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Hip fracture incidence in Lund, Sweden, 1966-1986.

The hip fracture incidence in the city of Lund and its rural surroundings was studied for the years 1966, 1972, 1981, and 1986. The total incidence increased from 3.3 to 5.1 per 1,000 inhabitants above 50 years of age. For persons more than 80 years old, the incidence almost doubled from 13.2 to 25.5, i.e., this group represented the entire increase in incidence. In the urban population, men with cervical fractures had an increased incidence. A smaller increase in incidence for both men and women was found in the rural area. Compared with larger cities, the incidence increase in the urban population in Lund was lower over time, but in 1986 the figures were comparable to those in Gothenburg in 1981. The total incidence in the mixed urban and rural population was as of 1981 higher than in Denmark and Finland, but lower than in Norway. If the incidence in the elderly continues to increase to 1995, there will be three times as many hip fractures as there were in 1966.

Adult↗

Sources of sexual information and sexual attitudes and behaviors of Anglo and Hispanic adolescent males.

A survey of Anglo and Hispanic adolescent males' sources of sexual information and their attitudes and practices was conducted. A comparison of attitudes and behaviors revealed little difference by ethnicity; however, a more detailed analysis of sources of information resulted in some interesting findings. The relationship between completing a sex education class and condom use was statistically significant in a positive direction. In addition, this relationship was much stronger for Hispanic youth. The important implications of this finding are discussed.

Adolescent↗

Influence of attitudes on the intention to use condoms in Quebec sexually active male adolescents.

PURPOSE: The purpose of this study was to determine the influence of attitudes and other variables on the intention to use condoms in sexually active male adolescents. METHODS: The survey was conducted from April to June 1989 on a sample of 433 sexually active boys aged 12-19 years registered in secondary schools in Laval, Quebec. RESULTS: Information on condoms provided by parents, peers, school, or media had no positive effect on male adolescents' intention to use condoms. Having a favorable attitude towards contraceptive responsibility, however, was significantly associated with the outcome variable. Endorsement of this responsibility seemed short-lived being replaced by the birth control pill in older adolescents. The study also found that in younger adolescents, intention to use condoms was significantly associated with supportive parental attitudes. CONCLUSIONS: The results of this study highlight the importance of developing strategies to encourage sexually active male adolescents to assume greater responsibility for using condoms, and suggest that in order for programs to be effective, STD and acquired immunodeficiency syndrome prevention should be done at younger ages while encouraging parents to take a greater role in sex education.

Adolescent↗

Investigation of motivational and behavioural factors influencing men who have sex with other men in public toilets (cottaging).

One-hundred-and-thirty-four individuals engaging in cottaging returned postal questionnaires. The sample was mainly urban and gay identified. Cottagers reported that cottaging was one way of meeting partners amongst a range of others they used. Most enjoyed it and felt in control of their cottaging. The majority of cottagers engaged in safer sexual activity, but there were a significant number who engaged in unsafe sexual activity last time they cottaged. Of those who had been voluntarily tested in the past and reported their serostatus, 23% were seropositive. Unsafe sexual activity was unrelated to whether tested or not, known serostatus or knowledge of the risks of transmission.

Adult↗

Inter-mediating risk factors in the relation between socioeconomic status and 25-year mortality (the Zutphen Study).

In the Zutphen Study data were collected on occupation, smoking habits, blood pressure, serum cholesterol, height and weight of 856 men who were 40-59 years old in 1960. Between 1960 and 1985 detailed information was collected on mortality. The effect of socioeconomic status as indicated by occupation on 25-year mortality was studied in relation to cigarette smoking, systolic blood pressure, serum cholesterol and Body Mass Index. It was found that socioeconomic status was an important determinant of mortality only in the men who were 40-49 years old in 1960. The risk of all-cause mortality among small business owners and manual workers was more than twice as high as that of men in the highest social class. After adjustment for the influence of cigarette smoking and systolic blood pressure these relationships remained. It can be concluded that socioeconomic status was an independent risk factor for long-term all-cause mortality, in men aged 40-49.

Adult↗

Vasectomy and cardiovascular deaths in Korean men: a community-based case-control study.

