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PubMed1988

[Clinical studies of male urethritis caused by Chlamydia trachomatis].

From January through June 1983, 178 male patients with urethritis were investigated on the etiology and epidemiological and clinical features. By using Chlamydia trachomatis direct specimen test (Micro Trak), C. trachomatis was detected in 60 (47.2%) among 127 patients with non-gonococcal urethritis, while it was detected 8 (15.7%) among 51 patients with gonococcal urethritis. The source of infection was a non-prostitute in 30% of chlamydial urethritis, while in gonorrheal urethritis only one patient was infected from a non-prostitute. Mean incubation period of chlamydial and gonorrheal urethritis was 28.5 and 9.2 days, respectively. In chlamydial urethritis, 33.3% of patients did not complain of urination pain and 20.4% showed no urethral discharge. Symptoms of chlamydial urethritis were milder than those of gonorrheal urethritis.

Adult↗
PubMed1987

Epidemiology of syphilis in Singapore over three decades (1955-1986).

The overall incidence of syphilis in the last three decades has decreased from 93.3 cases per 100,000 population in 1955 to 42.5 in 1986 amidst fluctuations in between. The decrease from 1955 to 1965 might be related to the widespread use of penicillins. The increase from 1965 to 1973 could be attributed to the influx of tourists and the use of Singapore as a rest and recreation centre during the Vietnam war period; better reporting system; and waning herd immunity as a result of disappearance of yaws. The introduction of the Medical Scheme and better contact tracing methods might account for the drop from 1974 to 1979. In the last 7 years, there was some fluctuations in the overall incidence, but the incidence of early infectious syphilis rose from 10 per 100,000 in 1979 to 29 in 1986 with the greatest increase in the female patients with early latent syphilis. Female prostitutes contributed a substantial proportion of all the cases of early infectious cases, accounting for 32% of all the cases in 1984. Moreover, female prostitutes were cited as the main source of contact, 46% in a local study. The incidence rate of congenital syphilis remained low over the last three decades, averaging 0.36 per 1000 live births. Both early and late syphilis occurred most commonly in the 20-29-year-old age group. The male to female ratio changed from 3.5 in 1976 to one in 1986 for early infectious syphilis while the ratio for late syphilis was 0.7 in 1976 and 1 in 1986. The closing of the gap reflects better clinic acceptance by both sexes, good contact tracing and better public health education.

Adolescent↗
PubMed1985

Prevalence of HTLV-III/LAV antibody in selected populations in Thailand.

Antibody to the human T-lymphotropic virus, type III/lymphadenopathy-associated virus (HTLV-III/LAV) by ELISA test was detected in one (1%) of 101 male homosexual prostitutes (confidence limit 95%:0.03-5.4%, in two (2%) of 100 thalassemia patients, and in none (C.L. 95%:0-3.6%) of 100 female prostitutes, 99 parenteral drug abusers, 100 male VD patients, 100 consecutive blood donors in serum collected from February through June 1985. Serum from the positive homosexual subject was strongly positive on repeated ELISA testing, and was also positive by Western Blot test. The two thalassemia patients, who were repeatedly weakly-positive by ELISA, were negative by Western Blot test and presumed to be false positive reactors. Prevalence of HTLV-III/LAV virus in sexually-active homosexuals in Thailand in 1985 appears to be similar to the 1% rate among homosexuals in San Francisco in 1978 at the start of the AIDS epidemic there.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Sexuality education groups in juvenile detention.

