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PubMed2002

Transfusion-transmitted virus prevalence in subjects at high risk of sexually transmitted infection in Turkey.

OBJECTIVE: To assess the possible sexual transmission of virus and to identify the prevalence of TTV viremia in Turkey and its association with other hepatotropic viruses. METHODS: Serum samples were collected from 81 subjects (74 prostitutes and seven homosexual men) at high risk of sexually transmitted infection and from 81 healthy controls (74 females and seven males). Sera of patients and controls were tested for TTV, hepatitis A virus, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Also, serum alanine and aspartate aminotransferases were measured. RESULTS: The prevalence rates of TTV viremia in the risk group and control group were 86.4% and 82.7%, respectively. There was a statistical difference in mean age between TTV-infected and uninfected subjects (38.6 +/- 9.9 versus 32.2 +/- 6.1 years, respectively, P < 0.001). Prevalence rates of TTV infection in subjects with positive anti-HAV and positive anti-HBc were high when compared with subjects who were negative for these. CONCLUSION: We suggest that TTV infection has a diverse route of transmission, and its prevalence increases with age; also, the prevalence rate of TTV is high in certain risk groups. The prevalence rates of TTV in the group at risk for sexual transmission (86.4%) and in the control group (82.7%) were among the highest ever reported in the world. Also, we suggest that TTV generally does not cause clinical disease, in spite of this high prevalence.

Adult↗
PubMed1995

Human T-lymphotropic virus type I and type II infections and correlation with risk factors in blood donors from São Paulo, Brazil.

BACKGROUND: Little is known about the prevalence of and risk factors for human T-lymphotropic virus type I and type II (HTLV-I, HTLV-II) infections in Brazil. STUDY DESIGN AND METHODS: Sera from 17,063 healthy Brazilian donors were screened by enzyme-linked immunosorbent assay for antibody to HTLV-I/II between August 1991 and July 1993. Repeatedly reactive samples were confirmed by Western blot, and discrimination between HTLV-I and HTLV-II was made by polymerase chain reaction or synthetic peptide enzyme-linked immunosorbent assay. A univariate analysis was performed on demographic and serologic data. RESULTS: HTLV-I infection was demonstrated in 83 percent of the 30 donors with reactive serologic tests (0.15% of the total tested [17,063]; 95% CI, 0.09-0.20) and HTLV-II infection in 17 percent (0.03% of the total tested [17,063]; 95% CI, 0.01-0.05). HTLV-I-positive donors were more likely than reference groups to be of Asian ethnicity (odds ratio [OR] 15.1; reference group: whites), more than 50 years old (OR 4.2; reference group: 20-29 years old), and positive for antibody to hepatitis C virus (anti-HCV) (OR 21.8) or to hepatitis B core (antigen) (anti-HBc) (OR 5.7). HTLV-II showed a significant association with anti-HCV (OR 75.2) and anti-HBc (OR 21.8). Eleven of the 25 HTLV-I-positive donors were counseled. Family origin in endemic areas of Japan (n = 4), prior blood transfusion (n = 3), or sexual contact with prostitutes (n = 1) were the risk factors reported by 8 donors. In 3 white men, no risk factors could be identified. CONCLUSION: Both HTLV-I and HTLV-II occur among Brazilian blood donors. HTLV-I is associated with Asian ethnicity, greater age, and the presence of anti-HCV and anti-HBc. Three HTLV-I-positive donors had a history of blood transfusion, which emphasizes the need for HTLV-I/II screening in Brazil.

Adult↗
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↗
PubMed2001

Risk factors for cancer of the oral cavity and oro-pharynx in Cuba.

In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking > or =30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9-48.3), similar to smoking > or =4 cigars daily (OR = 20.5). Drinking > or = 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8-18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba.

Adult↗
PubMed2000

[Sexual and physical abuse during early childhood or adolescence and later drug addiction].