This community-based case-control study was carried out in four cities in South Korea to examine whether vasectomy is associated with a long-term increased risk of cardiovascular death in Korean men. Our results coincide with those from epidemiological studies conducted in Western countries as well as the one study conducted in China and do not support the vasectomy--atherosclerosis hypothesis originating from animal research.

Adult↗

Changes in male sexual behaviour in response to the AIDS epidemic: evidence from a cohort study in urban Tanzania.

OBJECTIVE: To examine changes in sexual behaviour among men in urban Tanzania. DESIGN: An observational cohort study among factory workers during 1991-1994. METHODS: Data from five follow-up visits with structured questionnaire-guided interviews and biomedical data were analysed to examine trends in sexual behaviour and sexually transmitted disease/HIV among 752 men. In-depth interviews were conducted to evaluate the magnitude of reporting bias. RESULTS: During the 2 years of observation, the proportion of men with more than one sexual partner during the month preceding the interview declined from 22.3 to 12.2%. The proportion of men reporting casual sex partners during the last month was almost halved: from 9.8 to 5.2%. The decline in the reporting of extramarital partners was gradual and pronounced. There were only minor changes in reported condom use, notably an increase in use with casual partners, and no changes in coital frequency. Data from in-depth interviews confirmed that reduction in sexual partners was the predominant change. CONCLUSIONS: This study documents that, in response to the AIDS epidemic, changes in male sexual behaviour are taking place in urban areas in Africa. The predominant change among these men, who are predominantly married and aged over 25 years, is a reduction of the number of sexual partners, although condom use remains low.

Acquired Immunodeficiency Syndrome↗

Detection of human immunodeficiency virus antibody among homosexual men from Bombay.

BACKGROUND AND OBJECTIVES: In India, heterosexual transmission of HIV-infection is considered to be the major mode of transmission. However, no report is available on transmission of HIV-infection among homosexually active men. The prevalence of human immunodeficiency virus-1 (HIV-1) and human immunodeficiency virus-2 (HIV-2) infections among homosexual men from Bombay is discussed. GOAL OF THE STUDY: To determine the extent of presence of anti-HIV-1, anti-HIV-2 antibodies, or both anti-HIV-1 and anti-HIV-2 antibodies among homosexual men in India. STUDY DESIGN: Sixty-three blood samples were collected from two STD clinics of Bombay over a 6-month period from men with a history of homosexual behavior who were asymptomatic for HIV-infection. The mean age of the subjects was 31.6 years. For serological detection anti-HIV-1 antibody ELISA was used as the primary screening test followed by Western blot to confirm the results. For distinction between anti-HIV-1 and anti-HIV-2 antibody, line immunoassay was used. The sexually transmitted diseases (STDs) were diagnosed clinically, although Venereal Disease Research Laboratory (VDRL) tests were carried out as a routine test for screening STDs. For detection of gonorrhea, Gram stains of urethral smear were done routinely. RESULTS: From the 63 blood samples tested, 10 samples were reactive by ELISA for HIV-1 infection, and three samples were borderline reactive. These three samples were found to be reactive for anti-HIV-2 by the line immunoassay. The above 10 samples were also positive by Western blot for anti-HIV-1 antibody. Two blood samples were positive for both anti-HIV-1 and anti-HIV-2 antibodies. Using clinical diagnosis as the criteria, the different types of STD among the 63 subjects were as follows: condylomata (22), herpes (20), gonorrhea (15), candidiasis (3), and syphilis (3). However with VDRL, seven subjects were found to be reactive. Gram stains indicated gonorrhea in all the 15 subjects. CONCLUSIONS: This study reports for the first time the homosexual transmission of both HIV-1 and HIV-2 infections in India, although heterosexual transmission still is the major mode of transmission of the infection. The associated incidence of STDs among these men and that a few of these subjects were bisexual make them at high risk for transmission of HIV infection.

Adult↗

Risk factors for sexually transmitted disease in Harare: a case-control study.

