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PubMed1997

Behavioural and demographic characteristics of attenders at two genitourinary medicine clinics in England.

OBJECTIVES: To investigate how attenders with sexually transmitted disease (STD) differ from the general population with respect to sexual behaviour, and to identify which attenders at genitourinary medicine (GUM) clinics are at particular behavioural risk for acquiring STD. DESIGN: Multicentre cross sectional survey. SETTING: Two genitourinary medicine clinics, one in London and one in Sheffield SUBJECTS: 20,516 patients attending the two clinics over an 18 month period. MAIN OUTCOME MEASURES: Behavioural and demographic characteristics and clinical diagnoses were recorded for each patient. RESULTS: 8862 patients, in whom 12,506 diagnoses were made, were seen in the Sheffield clinic, and 11,654 patients, in whom 20,243 diagnoses were made, were seen in the London clinic. When compared with the reported results from a general population survey, there were higher proportions of clinic attenders reporting two or more sexual partners in the preceding 12 months (p < 0.001), and a higher proportion of males reporting homosexual contact (13% compared with 1%, p < 0.001). Only age and number of sexual partners in the past 12 months were significantly associated with acute STDs for each sex in each clinic. Acute STDs tended to occur with greater frequency in the younger age groups, peaking among 16-19 year olds, particularly among females. CONCLUSIONS: The results have confirmed that patients with STDs exhibit higher risk sexual behaviour than the general population, and have highlighted the problem of continuing high risk behaviour among younger attenders, particularly younger homosexual men. This study has demonstrated that among GUM clinic attenders age and number of sexual partners are key risk factors for the acquisition of an acute STD. The results of this survey also indicate, however, that half of the females and more than one quarter of males with acute STDs reported only one sexual partner in the past 12 months, suggesting that health education messages should point out that it is not only those who have multiple recent sexual partners, or who have recently changed sexual partner, that are at risk of STD, including HIV.

Adolescent↗
PubMed1992

Partner-specific condom use among adolescent women clients of a family planning clinic.

Because inconsistent condom use could put adolescent women at an increased risk for sexually transmitted diseases, it is important to understand when and with whom they use condoms. This study examined partner-specific condom use over time among adolescent women. The data were from a clinic-based, prospective study of 308 adolescent women who had at least one sex partner during a 6-month follow-up. Their condom use was examined with three types of partners: exclusive, nonexclusive primary, and nonexclusive secondary. Predictors of consistent condom use (using condoms 100% of the time with a specific partner) were explored in a multiple logistic regression analysis. Consistent condom use was more likely to occur in shorter relationships (less than 3 months) and with partners who preferred condoms for contraception. It was no more likely to occur with nonexclusive partners than with exclusive partners, and it was somewhat less likely to occur among consistent oral contraceptive users. These findings emphasize the importance of educating adolescent women to introduce and maintain condom use with all partners.

Adolescent↗
PubMedDate not supplied

The influence of sexual and social factors on the risk of Chlamydia trachomatis infections: a population-based serologic study.

BACKGROUND: Genital chlamydia infections often are asymptomatic, which promotes their spread in the population. In women, the possible consequences of infection are pelvic inflammatory disease and infertility. Most studies on the prevalence of Chlamydia trachomatis have been based on clinical series, and prevalences tend to vary with the clinical setting. Few seroepidemiologic studies have emerged from industrialized countries. GOAL OF THIS STUDY: To assess the prevalence of Chlamydia trachomatis using culture and serology, and its relationship with possible risk factors. STUDY DESIGN: This was a population-based study involving completion of a self-administered questionnaire, analysis of cervical samples for Chlamydia trachomatis, and serologic tests for Chlamydia trachomatis antibodies. RESULTS: The prevalence of Chlamydia trachomatis infection was 2.7%, and the seroprevalence was 24.7% among the sexually active women. Seropositivity was correlated with sexual behavior variables, and the incidence of serologic cross-reactivity with respiratory infections (strain TWAR) was low. Multivariate logistic regression analysis showed the number of sexual partners, age at first coitus, history of therapeutic abortion, and previous pelvic inflammatory disease to be independently correlated with seropositivity. CONCLUSION: Early sexual experience and multiple lifetime sexual partners are independent risk factors for Chlamydia trachomatis infection.

Adult↗
PubMed2001

Second-hand prostatism: effects of prostatic symptoms on spouses' quality of life, daily routines and family relationships.