Several major studies have described the magnitude and character of adolescent sexual activity and sexual knowledge related to contraception and sexually transmitted diseases (Diepold & Young, 1979; Hass, 1979; Sorenson, 1973; Zelnick & Kantner, 1980). Few systematic studies have been conducted, however, which analyze the attitudes toward sexuality and contraception of delinquent adolescents who are generally school dropouts and who may engage in socially unacceptable behaviors such as running away, drug abuse, and prostitution. Delinquent youths, especially delinquent girls, have been characterized as being more sexually active and less sexually knowledgeable than their nondelinquent peers (Gibbon, 1981; Mannarino & Marsh, 1978). Despite the assumed high-risk nature of this delinquent population, few juvenile detention facilities have offered systematically evaluated coeducational sex education programs. One barrier to implementation of such programs in juvenile detention centers is the lack of a treatment or program orientation of most staff, and/or staff denial of adolescent sexuality in general, an attitude which suppresses the development of healthier sexual values and often promotes pathologic sexual interaction within institutions (Shore & Gochros, 1981). A recent survey of adolescent sexuality (Diepold, 1979) points out that teenagers' feelings about their "sexual selves" impacts greatly upon their general self-image. Low self-esteem is more frequently found among delinquents than nondelinquents (Jones & Swain, 1977; Lund & Salury, 1980), and treatment for delinquent girls often focuses on increasing self-esteem and developing assertiveness skills based on feelings of self-worth (DeLange, Lanahan, & Barton, 1981; NiCarthy, 1981). Two studies carried out with juvenile detainees from a large urban center confirmed that sexual activity among delinquent adolescents is significantly greater than that of the general adolescent population, and that the delinquents have little or no knowledge of birth control methods or venereal disease (Deisher, 1980; Schroeder, 1981). Further, these adolescents appear to endorse constricted and conventional values related to sexual activity, abortion, and relationship issues and frequently have a background of sexual abuse and prostitution. These findings form the basis of the current study which attempts to develop an effective coeducational sex education program for this population within a detention facility. This program is specifically designed for a sexually active adolescent group aged 14 to 17.

Adolescent↗
PubMed1984

[Incidence of genital chlamydia and mycoplasma infections in women].

An investigation was carried out in 240 women to determine the prevalence of Chlamydia trachomatis and Mykoplasms in the genital tract. Three groups of women were compared: 80 prostitutes, 80 STD-patients and 80 dermatological patients without genital complaints. In the group of the prostitutes Chlamydia trachomatis was detected in 25% and Mycoplasms in 60%. STD-patients harbored Chlamydia trachomatis in 21% and Mycoplasms in 45%. In the group of dermatological patients Chlamydia trachomatis was isolated only in 3% and Mycoplasms in 33%.

Chlamydia Infections↗
PubMed1980

[Identification of Chlamydia trachomatis in cell culture (author's transl)].

The method for the identification of Chlamydia trachomatis in tissue culture described by Hobson was slightly modified and tested as to its usefullness for routine-diagnostic. Cervical swabs of 74 prostitutes and 100 unselected gynecological outpatients were examined for Chlamydia trachomatis. The isolation of Chlamydia was carried out by McCoy cell culture; the inclusions were identified by Giemsa and Lugol's train procedure. The isolation rate of Chlamydia trachomatis was 17% in the group of the prostitutes, whereas in the group of unselected women no Chlamydia were detected. The correspondence of our findings with previous results indicates the applicability of the method used.

Animals↗
PubMed1995

Sexual behaviour and HIV epidemiology: comparative analysis in France and Britain. The ACSF Group.

OBJECTIVE: France and Britain have similar size populations, yet the incidence of AIDS is threefold higher in France. The objective of this study was to compare data from two surveys recently performed in the two countries, in order to determine whether differences in sexual and drug-use behaviour could explain the different epidemiological patterns. DESIGN: Cross-sectional random sample surveys of France and Britain. RESPONDENTS: In France, 20,055 persons aged 18-69 years and in Britain, 18,876 persons aged 16-59 years were interviewed in 1990-1991. The following indicators were compared in the respondents aged 18-59 years: prevalence of homosexual experience and injecting drug use, number of sexual partners, prevalence of sexual practices, condom use and sex with prostitutes, age of sexual partners. RESULTS: Very similar results were found for the prevalence of male homosexual partnerships. Slightly higher numbers of lifetime partners were reported by French than British men, but no difference was found for recent periods. Anal intercourse and sex with prostitutes was more frequent among heterosexual French people than British people. Condom use was more systematic in Britain than in France. CONCLUSION: Only small differences were found between the two countries, although prevalence of risk indicators were higher in France. These differences combined with early development of prevention policies in Britain, together with the timing of virus introduction, may contribute to differences between the epidemics in the two countries.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Knowledge and attitudes about AIDS and sex behavior among school and university students of main urban cities of the country].