UNLABELLED: Sexual or physical abuse of children are discussed as possible causes or risk-factors for psychiatric disorders like posttraumatic stress disorder, alcohol and drug addiction. The aim of this study was to identify possible differences between sexually or physically abused and non-abused patients with polytoxic drug abuse. METHOD: 100 patients with polytoxic drug abuse were interviewed during their therapy about a history of sexual abuse prior to the age of sixteen. Using different questionnaires we tried to find possible differences between drug users being sexually abused or not and risk factors for later drug addiction. RESULTS: 70% of the female and 56% of the male drug users had been sexually abused as children, 40% of the male and 50% of the female participants had a history of severe sexual abuse with sexual intercourse. In over 50% friends or relatives were the perpetrators committed the crime, in no case the parents had. More than 40% showed also a history of physical abuse. Significantly more drug users than alcohol abusers had a sexual trauma. Especially severe sexual abuse was associated with abuse of hard illegal drugs. Furthermore, we could find significantly more symptoms such as autoaggressive and suicidal behaviour, social isolation, reduced emotional binding to others, tendency to be persistently victimized, prostitution and violence against others in the group of sexually abused. Many of these symptoms are not only characteristic of addiction, but can be found also in other psychiatric diseases such as borderline and eating disorder. In conclusion, we could not find a significant correlation between sexual abuse and later drug addiction. 80% of the drug users themselves did not relate the fact of being sexually abused as child to later drug abuse. However, there seems to be a positive correlation between sexual abuse and a more severe addiction to illegal drugs as well as higher rates of symptoms with a negative course of the disease. For this group of patients with an unfavourable prognosis special therapeutic concepts are needed.

Adult↗
PubMed1987

[Screening for HIV antibodies in pregnancy].

The results of the first screening in pregnant women for HIV antibodies published in the literature were obtained at the Charlottenburg Gynecological Clinic of the Free University of Berlin, and are communicated here. They indicate that in future it will be questionable whether AIDS should be looked for only among risk groups, as is currently the case in many obstetric centers. Tests for HIV were positive in 0.5% of 1295 pregnant women who did not belong to a risk group (heroin addicts, prostitutes, transfusion recipients); the findings were confirmed with the more specific Western Blot. Consequently, therefore, it is recommended that HIV screening should be included among the basic antenatal care examinations, the patient having been thoroughly informed. In order that the patient be aware of the reality of the risk, she should, if possible, be informed in early pregnancy: the family physician therefore has a special obligation to fulfil. The fact that increasing numbers of infected women do not belong to risk groups is a further argument in favor of HIV screening. Moreover, AIDS has become the most common infection with serious consequences for mother and child. Patients in whom the test for HIV antibodies is positive also require appropriate counseling and care. Finally, the need to protect both patients and staff against infection during birth must not be neglected.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[The Aids problem in pregnant women--a challenge to the obstetrician].

Nine pregnant women with the AIDS problem were under treatment and care at the Department of Gynaecology of the University of Berlin at Charlottenburg during 1985. Of these, seven had HTLV-III antibodies only, whereas one woman showed additional clinical signs such as lymphoadenopathy and opportunistic infections; another woman developed exanthemas during pregnancy that pointed to a possible manifestation of AIDS. The increasing incidence in our clinic of pregnant women infected with or actually suffering from AIDS is due to the fact that for several years we have been conducting heroin withdrawal programmes in pregnant women. It must be born in mind, however, that generally more and more women outside the high-risk groups covered by anamnesis are being infected with HTLV-III. Screening tests for HTLV-III can help to clarify matters and make it possible to care adequately for the patient and to guarantee the obstetric team an appropriate management of the risk of infection. However, it must be considered as a minimum demand to be made on the obstetrician to conduct tests for HTLV-III antibodies in women of the high-risk groups (heroin addicts, prostitutes, blood transfusion recipients, fathers at risk). Based on update knowledge, the authors supply pointers to a more realistic information of pregnant women. Suggestions are advanced in respect of care during pregnancy, childbirth and puerperium.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Increase in the prevalence of antibodies against LAV/HTLV III in drug addicts in West Germany].

