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PubMed1991

A serosurvey for HTLV-I among high-risk populations and normal adults in Egypt.

The prevalence of antibodies to human T-cell lymphotropic virus type I (HTLV-I) was determined in high-risk groups and normal adults in Egypt. Among 647 individuals tested, 6 (0.9%) were confirmed positive by western blot analysis. These included 2 (0.7%) of 279 drug addicts, 1 (3.3%) of 30 patients with sexually transmitted diseases, and 3 (2.2%) of 133 healthy individuals. Antibody was not detected in 47 blood recipients or 158 prostitutes. There was no correlation between sex or geographical location and HTLV-I infection. Fifty-three of the 647 sera (8%) were initially reactive by ELISA, but only 12 sera were repeatedly reactive. Since only 4 of these repeatedly reactive sera were confirmed by the western blot, the frequency of false positives using the DuPont screening ELISA was 1.2% (8/643). Two additional sera, confirmed positive by western blot, had been reactive, but not repeatedly, by ELISA. In comparison to the prevalence of HTLV-I antibody among risk groups in many parts of the world, the prevalence in Egypt was low.

Adolescent↗

PubMed2000

Cross-sectional study on risk factors of HIV among female commercial sex workers in Cambodia.

To describe epidemiological features on HIV prevalence among female commercial sex workers (CSWs), a cross-sectional study on sexual behaviour and serological prevalence was carried out in Cambodia. The CSWs were interviewed on their demographic characters and behaviour and their blood samples were taken for testing on sexually transmitted diseases, including HIV, Chlamydia trachomatis, syphilis, and hepatitis B. Associations between risk factors and HIV seropositivity were analysed. High seroprevalence of HIV and Chlamydia trachomatis IgG antibody (CT-IgG-Ab) was shown among the CSWs (54 and 81.7%, respectively). Univariate logistic regression analyses showed an association between HIV seropositivity and age, duration of prostitution, the number of clients per day and CT-IgG-Ab. Especially, high-titre chlamydial seropositivity showed a strong significant association with HIV prevalence. In multiple logistic regression analyses, CT-IgG-Ab with higher titre was significantly independently related to HIV infection. These suggest that existence of Chlamydia trachomatis is highly related to HIV prevalence.

Adolescent↗

PubMed2001

Men sex workers and other men who have sex with men: how do their HIV risks compare in New Zealand?

Sex workers have their perspective on HIV transmission, claiming that in general they are more similar than different from other people in HIV status and the practice of safe sex. Such an assertion of similarity goes against public and professional opinion that prostitution is a major vector in the spread of AIDS. Taking the sex workers' similarity claim seriously, this paper considers the conditions under which it would be valid. We focus on those factors that make a population more or less vulnerable to HIV and how they affect its spread into the sex work population. Data from New Zealand comparing men sex workers and other men who have sex with men is used to evaluate these ideas. Data partially support the hypothesis in that these two groups of men are similar with regard to their HIV status. We do find the sex workers to be different, however, in their being less likely to engage in safe sex practices. We provide an explanation for why this has not lead to their having a higher rate of seropositivity.

Adult↗

PubMed2000

Ethical issues in gestational surrogacy.

The introduction of contraceptive technologies has resulted in the separation of sex and procreation. The introduction of new reproductive technologies (mainly IVF and embryo transfer) has led not only to the separation of procreation and sex, but also to the redefinition of the terms mother and family. For the purpose of this essay, I will distinguish between: 1. the genetic mother--the donor of the egg; 2. the gestational mother--she who bears and gives birth to the baby; 3. the social mother--the woman who raises the child. This essay will deal only with the form of gestational surrogacy in which the genetic parents intend to be the social parents, and the surrogate mother has no genetic relationship to the child she bears and delivers. I will raise questions regarding medical ethical aspects of surrogacy and the obligation(s) of the physician(s) to the parties involved. I will argue that the gestational surrogate is "a womb to rent," that there is great similarity between gestational commercial surrogacy and organ transplant marketing. Furthermore, despite claims to freedom of choice and free marketing, I will claim that gestational surrogacy is a form of prostitution and slavery, exploitation of the poor and needy by those who are better off. The right to be a parent, although not constitutional, is intuitive and deeply rooted. However, the issue remains whether this right overrules all other rights, and at what price to the parties involved. I will finally raise the following provocative question to society: In the interim period between today's limited technology and tomorrow's extra-corporeal gestation technology (ectogenesis), should utilizing females in PVS (persistent vehetative state) for gestational surrogacy be socially acceptable/permissible--provided they have left permission in writing?