A national survey was conducted interviewing 4,522 students and 334 teachers. The result can be extrapolated to young people over 15 years of age and living in the large urban centers of the country. Thus the results can be extrapolated to approximately 330,000 persons. A good theoretical knowledge was detected but invalidated by erroneous beliefs, such as believing that A.I.D.S. is not contagious if relations are held within the same social group, that can be avoided by post-coital genital cleaning or by inquiring about the partner's previous sexual conduct. Forty four two per cent of the surveyed student are sexually active, and of this 32.6% of the men and 10.8% of the women have sexual relations with others outside their regular partners. The 72.9% believe that there is no possibility of A.I.D.S. contagion or that is very low. The erroneous beliefs, the high level of sexual activity the precocious initiation of sexual activity with prostitutes prostitutes and promiscuity among the surveyed, together with the generalized and false perception that there are not possibilities of contagiouness confirm that our youth is in very high risk level of contracting A.I.D.S. virus. Government politic is required to provide a global solution to this problem.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Validating population surveys for the measurement of HIV/STD prevention indicators.

OBJECTIVE: To validate the World Health Organization/Global Programme on AIDS (GPA) protocol for measuring HIV/sexually transmitted disease prevention indicators pertaining to knowledge and sexual practices of the general population. METHODS: Data were collected in Uganda during 1993. Three different interview strategies were complemented with qualitative methods, including observations at visits and key-informant interviews. Two interview strategies consisted of structured questionnaires which were applied to 460 randomly selected people aged 15-49 years and 60 intentionally selected women who were known prostitutes. The third strategy involved in-depth interviewing and was applied to a random subset of all respondents (n = 75). RESULTS: The three interview strategies generated similar results for demographic characteristics. The strategies using structured questionnaires gave similar results with regards to the number of reported sex partners and the prevalence of condom use, but differed from in-depth interviews on these aspects. The high numbers of casual sex partners of female prostitutes was confirmed by in-depth interviews but not via the questionnaires. CONCLUSION: The GPA questionnaire may not be optimal to capture people at high risk and to assess sexual behaviour, especially of people at high risk. Nevertheless, the questionnaire provides the most realistic option, since in-depth interviews are expensive and not as objective in assessing trends over time. Evaluation studies of HIV interventions in the general population should therefore be complemented with small qualitative studies to detect and iron out biases in interpreting results.

Adolescent↗
PubMed1994

Teenage obstetric and gynaecological problems in an African city.

OBJECTIVE: To measure the prevalence of sexually transmitted diseases (STD), pelvic inflammatory disease (PID), cervical cancer, pregnancy and use of contraception in teenagers, and to determine socioeconomic factors associated with these conditions to aid planners of medical services and promotion of sexual health. SUBJECTS: 181 Ethiopian teenagers and 1,845 women aged 20 to 45 years for comparison. SETTING: Gynaecological outpatient department, antenatal, postnatal and family planning clinics, in two teaching hospitals and a mother and child heath centre in Addis Ababa, Ethiopia. METHODS: Results of serologic tests for STD, clinical evidence of PID, and cervical cytology were analysed against socio-economic factors. RESULTS: In teenagers early age at first marriage/coitus, more common in those of rural origin, was associated with poverty, a greater number of lifetime sexual partners, and prostitution: 40 pc were first sexually active before the menarche. Prevalence of seropositivity to specific STD pathogens was; Treponema pallidum (TPHA) 21 pc, Neisseria gonorrhoeae (gonococcal antibody test: GAT) 40 pc, genital chlamydiae 51 pc, hepatitis B virus 36 pc, herpes simplex virus (HSV-2) 32 pc, and Haemophilus ducreyi 16 pc: 92 pc of teenagers were seropositive to one or more STD's. STD seroprevalence was higher in those with more than one sexual partner, those sexually active by age 15 (very high in those sexually active by age 12), those involved in prostitution and those attending the family planning clinic. Forty three pc had clinical evidence of PID; one married at age 10 had invasive cervical cancer by age 18; 40 pc of teenagers were pregnant compared with 25 pc of those aged 20 to 45; 21 pc attended for family planning; of regular FPC attenders 81 pc were GAT seropositive. CONCLUSION: Despite legislation early age of sexual debut is common, STD and PID are widely prevalent, the pregnancy rate in adolescents is high and contributes to the national population growth rate. Action is required at family, medical and governmental level to encourage cultural acceptance that marriage and sexual activity should not occur before the age of 16 years, with education appropriate to culture to prevent STD. Similar studies are recommended in other countries to establish a baseline for informed strategy regarding prevention of STD and health education.

