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PubMed2006

Potential bridges for HIV infection to men who have sex with men in Guangzhou, China.

To assess the potential for HIV acquisition among men who have sex with men (MSM) in Guangzhou, China, we conducted a cross-sectional, anonymous, face-to-face survey of MSM in the metropolitan area of Guangzhou, China. As a pilot recruitment for a cohort study, participants were recruited by convenience sampling through newspaper and television advertising, website information, and respondent referral. Blood samples were tested for HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis. Client-centered HIV and STD counseling was provided.A total of 201 MSM were interviewed and 200 blood samples were tested. The prevalence of HIV antibody was 0% (97.5% CI 0-1.8%); 17.5% of MSM were HBV surface antigen positive; 1.0% had HCV antibodies; 10.5% had antibodies to syphilis. Syphilis seropositivity was associated with sex with a foreign MSM in the last six months and 10.4% reported sex with a foreign MSM overall. The majority (54.7%) reported unprotected anal sex with other men. Nearly one-third (31.8%) had regular female partners; 25.9% were currently married to a woman; 6% had casual female partners; 4.5% had sex with a female sex worker; 4.5% had sex with a male sex worker; and 12.9% had unprotected vaginal sex and unprotected anal sex with a man in the past six months. Only one MSM reported injection drug use (0.5%). The currently low prevalence of HIV but high level of unprotected anal sex, high prevalence of syphilis infection, and sexual networks that include foreign MSM point to a transient window for HIV prevention among MSM in Guangzhou. We recognize challenges to recruiting a representative sample of MSM and retaining them in longitudinal cohort studies.

Adolescent↗
PubMed1996

PCR DNA typing of stamps: evaluation of the DNA extraction.

Today, the PCR analysis of DNA from the saliva deposited on a stamp of an anonymous letter can lead to an identification. However, this analysis still involves problems, and DNA extraction can be particularly difficult. A comparative study of two DNA extraction methods with two categories of postage stamps was carried out and a purification process was tested. This study shows that the extraction with phenol/chloroform gives much better results than Chelex extraction. A purification process such as the use of Centricon 100 microconcentrators is recommended when an inhibition of PCR is present. This operation, however, results in a large loss of material.

DNA↗
PubMed1992

Healthcare workers' risk of contact with body fluids in a hospital: the effect of complying with the universal precautions policy.

OBJECTIVE: To test whether healthcare workers' knowledge of and compliance with the basic principle of the Universal Precautions policy (i.e., that all patients should be treated equally regarding contact with body fluids) influenced the rate of contact with patient blood. DESIGN: Survey based on anonymous questionnaires. SETTING: A 380-bed secondary and tertiary care hospital receiving emergency and elective patients. PARTICIPANTS: All employees having any contact with patients. Nine hundred one of 1,308 (69%) of the questionnaires were returned. RESULTS: Twelve percent of the respondents (95% confidence interval [CI95] = 10.0%-14.4%) had experienced any contact with patient blood in the week preceding their answer. Physicians had the highest rate of contact with blood followed by nurses. In the five groups--physicians, nurses, laboratory technicians and phlebotomists, nursing aides, and student nurses--contact with blood was less frequent in the subgroup that did know and comply with the basic principle of the Universal Precautions policy, compared with the subgroup that did not. When adding the results for the 5 groups, contact with blood was experienced by 91 of 571 (15.9%, CI95 = 13%-19%) of the personnel who did not know and comply with Universal Precautions. The personnel who did know and comply with Universal Precautions had a significantly lower (9 of 111 [8.1%], p < .05, CI95 = 3.8%-15%) rate of contact with blood. CONCLUSIONS: The healthcare workers who knew and complied with Universal Precautions had a significant lower rate of contact with patient blood than those who did not.

Blood↗
PubMed1998

HIV surveillance among sexually transmitted disease clinic attenders in Amsterdam, 1991-1996.

