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PubMed1990

The prevalence of high-risk sexual behavior in male intravenous drug users with steady female partners.

A sample of 149 (70 White, 79 Black) male intravenous drug users with steady female sexual partners was interviewed in 1987, in treatment and street settings, about sexual practices during the previous five years. Eighty-three percent had multiple partners, 15 percent reported male sexual contact, 38 percent reported heterosexual anal intercourse, and 73 percent never used condoms. Thirty-seven White and 30 Black subjects reported bisexuality or heterosexual and intercourse or both.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Identifying the psychosocial correlates of condom use by female sex workers in Hong Kong.

This study examined factors affecting condom use by Hong Kong female sex workers when they have sex with their clients and steady partners. Our respondents consisted of 109 active female sex workers, mainly streetwalkers or sex workers who worked in villas. During a 30-minute interview, respondents were interviewed individually and were asked questions regarding their condom use practice. These questions were designed to measure various factors affecting their condom use practice, including attitudes toward condom use, normative pressure, perceived behavioural control, perceived AIDS risks, past condom use behaviour, and future condom use intentions with respect to the two types of partners. Multiple regression analyses reveal that perceived behavioural control is the most important factor associated with these respondents' future condom use across the two types of partners. Perceived AIDS risk is the additional predictor for condom use with clients, while normative pressure is the additional predictor for condom use with steady partners. Past condom use behaviour also provided significant additional prediction for both types of partners, implying the habitual nature of condom use among our respondents. These results have significant implications for designing intervention programmes targeting at increasing condom use by female sex workers in Hong Kong.

Acquired Immunodeficiency Syndrome↗

PubMed2005

An emerging HIV risk environment: a preliminary epidemiological profile of an MSM POZ Party in New York City.

OBJECTIVE: To develop a preliminary epidemiological description of a men who have sex with men (MSM) "POZ Party," an emerging sex environment for HIV+ MSM. METHODS: As part of a pilot study in New York City in 2003, data were collected using a brief, behavioural intercept survey at entry to POZ Party events. Domains include demographic characteristics, history of HIV infection, motivations for attending POZ parties, lifetime and recent exposure to drugs (including use during POZ Party events), and recent sexual practices (both within both POZ Party venues as well as in non-POZ Party venues). RESULTS: Predominantly white and over the age of 30, subjects in the sample include a broad range of years living with HIV infection. Motivations for using a POZ Party venue for sexual partnering include relief from burdens for serostatus disclosure, an interest in not infecting others, and opportunities for unprotected sexual exchange. High rates of unprotected sex with multiple partners are prevalent in the venue. Although the sample evidences high rates of lifetime exposure to illicit drugs, relatively little drug use was reported in these sexual environments. These reports are consistent with evidence from direct observation at the venues themselves, in which no drug use was apparent. CONCLUSION: Serosorting among HIV+ MSM may reduce new HIV infections, a stated interest of both POZ Party organisers and participants alike. However, high rates of unprotected anal intercourse within these venues signal continued risk for STIs. Additionally, unprotected sexual contact with HIV partners and status unknown partners outside POZ Party venues heightens concern for diffusion of HIV superinfection.

Adult↗

PubMed2000

Condom acceptance is higher among travelers in Uganda.

OBJECTIVE: To examine the role played by mobile residents in the spread of HIV through rural Uganda. DESIGN: Travel history and sexual network data were collected from a random sample of 1627 residents aged 15-49 years in Rakai District, Uganda during 1994. METHODS: Travelers and non-travelers are compared with respect to socio-demographic attributes, risk exposure, knowledge, attitudes and use of condoms using descriptive statistics and multivariate logistic regression. A demographic profile of travelers' partners is developed using information from a local network survey module. RESULTS: The population is highly mobile, with over 70% reporting travel to a potentially higher risk destination in the past year. Travelers are somewhat more likely to have higher levels of sexual risk behavior, but the risk appears to be offset by significantly greater knowledge, acceptance, and use of condoms. In multivariate analysis, the sexual risk differential for travelers is explained by occupational exposure and higher socio-economic status. The differential in condom acceptance, by contrast, appears to be associated with travel itself. Condom use with non-spousal partners is three times higher among travelers than non-travelers (P< 0.001), and travel remains a significant predictor after controlling for age, education, residence, occupation and multiple partners. Travelers are more likely to use condoms with both their local and non-local partners. Partners of male travelers are likely to be younger and better educated than those of male non-travelers. CONCLUSIONS: The mobile population in this rural region appears willing to adopt risk reduction measures appropriate to their exposure. This suggests that targeting condom promotion programs to travelers and their partners is likely to be effective in reducing the spatial diffusion of HIV, and may be an efficient method for spreading behavioral change into rural areas.