Adolescent↗
PubMed1994

Risk factors for repeatedly reactive HIV-1 EIA and indeterminate western blots. A population-based case-control study.

OBJECTIVE: Causes of indeterminate results of Western blot testing (IWB) for human immunodeficiency virus (HIV) type 1 include seroconversion, HIV-2 cross-reactivity, and autoimmune disease, but most IWB results remain unexplained. This case-control study assessed risk factors for IWB results, including early HIV infection, other retroviral infection, autoantibodies, and other medical conditions. DESIGN: Prospective study to determine HIV seroconversion rate, with a case-control design to assess other risk factors for IWB. Cases (persons with one or more repeatedly reactive HIV-1 enzyme immunoassay with IWB), their current sexual partners, and controls (persons with negative enzyme immunoassay and Western blot results) were recruited from blood banks, health department and prenatal clinics, and private providers in Washington and Oregon. RESULTS: Of 244 cases enrolled, 206 were followed up for 6 months or longer, and six (3.0%; 95% confidence interval [CI], 0.7% to 5.3%) with recent HIV risk behaviors seroconverted. The Western blot banding patterns differed among groups; cases usually had p17 or p24 bands, while controls and cases' sexual partners usually had polymerase bands. Conditional logistic regression indicated that independent risk factors for IWB among male cases and controls were a tetanus booster in the past 2 years (odds ratio, 3.2; 95% CI, 1.2 to 8.6) and sexual contact with a prostitute (odds ratio, 3.0; 95% CI, 1.0 to 9.5). Independent risk factors for women were parity (odds ratio, 1.2; 95% CI, 1.02 to 1.4) and autoantibodies, either rheumatoid factor or antinuclear antibodies (odds ratio, 2.3; 95% CI, 1.03 to 5.6). No cross-reactivity was detected with HIV-2, human T-lymphotrophic virus type 1, feline immunodeficiency or feline leukemia, or bovine immunodeficiency viruses. CONCLUSIONS: Evaluation of persons with reactive HIV-1 enzyme immunoassays and IWB should include an assessment of HIV risk and other possible risk factors, such as alloimmunization (ie, parity or recent immunization) or autoantibodies (ie, antinuclear antibodies and rheumatoid factor). The relationship of IWB among men who reported sex with prostitutes is intriguing and warrants further study.

Adolescent↗
PubMed1994

Diagnosis and differentiation of HIV-1 and HIV-2 infection by two rapid assays in Nigeria.

We evaluated the reliability, sensitivity, and specificity of two rapid assays, TestPack HIV-1/HIV-2 and Genie HIV-1/HIV-2, in Lagos, Nigeria. An alternative algorithm to EIA and Western blot was then examined with the TestPack HIV-1/HIV-2 used as the screening test and the Genie HIV-1/HIV-2 used as the supplemental test to differentiate HIV-1 and HIV-2 infection. In all, 845 prostitutes were evaluated for HIV-1 and HIV-2 infection using one of the two rapid tests and compared to EIA and Western blot results. Of these 845 cases, 437 samples were analyzed by both assays. Overall, 109 (12.7%) prostitutes were antibody positive for HIV-1, 13 (1.5%) for HIV-2, and six (0.7%) were dually reactive for both HIV-1 and HIV-2. Compared to Western blot, the Genie HIV-1/HIV-2 had a slightly higher sensitivity and specificity (98.4% and 99.7%) than the TestPack HIV-1/HIV-2 (97.6% and 99.3%). The alternative algorithm using both rapid assays had a sensitivity of 96.9% and a specificity of 99.9%. The Genie HIV-1/HIV-2 correctly identified 104 of 108 HIV-1 positive sera, 12 of 13 HIV-2 positive sera, and all six dually positive sera. Both assays performed well in the field. They required < 10 min to complete, no equipment, and little training. An algorithm incorporating two rapid assays can be used as a less expensive alternative to traditional testing strategies comparable in reliability to ELISA and Western blot; it provides the additional advantage of differentiating between HIV-1 and HIV-2.