Sera obtained from 927 drug addicts in 1983 to 1985 were tested for antibodies against LAV/HTLV-III. There was a steadily rising proportion of positive results: 10.1% in 1983, 17.6% in 1984 and 23.9% in 1985. In each year the prevalence of anti-LAV/HTLV-III was higher among female than male addicts. No increased proportion of positive results was demonstrable in relation to age. Among 152 sera from 1983/84, hepatitis-B markers were found in 72 (43.7%), of whom 10 (14%) were also anti-LAV/HTLV-III positive. Among hepatitis-B marker-negative sera there were 8 (6%) which were also anti-LAV/HTLV-III positive. The prevalence of anti-LAV/HTLV-III in drug addicts in prisons, rehabilitation centres, hospitals and medical practices was similar. There is a danger that prostitution by addicts for obtaining drugs will cause a penetration of LAV/HTLV-III in the rest of the population.

Adult↗
PubMed1979

A trial of minocycline given after exposure to prevent gonorrhea.

In a prospective evaluation of antibiotic prophylaxis against gonorrhea, 1080 men were given 200 mg of oral minocycline or placebo after sexual intercourse with prostitutes in a Far Eastern port. Later, at sea, gonococcal infection was detected in 57 of 565 men given placebo and 24 of 515 men given minocycline (P less than 0.001). Minocycline prophylaxis completely prevented infection by gonococci susceptible to 0.75 microgram or less of tetracycline per milliliter, reduced the risk of infection or prolonged the incubation period in men exposed to gonococci susceptible to 1.0 to 2.0 micrograms per milliliter, but did not prevent infection or prolong incubation in men exposed to gonococci resistant to 2.0 micrograms. Minocycline did not increase the proportion of asymptomatic infections. Minocycline prophylaxis would probably have limited effectiveness as a public-health measure because of the tendency to select resistant gonococci.

Administration, Oral↗
PubMed1988

The prevalence of infection with human immunodeficiency virus over a 10-year period in rural Zaire.

In 1985 we tested 659 human serum samples, collected in the remote Equateur province of Zaire in 1976, for antibody to human immunodeficiency virus (HIV). Five (0.8 percent) were positive, and HIV was isolated from one of these. Follow-up investigations in 1985 revealed that three of the five seropositive persons had died of illnesses suggestive of acquired immunodeficiency syndrome (AIDS), and two remained healthy but seropositive. In 1986, a serosurvey we conducted using a cluster-sampling technique in the same region showed a seroprevalence of 0.8 percent in 389 randomly selected residents. The seroprevalence in 283 prostitutes was 11 percent. Patients with AIDS were identified in various hospitals in the province. Risk factors for AIDS included a greater than average number of sexual partners and residence outside the area. We believe that the long-term stability of HIV infection in residents of rural Zaire suggests that social change may have promoted the spread of AIDS in Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa.

Heterosexual transmission of the human immunodeficiency virus (HIV) appears to occur readily in Africa but less commonly in North America and Europe. We conducted a case-control study among men attending a clinic for sexually transmitted diseases in Nairobi to determine the prevalence of HIV infection and the risk factors involved. HIV antibody was detected in 11.2 percent of 340 men who enrolled in the study. Reports of nonvaginal heterosexual intercourse and homosexuality were notably rare. Recent injections and blood transfusions were not associated with HIV infection. Travel and frequent contact with prostitutes were associated with HIV seropositivity. Men who were uncircumcised were more likely to have HIV infection (odds ratio, 2.7; P = 0.003), as were those who reported a history of genital ulcers (odds ratio, 7.2; P less than 0.001). A current diagnosis of genital ulcers was also associated with HIV seropositivity (odds ratio, 2.0; P = 0.028). Multivariate analysis revealed an independent association of genital ulcers with HIV infection in both circumcised and uncircumcised men. Uncircumcised men were more frequently infected with HIV, regardless of a history of genital ulcers. Our study finds that genital ulcers and an intact foreskin are associated with HIV infection in men with a sexually transmitted disease. Genital ulcers may increase men's susceptibility to HIV, or they may increase the infectivity of women infected with HIV. The intact foreskin may operate to increase the susceptibility to HIV.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Hormonal contraception and risk of sexually transmitted disease acquisition: results from a prospective study.