Depersonalization↗

PubMed2002

What's in a condom?---HIV and sexual politics in Japan.

Utilizing a range of ethnographic data from an AIDS hotline, a women's shelter, a night club, AIDS campaigns, news articles, and interviews with health bureaucrats, this paper explores the history of AIDS in Japan and the ways in which official practices reproduce systems of domination. This paper examines the official categories of "foreign woman" and "prostitution" as discursive strategies of containment, and argues that nationalist discourses and representations of sexuality are closely linked in maintaining relations of power.

Acquired Immunodeficiency Syndrome↗

PubMed1999

Gendered sex work in the San Francisco tenderloin.

The variable "gender" rarely appears in prostitution research. Its inclusion raises the same questions brought up with respect to other areas of work: Is there a gendered perspective with respect to the work and are gender inequalities reflected in it? This study examines gender differences in the work of 140 sex workers in the San Francisco Tenderloin. As well as women and men who are workers, we include transgender workers (genetic males who present themselves as women), further accentuating differences by gender. Looking at work-specific characteristics, we find that women do not suffer inequities of income. They are, however, more prone to occupational hazards. Transgenders, who suffer the most societal discrimination, are closer to women than men in their work situation. Examining the sexuality of sex workers, the women are the least likely to enjoy sex with clients. Men report more sexual enjoyment with clients and transgenders are closer to the men in this regard. Few differences are, however, found in sexual pleasure in the personal lives of the women, men, and transgenders. A gender difference that stands out is that the men have more noncommercial sex partners than the women. Again, transgenders are more like the men, although various aspects of their condition make for some unique differences.

Adult↗

PubMed2003

Contraceptive practices of non-HIV-seropositive injecting drug users.

AIMS: To study the sociodemographic characteristics and sexual behaviours in contraception choices of injecting drug users (IDUs) and to compare the contraceptive practices of non-HIV-positive IDUs to those of the general population. DESIGN: Two surveys were used: a sample of IDUs attending 10 drug abuse treatment centres in the Paris region (IDU) and the Parisian subsample of the National French Survey of Sexual Behaviour (ACSF). MEASUREMENTS: Percentages of contraception practices were estimated separately for 81 IDU and 130 ACSF women, and for 175 IDU and 168 ACSF men, aged 25-34, not reporting prostitution or HIV seropositivity. FINDINGS: Most IDU (77%) and ACSF (84%) women, and IDU (73%) and ACSF (75%) men currently used a contraceptive method. Male condoms were more widely used by IDUs than by the general population (64 vs. 10% in women, 75 vs. 14% in men), for all subgroups of educational level, marital status, recent multipartnership status and sexual activity. CONCLUSIONS: Contraceptives are used as often by IDUs as by the general population aged 25-34. However, the methods employed differ, with higher condom use by IDUs, which suggest that IDUs take into account the risk of HIV contamination in their contraceptive practices.

Adult↗

PubMed1981

Why did Van Gogh cut off his ear? The problem of alternative explanations in psychobiography.

One of the tasks of personality psychology is to explain the behavior of individual human beings. Vincent Van Gogh, for example, cut off the lower half of his left ear and gave it to a prostitute. More than a dozen different explanations of his actions have been proposed. Is one of these explanations true, are all of them true, or, perhaps, are none of them true? And how can we know? This incident is examined in order to explore some of the problems in applying personality theories to the life of a single individual. A sequential procedure for generating and critically evaluating alternative explanatory conjectures is presented a a partial, although not a complete, solution to the problem of multiple interpretations.