OBJECTIVES: The aim of this study was to explore the impact of male prostatic symptoms on their partners' quality of life, daily routines and family relationships. METHODS: A structured telephone interview study was carried out on a random sample of 215 of the wives and partners of men aged 50 years or older drawn from those registered at four family medicine centres in Israel. They were asked about sleep disturbances, number of night-time wakings, and the effect on sexual relations, travel, entertainment, family and social relationships. RESULTS: The vast majority of women (86%) were affected by their partners' prostatism, with multiple consequences for their daily routines, quality of life and relationships. Sleep was the area of greatest concern, with 46% of women regularly waking due to their partners' urination disorder. The women reported other limitations: 37% noted problems with sexual functioning; 17% were unable to take long trips with partners; 10% could not visit places without toilets; while 8% were unable to go to the cinema or theatre. Women felt that their partners' prostatic symptoms were also to be blamed for upsetting family relationships (10%) and relationships with friends (16%). There was near total correspondence between women and their male partners regarding the effects of prostatic symptoms. CONCLUSIONS: Prostatism has an impact on men and women; strategies that consider the whole couple should be developed and utilized when considering treatment options.

Comorbidity↗
PubMed2006

Finding solutions to challenges faced in community-based participatory research between academic and community organizations.

Partnerships between communities and academic institutions have been vital in addressing complex health and psychosocial issues faced by culturally diverse and hard-to-reach populations. Community-based participatory research (CBPR) has been suggested as a strategy to develop trust and build on the strengths of partners from various settings to address significant health issues, particularly those persistent health issues that reveal disparities among minority populations. There have been many challenges to developing these partnerships in the United States. The purpose of this paper is to discuss approaches and solutions used by this research team in response to the challenges they have faced in using CBPR. The team uses CBPR to understand and support the process of disclosure of intimate partner violence (IPV) within the context of the community health centers that provide services for multicultural and multi-lingual populations. While CBPR provides a route to develop trust and build on the strengths of partners from various settings, there are multiple challenges that arise when partnering organizations present with different infrastructures, missions, resources and populations served. Examples of common challenges and solutions from the literature and from the team's experience will be discussed. Implications for partners, partnerships, practice and research will be explored.

Cooperative Behavior↗
PubMed2002

Clinical screening and intervention in cases of partner violence.

Partner violence is a long-term health risk factor that can potentially have far-reaching, negative consequences on both those abused and their loved ones. The term "partner" is used to define opposite and same sex couples who are in relationships on a continuum ranging from casually dating to marriage. Partner violence includes physical, sexual, psychological, and economic abuse, as well as stalking behaviors. Even though the American Medical Association recommends screening for partner violence at multiple levels, there are many shortcomings of the current screening and intervention practice. Several factors facilitating the ineffectiveness of current practice include a lack of information related to the prevalence, duration, and severity of partner violence; physician s misguided beliefs regarding a victim s desire to disclose; and barriers that the victim faces when deciding whether to disclose partner violence. This article addresses these shortcomings and identifies nurses as an invaluable resource that has been under-utilized for screening and responding to partner violence. Also highlighted is one technique know by the acronym "RADAR" that is designed to address issues of both screening and intervention. Finally, resources for both health care practitioners and victims of abuse are provided.

Comorbidity↗
PubMed2002

HIV risk characteristics and prevention needs in a community sample of bisexual men in St. Petersburg, Russia.

A new and understudied HIV epidemic is quickly unfolding in the Central and Eastern European countries of the former Soviet Union. Men who have sex with men (MSM) in Russia constitute a population highly vulnerable to sexually-transmitted HIV infection. In a community sample of 434 Russian MSM accessed in gay venues in St. Petersburg, 126 had had both male and female partners in the past three months. In this paper, we report on their risk characteristics. Forty-five per cent of men reported recently engaging in unprotected anal intercourse with their male partners. Respondents had a mean of 3.3 male and 3.4 female partners in the past three months, and most had multiple male and female partners in this time period. There were serious and significant gaps in the AIDS risk knowledge levels of these men, and most believed they had no personal contact with HIV-positive people. Bisexual men were more likely than exclusively gay men to have engaged in commercial sex and tended to have lower AIDS risk knowledge. Although they did not differ in average age, bisexual compared to gay men more recently had their first sex with a man. Multivariate logistic and linear regression analyses showed that condom and safer sex attitudes, perceived norms, AIDS risk knowledge and age at first sex with a man were independent predictors of high-risk behaviour among bisexual men. HIV prevention interventions for bisexual men should address their sexual practices with both male and female partners, correct misconceptions about risk, address behaviour practices rather than gay identity, and recognize risk issues faced by the female partners of bisexual men.

