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PubMed1994

Chlamydia trachomatis from individuals in a sexually transmitted disease core group exhibit frequent sequence variation in the major outer membrane protein (omp1) gene.

60 cervical Chlamydia trachomatis infections identified by antigen detection from 51 prostitute women in Nairobi, Kenya were evaluated for sequence polymorphism in the major outer membrane protein (omp1) gene. DNA from clinical specimens was amplified by the polymerase chain reaction and cycle sequenced through variable domains (VD) 1, 2, and 4.37 (63%) samples had variant VD sequences, 19 (32%) samples had prototype VD sequences, and 4 (6%) samples had prototype VD sequences, and 4 (6%) samples contained omp1 sequences from two or more C. trachomatis strains. Among the 37 variant strains, 18 had two or fewer nucleotide substitutions in one or two VDs and represented point mutational drift variants. 19 strains had a larger number of nucleotide changes and displayed mosaic omp1 sequences that may have been generated by omp1 VD recombination. We conclude that the prevalence of C. trachomatis omp1 DNA polymorphism is substantial among prostitute women in Nairobi, Kenya and that this is the likely result of immune selection pressure.

Amino Acid Sequence↗
PubMed2005

Naming oneself criminal: gender difference in offenders' identity negotiation.

This qualitative research examines gender differences in offenders'ability to negotiate a positive identity once the pejorative labels of criminal, prostitute, drug dealer, and incompetent parents have been imputed onto them. In-depth semi-structured focused interviews were conducted with a purposeful information-rich sample of eight male and eight female offenders. Content analysis reveals that males were much more adept than female offenders at juggling with conventional and street norms to justify and/or resist stigmatizing labels in order to construct a favorable identity. Appeal to such personal strengths as know-how, competence, loyalty, and a code of honor allowed male offenders to challenge the boundaries between conventional and delinquent worlds. Concomitantly such an appeal gave rise to a sense of efficacy perception and an optimistic explanatory style. In contrast, even though female offenders were able to justify the labels of drug dealer, prostitute, and thief by appeal to higher loyalties and reject that of insane, all their justifications collapsed when having to negotiate the identity of incompetent mother. Female offenders' negative internal attributions and deprivation of the normative center-motherhood resulted in apathy, anomie, and lack of confidence in their ability to do something worthwhile. Rehabilitation guidelines would build female offenders' personal strengths while redirecting those exhibited by male offenders into lawful enterprises.

Adult↗
PubMed1993

Adolescent sexual behavior and condom use in Ile-Ife, Nigeria.

A study to identify risky sexual behaviors related to condom use was conducted in a Yoruba-speaking urban area of Nigeria. The subjects were 256 randomly selected male high school students, 15-19 years of age, who completed a self-administered questionnaire. The majority (79%, or 194) reported having had heterosexual intercourse in the previous 12 months, 9 (4.6%) with prostitutes and 107 (55.4%) with more than one sexual partner. Three subjects who had more than one sexual partner and 1 of the 9 who had sexual intercourse with a prostitute had used a condom. Condoms were reported to be used only for the prevention of unwanted pregnancy by 61.3% of the students. Implications of these findings for adolescent AIDS education in Africa are discussed.

Adolescent↗
PubMed1994

A profile of HIV-risk behaviours among travellers--a population based study of Danes visiting Greenland.

The population of Greenland has behavioural characteristics that indicate a high risk of HIV spread once HIV is introduced into the population. Much depends, however, on the degree of exposure from visitors, particularly in an initial phase. We used a national questionnaire survey of 4,680 randomly selected Danes between 18-59 years to study HIV risk behaviours among Danes with (+travellers) and without (-travellers) travel experience to Greenland. Median number of lifetime sexual partners was more than twice as high among male +travellers (median = 12 partners) compared to -travellers (median = 5; p < 0.0001) and also slightly higher among women (p = 0.03). Furthermore, a significantly higher percentage of male +travellers than -travellers reported prostitute contact (OR = 2.3 (95% CI: 1.4-3.9)), with a peak of 32.0% among men aged 40-49 years. A history of a sexually transmitted disease was three times (95% CI: 2.0-4.5) as common among +travellers as in -travellers. +Travellers were also significantly more likely to have visited other places outside Europe and Greenland, including HIV endemic areas (OR = 2.9 (2.0-4.1)). Overall, sexual contact with someone considered at high risk of HIV infection (a homo/bisexual man, intravenous drug user, prostitute, or previous or present resident of Sub-Saharan Africa) was reported by 33.5% of male +travellers compared to 15.6% of -travellers and among women by 9.7% and 5.0%, respectively. In conclusion, travellers tend to have more sexual partners and more sexual interaction with high HIV-risk group members than non-travellers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Topiramate in the treatment of compulsive sexual behavior: case report.

