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PubMed2005

The influence of partner type and risk status on the sexual behavior of young men who have sex with men living with HIV/AIDS.

OBJECTIVES: The influence of partner type and risk status on the unprotected sexual behavior of young men living with HIV (YMLH) who have sex with men is examined. METHODS: Sexual behavior and sexual partner characteristics of 217 YMLH recruited from adolescent care clinics in 4 AIDS epicenters (Los Angeles, San Francisco, New York, and Miami) were assessed. YMLH were categorized by sexual behavior pattern, and sexual partners were classified by type and risk status. Generalized linear modeling employing overdispersed Poisson distribution was used to analyze the effect of partner type and partner risk status on unprotected sex acts. RESULTS: Most YMLH (62%) reported multiple partners, 26% reported 1 sexual partner, and 12% reported abstinence in the past 3 months. Approximately 34% of polygamous and 28% of monogamous youth engaged in unprotected sex. Monogamous youth were most likely to have unprotected sex with HIV-positive partners. Polygamous youth were most likely to have unprotected sex with HIV-positive partners, irrespective of whether the partner was regular or casual. For polygamous YMLH, unprotected sex did not differ among single-time/new partners with different risk levels. CONCLUSIONS: Partner characteristics influence the condom use behavior of YMLH. YMLH make decisions regarding condom use based on perception of their partner's risk. Preventive interventions must include skills for acquiring accurate information about partner risk status and education regarding the health risks of unprotected sex with HIV seroconcordant partners.

Adolescent↗

PubMed1995

Sex without emotional involvement: an evolutionary interpretation of sex differences.

Two samples of male (n = 243) and female (n = 298) college students completed sexual surveys, and in-depth, oral interviews were conducted with 28 highly sexually active female college students. Findings supported five predictions derived from evolutionary (parental-investment) theory. Even when females voluntarily engaged in low-investment copulation, coitus typically caused them to feel emotionally vulnerable, and to have thoughts expressing anxiety about partners' willingness to invest. For females, increasing numbers of partners correlated positively with the incidence of these feelings and thoughts; for males, these correlations were negative. Females' attempts to continue regular coitus when they desired more investment than partners were willing to give produced feelings of distress, degradation, and exploitation despite acceptance of liberal sexual morality. Increasing numbers of partners did not mitigate these reactions in females and may exacerbate them. Multiple-partner females developed techniques for dealing with their emotional reactions to low-investment copulation: They frequently tested their partners for signs of ability and willingness to invest (e.g., dominance, prowess, jealousy, nurturance), and they limited or terminated sexual relations when they perceived partners' investment as inadequate. Results were consistent with the view that the emotional-motivational mechanisms that mediate sexual arousal and attraction are sexually dimorphic.

Adolescent↗

PubMed1997

Adolescent heterosexual experience: a new typology.

PURPOSE: The purpose of this paper is to define a typology that encompasses the full range of adolescent heterosexual behavior; to compare the usefulness of the new typology with that of the traditional dichotomy of "sexually active"/"sexually inactive" for understanding sexual behavior among adolescents; and to determine the implications of the new typology for the design and implementation of HIV prevention programs targeting adolescents. METHODS: Detailed face-to-face interviews were conducted with a cross-sectional sample of 907 mothers and their adolescents, ages 14-17 years, recruited from public high schools in Alabama, New York, and Puerto Rico. Information from the adolescent survey on precoital sexual behaviors and STD/HIV sexual risk and risk reduction behaviors was examined. A typology of adolescent heterosexual experiences was constructed using four behavioral dimensions. RESULTS: Ninety-nine percent (n = 894) of the sample was classified into one of the five patterns of sexual experience: Delayers, Anticipators, One-timers, Steadies, and Multiples. Among the participants who were not sexually active, precoital behaviors differed significantly between the 22% who anticipated initiating sexual intercourse in the next year (Anticipators) and those who did not (Delayers). Among those traditionally classified as "sexually active", One-timers and Steadies were significantly older when they first had penile-vaginal intercourse than those who had multiple partners. One-timers were more likely to use condoms than Steadies or Multiples, and only Multiples reported previous STDs. CONCLUSION: A typology that defines a range of adolescent heterosexual experiences was developed, and it was possible to classify 99% of our sample. The traditional dichotomy between "sexually active" vs. "not active" hides important behavioral intentions and sexual practices. These differences must be taken into account in the development and implementation of HIV prevention programs that target adolescents.