OBJECTIVE: To obtain information on risk factors and health-seeking behavior of men with sexually transmitted diseases (STDs) attending primary care clinics. STUDY DESIGN: Unmatched case-control. METHODS: Cases consisted of 256 consecutive men with genital ulcer disease (GUD) and 256 with other STDs. Control subjects (N = 256) were recruited from every third man with non-STD-related complaints. All subjects were at least 15 years of age. A structured questionnaire was administered. RESULTS: Genital ulcer disease cases reported more frequent sexual intercourse with a commercial sex worker (odds ratio [OR] = 17.4; 95% confidence intervals [CI] = 7.8-40.0) and a recent new sexual contact (OR = 6.7; CI = 3.3-14.1). Similarly, STD cases reported more frequent sexual contact with a commercial sex worker (OR = 3.4; CI = 2.0-5.6) and a recent new sexual contact (OR = 7.9; CI = 3.9-16.3). Reported condom use was less than 30% with all partner types. Of all STD cases, 80% sought treatment at the primary care clinics, with 35% delaying more than 7 days before seeking treatment. CONCLUSIONS: Culturally appropriate behavioral educational programs are advocated to reduce the risk of transmission and the period for seeking treatment for all STDs.

Adolescent↗

Behavioural risk factors for acquisition of HIV infection and knowledge about AIDS among male professional blood donors in Delhi.

In 1989-90 a study was carried out in Delhi of the risk behaviours and epidemiological characteristics exhibited by 15 paid blood donors who were positive for human immunodeficiency (HIV) virus and on 100 paid seronegative donors. All the donors were male. Compared with the seronegative donors, a significantly greater proportion of seropositive donors were unmarried, had lived in at least two cities in the previous 5 years, donated blood at least once per month, were heterosexually promiscuous, and had visited a clinic for sexually transmitted diseases. Awareness about acquired immunodeficiency syndrome (AIDS) was poor, and even those donors who had heard of AIDS were ignorant about certain important aspects. The results indicate that, based on the risk factors identified in this study, there is a need to adopt more careful selection criteria for blood donors in India.

Acquired Immunodeficiency Syndrome↗

Human immunodeficiency virus infection in the blood donors of Delhi, India.

In the present study, blood from paid and unpaid donors was screened for the presence of HIV infection using a competitive ELISA test. None of the 8,000 unpaid donors but 4 (0.23%) of the 1,700 paid donors showed evidence of HIV infection. All of these four ELISA-positive samples were confirmed by the Western blot test. The present study indicates that HIV infection has entered the group of paid donors in the Delhi metropolitan area. Careful donor screening, discouraging use of paid donors, and stringent screening of donated units of blood has become mandatory in India to prevent HIV transmission through blood and blood products.

Adult↗

Sexual networking in provincial Thailand.

Thailand is currently experiencing a major HIV epidemic, spread primarily through heterosexual contact. Patronage of prostitutes is relatively common. In-depth, open-ended interviews were conducted in a Central Thai province with a purposive sample of 181 urban men who had had sexual relations with at least two different women during the prior year. Additional qualitative information is provided by interviews with 50 women. The most common network pattern for men was a combination of commercial and noncommercial sexual relationships. Men reported that they commonly used condoms when they engaged in sex with prostitutes, but condom use was lowest for men who were the most frequent patrons. In noncommercial, nonmarital relationships, men screen partners for risk rather than practice safe sex, and condom use is generally low. Persons involved in noncommercial sexual networks are largely unaware that their partner may link them to a larger network of sexual contacts and associated risks of HIV infection. Men who have both commercial and noncommercial sexual partners can be found throughout the social strata. A program that focuses only on the closed commercial sex network will address only partially the real risk situations.

Condoms↗

Sexual behaviour and condom acceptance among Nigerian drivers.

A survey of 180 randomly selected drivers was carried out in June 1994 in Ilorin, Nigeria in order to gain information about high-risk sexual behaviours, to ascertain condom use and to identify obstacles to condom acceptance so as to facilitate the design of an intervention to prevent Sexually Transmitted Diseases/Acquired Immuno-deficiency Disease in this target population. Data was collected through face-to-face interview. Three-quarters of the respondents were married. Multiplicity of sexual partners including casual and commercial contacts, was common. Half of the respondents engaged in high-risk sexual behaviour and a high proportion of them (60 percent) reported unwillingness to use the condom. This was mainly due to general dislike and lack of knowledge of the method. Risk perception was poor. These findings support the need for male reproductive health services especially for this sub-population.

