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PubMed2001

Molecular characterization and phylogenetic analysis of a human T cell leukemia virus type 2 strain from French Guiana.

Extensive studies have been carried out on native Amerindian populations living in French Guiana in an attempt to detect human T cell leukemia virus type 2 (HTLV-2). However, the first strain of this virus identified in this region was not detected in these populations, but in a Brazilian woman of Amerindian origin. Comparative analyses of the nucleotide sequences of 589 bp of the gp21 env gene and of 625 bp of the long terminal repeat (LTR) showed that this new HTLV-2 strain (HTLV-2 GUY) was of subtype A. Sequence comparison and phylogenetic analyses demonstrated that HTLV-2 GUY was closely related to a group of distinct variants of HTLV-2 subtype A strains originating mostly from Brazilian inhabitants and formerly called HTLV-2 subtype C. As there is a high level of immigration from Brazil in French Guiana, we carried out a seroepidemiological study of 175 Brazilians, mostly women (obtained from a serum databank) and 72 female Brazilian prostitutes living in French Guiana to determine whether HTLV-2 is likely to become an emerging infection in this area. No HTLV-2 infection was detected, indicating that this virus is unlikely to become prevalent in the near future.

Base Sequence↗
PubMed2000

HIV risk and healthcare attitudes among detained adolescents in rural Alabama.

This qualitative study explored the dynamics of adolescent HIV risk through focus group interviews of male and female adolescents at an Alabama juvenile detention facility, key informant interviews, and through interviews of HIV-positive and -negative adults in institutional settings and public health clinics in Alabama. The interviews revealed that commodified or unprotected sex with multiple partners was a common risk activity for male and female adolescents, with a related high risk of sexually transmitted disease. The adolescents were aversive to condom use and lacked knowledge of the dynamics of HIV transmission. Bisexually behaving males who engaged in same-sex prostitution for money or drugs viewed female partners as the source of HIV infection. Illicit drug activity and risky sexual behavior were highly related to economic and status anxiety. Experiences of healthcare were often coercive or were undermined by negative perceptions of health professionals. These negative perceptions and avoidance or lack of access to healthcare compounded the already high risk of sexually transmitted disease for this group of adolescents.

Adolescent↗
PubMed2001

Correlates of partner violence among female street-based sex workers: substance abuse, history of childhood abuse, and HIV risks.

This study examines the prevalence of physical and sexual abuse by intimate and commercial sexual partners among street-based sex workers and explores correlates of partner abuse by commercial partners using the following factors: sociodemographics, substance abuse, sexual behavior, and physical and sexual childhood abuse. One hundred thirteen street sex workers were recruited from December 1996 through May 1997 while receiving services from the Foundations for Research on Sexually Transmitted Diseases (FROST'D), a nonprofit organization based in New York City. Partner abuse is a common occurrence among street sex workers. Two of three street prostitutes have experienced lifetime physical or sexual abuse by either an intimate or commercial partner. In addition, one of eight reported physical and sexual abuse by both intimate and commercial partners during her lifetime. Women who were homeless in the last year, those who reported exchanging for drugs and money as their main source of income, used injection drugs in the past year and had sex in crack houses, and who were human immunodeficiency virus (HIV)-positive were more likely to be report combined physical and sexual abuse. Understanding the relationship between partner violence, victim's substance abuse, and HIV-risk behavior is important for the development of public policies and treatment and prevention strategies to address the constellation of problems that drug-using female street sex workers face.

Adult↗
PubMed2003

Sexual activities of patients with STDs in the interval between noticing symptoms and presenting for treatment.