Art↗

PubMed1993

Perceptions of risk for AIDS among women in drug treatment.

In this article factors associated with the self-perceived risk for acquired immunodeficiency syndrome (AIDS) were examined using data obtained from a cross-sectional survey of 155 current and former drug-using women in methadone maintenance. Results suggest that drug-involved women are realistic in their self-perceptions of AIDS risk with respect to intravenous (IV) drug-using behavior but underestimate their risk from sexual activity. Perceived risk was associated with current IV drug use, duration of sexual relationship, and partner's nonsupportiveness. Partner's serostatus or history of IV drug use was unrelated to risk perception, as were multiple partners, anal sex, prostitution, and the nonuse of condoms. Implications of these findings for designing interventions for drug-involved women are considered.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Perceiving AIDS-related risk: accuracy as a function of differences in actual risk.

This study investigates the perceived risk of an HIV infection. Cognitive antecedents of biases in risk perception and their effects on behavioral intentions were investigated. The purpose of this study was to determine the relative accuracy of risk assessments for samples that vary in actual risk for AIDS. Subjects were citizens of Amsterdam, heterosexuals with private partners, gay men, and heterosexuals with prostitution partners. Although optimistically biased in all samples, perceptions of risk were related to previous risk behavior in high-risk samples only. Pessimism was more pronounced in samples higher at risk. Optimists had lower levels of previous risk behavior and increased intentions to adopt safe sex practices. Ss in samples higher at risk had, therefore, relatively adequate perceptions of risk.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Validation of a brief measure of posttraumatic stress disorder: the Distressing Event Questionnaire (DEQ).

The Distressing Event Questionnaire (DEQ) is a brief instrument for assessing posttraumatic stress disorder (PTSD) according to criteria provided in Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The DEQ possesses high internal consistency and exhibited satisfactory short-term temporal stability in studies with Vietnam War combat veterans and battered women. In a sample of Vietnam War veterans and 4 separate samples of abused women (with histories of incest, rape, intimate partner abuse, or prostitution and abuse), the DEQ exhibited very good discriminative validity when judged against structured interview assessment of PTSD. The DEQ exhibited strong convergent validity with other PTSD measures and other indexes of adjustment and also exhibited strong convergent validity as a measure of PTSD across ethnic groups in both the veteran sample and the combined women's sample.

Adult↗

PubMed1998

HIV risk-behavior in poor urban women with serious mental disorders: association with childhood physical and sexual abuse.

Associations between childhood sexual and physical abuse and HIV-related risky behavior were examined among low-income, urban women with severe mental disorders. Early sexual abuse was found to be related to adult sexual and physical assault, alcohol and cocaine abuse, and prostitution; childhood physical abuse was related to adult physical assault and alcohol abuse. Findings highlight the importance of making HIV risk-reduction programs a part of integrated services that address a full range of psychosocial needs.

Adult↗

PubMedDate not supplied

New human and simian HIV-related retroviruses possess functional transactivator (tat) gene.

New human retroviruses antigenically related to HIV and even more closely to STLV-III have been recently isolated from individuals from some West African countries. One of these viruses, HTLV-IVP, was reportedly isolated from lymphocytes of a healthy female prostitute. Another isolate, LAV-2FG, was obtained from an AIDS patient and third, SBL-6669, from an individual with lymphadenopathy. Current epidemiological studies indicate that some of these virus isolates cause immune deficiency whereas others may not or may be less efficient at inducing immune deficiency. Similarly, STLV-III apparently does not cause immune deficiency in its natural host, African green monkey. A novel feature of HIV is the possession of a gene termed tat, which is implicated in its pathobiology. We report here that, like HIV, HTLV-IVP, LAV-2FG (HIV-2) and SBL-6669, as well as STLV-IIIAGM possess the putative tat gene, irrespective of their pathogenic potential in vivo. Interestingly, HTLV-IVP/LAV-2FG long terminal repeat (LTR) is equally well transactivated by the HTLV-IVP/LAV-2FG and HTLV-IIIB tat function, HTLV-IIIB LTR responds better to its own tat function.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Determinants of HIV infection and recent risk behaviour among injecting drug users in Berlin by site of recruitment.

