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PubMed1997

HIV-1 risk and vaccine acceptability in the Ugandan military.

Between July and October 1993, 570 19- to 22-year-old volunteers were screened for HIV-1, with a resulting seroprevalence rate of 18.3% (95% CI: 14.0%, 22.6%). A cohort of 249 HIV-1-noninfected military recruits in the Ugandan Peoples' Defense Forces was followed prospectively for up to 18 months to document rates of HIV-1 seroprevalence, seroconversion, and knowledge and attitudes related to vaccine acceptability. The HIV-1 seroincidence rate was 3.56 per 100 person-years (95% CI: 1.49, 5.62) over 309 person-years of observation. At the 3- and 12-month visits, subjects were interviewed on issues of acceptance and knowledge about vaccines, including anti-HIV vaccines in particular. More than 90% believe that HIV vaccines will not cause HIV infection, and if offered, 88% report that they would take the vaccine if they were not already infected. Nonvaccine prevention methods were considered less reliable; monogamy and condom use were considered effective by only 33.5% and 69.3% of the cohort respectively. After completing the vaccine acceptability questionnaire at the 12-month visit, subjects were offered an approved polyvalent meningococcal vaccine as an indicator of general vaccine acceptance. All subjects reported receiving at least one previous vaccination, and 95% willingly accepted the meningococcal vaccination. The Ugandan military is a stable population at substantial risk for HIV-1 infection and may be a suitable population for vaccine efficacy trials.

AIDS Vaccines↗
PubMed1994

Sexual communication is associated with condom use by sexually active incarcerated adolescents.

PURPOSE: Incarcerated adolescents are at increased risk for infection by sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Moreover, condom use by this population is extremely low. Although interpersonal variables such as sexual communication have been found to be associated with condom use in other populations, few researchers have investigated this relationship among adolescents requiring detention in juvenile facilities. The present study investigated the relationship between communication about sexual history and incarcerated adolescents' condom use. METHODS: We used multivariate logistic regression techniques to analyze interview data from a predominantly Latino sample of 2,132 sexually active adolescents detained in Los Angeles County Juvenile Hall. RESULTS: Despite high numbers of lifetime sexual partners, a substantial majority of respondents (67%) reported that they never used condoms during sexual intercourse. Respondents who communicated with their sex partner(s) about each others' sexual history were significantly more likely to use condoms during sexual intercourse. Adolescents who reported that they knew someone with AIDS were also more likely to use condoms. CONCLUSIONS: Interventions designed to increase condom use among sexually active incarcerated adolescents should include a component addressing sexual communication practices. More research is needed on the ways in which adolescents learn to communicate about sex.

Adolescent↗
PubMed1991

Knowledge and attitudes relating to condoms on the part of African high school children around Johannesburg.

Senior high school children completed a self-administered questionnaire on sexual activity, knowledge of family planning methods, condoms and use of condoms. The study highlighted some useful and interesting information though its value is limited by a poor response rate. The results suggest that at least 50% of the scholars are sexually active, but only about 20% reported sexual intercourse during the month preceding the survey. This small group reports more than 1 sexual partner and unprotected sexual intercourse in over 50% of the cases. Knowledge of condoms was poor and a number of factors relating to resistance to condoms are identified. These must be addressed by a combination of social marketing and educational strategies. The most important finding is that half of the children were still not sexually active. Education programmes therefore should support the development of safe and responsible sexual lifestyles.

Adolescent↗
PubMed2000

Use of birth control pills, condoms, and withdrawal among U.S. high school students.

PURPOSE: To examine the use of contraception at last sexual intercourse among currently sexually active adolescents. METHODS: We analyzed data from national school-based Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey which uses a national probability sample of U.S. students in public and private schools from grades 9 through 12. RESULTS: From 1991 to 1997, condom use significantly increased (from 46% to 57%), birth control pill use decreased (from 21% to 17%), and use of withdrawal significantly decreased (from 18% to 13%). In 1997, although more students were using condoms, 13% reported using withdrawal and 15% reported using no method to prevent pregnancy at last sexual intercourse. In 1997, condom use among females was significantly lower in the 9th grade than in the 12th grade (p <.001), whereas birth control pill use was higher (p <.001) and use of withdrawal remained stable. Among males, condom use and withdrawal use remained stable from 9th to 12th grade, whereas birth control pill use by their partner increased (p <.001). CONCLUSIONS: Inadequate contraceptive use among sexually active adolescents continues to be a major public health problem in the United States. For young people who will not remain sexually abstinent, families, health care providers, schools, and other influential societal institutions should promote the correct and continued use of condoms as essential protection against sexually transmitted diseases and human immunodeficiency virus infection.