OBJECTIVE: To determine trends in HIV prevalence among attenders of a clinic for sexually transmitted diseases (STD), with emphasis on heterosexuals who did not have a history of injecting drug use. METHODS: Anonymous unlinked HIV surveys with individual consent, conducted each half year from 1991 to 1996 (except 1993) among STD clinic attenders who came for evaluation of a possible new STD episode. RESULTS: Of 10,940 eligible attenders 10,046 (92%) accepted HIV testing. Of all tested attenders, 312 (3.1%) were HIV-infected. Overall HIV prevalence decreased significantly from 4.6% in 1991 to 2.8% in 1996. HIV prevalence among heterosexual men and women who were not injecting drug users was less than 1% in all but one survey period. Except for one woman, none of the 48 HIV-infected heterosexuals was aware of their current serostatus. Among HIV-infected heterosexuals, 21 out of 28 males (75%) and 18 out of 20 females (90%) were of non-Dutch origin. HIV prevalence was 16% among all homosexual men, and 12% among young homosexual men aged < 30 years. HIV prevalence among young homosexual men decreased significantly over time. Among HIV-infected homosexual men, 58% of older men and 59% of younger men were not aware of their current HIV infection. Rates of current STD were generally significantly higher among HIV-infected participants compared with non-HIV-infected participants. CONCLUSIONS: Although HIV prevalence among heterosexual clinic attenders is low, there is a clear potential for ongoing sexual HIV transmission. Most heterosexually acquired HIV infections are found in non-Dutch persons. This observation suggests migration of HIV-infected heterosexuals or the separation of Dutch and non-Dutch heterosexual networks. Awareness of serostatus is almost non-existent among HIV-infected heterosexuals, and is low among male homosexual clinic attenders. To increase awareness of current HIV serostatus and possibly decrease risk behaviour, HIV counselling and testing should be offered actively to all clinic attenders.

AIDS Serodiagnosis↗
PubMed2006

Multiplex ligation-dependent probe amplification for rapid detection of proteolipid protein 1 gene duplications and deletions in affected males and carrier females with Pelizaeus-Merzbacher disease.

BACKGROUND: Pelizaeus-Merzbacher disease is a rare X-linked neurodegenerative disorder caused by sequence variations in the proteolipid protein 1 gene (PLP1). PLP1 gene duplications account for approximately 50%-75% of cases and point variations for approximately 15%-20% of cases; deletions and insertions occur infrequently. We used multiplex ligation-dependent probe amplification (MLPA) to detect PLP1 gene alterations, especially gene duplications and deletions. METHODS: We performed MLPA on 102 samples from individuals with diverse PLP1 gene abnormalities and from controls, including 50 samples previously characterized for the PLP1 gene by quantitative PCR but which were anonymized for prior results and sex. RESULTS: All males with PLP1 gene duplications (n = 13), 1 male with a triplication, 2 males with whole gene deletions, and all controls (n = 72) were unambiguously assigned to their correct genotype. Of 4 female carriers tested by MLPA and quantitative PCR, 3 were duplication carriers by both methods, and 1 was a triplication carrier by MLPA and a duplication carrier by quantitative PCR. For 1 sample with a partial deletion, MLPA showed exon 3 deleted but PCR showed exons 3 and 4 deleted. Sequence analysis of 2 samples with reduced dosage for exons 3 and 5 revealed point variations overlapping the annealing site for the corresponding MLPA probe. The precision of MLPA analysis was excellent and comparable to or better than quantitative PCR, with CVs of 4.3%-9.8%. CONCLUSIONS: MLPA is a rapid and reliable method to determine PLP1 gene copies. Samples with partial PLP1 gene dosage alterations require confirmation with a non-MLPA method.

Carrier State↗
PubMed2006

Factors associated with unprotected sexual intercourse with steady male, casual male, and female partners among men who have sex with men in Barcelona, Spain.