Acquired Immunodeficiency Syndrome↗

[The relation of alcohol intake to constitutional and biochemical variables in Japanese populations].

To investigate associations of alcohol intake to constitutional and biochemical variables, cross-sectional studies of men aged 40-59 years from six geographical and occupational populations with varied lifestyles were conducted in the 1990's. Systolic and diastolic blood pressures, glutamic oxaloacetic transaminase, gamma glutamyl transpeptidase, HDL-cholesterol, and uric acid were linearly associated with alcohol intake in all six populations. Drinkers of 2+ drinks (46 g ethanol or more) per day showed higher levels of triglyceride, glutamic pyruvic transaminase than never-drinkers. In two urban occupational populations, men who mainly drank beer had higher uric acid levels; men mainly drinking sake had higher blood pressures and lower serum total cholesterol; men mainly drinking whiskey had higher obesity indices. These differences in constitutional and biochemical variables related to type of alcoholic beverage consumed may be due to differences in lifestyles such as diet and physical activity.

Adult↗

Factors related to condom use with casual partners among urban African-American and Hispanic males.

Constructs from the Health Belief Model and the Theory of Reasoned Action were tested for their relationship to condom use with casual partners in a probability sample of urban African-American and Hispanic males aged 15-24. The results indicate the importance of 1) promoting a sense of male responsibility regarding condom use; 2) promoting the belief that condoms should be used with all partners; 3) developing skills for condom use and partner communication; and 4) increasing perceived susceptibility to HIV infection in design of intervention programs.

Adolescent↗

Condom use with casual partners by men in Kampala, Uganda.

OBJECTIVE: To estimate the prevalence and correlates of condom use with casual sex partners by men in urban Uganda and to identify barriers to condom use that are amenable to intervention. DESIGN: Cross-sectional, door-to-door survey of men residing in a poor area of Kampala, Uganda. SUBJECTS AND METHODS: A multistage, probability sample was approximated by recruiting participants within randomly selected neighborhoods. A total of 301 men between the ages of 18 and 45 years answered questions about condom knowledge, attitudes, beliefs and practices. The respondents also provided demographic and HIV risk-related information. RESULTS: Condom use was higher than previously found in studies in Uganda: 46% of men reported using a condom at the last casual sexual encounter; 31% reported always using condoms with casual partners. In multivariate analysis, independent correlates of condom use included higher condom self-efficacy (4-item scale, odds ratio 1.3 per scale point), lower embarrassment around condoms (3-item scale, odds ratio 0.44 per scale point), knowing where to buy a condom (odds ratio 3.9), knowing how to use a condom (8-item scale, odds ratio 1.4 per scale point), and increasing number of casual sex partners (odds ratio 1.4 per partner). CONCLUSIONS: These data suggest that condom use may be further increased in this population by conducting demonstrations of condom use skills, preparing individuals to anticipate circumstances that make using condoms difficult and using a variety of outlets to dispense condoms.

Acquired Immunodeficiency Syndrome↗

An epidemiologic study of sudden death at work in an industrial county, 1979-1982.

The descriptive epidemiology of sudden death at work was studied in an urban, industrial county. County coroner's records were used to identify the 212 deaths that occurred at work among employed white males in Allegheny County, Pennsylvania in 1979-1982. Occupations and industries with increased risks for either sudden natural deaths or fatal injuries at work were identified by comparison with the white male county employed population. Men employed in service occupations had the highest age-adjusted sudden natural death rate at work (27.0 per 100,000). This was 2.5 times as high as the overall county rate. Men employed in the construction industry had the highest age-adjusted rate of fatal injuries at work (24.3 per 100,000). This was 4.4 times as high as the overall county rate. Twenty-five per cent (17/68) of occupational fatalities involved multiple fatalities or injuries. Only 1 per cent (2/144) of natural deaths at work and 7 per cent (5/68) of fatal injuries had blood alcohol levels exceeding 0.1 mg/100 ml, the level of intoxication. Improvements in the prevention and surveillance of sudden deaths that occur at work are suggested. Coroner's records are suggested for use in future surveillance on sudden deaths at work because they identified more sudden deaths at work than death certificates did.

Accidents, Occupational↗