This study investigated differences in prevalence and determinants of HIV infection, and in recent risk behaviour (previous 6 months) among injecting drug users (IDUs) who are in contact with different types of services for IDUs in Berlin. Participants (n = 557) were recruited from drug-free long-term treatment centres, a storefront agency and a syringe exchange bus. HIV seroprevalence was lowest (3.9%) at the treatment centres, and highest among IDUs at the storefront agency (20.7%). In logistic regression, independent risk factors for HIV infection were duration of injecting drug use, borrowing syringes in prison, sex with HIV-positive partners, and prostitution. Syringe sharing in prison was the most important independent determinant of HIV infection among all three subpopulations of IDUs. Participants entering long-term treatment were most likely, and IDUs at the syringe exchange bus were least likely to have borrowed and passed on syringes in the previous 6 months. In logistic regression, site of recruitment was independently associated with recent borrowing of syringes, but not with condom use. Injection of drugs other than heroin only, and injecting in prisons, were also independent predictors of recent borrowing. The results indicate that IDUs entering treatment form an important target group for health education. There is a need for AIDS prevention measures in prisons. The comparatively low levels of recent injection risk behaviour among IDUs at the syringe exchange bus suggest that this type of intervention may be effective in harm reduction.

Adult↗

PubMed2000

Methadone maintenance and cessation of injecting drug use: results from the Amsterdam Cohort Study.

AIMS: To assess relationships between characteristics of methadone maintenance treatment and long-term cessation of injecting (> or = 1 year). DESIGN AND PARTICIPANTS: The incidence of cessation of injecting and relapse from non-injecting to injecting was estimated among 488 participants of the Amsterdam cohort study among drug users. We used a nested matched case-control design to identify methadone treatment characteristics significantly and independently related to cessation of injecting. To ensure detailed and valid assessment of methadone treatment, data of the Central Methadone Register were linked with cohort data. For 339 of 488 subjects of the initial study group methadone data were available. FINDINGS: The incidence of cessation of injecting increased from 2.2/100 person years in 1985-89 to 5.5/100 per year in 1995-97 (Ptrend = 0.005). Relapse to injecting was high: 17.2/100 person years (no trend). Methadone dosage and frequency of methadone programme attendance in themselves were not significantly related to cessation of injecting. However, an individual increase of 5 mg or more per year (OR 4.20, 95% CI 1.54-11.46) and receiving methadone mainly via the outpatient clinic for drug-abusing prostitutes and foreigners (OR 0.18, 95% CI 0.05-0.59) were independent predictors of cessation of injecting. After cessation of injecting, there were no HIV-seroconversions during the period of non-injecting (129 person years). After relapse to injecting there was one seroconverter; however, follow-up was small (23 person years). The HIV-incidence of those who continued injecting was 3.2/100 per year. CONCLUSIONS: Steadily increasing the methadone dosage in a harm reduction setting may be useful in supporting injecting drug users in the process of cessation of injecting and reducing the spread of HIV-infection.

Adolescent↗

PubMed2003

Trends in birthweight between 1857 and 1883, in Melbourne, Australia.