To increase understanding of the HIV epidemic among MSM in Barcelona, anonymous questionnaires were completed by 640 MSM recruited in the city in 2002. The prevalence of unprotected anal intercourse (UAI) with casual male partners in the prior 12 months was higher among self-reported HIV-positive men (confirmed through saliva testing) than among men who were HIV-negative or of unknown serostatus (35% vs. 20%, p < .01). The prevalence of UAI with steady male partners was substantially lower among HIV-positive men than other men (28% vs. 60%, p < .01). In multivariate analyses, UAI with casual partners was more likely among HIV-positive individuals; those who used drugs before sex; perceived less acceptance of their sexual orientation by family, friends, or coworkers; and were less concerned about HIV prevention because of antiretroviral therapy (ART). UAI with steady partners was more likely among HIV-negative men with seroconcordant partners, those living with a partner, and men less concerned about HIV prevention because of ART. Findings indicate a need for prevention programs targeting HIV-positive MSM in Barcelona. Attention to substance use and attitudes about HIV prevention are needed for MSM in general.

Adult↗
PubMedDate not supplied

A cross-sectional survey of the relationship between partner deployment and stress in pregnancy during wartime.

OBJECTIVE: The objective of this study was to determine if having a partner deployed during wartime increased the stress levels in pregnant women and altered their attitudes toward pregnancy. METHODS: We administered a cross-sectional survey of all military and civilian women attending the antenatal clinic at Naval Hospital Camp Lejeune. We collected the anonymous surveys in May 2003. The survey measured demographics, self-reported stress level, and other attitudes toward the pregnancy and deployment; blood pressure was recorded. Data were compared by partner deployment status and reported stress levels using chi-square, t-tests, and logistic regression analysis. RESULTS: Two hundred seventy-nine surveys were returned, representing 93.3% of those distributed. An almost equal number of patients had a partner deployed as nondeployed (49.1% versus 50.9%). Women with deployed partners were older, more had children at home, more often reported both significantly higher stress levels and a severe impact of the deployment on their stress, had a lower systolic blood pressure, more often reported changed eating habits, and reported that media coverage of the war worsened their stress than those whose partners were not deployed. Logistic regression analysis of stress found that partner deployment, having more than one child at home, and being active-duty were associated with reporting higher stress levels (odds ratio [OR] = 2.27, p = .013; OR = 3.11, p = .042; and OR = 4.03, p = .01, respectively). CONCLUSIONS: Pregnant women with deployed partners and those with more than one child already at home report higher stress levels than their peers with partners present. Increased stress in pregnant women with deployed partners may lead to adverse pregnancy outcomes. Further study is warranted to assess the impact of deployment on pregnancy and family life to better support homeland pregnant partners of deployed military members during wartime.

Adult↗
PubMed1991

HIV prevalence in a midwestern emergency department.

STUDY OBJECTIVE: To determine the prevalence of human immunodeficiency virus (HIV) seropositivity of patients 15 years of age and older in our emergency department. DESIGN: HIV status was determined anonymously, and the seroprevalence rate was calculated. The 95% confidence intervals also were calculated. Twenty demographic and predictor categorical variable were cross-tabulated with HIV status to determine associations. Only gender and male homosexual preference were significantly associated by Fisher's exact test. TYPE OF PARTICIPANTS: Excess serum samples from 454 randomly selected patients 15 years of age and older who required venipuncture for their ED evaluation were included in the study. MEASUREMENTS AND MAIN RESULTS: Of the 454 serum specimens, six (1.32%) were positive for HIV. The 95% confidence interval was from 0.27% to 2.37%. All six positive patients were men. The only statistically significant risk factors associated with HIV seropositivity were male sex (P = .00112) and male homosexual preference (P = .0000). CONCLUSION: HIV seropositivity occurs in 1.32% of our ED population over the age of 15 years. The only factors that correlate with HIV seropositivity are male homosexual preference and male sex.

Adolescent↗
PubMed1997

Survey of obstetricians' personal preference and discretionary practice.