Adolescent↗

PubMedDate not supplied

A Bayesian model for assessing the frequency of multiple mating in nature.

Many breeding systems have multiple mating, in which males or females mate with multiple partners. With the advent of molecular markers, it is now possible to detect multiple mating in nature. However, no model yet exists to effectively assess the frequency of multiple mating (f(mm))--the proportion of broods with at least two males (or females) genetically contributing--from limited genetic data. We present a single-sex model based on Bayes' rule that incorporates the numbers of loci, alleles, offspring, and genetic parents. Two genetic criteria for calculating f(mm) are considered: the proportion of broods with three or more paternal (or maternal) alleles at any one locus and the total number of haplotypes observed in each brood. The former criterion provides the most precise estimates of f(mm). The model enables the calculation of confidence intervals and allows mutations (or typing errors) to be incorporated into the calculation. Failure to account for mutations can result in overestimates of f(mm). The model can also utilize other biological data, such as behavioral observations during mating, thereby increasing the accuracy of the calculation as compared to previous models. For example, when two sires contribute equally to multiply mated broods, only three loci with five equally common alleles are required to provide estimates of f(mm) with high precision. We demonstrate the model with an example addressing the frequency of multiple paternity in small versus large clutches of the endangered Kemp's Ridley sea turtle (Lepidochelys kempi) and show that females that lay large clutches are more likely to have multiply mated.

Animals↗

PubMed1993

The sexual behavior of US adults: results from a national survey.

OBJECTIVES: One consequence of the acquired immunodeficiency syndrome (AIDS) epidemic has been to highlight the need for population-based estimates of the number of individuals engaging in sexual behaviors that place them at risk for human immunodeficiency virus (HIV) infection. This paper describes the prevalence of various sexual behaviors in a nationally representative sample of adults in the United States. METHODS: Data were collected as part of a household probability survey of adults (n = 2058) in the United States. Data collected on sexual behavior included sexual orientation, frequency of intercourse, condom use, and number of sexual partners. RESULTS: Nearly all respondents were sexually experienced. Of those who were currently sexually active, 13% (1% of married respondents) had had sex with more than one partner in the previous year. Of those reporting having intercourse with more than one partner in the previous year, 7% used condoms consistently and 23% used condoms consistently with their casual partners. CONCLUSIONS: A significant proportion of individuals were found to have intercourse with multiple partners without using condoms. A minority of these respondents acknowledged that their behavior may place them at risk for HIV transmission.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Gender power imbalance on women's capacity to negotiate self-protection against HIV/AIDS in Botswana and South Africa.

BACKGROUND: Gender power imbalance, which translates into a power imbalance in sexual interactions, is increasingly being recognized as a factor in fueling the spread of HIV/AIDS by increasing the number of unsafe sexual encounters. OBJECTIVES: To examine the influence of gender power imbalance and other factors on women's capacity to negotiate self protection against HIV infection; as well as men's response to the suggested condom use. METHODS: Drawing on data gathered from 2658 women aged 18-49 years in a cross-sectional survey in Kwa Zulu Natal Province of South Africa and Botswana, the study used descriptive statistics and logistic regression to reveal a number of gender related factors that significantly affect women's ability to protect themselves against HIV infection. RESULTS: Gender power imbalance significantly affects women's ability to suggest condom use to their partners. The study showed that it is women with partners 10 or more years older than them, abused women, and those economically dependent on their partners who are less likely to suggest condom use to their partners. Gender power imbalance also influences men's inclination towards refusing to use the suggested condom. The study showed that men are more likely to refuse to use the condom when the age difference between them and their female partners is wide, if they are in a married relationship, and where there is no communication about HIV/AIDS between them and their partners. What is more disturbing is the finding that it is men with multiple partners who are significantly more likely to refuse to use the condom. CONCLUSION: Across all levels of society, there is a need to see a social paradigm shift that transforms relationships between women and men, from the one of inequality and dominance as is the case in patriarchal societies, to equality, respect and consideration for one another.