BACKGROUND: Among the multiple mechanisms of action of topiramate, AMPA/kainate antagonism may be particularly interesting for the treatment of disorders characterized by conditioned cognitive and behavioral cue reactivity. CASE PRESENTATION: We report the case of a patient consulting primarily for obesity and cue triggered snacking, who responded well on topiramate at doses up to 50 mg. Coincidentally he reported on an improvement of compulsive nonparaphilic sexual behaviors (consumption of prostitution), which was also strongly triggered by environmental cues. Both addictive behaviors (snacking and consumption of prostitution) reoccurred after discontinuation of topiramate and again responded reintroduction of the drug. CONCLUSION: The present case report of topiramate's effect on comorbid obesity and nonparaphilic addiction could be interpreted as a further indication that topiramate acts on the common pathway underlying conditioned behaviors and seems to be a treatment of behavioral disorders associated with environmental cues.

Adult↗
PubMed1998

Risk factors for concordant HIV infection in heterosexual couples in Trinidad.

Risk factors for HIV infection in partners of HIV-seropositive index cases were investigated in a cross-sectional survey. Between September 1992 and April 1994 a total of 251 HIV-infected persons and 76 of their sexual partners were interviewed at the main sexually transmitted diseases (STDs) clinic in Trinidad. All participants gave signed consent and responded to a questionnaire. Sixty-four couples had risks for HIV infection through heterosexual intercourse only. However, many recruited sex partners (57/64) reported heterosexual intercourse with persons in addition to the index cases. Overall HIV concordance (both index case and partner HIV infected) was 45% in the couples. HIV concordance was not found to be related to the sexual practices within the studied unions nor to the clinical status of the index case. After allowing for confounding factors there was an increased risk for HIV concordance in couples in unions for > or = 1 year (adjusted OR 3.48; 95% CI 0.89-13.69, P = 0.055), and in those in which sex partners had a past history of genital sores (adjusted for prostitution: OR 4.50; 95% CI 1.01-20.4). Interventions targeted at reducing high-risk sexual behaviour, prostitution and cocaine use could be beneficial in reducing the spread of STDs and HIV in Trinidad.

Adolescent↗
PubMed2002

[A sexual health study of high school students at the 3 high schools in Kitakyushu City].

OBJECTIVES: The purpose of this study was to clarify the actual sexual behavior and attitudes of high school students in Kitakyushu city, Fukuoka and then to develop effective sex education methods for high school students in this region. METHODS: This study investigated the sexual behavior and attitudes of 1,297 high school students in Kitakyushu by self-administered questionnaire. The differences in their answers by sex, prevalence of sexual intercourse and change in sexual behavior and attitude before and after the sex education lecture were examined. RESULT: 39.3% of the students had had sexual intercourse and 74.1% answered that they might have sex, if it were with a partner whom they loved. However, they did not have enough knowledge about contraception and sexually transmitted diseases. This result shows that they did not recognize the risks accompanying sexual intercourse. There are significant differences between male and female students in their sexual attitudes. Male students tend to permit premarital sexual intercourse, unfaithfulness, prostitution, hiring a prostitute and abortion. Male students tend to give more approval to the following opinions: both men and women should agree to sexual contact if the partner wants it; men should take the initiative in sexual contact; women should not talk about sex. Many female students answered that women should make their own decisions to have or not to have sex, however a considerable number of female students answered that for their first intercourse, they just agreed with their partner even though they really did not want to do so. After the sex education lecture, the students have more knowledge about contraception and STDs. However, there is no significant difference in their sexual attitudes before and after the lecture. CONCLUSION: In order to facilitate more desirable and safer sexual behavior among the younger generation, it is not enough to simply give them knowledge about contraception or STDs, etc. To organize more comprehensive sex education, it is also important to pay enough attention to gender problems and other social factors such as family background or regional background, etc.