OBJECTIVE: To determine obstetricians personal choices in relation to Down syndrome screening and mode of delivery for themselves or their partners. STUDY DESIGN: Structured anonymous postal survey. All 282 obstetric consultants, senior registrars and registrars in NHS obstetric units within London's M25 region were surveyed. RESULTS: The response rate was 73% (206). Fifty one per cent (105) chose to have elective amniocentesis/CVS without a previous screening test when maternal age was > or = 35 years and 11% (23) when < 35 years. Of the remainder, the majority wanted both maternal serum screening and nuchal translucency rather than a single screening test. In relation to mode of delivery, 17% (33) of obstetricians chose elective caesarean section (CS) in the absence of any clinical indication. Of those who chose CS, 88% did so out of fear of perineal damage. However when faced with a mid-cavity instrumental delivery in the second stage, only 5% (8) wanted CS, the remainder choosing operative vaginal delivery. With an uncomplicated breech presentation, only 27% (55) opted for external cephalic version while 57% (114) chose elective CS. CONCLUSION: This study demonstrates interventionist attitudes among a sizeable percentage of obstetricians in relation to antenatal screening and their own preferred mode of delivery. It suggests that obstetricians regard management options not normally available to pregnant women as valid choices for themselves or their partners.

Adult↗
PubMed1998

Factors associated with smoking among children and adolescents in Connecticut.

INTRODUCTION: The age of smoking initiation has dropped over the past four decades. Since behaviors and attitudes adopted in late childhood or early adolescence predict future smoking, it is important to understand the smoking and other risk-taking behaviors and attitudes of children aged 12 and younger. The goal of the analyses presented here was to describe behavioral and attitudinal factors associated with smoking among elementary school (grades 4-6), middle school (grade 7-8), and high school (grades 9-12) students in Connecticut. METHODS: We have used data from 8 years (1988-1996) of an anonymous, self-administered health risk appraisal survey given to children and adolescents in self-selected public and private schools. We compared the proportion of smokers and nonsmokers who reported various behaviors and attitudes and compared them with the chi-square test. RESULTS: Fifteen percent (n = 4,884) of the total population (n = 31, 861) were current smokers. At all grade levels, current smokers were more likely than nonsmokers to engage in risk-taking behaviors, and to report more stress and depression. Indicators of risk-taking and stress were also associated with the intent to smoke among children in grades 4-6. CONCLUSIONS: Smoking occurs within the context of other risk-taking behavior and psychological distress, among both children and older adolescents. Our data provide support for the idea of early identification and targeting of children at high risk of smoking in elementary school, possibly as early as grade four.

Adolescent↗
PubMed2002

HIV-related behaviours among voluntary blood donors in Hong Kong.

The present study examined the prevalence of and factors associated with deferrable risk behaviours practised by male voluntary blood donors in Hong Kong. Attitudes and knowledge related to HIV/AIDS and blood donation among both male and female blood donors were also studied. In total, 2,162 (1,190 male and 972 female) blood donors in four Hong Kong Red Cross Blood Transfusion Services (HKRCBTS) centres completed an anonymous structured questionnaire. About 11% of the male respondents have practised deferrable risk behaviours (e.g. sharing syringes, commercial sex-networking, or having sex with another man). Furthermore, among male respondents, 5.9% indicated that they are using blood donations as a means of testing for their HIV status. These male 'potential test seekers' tended to be younger, single, unemployed and first-time donors; relevant knowledge and perceptions towards the screening guideline were also associated with potential test seeking and deferrable risk. About 5% of all respondents would go to the HKRCBTS to perform an HIV test, if required. Many blood donors in Hong Kong were not knowledgeable about HIV-related issues. There is a need to review the effectiveness of the present deferral system, which is based on the goodwill of the donor to disclose personal health risk factors.

Adolescent↗
PubMed1997

Contribution to the physically anchored linkage map of the pig.

Thirty-three microsatellites have been mapped on the PiGMaP porcine genetic map. By comparison with the previously published PiGMaP maps, the maps of chromosome 2 (140 cM/70 cM) and chromosome 3 (180 cM/110 cM) were extended and new markers were mapped on the p-arm extremity of chromosome 7 and on the centromeric extremity of chromosome 15. New orders are proposed for markers on chromosomes 3 and 17. Six microsatellites isolated from cosmids were also localized on the cytogenetic map by fluorescent in situ hybridization. We tested the subcloning ligation mixture-polymerase chain reaction (SLiM-PCR) method for isolating microsatellites from cosmids. Subcloning is more effective when the cosmid harbours several microsatellites whereas SLiM-PCR is more straightforward when the cosmid contains a single microsatellite. Fifteen anonymous microsatellites were regionally assigned by using a hybrid cell panel. For map integration, the determination of a regional assignment of anonymous microsatellites by using a hybrid cell panel offers an alternative to microsatellite isolation from cosmids and their localizations by in situ hybridization.