Adult↗
PubMed2005

Drosophila N-cadherin mediates an attractive interaction between photoreceptor axons and their targets.

Classical cadherins have been proposed to mediate interactions between pre- and postsynaptic cells that are necessary for synapse formation. We provide the first direct, genetic evidence in favor of this model by examining the role of N-cadherin in controlling the pattern of synaptic connections made by photoreceptor axons in Drosophila. N-cadherin is required in both individual photoreceptors and their target neurons for photoreceptor axon extension. Cell-by-cell reconstruction of wild-type photoreceptor axons extending within mosaic patches of mutant target cells shows that N-cadherin mediates attractive interactions between photoreceptors and their targets. This interaction is not limited to those cells that will become the synaptic partners of photoreceptors. Multiple N-cadherin isoforms are produced, but single isoforms can substitute for endogenous N-cadherin activity. We propose that N-cadherin mediates a homophilic, attractive interaction between photoreceptor growth cones and their targets that precedes synaptic partner choice.

Animals↗
PubMed1975

[Pregnancy in spite of multiple factors of infertility in both marital partners (Author's transl)].

Case report of two deliveries in a woman with an oligospermic husband who had a laparoscopic coagulation of the uterosacral ligament for endometriosis, followed by ulilateral salpingectomy and partial resection of the other tube for bilateral pyosalpinx. The tubal stump was stitched into the ovary. The case is reported to demonstrate that it is worthwhile to retain a minimun of chance for conception even in a case with a very bad prognosis.

Adnexal Diseases↗
PubMed2006

Organization of human interferon gamma-heparin complexes from solution properties and hydrodynamics.

Heparan sulfate (HS) recognizes a variety of proteins, one of which is the pleiotropic cytokine IFN-gamma, and as such modulates many biological processes. IFN-gamma is a homodimer with a well-defined core and two flexible C-termini that constitute HS binding domains. We show here using molecular modeling that an extended IFN-gamma structure overlaps a HS fragment of 16 disaccharides (16 nm). Since a 21-24-disaccharide HS fragment was experimentally defined as the minimum size that interacts with IFN-gamma [Lortat-Jacob, H., Turnbull, J. E., and Grimaud, J. A. (1995) Biochem. J. 310 (Part 2), 497-505], this raises the question of the complexe organization. We combine analytical ultracentrifugation, size exclusion chromatography, and hydrodynamic bead modeling to characterize the complexes formed in solution with heparin oligosaccharides. For oligosaccharides of 14 and 20 nm, two types of complexes are formed with one IFN-gamma and one or two heparin molecules. Complexes consisting of two IFN-gamma and one or two heparin molecules are present for a fragment of 25 nm and aggregates for a fragment of 35 nm. The complexes are rather compact and can be formed without major conformational changes of the partners. The complex pattern of interaction is related to the size of the partners and their multiple binding possibilities. These various possibilities suggest networks of interactions at the crowded surface of the cells. Hydrodynamic methods used here proved to be very efficient tools for describing protein-HS complexes that, due to the intrinsic heterogeneity and flexibility of the partners, are otherwise very difficult to analyze.

Chromatography, Gel↗
PubMed2001

Prevalence and risk factors for hepatitis C virus infection at an urban Veterans Administration medical center.

This study was designed to determine the seroprevalence and risk factors for hepatitis C virus (HCV) infection in veterans. Anti-HCV testing was performed in 1,032 patients and a questionnaire regarding sociodemographic characteristics and potential risk factors was administered. Adjusted prevalence of unique HCV-positive patients using outpatient services was 17.7% (95% confidence interval [CI] 17.2%, 18.2%). The following risk factors were associated with HCV infection: a history of injection drug use (IDU), receipt of blood transfusion prior to 1992, history of tattoo (odds ratio [OR], 2.93; 95% CI, 1.70-5.08), combat job as a medical worker (OR, 2.68; 95% CI, 1.25-5.60), history of incarceration over 48 hours (OR, 2.56; 95% CI, 1.52-4.32), greater than 15 lifetime sexual partners (OR, 1.61; 95% CI, 0.94-2.76) and sexual relations with a prostitute (OR, 0.46; 95% CI, 0.25-0.82). We concluded that HCV is common in veterans. Risk factors independently associated with infection are IDU, prior transfusion, prior tattoo, combat medical work, incarceration, and multiple opposite sex partners. Infection with HCV among veterans is strongly associated with traditional risk factors for infection and less strongly associated with combat-related risk.