Adolescent↗
PubMed1989

Sexual behavior, contraception and unintended pregnancy among young females.

Information about contraceptive usage and sexual experiences was sampled in 1985-86 from 16-20-year-old Danish females admitted for legally induced abortion on Funen (N = 140). In attempts to elucidate the causal relations behind undesired pregnancy among teenagers, data were in the present context compared with answers to the same questions from a representative Danish sample of sexually experienced, non-pregnant females of the same age (N = 201). Of the reference sample, 83.6% were using contraceptives at the time of the interview--mostly oral contraceptives (O.C.). Of the abortion sample, 90.7% said they had used contraception earlier in their reproductive life. Approximately one third conceived in spite of contraception (most frequently the condoms). O.C. was the contraceptive method used most recently (by 43.6%). Thus, a pause in an effective contraceptive often precedes an unintended pregnancy, pointing to the need for follow-up counselling when O.C. is prescribed to teenagers. Only the minority could state the total number of times they had experienced sexual intercourse. Significantly more females in the abortion sample were in an alliance with a male partner with whom they had regular sexual intercourse. However, they also reported a higher average number of different sexual partners, indicating an association between changing sexual relationships and undesired pregnancy. In the abortion sample significantly more pregnancies prior to the index pregnancy were reported during a corresponding period of risk of conception lasting only a few years. Taking the widespread use of contraception into account, it is possible that an increased fecundity might be a co-factor behind unsuccessful contraception.

Adolescent↗
PubMed1997

AIDS and condoms in Brasilia: a telephone survey.

A telephone survey was conducted to measure AIDS knowledge, media usage and condom attitudes and behaviors among 500 adults aged 18 to 49 in Brasilia, as well as to evaluate the feasibility of the telephone survey method in a developing country. The response rate was 91.6%. Respondents had good knowledge about correct modes of HIV transmission and prevention but also believed HIV was transmitted through blood donation, public toilets, swimming pools, and mosquito bites. TV and newspapers were the most important sources of information on health matters and AIDS, though health workers were considered the most credible sources of such information. Only 19% of sexual encounters in the 4 weeks prior to the survey included condoms. Single and younger respondents and those with more positive attitudes used condoms more frequently. More work is needed to identify appropriate messages to motivate people to use condoms. Telephone surveys regarding AIDS and sexual attitudes and behaviors are feasible in Brasilia, a planned community with universal telephone coverage.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Who's at risk? Men's STD experience and condom use in southwest Nigeria.

Many STD/HIV-prevention programs worldwide assume that individuals' risk of acquiring sexually transmitted diseases, including HIV infection, is highest in the context of commercial sex. To address this assumption, research conducted in urban Southwest Nigeria combined qualitative and quantitative methods to examine men's sexual behavior, condom use, and STD experience in different types of sexual relationships (marital, casual, and commercial). Logistic regression analysis of survey data indicates that number of sexual partners and sex with sex workers are positively and significantly related to STD experience. Follow-up in-depth interviews with clients of sex workers indicate, however, that these men are actually more likely to report having contracted an STD from a casual sex partner than from a sex worker. Men are most uncertain about their vulnerability to STDs with casual partners. Men's condom use is highest in commercial sex, inconsistent in casual relationships, and lowest in marriage. STD/HIV-prevention programs need to address the range of sexual relationships and the meanings and behaviors associated with them.

Adolescent↗
PubMed2005

Interleukin-13 is the key effector Th2 cytokine in ulcerative colitis that affects epithelial tight junctions, apoptosis, and cell restitution.