Animals↗
PubMed1988

Systemic organizational support for self-help groups.

A framework for analyzing relationships between self-help groups and systemic organizational support is presented and two affiliation hypotheses tested. Self-help group birthrates in New Jersey over an 18-month period exceeded death rates. Affiliated groups greatly outnumbered independent groups but the birthrate for the latter was higher. Death rates for different types of groups were similar, except for Alcoholics Anonymous groups, which had a higher survival rate.

Birth Rate↗
PubMed2006

Prisoners' attitudes towards cigarette smoking and smoking cessation: a questionnaire study in Poland.

BACKGROUND: In the last decade Poland has successfully carried out effective anti-tobacco campaigns and introduced tobacco control legislation. This comprehensive strategy has focused on the general population and has led to a considerable decrease in tobacco consumption. Prisoners constitute a relatively small part of the entire Polish population and smoking habits in this group have been given little attention. The aim of the study was to assess the prevalence of cigarette smoking in Polish male prisoners, factors determining smoking in this group, prisoners' attitudes towards smoking cessation, and to evaluate prisoners' perception of different anti-tobacco measures. METHODS: An anonymous questionnaire including personal, demographic and smoking data was distributed among 944 male inmates. Of these, 907 men aged between 17 and 62 years (mean 32.3 years) met the inclusion criteria of the study. For the comparison of proportions, a chi-square test was used with continuity correction whenever appropriate. RESULTS: In the entire group, 81% of the subjects were smokers, 12% - ex-smokers, and 7% - never smokers. Current smokers had significantly lower education level than non-smokers (p < 0.0001) and ever-smokers more frequently abused other psychoactive substances than never smokers (p < 0.0001). Stress was reported as an important factor in prompting smoking (77%). Forty-nine percent of daily smokers were aware of the adverse health consequences of smoking. The majority of smokers (75%) had attempted to quit smoking in the past. Forty percent of smoking prisoners considered an award for abstaining from cigarettes as the best means to limit the prevalence of smoking in prisons. CONCLUSION: The prevalence of cigarette smoking among Polish prisoners is high. However, a majority of smokers attempt to quit, and they should be encouraged and supported. Efforts to reduce cigarette smoking in prisons need to take into consideration the specific factors influencing smoking habits in prisons.

Adolescent↗
PubMed1996

Heterogeneity of physician agreement with recommended therapeutic guidelines for the management of HIV-associated disease.

The aims of this study were to assess the degree of heterogeneity in the knowledge of therapeutic management of HIV infection among HIV-experienced physicians in British Columbia, Canada, and to identify associations between physician characteristics and their agreement with contemporary therapeutic guidelines. A self-administered anonymous questionnaire was mailed to 6500 physician members of the British Columbia Medical Association. The questionnaire provided information about demographic and personal characteristics, including sex, age, medical specialization and practice location; level of experience in treating HIV-infected patients; use of HIV testing procedures; use of preventative vaccinations and tests; and preferred approaches to antiretroviral therapy and the prophylaxis and acute treatment of opportunistic infections. We compared physicians' patterns of knowledge with contemporary recommendations. Logistic regression identified associations between physician characteristics and their agreement with contemporary guidelines. A total of 463 HIV-experienced physicians (a high proportion of the HIV-experienced physicians in British Columbia, Canada) responded to the questionnaire. The agreement with contemporary guidelines about HIV testing and preventative vaccinations and tests among responders ranged from 27% to 71%. For antiretroviral therapy, agreement with the guidelines ranged from 12% to 35%. For the prophylaxis and treatment of opportunistic infections, agreement with the guidelines ranged from 11% to 89% (prophylaxis) and from 46% to 91% (treatment). Regression analysis revealed that physicians actively involved in the care of HIV-infected patients were more likely to agree with the guidelines in all areas of patient care. General practitioners were more likely to agree with the guidelines regarding preventative therapies, and male general practitioners under 45 years old were more likely to agree with the guidelines on antiretroviral therapy. Our data confirm that there is substantial heterogeneity in the management of HIV-associated disease, including some deviations from contemporary guidelines. Concordance with contemporary guidelines increased with the physician's level of HIV-related experience. Our results support the idea that adherence to state-of-the-art practices may be responsible, at least in part, for the recently described association between physician experience and improved survival of HIV-infected individuals.