Algorithms↗
PubMed1993

Demographic characteristics of retroviral infections (HIV-1, HIV-2, and HTLV-I) among female professional sex workers in Lagos, Nigeria.

In 1990/1991, 885 prostitutes residing in 11 of the 12 Local Government Areas (LGAs) of Lagos State, Nigeria, participated in a cross-sectional study to determine current seroprevalence of antibodies to human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2), and human T-cell lymphotropic virus type I (HTLV-I). The overall prevalence of HIV-1 was 12.3%, of HIV-2, 2.1%, and of HTLV-I, 2.8%. HIV-1 seropositivity did not vary significantly by age, socioeconomic class, or nationality, but HIV-1 seroprevalence was significantly elevated for prostitutes resident in the Port area of Lagos which serves as a crossroads for international and national commerce (OR = 2.3; 95% CI = 1.1, 4.6). HIV-2 infection was significantly associated with low socioeconomic class (OR = 3.7; 95% CI = 1.2, 10.8) and non-Nigerian nationality (OR = 6.7; 95% CI = 2.5, 18.4). Prevalence of HTLV-I infection increased significantly with age (OR = 2.3; 95% CI = 1.0, 5.3). The high seroprevalence of HIV-1 in this survey, compared with previous surveys reported in the last several years and the correlation between high prevalence and areas of international commerce suggest that HIV-1 is spreading in this area of Nigeria. Intensified prevention campaigns are needed to address this possible emerging epidemic.

Adolescent↗
PubMed1993

Prevalence of Pthirus pubis (Anoplura: Pediculidae) among sex workers in urban Jos, Nigeria.

Between May and October 1992, 374 sex workers comprising of 372 prostitutes and 2 homosexuals were examined for Pthirus pubis infestation. While none of the homosexuals was found to be infested, 52.69% of the prostitutes were infested with the highest and lowest infestation in the 40-49 year old group and 20-29 year old group respectively. The educational level was found to determine the extent of disease awareness among the sex workers. Questions are raised about the role of Pthirus pubis is AIDS transmission among sex workers.

Adolescent↗
PubMed1993

Seroprevalence of and risk factors for HIV-1 infection in injection drug users in Montreal and Toronto: a collaborative study.

OBJECTIVE: To determine the prevalence of antibodies to HIV-1 and risk factors for HIV-1 infection among injection drug users. DESIGN: Questionnaire survey. A venous blood sample was taken for HIV-1 antibody testing. SETTING: Montreal and Toronto. PARTICIPANTS: A total of 810 subjects who had used injection drugs in the previous 6 months recruited mainly from treatment centres and from the street in Montreal (425 subjects) and from treatment centres in Toronto (385 subjects) between September 1988 and September 1990. The overall participation rate was 82%. OUTCOME MEASURES: HIV-1 seropositivity, sociodemographic and behavioural risk factors for HIV-1 infection. RESULTS: The overall seroprevalence rate of HIV-1 infection was 4.8% (95% confidence limits [CL] 3.5 and 6.5). In Montreal the rate was 8.2% (95% CL 6.0 and 11.2), and in Toronto 1.0% (95% CL 0.4 and 2.6) (p < 0.001). Seropositive subjects were significantly older (p = 0.041) and were more likely to have a history of imprisonment (p = 0.006) than seronegative subjects. In univariate analysis seropositivity was associated with the following behaviours: more frequent cocaine use (p < 0.001), injecting drugs in "shooting galleries" (p = 0.002), sharing equipment with a person known to be HIV-1 seropositive (p = 0.006), "booting" fresh blood (p = 0.004), homosexual or bisexual orientation (p = 0.006), engaging in prostitution (p < 0.001) and, for men, number of male sexual partners in the previous 6 months (p = 0.007). In multivariate analysis the determinants of HIV-1 seropositivity were Montreal as the city of recruitment (odds ratio [OR] 6.7, 95% CL 2.32 and 19.42), engaging in prostitution (OR 2.13, 95% CL 1.01 and 4.75), a history of imprisonment (OR 3.51, 95% CL 1.33 and 9.29) and sharing equipment with a person known to be HIV-1 seropositive (OR 4.43, 95% CL 1.43 and 13.74). CONCLUSIONS: Our findings show that HIV-1 is circulating among injection drug users in Montreal and Toronto and that both drug use and sexual behaviours are implicated in the transmission of infection in the populations studied. Adapted preventive programs should be developed to prevent further spread of HIV-1 infection in this population.