Epidemiological evidence suggesting that subjects with lower birthweight have an increased risk of adult cardiovascular disease has led to increased interest in factors influencing birthweight. We have documented large changes in mean birthweight over a relatively short historical period from 1857 to 1883. Mean birthweight declined progressively from 7.9 lb (3.6 kg) in the period 1857-63 to 6.9 lb (3.1 kg) in 1874-78, then rose to 7.5 lb (3.4 kg) for the period 1879-83. We found the expected relationships between infant birthweight and maternal age, parity and marital status, and identified an association between birthweight and maternal country of birth. However, neither temporal changes in recorded maternal characteristics nor external economic indicators for the colony explained the trends in birthweight. From historical information, we believe that the explanation for our findings lies primarily with the increasing poverty, disease, mental illness, alcohol abuse and criminal activity among women admitted to the hospital between 1860 and the mid-1870s, and improvements from around 1880, when old housing was replaced and prostitutes were moved out of the area. Our findings highlight the difficulty of capturing lifestyle factors using routinely collected data, and the need for historical expertise when examining historical data.

Analysis of Variance↗

PubMed2004

Proof of paternity: historical reflections on an andrological-forensic challenge.

Throughout the history of medicine, there have been difficulties in forensic proving of unsolved paternities, making this a major andrological-forensic challenge. In the Roman empire, children procreated by incest, called 'incestuosi', had no rights at all and other illegitimates, e.g. children born of prostitutes or as a result of adultery, could not assert rights towards the father. Only through the 'corpus iuris civilis' of the Roman Emperor Justinian I (6th century ad) could claims of alimony be made in some cases. In later times, evidence of presumable impotence of a potential father was determined by the congressus, where defined juristical 'sexual fights' had to be held before official matrons, surgeons and priests. Men had to demonstrate their erectile and ejaculatory function. A special significance must be attributed to the microscopical discovery of spermatozoa by the medical student Johann Ham in 1677 and the further investigation by Antoni van Leeuwenhoek. After centuries of personally biased and scientifically incorrect concepts of paternity determination, the discovery of the blood grouping system by Karl Landsteiner at the beginning of the 20th century paved the way for sophisticated techniques to prove or rather to disprove paternity. In 1921, Reuben Ottenberg from New York was the first to suggest the application of the system to medico-legal questions, but it was not before the 1950s that legal courts accepted this method. A famous example of disregarding clear blood grouping results was the case of the movie star Charles Chaplin in California in 1946. Modern DNA techniques, today the golden standard in forensic medicine, have also been applied recently for historical investigations. One of the very illustrious examples is the dispute about Thomas Jefferson, third President of the US, fathering a child of one of his slaves.

Andrology↗

PubMed2000

HIV-1-specific cellular immune responses among HIV-1-resistant sex workers.

The goal of the present study was to determine whether there were HIV-1 specific cellular immune responses among a subgroup of women within a cohort of Nairobi prostitutes (n = 1800) who, despite their intense sexual exposure to HIV-1, are epidemiologically resistant to HIV-1 infection. Of the 80 women defined to be resistant, 24 were recruited for immunological evaluation. The HIV-1-specific T-helper responses were determined by IL-2 production following stimulation with HIV-1 envelope peptides and soluble gp120. Cytotoxic T lymphocyte responses were determined by lysis of autologous EBV-transformed B cell lines infected with control vaccinia virus or recombinant vaccinia viruses containing the HIV-1 structural genes env, gag and pol. Resistant women had significantly increased HIV-1 specific T-helper responses, as determined by in vitro IL-2 production to HIV-1 envelope peptides and soluble glycoprotein 120, compared with low-risk seronegative and HIV-1-infected controls (P < or = 0.01, Student's t-test). Seven of the 17 (41%) resistant women showed IL-2 stimulation indices > or = 2.0. HIV-1-specific CTL responses were detected among 15/22 (68.2%) resistant women compared with 0/12 low-risk controls (Chi-squared test, P < 0.001). In the two resistant individuals tested, the CTL activity was mediated by CD8+ effectors. Many HIV-1-resistant women show evidence of HIV-1-specific T-helper and cytotoxic responses. These data support the suggestion that HIV-1-specific T-cell responses contribute to protection against HIV-1 infection.

Adult↗