BACKGROUND & AIMS: Ulcerative colitis (UC) is characterized by a Th2 immune response with inflammation and epithelial barrier dysfunction. So far, Th2 cytokines have not been shown to directly influence epithelial barrier function. METHODS: Lamina propria mononuclear cells (LPMCs) were stimulated and interleukin (IL)-13 was measured by enzyme-linked immunosorbent assay. Functional IL-13 and IL-4 effects were studied on HT-29/B6 colonic epithelial cells in Ussing chambers and by conductance scanning. Apoptosis was detected by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling assays. IL-13/IL-4 receptors were analyzed by reverse-transcription polymerase chain reaction and immunofluorescence. Western blotting combined with immunofluorescence was used to detect tight junction proteins. Furthermore, restitution velocity was measured. Finally, mucosal biopsy specimens from patients with UC were compared with cultured cells for these features. RESULTS: LPMCs from patients with UC produced large amounts of IL-13 (985 +/- 73 pg/mL), much more than from controls or patients with Crohn's disease. IL-13Ralpha1 and IL-4Ralpha receptors were present in HT-29/B6 cells and colonic epithelial cells of control patients and patients with UC. IL-13 had a dose-dependent effect on transepithelial resistance of HT-29/B6 monolayers (reduction to 60% +/- 4%), whereas IL-4 had no effect. This was due to an increased number of apoptotic cells (5.6-fold +/- 0.9-fold) and an increased expression of the pore-forming tight junction protein claudin-2 to 295% +/- 37%, both of which contributed equally. Finally, epithelial restitution velocity decreased from 15.1 +/- 0.6 to 10.6 +/- 0.5 microm/h after treatment with IL-13. Parallel changes were observed in human samples, with an increase in claudin-2 expression to 956% +/- 252%. CONCLUSIONS: IL-13 was identified as an important effector cytokine in UC that impairs epithelial barrier function by affecting epithelial apoptosis, tight junctions, and restitution velocity.

Adult↗
PubMed1998

Condom use by Hispanic and African-American adolescent girls who use hormonal contraception.

PURPOSE: The purpose of the present study was to examine condom use by teens who use hormonal contraceptives [i.e., Depo-Provera, Norplant, or oral contraceptives (OCs)]. METHODS: This is a cross-sectional study of 578 Hispanic and African-American female adolescents between the ages of 12 and 21 years who came to a reproductive health care clinic. A paper-and-pencil questionnaire which addressed sexual behaviors, sexual history, and communication about sexuality was distributed to adolescent girls attending the clinic. Several important analyses included only those who had been sexually active in the last 4 weeks (n = 452). RESULTS: Adolescents who used OCs [odds ratio (OR) 1.7], long-acting agents (i.e., Depo-Provera or Norplant) (OR 1.6), were less likely to have used a condom in the last 4 weeks than teens whose only method of birth control was condoms. Only those teens who had previously been diagnosed with a sexually transmitted disease (STD) were more likely to have used a condom (OR .67 for not using a condom). Overall, condom use by teens in this sample was low, with only 19% reporting that they "always" use a condom, and 47% of the teens who had been sexually active in the last 4 weeks reporting that they had not used a condom at least once during that time. CONCLUSIONS: This study provides data which suggest that adolescent girls who use hormonal contraceptives are less likely to use condoms than other sexually active teens. Therefore, when prescribing hormonal contraception to prevent pregnancy, clinicians must provide appropriate counseling to mitigate against the potential to increase the risk of STDs.

Adolescent↗
PubMedDate not supplied

The use of condoms with other contraceptive methods among young men and women.

In a nationally representative sample of sexually experienced youths aged 14-22, 37% of young women and 52% of young men said the condom was the primary method used to prevent pregnancy at last intercourse; an additional 8% and 7%, respectively, said they used a condom at last intercourse; much of this represents dual use [corrected]. Condom use at last intercourse was reported by 25% of young men whose partner was using the pill. Significant independent predictors of condom use with the pill among men included younger age, black race, engaging in fewer nonsexual risk behaviors and having received instruction about HIV in school. Among young women, 21% of those relying on the pill reported also using a condom at last intercourse. For women, independent predictors of dual use included younger age, black race, older age at first sex, fewer nonsexual risk behaviors, having no partners in the previous three months and having talked to parents or other adult relatives about HIV.

Adolescent↗
PubMed1996

HIV risk behavior, street outreach, and condom use in eight high-risk populations.

In this paper we examine risk behavior, exposure to street outreach, and condom use in samples of injecting drug users (IDUs) and high-risk youth. We used systematic sampling methods to produce representative samples of injecting drug users IDUs (five sites) and high-risk youth (three sites). The populations surveyed engaged in high levels of sexual risk behavior: 20% to 46% reported two or more sex partners in the last month. The majority (62% to 97%) knew someone infected with HIV. Condom use rates approached national health promotion goals for nonsteady partners but not for steady or main partners. Having a condom at time of interview was the most consistent predictor of condom use at last intercourse. Many of the respondents have been in contact with street outreach programs and many acknowledged some personal risk for HIV infection. However, most of the injecting drug users and high-risk youth interviewed (and their sex partners) were still at risk through unprotected sex.