AIDS Serodiagnosis↗
PubMed1995

Male circumcision, sexually transmitted disease, and risk of HIV.

Our objective was to describe associations among male circumcision, behavioral and demographic variables, ulcerative and nonulcerative sexually transmitted disease (STD), and human immunodeficiency virus (HIV) infection via a cross-sectional study in Kigali, the capital of Rwanda. Our subjects were 837 married men who volunteered for HIV testing and counselling. Uncircumcised men had a relatively low-risk profile in that they reported fewer lifetime sexual partners and prostitute contacts than circumcised men and were more likely to live in rural areas with lower HIV prevalence rates. Uncircumcised men were also less likely to report a history of sexually transmitted disease (64% versus 73%, p = 0.01), although they were more likely to report genital ulceration (GUD) (24% versus 17%, p < 0.03) and to have inguinal adenopathy noted on physical exam (42% versus 29%, p = 0.009). Despite the low-risk profile, uncircumcised men had a higher prevalence of HIV infection than circumcised men (29% versus 21% HIV positive, p = 0.02), which was most marked in men reporting five or more lifetime sex partners (36% versus 23% HIV positive, p = 0.005) or contact with prostitutes (35% versus 23% HIV positive, p = 0.009). Circumcision remained a predictor of HIV infection in multivariate analyses (multivariate odds ratio 1.69, 95% confidence interval 1.16-2.47). Lack of circumcision is associated with a higher risk of HIV infection in Rwandan men. Further research is needed to determine whether this higher risk is due in part to poor hygiene or to complex mechanisms operating through the acquisition of other sexually transmitted diseases. Circumcision may be an appropriate risk reduction approach for men with known exposures to the virus when there are constraints to alternatives, such as condom use.

Adult↗
PubMed1995

The HIV-associated risk behaviour among male drug abusers in Malaysia.

To examine the risk factors of HIV type-I infection among male drug addicts in Malaysia, a case-control study was conducted on inmates, aged 20-40 years, at a drug rehabilitation centre in January, 1994. Stratified random sampling was performed. A total of 87 cases and 261 controls, chosen by frequency matching for age and ethnicity, answered self-administered questionnaires. About 59.8% of the subjects administered drugs intravenously and of these, 71.2% shared needles. Practices significantly associated with HIV infection were needle-sharing (OR = 8.53; 95% CI = 3.36-5.52), sexual relationship with prostitutes (OR = 3.70; 95% CI = 2.10-6.56), homosexuality (OR = 4.05; 95% CI = 1.49-11.11) and non-condom use while having sex with prostitutes (OR = 2.27; 95% CI = 1.05-4.97).

Adult↗
PubMedDate not supplied

[Prevalence of risk factors associated with hepatitis C in blood donors in the municipality of Durango, Mexico].

OBJECTIVE: To determine the prevalence of anti-viral hepatitis C antibodies (HCV-Ab+) in voluntary blood donors and to identify the main risk factors associated with it. MATERIAL AND METHODS: A case-control study was conducted over a 20-month period beginning in June 1993. A clinical history was obtained from all blood donors seen at the Centro Estatal de la Transfusión Sanguínea (State Blood Transfusion Center) and the Instituto Mexicano del Seguro Social in Durango, Mexico. HCV-Ab+ was determined in 5 915 serum assays using the second generation enzymatic immunoassay (UBI HCV EIA). RESULTS: The prevalence of HCV-Ab+ was 1.47 per 100 donors. The HCV-Ab+ prevalence was similar for urban and rural donors (1.54% and 1.34%) with no history of work migration. The main risk factors associated with HCV were a history of transfusions, (odds ratio -OR- 14.80, 95% confidence interval -CI-4.97-47.17) and sexual promiscuity or intercourse with prostitutes, (OR 6.53, 95% CI 2.61-16.54). CONCLUSIONS: The high prevalence of HCV-Ab+ may be explained by the lack of epidemiological surveillance of the population at risk. These data underscore the need for routine screening of HCV-Ab among voluntary blood donors and male or female prostitutes.

Adult↗