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The social and economic origins of genetic determinism: a case history of the American Eugenics Movement, 1900-1940 and its lessons for today.

Eugenics, the attempt to improve the genetic quality of the human species by 'better breeding', developed as a worldwide movement between 1900 and 1940. It was particularly prominent in the United States, Britain and Germany, and in those countries was based on the then-new science of Mendelian genetics. Eugenicists developed research programs to determine the degree in which traits such as Huntington's chorea, blindness, deafness, mental retardation (feeblemindedness), intelligence, alcoholism, schizophrenia, manic depression, rebelliousness, nomadism, prostitution and feeble inhibition were genetically determined. Eugenicists were also active in the political arena, lobbying in the United States for immigration restriction and compulsory sterilization laws for those deemed genetically unfit; in Britain they lobbied for incarceration of genetically unfit and in Germany for sterilization and eventually euthanasia. In all these countries one of the major arguments was that of efficiency: that it was inefficient to allow genetic defects to be multiplied and then have to try and deal with the consequences of state care for the offspring. National socialists called genetically defective individuals 'useless eaters' and argued for sterilization or euthanasia on economic grounds. Similar arguments appeared in the United States and Britain as well. At the present time (1997) much research and publicity is being given to claims about a genetic basis for all the same behaviors (alcoholism, manic depression, etc.), again in an economic context--care for people with such diseases is costing too much. There is an important lesson to learn from the past: genetic arguments are put forward to mask the true--social and economic--causes of human behavioral defects.

Eugenics↗

Characteristics of HIV-positive chronically mentally ill inpatients.

The growing population of chronically mentally ill persons who are HIV-positive or who have AIDS has not yet been adequately studied. We describe the entire population of known HIV-positive inpatients in a state psychiatric center in New York City. In this sample, the typical patient with known HIV infection is as likely to be a man as a woman and is a member of an ethnic minority group. HIV-positive patients had multiple risks for HIV infection including injecting drug use (IDU), sex with IDU partners, prostitution and male homosexual activity. Most patients were at a late stage of HIV-infection, typically with CD4+ cell counts of 400. Discharge plans were complicated by HIV illness and most HIV-positive patients had a longer length of hospital stay than non HIV-positive patients. We discuss the need to plan for the management of increasing numbers of HIV-positive patients in inpatient, outpatient, and residential facilities.

Acquired Immunodeficiency Syndrome↗

The relationship between nonenforcement of state pornography laws and rates of sex crime arrest.

The nonoperation of antipornography statutes in four states (Maine, North Carolina, Pennsylvania, and Washington) for varying periods between 1973 and 1986 provided an opportunity to examine the impact of such statutes and pornography availability on sex crimes because nonenforcement is associated with an increase in the availability of sexually explicit materials. Arrests for property offenses and for rape, prostitution, and other sex offenses during the period before the suspension of the laws, when compared with the period during suspension, reflected no significant changes. Findings are consistent with other foreign and American studies that have failed to find a link between exposure to sexually explicit media materials and rates of reports of rape and other sex offenses.

Crime↗

Cycles of the uterus mucous membranes and estimation of time of death.

In a case where a 27-year-old prostitute was found stabbed to death, histological examination of the uterus mucous membranes was performed to estimate the time of death after a long postmortem interval. The time of menstruation was obtained from a witness statement. Assuming a regular cycles, the histology of the uterus tissue indicated an early stage of menstruation suggesting that death occurred shortly after the woman disappeared.

Adult↗

HIV infection presenting as renal polyarteritis nodosa.

We present a case of renal vasculitis (polyarteritis nodosa) in a 36-year-old female prostitute having undetected HIV infection (AIDS-related complex) and chronic B-hepatitis. The pathogenesis and significance of the association between these entities are reviewed.

AIDS-Related Opportunistic Infections↗

Hepatitis TT virus infection in high-risk groups.

The novel hepatitis TT virus first described by a Japanese group has been reported to be parenterally transmitted and furthermore, to have been detected in patients with hepatitis of unknown etiology. Hence, in the present study its prevalence was investigated within groups at high risk for contracting blood-borne viruses, such as individuals with chronic liver disease, intravenous drug users and recipients of blood and blood products, as compared to voluntary blood donors and pregnant women. To that end, DNA was extracted from sera obtained from the respective patients and subjected to PCR using semi-nested primers. The frequency of TTV DNA detected within high risk groups, such as nine out of 50 patients with chronic non-A-to-G liver disease (18%), nine out of 98 hepatocellular carcinoma cases (9.2%), 17 out of 52 intravenous drug users (32.7%), 15 out of 80 thalassemia patients with multiple blood transfusions (18.8%) and three out of 31 prostitutes (9.7%) exceeded that among voluntary blood donors and pregnant women, which amounted to 14 out of 200 (7%) and seven out of 103 (6.8%), respectively. Additional molecular research should be performed in order to determine its short-, as well as long-term clinical significance.