OBJECTIVES: To examine the relationship between use of oral contraceptive pills or depot medroxyprogesterone acetate and sexually transmitted disease acquisition. STUDY DESIGN: Prospective cohort included 948 Kenyan prostitutes. Multivariate Andersen-Gill proportional hazards models were constructed, adjusting for sexual behavioral and demographic variables. RESULTS: When compared with women who were using no contraception, users of oral contraceptive pills were at increased risk for acquisition of chlamydia (hazard ratio, 1.8; 95% confidence interval, 1.1-2.9) and vaginal candidiasis (hazard ratio, 1.5; 95% confidence interval, 1.2-1.9) and at decreased risk for bacterial vaginosis (hazard ratio, 0.8; 95% confidence interval, 0.7-1.0). Women using depot medroxyprogesterone acetate had significantly increased risk of chlamydia infection (hazard ratio, 1.6; 95% confidence interval, 1.1-2.4) and significantly decreased risk of bacterial vaginosis (hazard ratio, 0.7; 95% confidence interval, 0.5-0.8), trichomoniasis (hazard ratio, 0.6; 95% confidence interval, 0.4-1.0), and pelvic inflammatory disease (hazard ratio, 0.4; 95% confidence interval, 0.2-0.7). Consistent condom use was associated with significantly decreased risk of gonorrhea, chlamydia, genital ulcer disease, bacterial vaginosis, and pelvic inflammatory disease. CONCLUSIONS: The use of oral or injectable hormonal contraception altered susceptibility to sexually transmitted diseases, which may in turn influence transmission of human immunodeficiency virus type 1. Consistent condom use was protective with regards to sexually transmitted disease and should be encouraged for the prevention of sexually transmitted disease and human immunodeficiency virus type 1 among women who use hormonal contraception.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Sex in prisons--a management guide.

Prisons are invariably unisex institutions where, besides many deprivations, heterosexual expression in its normal sense is absent. It is this characteristic that make prisons settings potentially fertile grounds for sexual aberrations. Since definite and accurate data concerning sexual activities among prison inmates are difficult to obtain, the phenomenon of sexual practices in prisons has traditionally been a topic of much speculation. However, the descriptions and explanations of most authors on the subject are often contradictory, and some of the best information are from unpublished sources. This article is an attempt to subsume many fragmented explanations about seven main types of sexual issues in prisons (i.e. consensual homosexuality, masturbation, transsexualism, prostitution, conjugal visits, sex between prisoners and prison staff, and rape among prison inmates) under more general criminological and management concepts. Suggestions for prison administrators on how to manage these complex issues in the best interests of security and inmates' health are also provided.

Family Relations↗
PubMed1994

Population migration and the spread of types 1 and 2 human immunodeficiency viruses.

Over 14 million people are estimated to be infected with the human immunodeficiency viruses (HIV), with nearly three-fourths of the infected persons residing in developing countries. One factor responsible for dissemination of both HIV-1 and HIV-2 worldwide was the intense migration of individuals, from rural to urban centers with subsequent return migration and internationally due to civil wars, tourism, business purposes, and the drug trade. In sub-Saharan Africa, between 1960 and 1980, urban centers with more than 500,000 inhabitants increased from 3 to 28, and more than 75 military coups occurred in 30 countries. The result was a massive migration of rural inhabitants to urban centers concomitant with the spread of HIV-1 to large population centers. With the associated demographic, economic, and social changes, an epidemic of sexually transmitted diseases and HIV-1 was ignited. Migratory patterns were also responsible for the spread of endemic HIV-2 to neighboring West African countries and eventually to Europe, the Americans, and India. Although Southeast Asia was the last region in which HIV-1 was introduced, it has the greatest potential for rapid spread due to population density and inherent risk behaviors. Thus, the migration of poor, rural, and young sexually active individuals to urban centers coupled with large international movements of HIV-infected individuals played a prominent role in the dissemination of HIV globally. The economic recession has aggravated the transmission of HIV by directly increasing the population at risk through increased urban migration, disruption of rural families and cultural values, poverty, and prostitution and indirectly through a decrease in health care provision. Consequently, social and economic reform as well as sexual behavior education need to be intensified if HIV transmission is to be controlled.

Behavior↗
PubMed1990

Crack abuse. Do you known enough about it?