Adolescent↗

PubMed2003

Proliferating cell nuclear antigen (PCNA): a dancer with many partners.

Proliferating cell nuclear antigen (PCNA) was originally characterised as a DNA sliding clamp for replicative DNA polymerases and as an essential component of the eukaryotic chromosomal DNA replisome. Subsequent studies, however, have revealed its striking ability to interact with multiple partners, which are involved in several metabolic pathways, including Okazaki fragment processing, DNA repair, translesion DNA synthesis, DNA methylation, chromatin remodeling and cell cycle regulation. PCNA in mammalian cells thus appears to play a key role in controlling several reactions through the coordination and organisation of different partners. Two major questions have emerged: how do these proteins access PCNA in a coordinated manner, and how does PCNA temporally and spatially organise their functions? Structural and biochemical studies are starting to provide a first glimpse of how both tasks can be achieved.

Animals↗

PubMed1990

Incidence of Kaposi's sarcoma in a cohort of homosexual men infected with the human immunodeficiency virus type 1. The Multicenter AIDS Cohort Study Group.

Longitudinal data on 2,125 participants in the Multicenter AIDS Cohort Study (MACS) with documented antibodies to the human immunodeficiency virus type 1 (HIV-1) were used to examine the incidence of acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) over time and to determine if sexual practices and hematologic variables prior to diagnosis differed for participants who develop KS vs. non-KS AIDS (NKS). In the first 4 years of the study, 84 seropositive men were observed to develop KS and 307 presented with an AIDS diagnosis other than KS. A systematic trend in the incidence of KS over time was not apparent in this population. The number of anal-receptive intercourse partners prior to diagnosis declined in a similar fashion for both AIDS groups. Although the number of partners with whom the men performed rimming decreased prior to diagnosis for both AIDS groups, a greater proportion of the KS AIDS group had performed this activity with multiple partners than had the non-KS AIDS group. Furthermore, history of oral gonorrhea was significantly (p = 0.027) more prevalent in the KS group. In addition, the KS AIDS group had lower cytomegalovirus antibody levels prior to diagnosis and higher levels of total immunoglobulin G. The groups did not differ with respect to baseline hematological measures, temporal trends in helper and suppressor T cells, or hepatitis B surface antigen or antibody. Given this profile of factors associated with the occurrence of KS, an infectious agent, in addition to HIV-1, is plausible as a proposed cofactor in the development of KS.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Sexually transmitted diseases in adolescents: update 1991.

Clinicians caring for sexually active adolescents are likely to be called on to diagnose and treat many of the STDs discussed in this article. A variety of other STDs not covered here also may be observed, including lymphogranuloma venereum, granuloma inguinale, molluscum contagiosum, scabies, pediculosis, and hepatitis A, B, and C. Some of the special issues related to gay and lesbian youth are discussed in the article by Drs Bidwell and Deisher (see "Adolescent Sexuality: Current Issues," pp 293-302). Nonetheless, it should be mentioned that the same STDs occur in homosexual youths as in their heterosexual counterparts. However, the prevalence rates for many STDs differ between the two groups, and some STDs are rarely seen in heterosexual males. These discrepancies may be explained by a number of determinants including anatomic and physiologic factors (eg, lesbian women have lower rates of STDs), differences in sexual practices (eg, genital-anal and oral-anal contact), and numbers of sexual partners, although this last factor may be less important in adolescents as compared with adult gay men. Discovery of one STD should always prompt a search for others because multiple concurrent infections is the rule rather than the exception. A serologic test for syphilis and a discussion of the potential for HIV infection (possibly testing for HIV as well) should take place at each new encounter for an STD. Some patients, including those with multiple partners, have an increased chance for acquisition of an STD. However, the reality is that any adolescent who has had sexual intercourse could have an STD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

Crack, crack house sex, and HIV risk.