Adolescent↗
PubMed1993

Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples.

OBJECTIVE: To investigate the relationship between psychological distress, alcohol, drug and condom use in HIV-serodiscordant heterosexual couples. METHODS: Structured interviews were conducted to collect demographic information, detailed data on psychological distress, drug and alcohol use and sexual behavior. RESULTS: Analyses were based on 106 pairs of sexually active discordant couples. Significant differences among heterosexual condom users and non-users varied according to gender and HIV serostatus. Affect domains of interpersonal sensitivity and hostility were significant, as were the variables of regular drug or alcohol use and combining sex with drugs or alcohol. Employment was strongly associated with condom use in HIV-negative women whose regular sexual partners were HIV-positive men. CONCLUSION: The risk of vaginal sex without condoms in HIV-serodiscordant heterosexual couples may be reduced by specific psychological counseling and attention to drug and alcohol use as risk factors. Further research on the effect of employment of HIV-negative women is required.

Adolescent↗
PubMed1997

Association of contraceptives and HIV-1 infection in Thai female commercial sex workers.

We conducted a case-control study to evaluate the association between contraceptive methods and HIV infection among Thai female commercial sex workers in Khon Kaen and Lumpang provinces, Thailand; 118 cases of HIV-1 infected sex workers were eligible for inclusion and 258 HIV-1 negative women were recruited as controls during the period of October 1, 1993 to December 31, 1994. Cases and controls were matched by age, education, parity, age at first exposure to commercial sex, number of clients per night, duration of work and sexual practice during menstruation. The ratio of case per control was 1:2. Both cases and controls were interviewed and underwent blood testing by a team of investigators. The study revealed no significant association between oral pill, injection, other contraceptives and HIV-1 infection. However, condom usage showed a significant protective effect. It is suggested that these contraceptives in this high-risk group of women do not increase the risk of HIV infection. In contrast, the use of condoms could reduce the risk of HIV infection.

Adult↗
PubMed2000

Blood-brain barrier function in cerebral malaria and CNS infections in Vietnam.

BACKGROUND: The intraerythrocytic parasite Plasmodium falciparum induces the life-threatening neurologic syndrome of cerebral malaria (CM) from within cerebral blood vessels, without entering the brain parenchyma. OBJECTIVES: 1) To assess the use of CSF as an indicator of specific pathologic processes occurring in the brain during CM; 2) to compare this with other neurologic and infectious diseases to understand the distinct pathogenic features of CM; 3) to test the hypothesis that CM involves a specific functional breakdown of the blood-brain barrier (BBB). METHODS: 1) Radial immunodiffusion assays to detect albumin and IgG in matched plasma and CSF samples as indicators of BBB integrity and intrathecal IgG production; and 2) ELISA for soluble intracellular adhesion molecule-1 and sE-selectin, the cytokines tumor necrosis factor-alpha and transforming growth factor-beta1, and the matrix metalloproteinase MMP-9, to detect cellular activation and inflammatory responses within the brain. RESULTS: Albumin and IgG indices implied only minimal degree of BBB breakdown in a few cases of CM, with most remaining within the normal range. In contrast, cryptococcal, tubercular, and acute bacterial meningitis produced detectable changes in the composition of the CSF and evidence of BBB breakdown. CONCLUSIONS: CM appears to involve only subtle functional changes in BBB integrity with minimal intraparenchymal inflammatory responses compared with other neurologic infections. This focuses attention on local events within and around the cerebral microvasculature in CM, rather than indicating widespread parenchymal disease.

Adolescent↗
PubMed1991

Condom use and breakage among women in a municipal hospital family planning clinic.

For those who choose to be sexually active, condoms are the best available means of protection against sexually transmitted diseases including the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Condoms are also an effective method for preventing pregnancy. Unfortunately, condoms are not 100% effective at preventing pregnancy or the spread of infection, in part because condoms do break. In order to gain insight into condom breakage, a questionnaire was administered to women attending a municipal hospital family planning clinic. Thirty-six percent of the 106 subjects had experienced at least one condom breakage. Condom breakage occurred in approximately 1 out of 100 acts of intercourse using condoms, with a lifetime breakage rate of 10 per 1000 condom uses and a past year breakage rate of 8 per 1000 condom uses. Breakage rates did not differ substantially by age. Five percent of the women's unplanned pregnancies were attributed to broken condoms. The results of this study corroborate previously reported rates. Factors associated with these women's most recent breakage experiences included: vaginal intercourse, minimal foreplay, and breakage prior to ejaculation. Controlled studies will be needed to determine how the condom can be used to reduce the likelihood of breakage.