Adolescent↗

Subtyping of human T-lymphotropic virus type I by amplification of long terminal repeat sequences and restriction fragment length polymorphism analysis in carriers with multiple transfusions.

Five major subtypes of human T-lymphotropic virus type I (HTLV-I) have been proposed: cosmopolitan, Japanese, West African, Central African, and Melanesian. Based on nucleotide variations specific to particular subtypes, it was possible to genotype HTLV-I rapidly by restriction fragment length polymorphism (RFLP) studies following polymerase chain reaction (PCR). In this study, the restriction patterns of two LTR fragments were analyzed using eight restriction endonucleases (AvaI, Eco57I, BsoFI, NdeI, SacI, DraI, MaeII, and MaeIII). Genotyping of HTLV-I was done in nine patients with adult T-cell leukemia or HTLV-I-associated myelopathy/tropical spastic paraparesis, in three prostitutes, and in 19 carriers with multiple transfusion in Taiwan. The subtyping results of RFLP studies using these eight restriction endonucleases were in accordance with those of phylogenetic analysis. A substitution of G by A at nucleotide position 503, which creates the DraI site but suppresses the SacI site, was found not only in the Japanese subtype but also in a minority of the cosmopolitan subtype. A mutation near the position of subtype-specific nucleotide variations might suppress the restriction site and lead to unexpected restriction patterns. Amplification of more than one proviral fragment and RFLP studies with a group of appropriate restriction endonucleases may provide rapid and accurate genotyping of HTLV-I. More carriers are required to evaluate the possibility of mixed infection with different HTLV-I subtypes.

Base Sequence↗

[Sudden cardiovascular death during sexual intercourse--results of a legal medicine autopsy study].

This epidemiologic, retrospective follow-up mortality study is based on the data gathered in the department of forensic medicine at the University Hospital of Johann Wolfgang Goethe University in Frankfurt/Main. Over a period of 21 years (1972-1992), roughly 21,000 forensic autopsies revealed 39 cases (0.19%) of natural deaths occurring during sexual activity. Except for two women, all of these cases were men of an average age of 61.3 years. The most frequent cause of death was myocardial infarction (n = 21/53.8%), three of these cases involving pericardial tamponade accompanied by myomalacia. The medical history of twelve of the deceased showed a previous myocardial infarction. Most of the deaths took place during or after sexual intercourse or manual stimulation. In most cases sudden death occurred during the sexual act with a prostitute. The annual incidence of sudden cardiovascular deaths during sexual activity is estimated to be 0.2/100,000 men. The risk for women is lower by a factor of 12.

Adult↗

Post-mortem detection and identification of sildenafil (Viagra) and its metabolites by LC/MS and LC/MS/MS.

The highly putrefied corpse of an 80-year-old man was found in the apartment which he had rented to a prostitute. A package of Viagra 25 was found beside the corpse and three tablets were missing. Autopsy revealed severe coronary artery sclerosis as well as signs of previous myocardial infarctions. For the detection and identification of sildenafil and three metabolites in urine and tissue samples, solid-phase extraction, LC/MS and MS/MS methods were developed. Blood was not available for toxicological analysis due to the putrefaction. For method development, urine from a volunteer who had ingested 25 mg sildenafil was collected over 8 h, and three metabolites were identified by MS/MS. These metabolites were also found in the victim's urine. These findings prove that sildenafil was taken some time prior to death, but the causality of sildenafil intake and fatal cardiac failure could not be proven, since no blood was available for analysis. However, the administration of sildenafil was contraindicated due to several previous myocardial infarctions.

3',5'-Cyclic-GMP Phosphodiesterases↗

Seroprevalence of herpes simplex virus types 1 and type 2 in the Frankfurt am Main area, Germany.