Adolescent↗

PubMed2003

Microgravity research results and experiences from the NASA/MIR space station program.

The Microgravity Research Program (MRP) participated aggressively in Phase 1 of the International Space Station Program using the Russian Mir Space Station. The Mir Station offered an otherwise unavailable opportunity to explore the advantages and challenges of long duration microgravity space research. Payloads with both National Aeronautics and Space Agency (NASA) and commercial backing were included as well as cooperative research with the Canadian Space Agency (CSA). From this experience, much was learned about long-duration on-orbit science utilization and developing new working relationships with our Russian partner to promote efficient planning, operations, and integration to solve complexities associated with a multiple partner program. This paper focuses on the microgravity research conducted onboard the Mir space station. It includes the Program preparation and planning necessary to support this type of cross increment research experience; the payloads which were flown; and summaries of significant microgravity science findings.

Acceleration↗

PubMed2001

Variation in health and risk behavior among youth living with HIV.

Lifetime and current health practices and risk behaviors were examined among 350 youth living with HIV (YLH) aged 14-23 years from four AIDS epicenters (72.6% male; 26.2% African American, 36.9% Latino). YLH were relatively healthy (M CD4 cells = 499), had used substantial health care and were satisfied with the care. YLH's sexual and substance-use histories indicated substantial HIV related risk acts: the median number of lifetime partners was 25 with only 8% using condoms consistently; 14.9% had injected drugs, and 61.2% had used hard drugs. Compared with females, males had more lifetime and recent sexual partners and had used more drugs. Youth who were recently sexually active (81.3%) had multiple partners. Most of the sexually active YLH used condoms consistently (81.6%). YLH who were symptomatic or had an AIDS diagnosis were likely to have recently had more seropositive sexual partners than the asymptomatic youth. Youth disclosed their serostatus to about half of their sexual partners (53.9%). YLH with AIDS used fewer hard drugs than those without an AIDS diagnosis. Health and risk behaviors of the YLH varied significantly based on their disease stage, gender, and ethnicity, suggesting the need for tailoring interventions for subgroups of YLH.

Adolescent↗

PubMedDate not supplied

Condom use with regular and casual partners among women attending family planning clinics.

A survey of 16,632 women attending family planning clinics in Pennsylvania found that only 13 percent of the sample used condoms. Moreover, 67 percent of the women with regular partners never used condoms with those partners, and 72 percent of women who had casual partners never used them with those partners. Levels of condom use with both regular and casual partners were higher among women younger than 20, those who were nonwhite, those with multiple partners and those who reported a previous STD infection. However, women who had sex partners who used intravenous drugs were less likely to use condoms with regular or casual partners than were women who did not have drug-using partners.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Relationship status and testosterone in North American heterosexual and non-heterosexual men and women: cross-sectional and longitudinal data.

Previous research has found that single heterosexual (Het) men have higher salivary testosterone (T) concentrations than partnered Het men. Here, we used both longitudinal and cross-sectional analyses to examine a more diverse population (n = 258) that included Het and non-heterosexual (Non-Het) women and men. Results showed that, for Het men (but not Het women) and Non-Het women (but not Non-Het men), baseline T was significantly lower in partnered than unpartnered individuals. Longitudinal analyses indicated that changes in partnered status were not associated with changes in testosterone concentrations; instead, women and men with lower T at baseline were significantly more likely to be partnered at follow-up. These findings thus suggest that partnered status is associated with stable, trait-level T values, rather than current state. Furthermore, the observed effect is limited to individuals (male or female) who are oriented toward female partners. The results are discussed in terms of evolutionary trade-offs between single and multiple partners, and the possibility of female choice and/or disinterest.