Adolescent↗
PubMed2002

Reaching and identifying the STD/HIV risk of sex workers in Beijing.

China's HIV cases are growing by more than 30% annually. Few researchers have been able to reach sex workers and examine their risk behavior patterns. Key informants in illegal prostitution connected with owners of establishments in Beijing to recruit the involvement of sex workers. A total of 69 were surveyed about their background and risk behaviors in spring, 2000 in four venues; hair salons, bathing centers, karaoke bars, and the street. The women were mostly young (in their 20s), of low socioeconomic status, and from small towns and villages. They worked about 3 to 4 days a week, averaged one to two clients per day, made the equivalent of about U.S. $135 a week, and averaged about 3 months at any one establishment. They lacked accurate knowledge of STDs/HIV, and although 61% reported consistent condom usage 93% associated usage with prevention of pregnancy and 72% perceived a low risk of HIV infection. Nearly all (98%) felt condoms were affordable, yet 37% reported they were not accessible; 74% had obtained a medical exam in the last year, but 29% were examined when sick; only 10% received prevention information during medical visits, and 55% did not know where to go for HIV testing. Based on venue, stratification among sex workers existed, impacting their risk. Sex workers are at high risk of HIV infection/transmission, especially as the virus becomes more established in Beijing. Although risk factors were consistent with those of sex workers in other countries, the variation by venue, the low perceived vulnerability to HIV, the highly illegal nature of prostitution, and high mobility of sex workers in Beijing calls for a tailored intervention approach. Prevention messages/strategies should be responsive to the differing background, knowledge,

AIDS Serodiagnosis↗
PubMed2003

HIV risk behavior history of prison inmates in Hungary.

As part of an intervention in correctional facilities in Hungary, we conducted research on AIDS-related attitudes and the HIV risk behavior history of 551 male and 81 female inmates to assess needs for and to tailor AIDS education programs. Although lifetime injection drug use was uncommon (8% of men, 3% of women), many Hungarian inmates had engaged in unprotected sex and had had high-risk sex partners: a quarter of men had primary partners who sold sex, about half of them had sex with female prostitutes, 13% of women had worked as prostitutes, and 9% of all inmates indicated having had sex in prison. Because many prison inmates may constitute a potential bridge population for the sexual transmission of HIV between the general population and high-risk populations, interventions among prison inmates may provide an opportunity to reach an at-risk population and to prevent the wider spread of sexually transmitted HIV.

Adult↗
PubMedDate not supplied

[HIV prevalence among individuals having had serology performed in eight Spanish cities following heterosexual exposure, 1992-2003].

BACKGROUND: The human immunodeficiency virus (HIV) epidemic in Spain was characterized throughout the first few years by the predominance of infections among injected drug users (IDU's), but everything currently points to a progressive predominance of sexual transmission. This study is aimed at describing the trend in HIV infection among several heterosexual populations groups and at characterizing the situations in which the infections occurred. METHODS: Descriptive study of the individualls who had the test conducted for the first time at nine HIV diagnosis centres within the 1992-2003 period due to high-risk heterosexual exposures, not including injected drug users. RESULTS: A total of 47,870 individuals had serology performed during the period under study. The HIV prevalence among the population under study dropped from 3.2% to 1.0% (p< 0.001). Among the individuals with an HIV infected partners, the prevalence remained at around 10%, the male users of prostitution having dropped from 1.9% to 1.0% (p=0.049); among women involved in prostitution, from 1.4% to 0.7% (p=0.008); and among all other heterosexuals, having dropped from 1.6% to 1.0% among males (p=0.014) and from 1.1% to 0.7% among women (p=0.012). CONCLUSIONS: The results indicate advances in the control of heterosexual human immunodeficiency virus transmission, mainly among women, although it is necessary to still continue stressing prevention.

AIDS Serodiagnosis↗
PubMed1995

Condom use among female commercial sex workers in Nevada's legal brothels.