Examining the patterns of and reasons for sexual behaviors of patients with sexually transmitted diseases (STDs) while symptomatic may help to develop effective prevention strategies for both STDs and AIDS. However, little is known about patients' sexual activities after noticing STD symptoms in China, where AIDS and STDs are spreading rapidly. We conducted a cross-sectional study at four STD clinics in Hefei, China. Patients' reported sexual activities were queried, using a tape recorder and earphones. A consecutive sample of 406 male patients with STDs were interviewed. One hundred sixty-four (40%) men reported having sex after having STD symptoms; 45% were married, 27% were single, and 47% cohabiting or divorced. Their sex partners included spouses, girlfriends, and prostitutes. Only 10% of patients with STDs who had sex after noticing STDs reported frequently using condoms or using them for every act of sex. Approximately 60% had never used a condom. Logistic regression analysis indicated that having sex after noticing STD symptoms was associated with lower education, having a previous STD episode, having low HIV/STD knowledge, and having other urethral discharge not caused by C. trachomatis or gonorrhea. Our findings suggest that male patients with STDs may serve as a bridge population linking the STD, and potentially, HIV epidemic from individuals at higher risk to the general population. Intervention programs including health education and condom promotion need to target both those at high risk and those at apparently lower risk.

Adolescent↗
PubMed2003

Development of functional human monoclonal single-chain variable fragment antibody against HIV-1 from human cervical B cells.

A panel of novel recombinant single-chain variable fragment (scFv) antibody against human immunodeficiency virus type-1 (HIV-1) was isolated and characterized. We generated human scFvs using RNA harvested from cervical B lymphocytes of Kenyan prostitutes who are highly exposed to HIV-1, but remain persistently seronegative. The variable regions of the heavy (VH) and light (VL) chain antibody genes were selected as hybrids using guided-selection with the VL and VH, respectively, of a derivative of IgGb(12) using the phagemid vector pComb3X. IgGb(12) is a previously well-characterized HIV-1 neutralizing human monoclonal antibody (MAb). One of the hybrid scFv, IgA6/4L, neutralizes HIV-1 infectivity in in vitro cell culture assay. The cervical VH and VL chain antibody genes were connected by a DNA linker and subcloned in pComb3X. The cervical scFv clones were functional in recognizing HIV-1 gp120 by enzyme-linked immunosorbant assay (ELISA) and on cells in flow cytometry. Whole IgGb(12) does not inhibit binding of clones IgA6/5k nor IgA6/30lambda to gp120, which suggests that they bind different epitopes. Nucleotide sequence analysis of the cervical scFv show the clones are unique and reveal interesting characteristics of human cervical V gene pools. This work demonstrates, for the first time, cloning of a functional scFv MAb to a sexually transmitted disease pathogen from local cervical B-cell pools in exposed humans.

Amino Acid Sequence↗
PubMed1992

Prevalence of HTLV infection in the Dominican Republic: association with neurological disease.

The presence of the human T-cell leukemia virus (HTLV) in Dominican blood donors and patients with tropical spastic paraparesis (TSP) was first detected in 1987. To define further the seroprevalence in the country, nearly 4,000 samples from high- and low-risk populations, as well as patients with neurological disease and with leukemia or lymphoma were tested for HTLV antibodies. A 1-2% seropositivity rate was found among the low-risk population, a 2-5% in the high-risk, and at least 87% in those with TSP. A few patients with malignancy also had antibodies to HTLV. An increase in seropositivity with age and a predominance of female seropositive individuals were found. Infectious virus was isolated from TSP patients, prostitutes, and family members of index patients. These data indicate the substantial level of HTLV infection in another Caribbean country and its relation to neurologic disease.

Adolescent↗
PubMed1998

Needle sharing and high-risk sexual behaviors among IV drug users in Southern Thailand.

This study sought to determine the prevalence of needle sharing and high HIV risk sexual behaviors and to identify characteristics associated with these practices in southern Thailand. Data were obtained using a structured questionnaire from 298 male intravenous drug users (IVDUs) seen in a methadone clinic during the previous year. The prevalence of HIV was 37%, and that of needle-sharing in the preceding months was 45%, although only 10% claimed to have had unsafe sex with a casual partner or prostitute in the same period. Determinants for needle sharing included shorter duration of drug injection, diminished knowledge of HIV prevention, a carefree attitude toward risk of HIV infection, and lower levels of income. Young single IVDUs with a low knowledge of HIV prevention were most likely not to use a condom. In conclusion, needle sharing among the study subjects was still a common practice, whereas high HIV risk sexual behavior was not. Attitudinal change may be necessary to reduce needle-sharing behavior and not just information on disease transmission.