Contraceptive Devices, Male↗
PubMedDate not supplied

Attitudes toward childbearing and changes in sexual and contraceptive practices among HIV-infected women.

BACKGROUND: Women now constitute 12% of persons with acquired immunodeficiency syndrome (AIDS), and three quarters of them are well within their childbearing age. OBJECTIVE: To determine if women infected with human immunodeficiency virus (HIV) change their attitudes toward childbearing and their sexual and contraceptive practices. METHODS: Questionnaire and interview. RESULTS: Forty-six women age 18 to 44 participated; 33 were white, 12 were Hispanic, and 1 was black. Intravenous drug abuse was reported by 65%. Nineteen had symptomatic HIV disease or AIDS. Only 70% said they had received counseling after testing. Of these, 59% said they were counseled on avoiding pregnancy, and 81% said they were counseled on use of condoms. Before testing, 59% had wanted to have children; after testing, only 17% did. Only 4% said they had always used condoms before testing, but 54% said they did after testing; 39% said they used some form of birth control before testing compared with 70% who said they did after testing. CONCLUSIONS: Counseling was not optimal. Sexual and contraceptive practices changed, but follow-up study will be needed to see if such changes are sustained.

Adolescent↗
PubMed1999

Fathering pregnancies: marking health-risk behaviors in urban adolescents.

PURPOSE: To establish self-reported rates and associated correlates of fathering pregnancies in urban teen males, and to explore the possibility of using their pregnancy history as a marker for other health-risk behaviors. METHODS: A blinded, self-administered questionnaire was given to the predominantly African-American patients of an inner-city adolescent outpatient clinic. Urine was also collected in a blinded, anonymous fashion, matched to the questionnaires, and tested for five drugs of abuse. Males were classified as having or not having a pregnancy history (PH) according to a questionnaire response item. PH and non-PH participants were compared for eight risk factors using univariate and multivariate methods. RESULTS: A total of 24.2% reported a PH. These males were about 14 times more likely to report three or more sex partners in the last year, more than five times as likely to report a sexually transmitted disease history, more than three times as likely to test positive for drugs, and more than 2.5 times as likely to be inconsistent or nonusers of condoms as compared to males without a pregnancy history. An association between violent behavior and PH is unsupported. CONCLUSIONS: Pregnancy history can be a valuable marker for other risk factors among inner-city African-American males. With some patients, it may be easier for clinicians to discuss pregnancy history or fatherhood as opposed to drug abuse and other more sensitive risk factors. The topic can then be used as a gateway for discussion of other risk factors.

Adolescent↗
PubMed2003

[Synthesis of prodrugs of tacrine hydrochloride and evaluation of the stability and biodistribution in mice].

AIM: To synthesize acylated prodrug of tacrine hydrochloride (THA) to improve the infiltration ability across the blood brain barrier (BBB). METHODS: A series of prodrugs were prepared by acylation of the 7-amino group of THA. The degradation of prodrugs was investigated under different conditions. Biodistribution studies of N-butyramide-THA (BTHA) in mice were carried out to evaluate the function of brain targeting. RESULTS: The structures of prodrugs were confirmed by IR, 1HNMR and MS. All prodrugs were stable in different medium. Octanol-water partition coefficients indicated increased lipophlicity for various prodrugs compared to the THA. In vivo distribution studies showed that BTHA was mainly distributed in brain, blood and liver (the maximum concentrations were 17.5725, 13.1400 and 22.8279 mg.L-1, respectively), while the THA concentration were very low in lung and heart (the maximum concentrations were 4.9475 and 4.4925 mg.L-1, respectively). The BTHA concentration (2.4159 mg.L-1) was relatively high even 12 h after administration, showing that BTHA degraded more slowly in brain than in other tissues. CONCLUSION: The infiltration ability of THA across BBB was increased in the form of N-acylate-THA prodrug, indicating that this kind of prodrug is a promising brain-targeting delivery system.

Animals↗