN, a prevalence rate of 18.2%. However, multiple sexual partners was the only factor incriminated to significantly increase the risk of occurrence of CIN. Targeting women with multiple sexual partners may help in directing limited screening resources to those more likely to be positive.

Journal Article↗
PubMedDate not supplied

A proposed feedback loop of sexually transmitted diseases and sexual behavior: the Red Queen's Dilemma.

(Micro)organisms, such as bacteria, which cause sexually transmitted diseases (STDs) in humans are presented with an interesting ecological challenge. These microorganisms need humans to have sexual contact with each other in order for the microorganisms to spread to other hosts as well as to have subsequent generations of descendants. However, diseases tend to lower the sex drive and to render the host less sexually attractive. It is argued that, over time, selective advantages sculpted organisms which cause STDs to be minimally symptomatic and to indirectly increase the number of sexual partners of the host. Neisseria gonorrhoeae which cause the STD gonorrhea are used as a prototype for these putative sexual dynamics. As a counter to the (micro)organisms' biological adaptations, human cultural innovations emerged and became integrated into the various traditions of social structures.

Adaptation, Physiological↗
PubMed1993

Sexual activity among never-married men in northern Thailand.

We use data collected in 1991 to investigate sexual activity among never-married men in Thailand, with a focus on age at first intercourse, characteristics of sexual partners, and conditions under which men visit prostitutes. We sampled men from a broad spectrum of northern Thai society, including university undergraduates, soldiers, and semi-skilled/unskilled workers. We found that except for the students, the majority of each subsample is sexually experienced; prostitutes are the most common type of sexual partner for all groups. Alcohol consumption is associated with several measures of sexual activity. Condom use with prostitutes varies among the subsamples. Among men who have both prostitute and nonprostitute partners, the majority of those who do not use condoms with prostitutes also do not use condoms with their nonprostitute partners. We consider the implications of these results for the AIDS epidemic in Thailand.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Gender differences in pornography consumption among young heterosexual Danish adults.

The aims of the study were (1) to investigate gender differences in pornography consumption among Danish adults aged 18-30 and (2) to examine gender differences in situational, interpersonal, and behavioral characteristics of pornography consumption. A national survey study was conducted using a representative sample of 688 young heterosexual Danish adult men and women. The study found large gender differences in prevalence rates of pornography consumption and consumption patterns. Compared to women, men were exposed to pornography at a younger age, consumed more pornography as measured by time and frequency, and used pornography more often during sexual activity on their own. Gender differences in the interpersonal context of use were also evident, with women using pornography more often with a regular sexual partner than men. In turn, men were found to use pornography more often on their own or with friends (non-sexual partners) than women. For both men and women, the usual place of use was home and no significant gender difference was found in this regard. Men and women were found to vary in their preferences in pornographic materials, with men both preferring a wider range of hardcore pornography and less softcore pornography than women. Gender differences in sexual behavioral factors were limited to masturbation patterns with men masturbating more than women. Male gender, higher frequency of masturbation, lower age at first exposure, and younger age were found to account for 48.8% of the total variance of pornography consumption. The results were discussed in relation to the sociocultural environment and evolutionary theory. It is argued that gender differences in social acceptability, adherence to gender stereotypes, traditions of gender sexuality, gender norms, and mating strategies are key factors in understanding gender differences in pornography consumption.

Adult↗