Adult↗
PubMed2005

Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.

Adolescent↗
PubMed2001

Human papillomaviruses and cervical cancer in Bangkok. I. Risk factors for invasive cervical carcinomas with human papillomavirus types 16 and 18 DNA.

Personal interviews, tests for antibodies to herpes simplex virus type 2, Treponema pallidum, and hepatitis B, tests for hepatitis B surface antigen (HBsAg), and polymerase chain reaction-based assays for human papillomavirus (HPV) DNA in cervical scrapings were obtained from 190 women with squamous cell and 42 women with adenomatous cervical carcinoma and from 291 hospitalized controls diagnosed in Bangkok, Thailand, between September 1991 and September 1993. Risk was strongly associated with oncogenic HPV types, with types 16 and 18 predominating in squamous and adenomatous lesions, respectively. The 126 cases with HPV-16 and the 42 cases with HPV-18 were compared with 250 controls with no evidence of any HPV. The risk of both viral tumor types increased with decreasing age at first intercourse in this predominantly monogamous population, which may be explained by more visits to prostitutes by the husbands of cases with early than late age at first intercourse. HPV-16 tumors were weakly associated with HBsAg carrier state and smoking. The risk of tumors of both viral types increased with parity and use of oral contraceptives but not with injectable progestogens. Factors that may predispose to persistent, oncogenic HPV-16 or -18 infection may include estrogens or progestins in the presence of estrogens, immunosuppression, and smoking, but other factors related to low socioeconomic status are also involved.

Adult↗
PubMed2000

Product limit estimation for infectious disease data when the diagnostic test for the outcome is measured with uncertainty.

Low sensitivity and/or specificity of a diagnostic test for outcome results in biased estimates of the time to first event using product limit estimation. For example, if a test has low specificity, estimates of the cumulative distribution function (cdf) are biased towards time zero, while estimates of the cdf are biased away from time zero if a test has low sensitivity. In the context of discrete time survival analysis for infectious disease data, we develop self-consistent algorithms to obtain unbiased estimates of the time to first event when the sensitivity and/or specificity of the diagnostic test for the outcome is less than 100%. Two examples are presented. The first involves estimating time to first detection of HIV-1 infection in infants in a randomized clinical trial, and the second involves estimating time to first Neisseria gonorrhoeae infection in a cohort of Kenyan prostitutes.

Journal Article↗
PubMed2006

Third Italian national survey on knowledge, attitudes, and sexual behaviour in relation to HIV/AIDS risk and the role of health education campaigns.

AIM: The survey, supported by the National Health Institute (ISS), investigates on sources of information for HIV/AIDS and sexual behaviour of the Italian general population. METHODS: The survey was carried out in four different Italian provinces with different geographical, social, and epidemiological patterns of HIV/AIDS: Bari, Milan, Parma, and Perugia. A self-administered questionnaire was used to interview a sample of 2000 people, aged 18-49 years, chosen using a quota-sampling, considering age, sex, and level of education. RESULTS: A total of 1985 persons filled in the questionnaire. Among them, 73.2% reported Ministry of Health as their main source of information and 76.7% TV/radio advertising as their main means of information. Sexually active subjects, experiencing occasional sexual intercourse, were 22.4%; of them 34.6% did not refer a systematic use of condom. Among sexually active people, half (45.7%) reported as irrelevant their risk of infection, 6.9% as high. Being male (OR = 6.175) and having the first sexual intercourse before 18 years (OR = 2.076) were significantly associated with sexual behaviour at risk (males having unsafe sexual intercourses with prostitutes or during partners' menstrual period; both sexes having unsafe occasional sexual intercourses or anal sex), while living in Northern Italy (OR = 0.672) was significantly protective. Subjects with sexual behaviour at risk were about 40%. CONCLUSIONS: The need for further education campaigns, and their consequent evaluations, is relevant. Monitoring sexual behaviour of general population, focusing on risk behaviour rather than risk groups, is fundamental nowadays in preventing HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Sexual factors and prostatic cancer: results from a case-control study.