AIDS-Related Opportunistic Infections↗
PubMed2002

[Identification of quality problems in the clinical information to hospital emergency department patients].

OBJECTIVES: To evaluate the comprehension level of the information provided to patients and relatives attending an emergency department and to know their satisfaction degree. METHODS: A cross-sectional descriptive study was designed. The selection of study patients was made by means of a simple randomized sampling and the total of patients was 213. At discharge, these patients and their relatives answered a written, anonymous questionnaire. To evaluate the comprehension of the information provided, the questionnaire responses were checked against the clinical records. RESULTS: The self-identification of the health care providers, information on the estimated length of stay at the ED, the explanation of complementary tests and their results significantly determined the satisfaction score on the provided information, which for the patients was 6.3 on a 10-point scale. The percentages of patients who were knowledgeable of the performed tests, diagnosis, and administered treatment were 61.5%, 50.7%, and 35.2%, respectively. Understanding the diagnosis and the administered treatment differed according to age (p < 0.001) and the assimilation of the information on recommendations at patients's discharge differed according to the education level (p < 0.05). CONCLUSIONS: The self-identification of health care personnel would allow for a better bi-directional information flow. Given the socio-cultural characteristics of our population, the information provided should be clear and concise. The transmission of information to most emergency department users would be best achieved with previous information of the workflow at the emergency department in the form of booklets at the entrance, and also establishing protocols for the informed consent on different diagnostic and treatment techniques inherent to emergency care.

Adolescent↗
PubMed1992

[Risk factors related to the use of amphetamines in adolescent students].

The prevalence of amphetamine abuse among school children was studied by asking 3548 adolescent students (aged 12-15, response rate 98.6%) to complete a questionnaire anonymously, which was developed and evaluated by the authors. A complete set of data was collected for 3200 (90.2%) students. Eighty-five (2.7%) of them who admitted that they had used amphetamines constituted the case group. Non-users with negative urine tests formed the control group. Six independent factors were found to be related to amphetamine use when the answers were analyzed by stepwise logistic regression. The prevalence odds ratio estimation was elevated in: males compared females, students who did not live with both parents compared to those who lived with both parents, students with amphetamine-user friends compared to those with no-user friends, smokers compared to non-smoker, betel nut chewers compared non-chewers, and in students with positive attitudes compared to those with negative attitudes. The average starting age for smoking was 12.5 +/- 0.1 years; later this was followed by alcohol abuse, chewing of betel-nuts, and use of amphetamines. The average age of starting to use amphetamines was 13.5 +/- 0.2 years; a common reason given for using amphetamines was curiosity (65.4%). Many students (54.2%) obtained the amphetamine from their friends and most of them (85.2%) used it six months before responding to the questionnaire.

Adolescent↗
PubMed1995

HIV-infected physicians: how best to protect the public?

The debate about public safety as it relates to physicians living with HIV infection concerns all Canadians. A review of the evidence strongly suggests that the best way to protect the public is by strict adherence to universal precautions and the voluntary use of expert advisory panels on an anonymous basis. Mandatory reporting of the identities of HIV-positive physicians and the use of expert panels that have the authority to ban doctors from doing certain procedures would only lead to fewer doctors at risk for HIV infection coming forward for testing and treatment and to mandatory testing for all.

AIDS Serodiagnosis↗