Adult↗
PubMedDate not supplied

Associations between number of lifetime partners and other health behaviors.

OBJECTIVE: To examine associations between health behaviors and lifetime sexual partners among college students. METHODS: Data from the 1995 National College Health Risk Behavior Survey were analyzed. RESULTS: After adjusting for age, sex, and race, having 2 or more lifetime sexual partners was associated with infrequently using seat belts, driving after drinking, having a physical fight, considering suicide, and using chewing tobacco and marijuana. Significant sex interactions occurred with cigarette smoking and fruit and vegetable consumption, and significant age interactions occurred with binge drinking. CONCLUSIONS: Having multiple lifetime sexual partners (> or = 2) was associated with several negative health behaviors.

Age Factors↗
PubMed2002

The role of self-efficacy and relationship quality in partner notification by adolescents with sexually transmitted infections.

OBJECTIVE: To evaluate the role of self-efficacy, anticipated negative consequences, and relationship quality in patient-initiated sex partner notification following treatment for sexually transmitted infections. SUBJECTS: Two hundred forty-one 13- to 20-year-old subjects (83% women; 83% African American) diagnosed with gonorrhea, chlamydia, trichomonas, or nongonococcal urethritis. Subjects were patients at a public sexually transmitted diseases clinic or primary care adolescent clinics. METHODS: Structured interviews at enrollment and 1 month following treatment. At enrollment, recent sexual partners were identified. Coital frequency, partner-specific sexually transmitted infection notification self-efficacy, anticipated consequences of notification, and relationship quality were measured with multi-item scales. At 1 month, subjects were asked whether partners had been notified and about the timing of notification relative to treatment. RESULTS: Subjects reported 279 partners. Of these, 61% of women's partners and 52% of men's partners were notified. Multiple logistic regression adjusted by generalized estimating equations showed that notification was predicted by antecedent notification self-efficacy (adjusted odds ratio, 1.16; 95% confidence interval, 1.03-1.30) and relationship quality (adjusted odds ratio, 1.17; 95% confidence interval, 1.08-1.27). Age, sex, race/ethnicity, prior sexually transmitted infection, coital frequency, and anticipated consequences were not related to partner notification. CONCLUSIONS: Partner notification is increased among persons with higher levels of self-efficacy and in relationships with stronger affiliative and emotional ties. Self-efficacy and partner communication could be especially amenable to interventions to increase patient-initiated partner notification for curable sexually transmitted infections.

Adolescent↗
PubMed2002

Chromosomal and genetic abnormalities in myeloma.

Chromosomal translocations are a hallmark of lymphoid tumours. Multiple myeloma (MM) is a tumour of the plasma cell, the terminally differentiated B lymphoid cell. In recent years, a large number of chromosomal and genetic abnormalities have been detected in myeloma, the most prominent being chromosome 13q deletions and translocations affecting the immunoglobulin heavy chain (IgH) locus on chromosome 14q32. The latter involve a large array of chromosomal partners, from which multiple oncogenes have been proposed as candidates for dysregulation. In addition, a wide variety of changes including numerical aberrations, translocations involving loci other than the immunoglobulin genes, and aberrations of known oncogenes such as N-ras mutations, have been found. With the refinement of molecular cytogenetic techniques, the sensitivity of detecting these molecular abnormalities is continuing to increase. However, with the exception of 13q deletions which have been consistently associated with an adverse prognosis, the role of the other changes in the pathogenesis of MM, and their effect on disease behaviour and prognosis are still being clarified. In this review, we will discuss the most common molecular abnormalities found in primary MM and cell lines, and consider the available evidence for a pathogenic role in MM.

Chromosome Aberrations↗
PubMed1998

Social role quality and psychological well being in employed black and white midlife women.