A case-control study of a number of factors of possible etiologic significance for prostatic cancer was conducted in the Minneapolis-St. Paul area. The focus was primarily on sexual factors. Two hundred and fifty incident cases of prostatic cancer, 238 hospital controls, and 240 neighborhood controls were included. Controls were matched to cases on age, sex, and race. Cases were somewhat more educated than controls. An association was found between prostatic cancer and a history of venereal disease in their sexual partners: odds ratio (OR) = 2.71, 95% confidence interval (CI) = 1.14 to 6.46 and OR = 2.09, 95% CI = 1.02 to 4.29 for hospital and neighborhood controls, respectively. Cases had more sexual experiences with prostitutes, although their overall lifetime frequency of sexual intercourse with all partners was somewhat lower. Cases also reported more homosexual partners than controls. The results from the study lend some support to an infectious hypothesis for prostatic cancer. The lower frequency of sexual intercourse (OR = .54, 95% CI = .34 to .83 and OR = .68, 95% CI = .47 to 1.01 for hospital and neighborhood controls, respectively) is also noteworthy and may be indicative of a hormonal difference related to sexual interest or drive.

Adult↗
PubMed2006

Having the rug pulled from under your feet: one project's experience of the US policy reversal on sex work.

After the election of President George W Bush in 2000, US government policy toward sexual and reproductive health changed dramatically. In May 2003, the Global AIDS Act was passed and prohibits allocation of US government funds to organizations that 'promote or advocate' legalization and practice of prostitution and sex trafficking. There are few documented examples of early impacts of this policy reversal on USAID-funded programmes already working with sex worker communities. This paper offers an anecdotal account of one programme in Cambodia that found itself caught in the ideological cross-fire of US politics, and describes consequent negative effects on the project's ability to offer appropriate and effective HIV prevention services to vulnerable migrant sex workers.

Cambodia↗
PubMed1988

Risk factors for HIV infection in drug addicts from the northeast of Italy.

Prevalence and determinants of HIV infection were assessed in 313 parenteral drug addicts admitted to five Centers for Drug-Addict Assistance and two prisons located in the northeast of Italy (Friuli Venezia-Giulia), an area some distance from the major Italian cities first reached by the AIDS epidemic. The overall prevalence of HIV positivity was also rather high in this area, ie 30% with 24-36% confidence interval. The most important risk factors (besides syringe sharing applicable to all drug addicts), turned out to be of a geographical nature, ie living in Pordenone province (where a US military base is located) or coming from other endemic areas and having travelled long distances in the past three years. Prostitution also seemed to increase the risk of infection, but duration of drug addiction had little effect. In addition to persistent generalized lymphadenopathy (closely linked to HIV infection), reversal of helper:suppressor T-cell ratio was found in 67% of HIV positive individuals, but also in 31% of HIV negative ones. Clinical signs and symptoms strongly linked with HIV positivity were fatigue, weight loss, splenomegaly, fever and nocturnal sweats.

Adolescent↗
PubMed1993

Determinants of HIV-1 infection in intravenous drug users in Valencia, Spain, 1987-1991.

From 1987 through 1991, 2687 intravenous drug users recruited at three AIDS information centres in the Region of Valencia (Spain) were interviewed about drug use and sexual behaviour and subsequently tested for HIV-1 antibody. The overall seroprevalence was high, 50% (95% confidence interval [CI]: 41.8-51.9%). There were no differences by gender, but HIV-1 infection was related to older age and city of residence. After adjustment by means of logistic regression age (odds ratio [OR] = 1.80), sharing of injection equipment (OR = 2.16), duration of addiction (OR = 6.59) and prostitution (OR = 1.77) were significantly associated with HIV-1 prevalence. High educational level was inversely related to HIV-1 status (OR = 0.43) and a decreasing trend of prevalence with time was observed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Sharing of injection equipment among 3755 intravenous drug users in Valencia, Spain, 1987-1992.