OBJECTIVES: The purpose of this study was to evaluate condom use and the incidence of breakage and slippage during vaginal intercourse among female prostitutes in legal Nevada brothels, where use of condoms is required by law. METHODS: Forty-one licensed prostitutes in three brothels were enrolled in a prospective trial in August 1993. Used condoms were collected to verify reported breaks visually. Retrospective breakage and slippage rates were obtained in a standardized interview. RESULTS: Condoms were used for every act of vaginal intercourse with a brothel client during the study period, as well as in the previous year. In the prospective study phase, condoms were used in 353 acts of vaginal intercourse with clients. No condoms broke, and none fell off the penis during intercourse. Only twice (0.6%) did condoms completely fall off during withdrawal. Twelve times (3.4%) during intercourse and 15 times (4.3%) during withdrawal, condoms slipped down the penis but did not fall off. CONCLUSIONS: These findings, among the lowest breakage and slippage rates published, suggest that regular condom use may lead to condom mastery and the development of techniques to reduce the likelihood of breakage and slippage.

Adult↗
PubMed1998

Facilitating condom use with clients during commercial sex in Nevada's legal brothels.

OBJECTIVES: This study examined condom use in legal Nevada brothels. METHODS: Forty female prostitutes in two brothels were interviewed about client resistance to condoms and techniques for facilitating condom use. RESULTS: Of 3290 clients in the previous month, 2.7% (95% confidence interval [CI] = 2.2%,3.4%) were reluctant to use condoms. Of these individuals, 72% ultimately used condoms, while 12% chose nonpenetrative sex without condoms. The remaining 16% left the brothels without services. Condom use rates were markedly lower with nonpaying sex partners (lowers) than with clients. CONCLUSIONS: Brothel prostitutes may be at greater risk for acquiring HIV and other sexually transmitted diseases from lovers than from clients.

Adult↗
PubMed2003

Zoning out crime and improving community health in Sarasota, Florida: "Crime Prevention Through Environmental Design".

Sarasota, Fla, used Crime Prevention Through Environmental Design (CPTED) principles to guide revitalization efforts in its crime-ridden North Trail area. A team of city planners, police officers, and architects examined land use and crime data and sought input from local businesses, residents, and community leaders. Beginning in 1990, interventions included increased police patrols to reduce prostitution and the creation of a new zoning district to encourage area redevelopment based on CPTED principles. Compared with the rest of Sarasota, from 1990 to 1998 the North Trail Corridor experienced decreases in calls for police service (P <.005), crimes against persons and property (P = not significant), and prostitution (P <.05). These results suggest that community design may be a useful tool for decreasing crime and improving community health.

City Planning↗
PubMed1996

A seroepidemiologic study of Chlamydia pneumoniae, Chlamydia trachomatis and Chlamydia psittaci in different populations on the mainland of China.

To evaluate and compare the prevalence of antibodies to 3 chlamydial species in various populations on the mainland of China, the MIF test was used to detect both serum IgG and IgM antibodies to these species in the normal population (n = 711), in poultry workers (n = 51), in female prostitutes (n = 106), in patients attending the sexually transmitted diseases clinic (n = 98), and in adult patients with pneumonia and bronchitis (n = 108). In the normal population, IgG antibodies against C. pneumoniae, C. trachomatis and C. psittaci were present in 61.5%, 9.3%, and 3.5%, respectively, and increasing with age. Prevalence and geometric mean titers (GMT) of IgG antibodies to C. trachomatis in prostitutes (54.7%) and female (55%), but not male (15.4%) sexually transmitted disease patients were significantly higher than in the normal adult female population. The prevalence indicating both previous and recent C. psittaci infections in poultry workers was no higher than in the others. The prevalence of IgG antibodies and GMT to C. pneumoniae in patients with pneumonia and bronchitis was not statistically higher than in the normal adult population. Evidence of cross-reactivities in the MIF test between different species was found in both prevalence and GMT. Serum IgM antibodies were usually absent in patients who met the serological criteria of recent C. pneumoniae infection, indicating that most of them could be considered as reinfections. On the basis of our survey, acute antibodies to C. pneumoniae by the MIF test, if they are detected, may be valuable in the diagnosis of recent C. pneumoniae infections.

Adolescent↗
PubMed1993

Modeling the behavior and attributes of injecting drug users: a new approach to identifying HIV risk practices.