This study examined relationships among job, partner, and parent role quality and psychological well being in midlife black (n = 51) and white (n = 56) women employed in occupations varying by socioeconomic status (SES). Oversampling for black women ensured balanced occupational representation, allowing investigation uncontaminated by SES. Instruments included Baruch and Barnett's Rewards and Concerns Scales, Bradburn Affect Balance Scale, and Center for Epidemiological Studies Depression Scale (CES-D). Better well being scores were reported by black women than whites, and by professionals than non-professionals. However, when race, occupational group, and menopausal status were held constant in a multiple regression analysis, partner role quality was significantly related to both well being scores, parent role quality was related to life satisfaction only, and job role quality was not related to either. Nurses in the workplace can help women identify problematic aspects of their multiple social roles, and facilitate resolution of problems to improve worker health.

Adult↗
PubMed1996

Tracing interactions of thymocytes with individual stromal cell partners.

Cellular interactions in T cell development can be analyzed using thymus chimeras prepared in vitro, in which stromal cells and T cell precursors are manipulated separately. In an earlier study, we showed that for optimal T cell maturation most--if not all--stromal cells must display appropriate (selecting) major histocompatibility complex (MHC) molecules: the substitution of selecting by nonselecting stromal cells leads to a proportional decrease in mature T cell production. These data imply that the availability of selecting stromal micro-environments is rate limiting for positive selection, and that in positive selection each thymocyte engages only one (rather than multiple) stromal cell partners. To test this hypothesis, we developed a tracing system for thymocyte/stromal cell interactions, based on the acquisition by thymocytes of stroma-derived MHC class II determinants. When MHC class II-deficient precursors are placed in H-2b x k F1 environments (where all stromal cells co-express H-2b and H-2k), individual thymocytes acquire class II determinants of both haplotypes. In striking contrast, when placed in mosaic stromal environments (where stromal cells express either H-2b or H-2k evenly interspersed), individual thymocytes preferentially acquire MHC class II determinants of one or the other haplotypes, but rarely both. This provides strong evidence that thymocytes have intimate interactions with individual stromal cells: having engaged one stromal cell niche, thymocytes do not (or only rarely) have promiscuous liaisons with others.

Animals↗
PubMed1993

AIDS-related risk behavior, knowledge, and beliefs among women and their Mexican-American sexual partners who used intravenous drugs.

OBJECTIVE: To assess the risk behaviors, knowledge, and beliefs regarding human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among women and their sexual partners who were Mexican-American men who used intravenous drugs. DESIGN: Survey of male methadone users and their female sexual partners. PARTICIPANTS AND SETTING: Mexican-American male clients at a methadone clinic in Los Angeles, Calif, were consecutively recruited for the study. A method similar to partner contact tracing was used to identify female subjects. One hundred subjects, representing 50 male-female pairs of sexual partners, answered identical questionnaires. The responses from females were compared with those from their male partners. RESULTS: Seventy-four percent of the females disclosed that they used intravenous drugs, and 88% knew that their male partners were intravenous drug users. Of subjects who used intravenous drugs, 73% (27/37) of females and 88% (44/50) of males currently injected themselves and shared uncleaned needles. Seventy-six percent of females and 84% of males never used a condom during the previous year, and about 20% of both sexes had more than one sexual partner. Even though most of the females understood how HIV was transmitted and recognized themselves as at risk for AIDS, they continued to share needles unsafely and place themselves at risk for acquiring HIV infection through sex. CONCLUSION: This group of females and their male sexual partners engaged in multiple behaviors that may contribute to the further propagation of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Chlamydia trachomatis infection in sexually active adolescents: prevalence and risk factors.

The prevalence of Chlamydia trachomatis genital infection was studied in a sexually active urban Baltimore adolescent population. Possible risk factors such as age, past history of sexually transmitted disease, number of sexual partners, contact with sexually transmitted disease, oral contraceptive use, and concomitant gonococcal infection were also evaluated. The prevalence of chlamydial infection in the 280 adolescents studied was 26%: 35% in male adolescents, 27% in pregnant female adolescents, and 23% in nonpregnant female adolescents. Chlamydia was almost three times as prevalent as gonorrhea in the same population. Age, past history of sexually transmitted disease, oral contraceptive use, and concomitant gonorrhea were not significantly associated with chlamydial infection. However, multiple current sexual partners, contact with sexually transmitted disease, genitourinary symptoms, and cervical ectopy were significantly associated with chlamydial infection. Testing for chlamydial infection in sexually active urban teenagers is recommended for those with genitourinary symptoms, those with cervical ectopy, or those who are contacts of persons with sexually transmitted disease. Considering the reservoir of infection in the asymptomatic female adolescents, screening for chlamydial infections in family planning clinics warrants consideration.

Adolescent↗