Adult↗

PubMed1995

Factors associated with Hispanic women's HIV-related communication and condom use with male partners.

To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.

Acculturation↗

PubMedDate not supplied

Multiple sexual-partner behavior among sexually active US adolescent girls.

OBJECTIVE: To examine the relationship of multiple sexual-partners to other risk behaviors among adolescent girls. METHODS: Ninth- through 12th-grade sexually active girls (N=3288) who completed the 1999 national Youth Risk Behavior Survey were participants. Multivariate logistic regression was used to examine all significant independent relationships. RESULTS: Having one recent sexual-partner was associated with lack of condom use and being in 12th grade whereas having 2 or more partners was associated with fighting, cigarette use, binge drinking, and African American ethnicity. CONCLUSIONS: A small but important subset of adolescent girls report having recent multiple sexual-partners. These girls are more likely to report other problem-prone health behaviors.

Adolescent↗

PubMed1999

Heterosexual transmission of hepatitis C in Italy.

Data from a surveillance system for type-specific acute viral hepatitis in Italy has been used to evaluate the risk of heterosexual transmission of hepatitis C virus (HCV) associated with sexual activity with multiple partners in subjects > or = 15 years of age. Hepatitis A cases were used as controls. During the period 1991-1996, 1,359 acute hepatitis C and 4,365 hepatitis A cases were recorded among subjects > or = 15 years of age. Intravenous drug use was the most frequent source of infection (35.9%) reported by HCV cases; two or more sexual partners during the 6 months before disease onset accounted for 34.9% of hepatitis C cases. Adjusting by multiple logistic regression analysis for the confounding effect of all risk factors considered (blood transfusion, intravenous drug use, surgical intervention, dental therapy, other parenteral exposure), and for age, sex, area of residence, and educational level of subjects, showed that having two or more sexual partners is an independent predictor of the likelihood of hepatitis C (OR=2.2; 95% CI=1.7-2.7). After excluding intravenous drug users and patients transfused with blood from analysis, the increase in the adjusted OR for the association between HCV and the number of sexual partners correlated with the increase in the number of sexual partners. The risk of hepatitis C was 2.0 times higher (95% CI=1.4-2.9) for subjects with two sexual partners and 2.8 times higher (95% CI=2.1-3.8) for subjects with three or more sexual partners, as compared to subjects with less than two sexual partners. These findings suggest that heterosexual transmission may play an important role in the spread of hepatitis C in Italy.

Adolescent↗

PubMed2004

Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania.

In population-based surveys on sexual behaviour, men consistently report higher numbers of sexual partners than women, which may be associated with male exaggeration or female under-reporting or with issues related to sampling, such as exclusion of female sex workers. This paper presents an analysis of data collected in the context of a longitudinal study in rural Tanzania, where a sexual partnership module was applied to all participating men and women in the study population. Since the study design included all men and women of reproductive ages and did not involve sampling, these data provide a unique opportunity to compare the consistency of aggregate measures of sexual behaviour between men and women living in the same villages. The analysis shows that non-marital partnerships were common amongst single people of both sexes--around 70% of unmarried men and women report at least one sexual partner in the last year. However, 40% of married men also report having non-marital partners, but only 3% of married women did so. Single women reported about half as many multiple partnerships in the last year as men. Under-reporting of non-marital partnerships was much more common among single women than among married women and men. Furthermore, women were more likely to report longer duration partnerships and partnership with urban men or more educated men than with others. If a woman reports multiple partners, biological data indicate that she is at high risk of contracting HIV. For men, however, there is only a weak association between number of partnerships and the risk of HIV, and it cannot be excluded that men, especially single men, exaggerate the number of sexual partners.