Herpes simplex virus (HSV) types 1 and 2 are widespread human infectious agents that are responsible for persistent and latent infections. HSV type 2 (HSV-2) infection is usually transmitted sexually, while HSV type I (HSV-1) is commonly acquired by saliva contact during childhood. In a retrospective study, sera from more than 4,800 patients were analyzed for HSV type-specific IgG antibodies. In people older than 15 years, the seroprevalence of HSV-1 showed no statistically significant discrepancy between the control group (76.3% in females and 75.2% in males), HIV-infected patients (82.8% in females and 84.3% in males), and organ transplant (OTX) recipients (90.3% in females and 86.3% in males) (P>0.05). Age-related analysis of the control group showed that there is an age-dependent increase of HSV-1 seroprevalence in both sexes, reaching its peak in those aged 40 years and older (women 85.4%, men 82.8%). The only age group in which there is a significantly higher seropositivity rate in women than in men is in those aged between 15 and 39 years, with 70.8% versus 63.7% (P<0.05). As with HSV-1, there is an age-related increase of the HSV-2 seroprevalence; however, this increase starts later in life, with the onset of sexual activity. The HSV-2 prevalence across all age groups was highest in female prostitutes (78.0%) and among HIV-infected patients (women 64.1%, men 54.3%); this contrasts with the control group (overall women 17%, men 12.5%; those above 15 years of age, women 18%, men 13.8%) and the OTX patients (women 22.6%, men 9.8%). In the control group the rate of positivity increases with age and peaks in the group older than 40 years (24.2% in women and 16.2% in men). In females the seroprevalence is always elevated compared with males. The data presented show that female sex and older age are independent predictors of HSV-2 seropositivity, while immunosuppression is not. Our additional data show no evidence of a statistically significant humoral HSV-1/HSV-2 cross-immunity. People with HSV-1 serum antibodies have no lower risk of HSV-2 seropositivity than those lacking antibodies to HSV-1. The same is true when investigating HSV-1 seroprevalence rates in HSV-2-seropositive or -negative individuals, retrospectively.

Adolescent↗

Two patients with acute hepatitis B with suspected sexual transmission of hepatitis G virus.

Two patients with acute hepatitis B with suggested sexual transmission of hepatitis G virus (HGV) are reported. A total of 18 patients with community acquired acute hepatitis B were analyzed in this study. Two of the 18 patients (patients 1 and 2) were positive for serum HGV RNA at the initial consultation. Both patients had had sexual contact with prostitutes several weeks before the onset of acute hepatitis, and hepatitis B virus (HBV) was suggested to be infected through the sexual contacts. These patients showed no other history of exposure to possible transmission routes for blood-borne hepatitis viruses. Patient 1 was diagnosed as with acute HGV infection because the antibody to HGV envelope-2 protein seroconverted to positive during the course of acute hepatitis. HGV RNA was negative in a serum sample collected from patient 2 before the onset of acute hepatitis, also suggesting acute HGV infection. These results indicate that in patients 1 and 2 HGV was infected along with HBV through sexual contact. The clinical manifestations of acute hepatitis in the two patients with HGV co-infection did not differ from those in the 16 patients with HBV infection alone.

Adolescent↗

Violence against women in South Asian countries.

In South Asian countries the amalgamation of Buddhist, Confucian, Hindu, Islamic and Christian traditions have shaped the personalities of women and determined their social status. Rigid cultures and patriarchal attitudes which devalue the role of women, result in the wide spread occurrence of violence against women. The family structure, in which the man is the undisputed ruler of the household, and activities within the family are seen as private, allows violence to occur at home. As well as traditional forms of violence such as wife-battering and sexual assault, women in these countries are also exposed to dowry crimes such as bride burning, kidnapping for the purposes of prostitution, and "honour killings". Laws permit discrimination against women and discourage reporting of violent acts. Efforts to remedy this situation must include changes in local laws as well as assistance from the United Nations and the international community.

Asia, Southeastern↗

Exploring the motivations and fantasies of strip club customers in relation to legal regulations.

Strip clubs are a popular form of adult entertainment in the contemporary United States. Strip clubs are also highly embattled entertainment venues, based on assumptions about their associations with prostitution, drug use, and "negative secondary effects" in surrounding areas, such as increased crime rates and decreased property values. Based on participant observation in five strip clubs in one city and on qualitative interviews with 30 regular male customers of those clubs, this essay seeks to challenge assumptions about the kinds of encounters sought in and purchased in such venues. Instead of visiting strip clubs out of a desire to purchase sexual release with the dancers, I found that the regular male customers were seeking an atmosphere different from both work and home, personal and sexual acceptance from women and the pleasure of a sexualized encounter without the pressures of physical performance, and a form of leisure that offered a relative degree of "safety" as well as "excitement." Further, the men's own fantasies of identity, their understandings of marriage, and their commitment to a particular kind of monogamy influenced their choice of entertainment and the pleasure that they took in their encounters with the dancers. The essay discusses these motivations and their relational aspects and assesses strip club regulation in light of these observations and findings.

Adult↗

Selling sex in a population-based study of high school seniors in sweden: demographic and psychosocial correlates.