The behaviors and attributes of 503 Scottish injecting drug users were modeled using the linear structural equations program LISREL. Drug use was directly related to prison experience, sexual activity, sharing of injecting equipment, and prostitution. Although the prevalence of HIV among the sample was low (2.0%), the pattern of risk behaviors observed in the data affords potential for future spread of the virus. Harm reduction measures taken by injectors in response to the threat posed by AIDS were inversely related to drug use but, more encouragingly, directly related to awareness of the disease, treatment for drug use, and prostitution.

Awareness↗
PubMed1992

Prevalence of human T cell lymphotropic virus types 1 and 2 (HTLV-1/2) in selected Tijuana subpopulations.

To assess the prevalence of human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) infections among potentially high-risk populations in the city of Tijuana, Mexico, the prevalence of specific antibodies was determined and information on risk behaviors was obtained between June and October 1988. The study involved 631 presumably healthy individuals, randomly selected from a study population recruited sequentially from prisoners, prostitutes, and injecting drug users (IDUs), and randomly from homosexual and bisexual men. The presence of HTLV-1/2 antibodies was determined by enzyme immunoassay and an immunofluorescence method, and positive reactions were confirmed by a radioimmunoprecipitation assay and Western blot. The prevalence of HTLV-1/2 was 2% (2 of 105) among prostitutes, 7% (29 of 410) among prisoners, 1% (1 of 105) among homosexual/bisexual men, and 21% (22 of 106) among IDUs. To properly identify the specific HTLV type, a subsequent sample of 41 imprisoned IDUs were voluntarily and anonymously recruited in June 1990 and asked to donate 20 ml of whole blood. Twenty-two percent (9 of 41) were serologically positive for HTLV-1/2, and polymerase chain reaction analysis performed on peripheral blood mononuclear cells identified HTLV-2 as the specific virus prevalent in this group. Two individuals were positive for human immunodeficiency virus type 1 (HIV-1). One of these individuals was coinfected with HTLV-2.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1994

Type-specific immune response to human T cell lymphotropic virus (HTLV) type I and type II infections in Nigeria.

Type-specific antibody responses to human T cell lymphotropic virus type I (HTLV-I) and type II (HTLV-II) were studied in blood samples collected from 25 different locations in Nigeria between 1985 and 1991 and stored at the University College Hospital in Ibadan. A total of 4,153 sera were collected from participants in the National Immunity Survey of Viral Infections (n = 1,640), patients with tuberculosis (TB) (n = 140), patients with sexually transmitted diseases (STDs) (n = 876), patients with other medical conditions (n = 1,285), female prostitutes (n = 60), and health care workers (n = 152). The overall seroprevalence of HTLV was 5.6%, with similar rates among males and females. Using enzyme immunoassays that differentiated between antibodies to the two viruses, the seroprevalence rates were 2.5% for HTLV-I and 1.9% for HTLV-II, with an additional 1.2% of the samples dually reactive for both HTLV-I and HTLV-II. The seroprevalence rates for HTLV were low among children (0.8%) and adolescents (1.7%), with substantially higher rates among adults (range 5.0-7.4%). Age-specific patterns among adults appears to differ for HTLV-I and HTLV-II, with HTLV-I rates peaking above age 50 and HTLV-II rates peaking below age 50. The highest overall HTLV prevalence rates were observed for STD patients (16.3%), followed by female prostitutes (8.3%), TB patients (6.4%), health care workers (3.3%), patients with other medical conditions (3.2%), and immunity survey participants (1.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1997

Association of infections with human immunodeficiency virus and human papillomavirus in Honduras.

The etiologic role of the oncogenic types of human papillomavirus (HPV) in the development of cervical cancer has been widely proven. Since this cancer occurs more frequently in immunosuppressed individuals, we sought to evaluate the prevalence of HPV infection among human immunodeficiency virus (HIV)-infected and HIV-noninfected prostitutes in Tegucigalpa, Honduras. Cervical scrapes were collected from 23 HIV-seropositive and 28 HIV-seronegative prostitutes for HPV DNA detection by the polymerase chain reaction. Fifty-six percent of the HIV-seropositive women and only 18% of the seronegative women were HPV DNA positive (odds ratio = 6.0). In addition, there was a significant association between seropositivity for HIV with a history of sexually transmitted diseases (P < 0.01). Our data confirm the association between infections with HIV and HPV.

Adult↗