Crack use has increased dramatically because the drug is cheap, highly addictive, and easy to use. As a result, an increased frequency of cocaine-related medical problems has been noted. The effects of crack abuse on fetal outcome and neurobehavioral development are becoming more apparent. In addition, the role of crack use in furthering transmission of sexually transmitted diseases has been documented, and the implications for AIDS transmission have been speculated on. Crack use enhances social disorganization, particularly in poor urban areas, where increased child abuse, neglect, and prostitution are common. Ever present are the financial incentives to increase the number of crack users. Cocaine was once considered a drug for the elite, rich, and famous. Crack clearly has changed that notion.

Cardiovascular System↗
PubMed1993

The she-male phenomenon and the concept of partial autogynephilia.

The term autogynephilia denotes a male's propensity to be sexually aroused by the thought or image of himself with female attributes. Some autogynephiles imagine themselves, in their sexual fantasies, as complete women. Others, here called partial autogynephiles, imagine themselves with a mixture of male and female anatomic features, usually women's breasts and men's genitals. Partial autogynephiles evince a particular sexual interest in those individuals known in the vernacular as she-males. These are men, often involved in prostitution or pornography, who have undergone breast augmentation while maintaining their male genitals. Partial autogynephiles appear less likely to pursue surgical sex reassignment than gender-dysphoric men whose erotic self-image includes a vagina. Some patients with a persistent desire for women's breasts but no or conflicted desires to live as women full-time or undergo vaginoplasty may be pacified with mildly feminizing doses of estrogenic hormones.

Adult↗
PubMed1989

Clinical features of paediatric AIDS in Uganda.

A total of 177 children seen at two hospitals in Kampala are described who were strongly suspected of having acquired immunodeficiency syndrome (AIDS), either on clinical grounds or because they fulfilled the World Health Organization (WHO) case-definition criteria for diagnosis of paediatric AIDS. Blood was taken from the 177 children and 154 of their mothers and tested for antibody to human immunodeficiency virus (HIV) by an enzyme-linked immunoassay (ELISA). Altogether, 119 (67%) children were seropositive, but only 85 (71%) fulfilled the WHO case-definition criteria, and they were significantly older than the 34 who did not fulfil the criteria. A further 58 children were seronegative but fulfilled the WHO criteria. Of the 119 seropositive children, only 3 had a history of previous blood transfusion, but 103 (98%) of 105 mothers were HIV seropositive: consequently, their children were considered to have been infected in utero or perinatally. Thirteen (26%) of 49 mothers of seronegative children were seropositive. Eighty per cent of HIV-infected children were under 2 years of age at diagnosis and 23% died within 3 months of diagnosis. None of the parents was known to be an intravenous drug user, a prostitute or bisexual. The difficulty of accurate diagnosis of AIDS presents a major problem in Africa, as the WHO clinical case-definition criteria alone are clearly not adequate.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

High-risk behaviors for HIV: a comparison between crack-abusing and opioid-abusing African-American women.

High rates of unprotected sexual behaviors and the exchange of sex for crack have been reported among female crack cocaine users. This subpopulation of drug users is at significant risk for contracting and transmitting HIV and AIDS. To date, there has been no research comparing crack- and opioid-abusing women, particularly regarding their involvement in high-risk behaviors and other key background indicators for different subgroups of drug-abusing women. Sixty-one crack-abusing African-American women who recently entered an intensive outpatient treatment program were compared to 64 matched women whose primary drug of abuse was heroin. The opioid subgroup represented both those who were involved in methadone maintenance and those who were out of treatment. Higher rates of high-risk sexual behaviors were reported by the crack subgroup, including prostitution, number of sexual partners, and infrequency of condom use. As expected, i.v. drug use and high-risk behaviors associated with needle use were much higher among the opioid subgroup. Other significant differences were found between the two groups across key indicators. Individuals in the crack subgroup were younger, cared for more children, were less employable, were less likely to be married, and had more extensive lifetime substance abuse. Quantitative and qualitative background and clinical data are also presented. The nature of crack versus heroin abuse is also discussed, particularly in relation to high-risk sexual behaviors. Finally, the impact of the findings on developing appropriate treatment interventions for both groups is addressed.

Adolescent↗