Adolescent↗

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↗

PubMed1995

HIV risk behavior among homeless adults.

Very little information is available regarding HIV risk behavior among homeless adults despite increasing evidence that HIV infection disproportionately affects inner-city residents and disadvantaged populations. In the present study, adults (N = 94) entering a storefront medical clinic for the homeless completed an AIDS risk survey. The results suggest that homeless adults are engaging in sexual and substance-use behaviors that place them at high risk for HIV infection. Sixty-nine percent of the present sample was at risk for HIV infection from either 1) unprotected intercourse with multiple partners, 2) intravenous drug use (IVDU), 3) sex with an IVDU partner, or 4) exchanging unprotected sex for money or drugs. Many persons within the sample evidenced multiple risk factors: 45% reported at least two of the risk factors described above and 26% reported three or more risk factors. The results suggest there is an urgent need to develop and evaluate AIDS-prevention strategies for homeless adults.

Adolescent↗

PubMed2004

Prevention of gonorrhea and Chlamydia through behavioral intervention: results of a two-year controlled randomized trial in minority women.

BACKGROUND: Sexually transmitted disease (STD), including AIDS, disproportionately affects African-American and Hispanic women. GOAL: To evaluate efficacy of standard and enhanced (addition of optional support groups) gender- and culture-specific, small-group behavioral interventions, compared to interactive STD counseling, in high risk minority women for two years. METHODS: Women with a non-viral STD were treated and enrolled in a randomized trial. Follow-up screens and interviews occurred at 6 months, 1 year, 18 months (short interview, optional exam) and 2 years. The primary outcome was subsequent infection with chlamydia and/or gonorrhea. Secondary outcomes included risky sexual behaviors. We employed logistic regression based on intention-to-treat. RESULTS: Data from 775 women were included; the retention rate was 91%. Adjusted infection rates were higher in the controls in Year 1 (26.8%), Year 2 (23.1%), and cumulatively (39.8%) than in the enhanced (15.4%, P = 0.004; 14.8%, P < 0.03; 23.7%, P < 0.001, respectively) and standard (15.7%, P = 0.006; 14.7%, P = 0.03; 26.2%, P < 0.008, respectively) intervention arms at these time points. Enhanced-intervention women who opted to attend support groups (attendees) had the lowest adjusted infection rates in Year 1 (12.0%) and cumulatively (21.8%). Intervention women in general, but particularly attendees, were significantly less likely than controls to have repeat infections. Multiple partners and unprotected sex with an untreated or incompletely treated partner helped explain group differences in infection. CONCLUSIONS: Risk-reduction interventions significantly decreased both single and multiple infective episodes with chlamydia and/or gonorrhea and risky sexual behaviors in the two-year study period. Support-group attendance appeared to contribute additional risk reduction in Year 1.

Adult↗

PubMed2005

[Sexual transmission of hepatitis C virus].

Hepatitis C virus (HCV) is usually transmitted parenterally, but sexual transmission is considered likely in the 20% of cases with no other risk factors. Retrospective cohort studies conducted among persons who have never injected drugs show that factors predictive of HCV seropositivity include the number of lifetime sexual partners, high-risk sexual practices, other sexually transmitted infections, and HIV seropositivity. Persons in long-term monogamous heterosexual relationships with a partner seropositive for HCV are at lower risk of HCV acquisition (0 to 0.6% peryear) than persons with multiple partners or those at risk for sexually transmitted diseases (0.4 to 1.8% per year). HCV RNA is detectable in genital fluids, but there is not yet any proof that the HCV RNA in genital secretions represents infectious virus. HCV can be transmitted by sexual intercourse but much less efficiently than other sexually transmitted viruses, such as HBV and HIV. Sexual transmission of HCV may be enhanced by other concomitant sexually transmitted infections with genital erosive lesions or via traumatic sexual intercourse with abrasion of the genital mucosa.

Adolescent↗