BACKGROUND: In order to identify, in a sample of heroin intravenous drug users (IVDU), those factors associated with the predominant risk behaviour related to the transmission of HIV-1 infection--sharing of injection equipment--a cross-sectional survey was carried out in Valencia, Spain from 1987 to 1992. METHODS: Informed consent and pertinent data were obtained from 3755 heroin IVDU recruited at two public AIDS Information Centres in two cities in the region of Valencia. Data were gathered on sociodemographic variables, and sexual and drug use behaviour by interview. The subjects were subsequently tested for HIV-1 antibody. A univariate analysis was carried out to identify variables that were significantly associated with sharing injection equipment. A logistic regression model was used to control for possible confounders. RESULTS: The IVDU who were teenagers, prostitutes (OR = 1.95), who had antibodies to HIV-1 (OR = 1.30) or who had an IVDU steady partner were at significantly higher risk for sharing of injection equipment. Higher levels of education, condom use (OR = 0.65) and living in the smaller city (OR = 0.75) were inversely related to sharing injection equipment. CONCLUSIONS: Our results suggest that different subgroups of IVDU have different characteristics that place them at different risk for HIV-1 infection. These characteristics should guide the design and intensity of specific preventive interventions. Teenagers and IVDU with low educational levels should be targetted for special attention by health authorities.

Adolescent↗
PubMed1976

Social and behavioural aspects of venereal disease among resident male university students.

A study of 1500 male students at Banaras Hindu University, Varanasi, India was conducted to establish the prevalence and related social and behavioural aspects of venereal diseases. The prevalence was found to be 3.93 per cent. The majority of the students (86.4 per cent) belonged to the Hindu religion which is based on the caste system. Students from the Vaishya caste were more affected with venereal diseases. The social acceptability of having more than one wife had a definite impact on the incidence of venereal diseases. Students who practised masturbation and homosexuality were also more affected with venereal diseases. Prostitutes were the main source of infection. It was found that 28.8 per cent of these students had been infected on a previous occasion.

Adolescent↗
PubMed2004

Sexual behaviour, history of sexually transmitted diseases, and the risk of prostate cancer: a case-control study in Cuba.

BACKGROUND: The relationship between the risk of prostate cancer and sexual activity and history of sexually transmitted diseases was investigated in a case-control study conducted in Cuba aimed at assessing the effect of lifestyle and environmental factors, as well as hormonal and genetic factors, on the occurrence of this disease. METHODS: During the period 1998-2000, all men up to 84 yr old with newly diagnosed, cytologically and/or histologically confirmed prostatic cancer who were resident in Havana City were identified in nine major hospitals in the area. Controls were resident in the same city, frequency-matched by age (+/-5 years) and hospital. The study included 273 cases and 254 controls. Information was obtained through an interview. RESULTS: The risk of prostate cancer was increased among men with a history of venereal disease (odds ratio = 1.7, 95% CI = 1.1-2.5). A higher frequency of cases reported having had sex with prostitutes, although the estimate of relative risk did not reach statistical significance. Similarly, a nonsignificant positive association was found with the number of female sexual partners. A significant increased risk was observed in subjects who reported having sexual intercourse more than 7 times per week compared with those who reported a weekly frequency of 3 times or fewer (odds ratio = 2.1, 95% CI = 1.2-3.7). Moreover, a significant trend was demonstrated. CONCLUSIONS: The study supports the hypothesis that an infectious factor related to sexual behaviour could be involved in the occurrence of prostate cancer. A role for hormonal factors related to sexual activity cannot be ruled out.

Aged↗