Adolescents reporting selling sex for payment were studied with respect to socioeconomic background, perceived mental health and health behavior, antisocial behavior, sexual experiences, including sexual abuse and abusive behaviors, and the use of pornography. The sample consisted of a representative sample of 4,339 students (response rate, 77.2%) from the third year of upper secondary schools in five Swedish cities. Of the participating adolescents, 1.8% of the boys and 1.0% of the girls indicated that they had sold sex for money or other reimbursements. Selling sex was associated with having an immigrant background, higher level of unemployment in the family, and studying a practical/vocational program. Adolescents with the experience of selling sex had an increased risk for different psychosocial problems, such as poorer mental health, weekly use of alcohol, and antisocial behaviors. The adolescents selling sex were also characterized by having had a greater number of sexual experiences, a greater preoccupation with sex, relatively early sexual debut, and experience with sexual abuse as victim and/or perpetrator. The index group students watched pornography more frequently than the majority and they also watched more deviant forms of pornography. The significance of the higher frequency among boys and the gray zone between normal sexual exploration and prostitution are discussed.

Adolescent↗

Health and economic impacts of an HIV intervention in out of treatment substance abusers: evidence from a dynamic model.

INTRODUCTION: A community-based intervention program found that the high-risk target population interacts with its surrounding community as a source of drugs and prostitution, creating a measure of co-dependence in the health status of each group. METHODOLOGY: The intervention collected extensive data on sexual and drug use practices in the target population. A dynamic compartment model estimates the epidemiological impact of the intervention, which serves as the basis for the economic assessment comparing intervention costs and lifetime HIV treatment costs. RESULTS: Approximately 2/3 of the new infections arise in the surrounding community. Intervention spillover benefits in the surrounding community are sufficient to make the intervention cost-saving in the first year--a savings of approximately 534,000 dollars. CONCLUSIONS: Conducting the intervention results in health benefits and cost-savings not only for the risk group, but for the entire community in which it resides. Quantifying the spillovers is vital to policymakers attempting to allocate scarce public health resources.

Adolescent↗

Rape shield laws and sexual behavior evidence: effects of consent level and women's sexual history on rape allegations.

Rape shield laws, which limit the introduction of sexual history evidence in rape trials, challenge the view that women with extensive sexual histories more frequently fabricate charges of rape than other women. The present study examined the relationship between women's actual sexual history and their reporting rape in hypothetical scenarios. Female participants (college students and a community sample, which included women working as prostitutes and topless dancers, and women living in a drug and alcohol rehabilitation center) imagined themselves in dating scenarios that described either a legally definable act of rape or consensual sexual intercourse. Additionally, within the rape scenarios, level of consensual intimate contact (i.e., foreplay) preceding rape was examined to determine its influence on rape reporting. Women were less likely to say that they would take legal action in response to the rape scenarios if they had extensive sexual histories, or if they had consented to an extensive amount of intimate contact before the rape. In response to the consensual sexual intercourse scenarios, women with more extensive sexual histories were not more likely to say that they would report rape, even when the scenario provided them with a motive for seeking revenge against their dating partner.

Adolescent↗

"Something covered with an old blanket": Nancy and other dead mothers in Oliver Twist.

In Powers of Horror: An Essay on Abjection, Julia Kristeva outlines her theory of abjection as a simultaneous fascination and horror stemming from sensorial reminders of the subject's primal, psychological relation to the mother. In this essay, I show how these psychological perspectives can potentially result in acts of physical violence, which I call the "abject response." Applied to literature, a study of the abject response explains why sexually active female characters, such as Nancy, the prostitute, in Oliver Twist, suffer extreme acts of physical violence: not simply because they are sexual, as critics of Victorian domestic ideology most often argue, but rather because their particularly female bodies give them an agency which threatens to destroy the mastery of women on which Victorian male identity is based. Reading Oliver Twist through the lens of Kristeva reveals the ways in which Sikes, Nancy's murderer, psychically links her sexuality to the fatal potential he perceives in her body. This threatening construction of women's sexuality derives from an imbalanced focus in the male psyche on the repulsion aspect of abjection, a focus socially inscribed as a threatening power, which is used to justify violent usurpations of the feminine in masculine constructions of gender.

Dominance-Subordination↗

Managing HIV/AIDS in correctional settings.

Approximately one quarter of people living with HIV/AIDS in the United States pass through the correctional system, resulting in a burden of infection on the correctional health care system that has challenged correctional and public health officials. The HIV epidemic behind bars results from the high prevalence of HIV risk behaviors among those incarcerated: illicit drug use, untreated mental illness, prostitution, homelessness, and poverty. Challenges to HIV care in correctional settings include management of comorbid conditions, remoteness from HIV care sites, organizational constraints, and access to effective therapies. Despite these challenges, prisoners with HIV have derived considerable benefit from HIV detection and treatment. In order to achieve parity in HIV outcomes among vulnerable populations, effective prison-release programs that incorporate effective case management with effective drug treatment and adherence strategies are required to extend the benefit of highly active antiretroviral therapy as prisoners transition back to community settings.

Antiretroviral Therapy, Highly Active↗