Limited attention has been focused on HIV risk behaviors of crack smokers and their sex partners, yet there is evidence that the crack house and the crack-using life-style may be playing significant roles in the transmission of HIV and other sexually transmitted diseases. The purposes of this research were to study the attributes and patterns of "sex for crack" exchanges, particularly those that occurred in crack houses, and to assess their potential impact on the spread of HIV. Structured interviews were conducted with 17 men and 35 women in Miami, Florida, who were regular users of crack and who had exchanged sex for crack (or for money to buy crack) during the past 30 days. In addition, participant observation was conducted in 8 Miami crack houses. Interview and observational data suggest that individuals who exchange sex for crack do so with considerable frequency, and through a variety of sexual activities. Systematic data indicated that almost a third of the men and 89% of the women had had 100 or more sex partners during the 30-day period prior to study recruitment. Not only were sexual activities anonymous, extremely frequent, varied, uninhibited (often undertaken in public areas of crack houses), and with multiple partners but, in addition, condoms were not used during the majority of contacts. Of the 37 subjects who were tested for HIV and received their test results 31% of the men and 21% of the women were HIV seropositive.

Adult↗

PubMed1991

The effect of variable infectivity on the risk of HIV infection.

This paper analyses the risk that an individual contracts the AIDS virus in terms of the number of sexual contacts and the number of different partners. It considers the effect of the variability of susceptibility and infectiousness on the evaluation of this risk. In particular, it shows why this variability leads to a greater risk from multiple partners than previously thought.

HIV Infections↗

PubMed2004

HIV, STIs, and sexual behaviors among men who have sex with men in Phnom Penh, Cambodia.

A probability sample of 206 men who have sex with men from 16 sites in Phnom Penh were surveyed about sexual behaviors and tested for HIV and sexually transmitted infections (STIs). HIV and syphilis prevalence was 14.4% and 5.5%, respectively. Out of the total sample, 81% reported anal sex with any male partners in the past 6 months, and 61.2% reported having had vaginal sex. In the past 6 months, 82.8% of the sample reported having male partners who paid them to have sex. Self-reported sexual orientation did not match well with self-reported sexual behavior. Significant risk factors for HIV infection were anal sex with multiple partners, unprotected vaginal sex with commercial female partners in the past month, and any STI. Complex sexual networks indicate that men who have sex with men act as a bridge between higher and lower HIV prevalence populations. Better prevention efforts structured around behaviors rather than sexual identities are needed.

Adult↗

PubMed1985

[Prevention of genito-anal and bucco-laryngo-esophageal cancers caused by sexually transmitted viruses].

Whilst some viruses of the Papilloma family cause warts on the skin, others infect mucosal cells. The types called 6 and 11 produce benign papillomas, called condylomata acuminata, visible to the naked eye, not only on the vulva, vagina, penis (cockscomb), but also in the anus, and occasionally the larynx, mouth (tongue) and oesophagus. Types 16 and 18 cause cervical cancer (generally called in situ) and especially very small flat lesions that can only be seen through the colposcope in women and a lens in men. These flat micro-lesions can also be found on the vulva, vaginal walls and on the glans and, balano-preputial area and shaft in males, the distal urethra, anus, larynx (especially the vocal cords), the mouth and oesophagus. These flat micro-lesions are either early cancers (here the deoxyribonucleic acid (DNA) of the virus 16 and/or 18 is integrated into the cell genome), or precancerous lesion in which case the viral DNA is not integrated. Their malignant transformation is much more frequent at the junction of the glandular and squamous parts of the cervix, than in the vulva or vagina. Co-carcinogenic factors appear to have an important role in the malignant transformation;--as for instance sexually transmissible infections including chlamydiae, bacteria that produce carcinogens such as nitrosamines, herpes virus which is known to cause mutations predisposing to the integration of the Papova viruses, chemical substances applied to the genitalia. The role of low hygiene standards in male sexual partners is the major cause (such men can carry simultaneously several sexually transmissible diseases (STD], who are never examined in search for flat lesions, who do not seek medical advice and have multiple sexual contacts with many women among whom some are more dangerous than prostitutes, especially since the wide use of hormone contraceptives and abortion that has multiplied the incidence of cervical cancer by 3 among the 20 year-old females, by 4 among the 25 year-old ones and by 2.5 among the 30 year-old ones, between 1961-65 and 1982-83. These changes in contraception have now made intra-vaginal ejaculation the rule (this not only carries viruses and other micro-organisms into the female genital tract, but also deposits sperm that contains some thirty factors that suppress local immunity). This with the rise of multiple partners, early sexual activity in particular in girls (hardly post-puberty) explains the increase of the frequency of cervical cancer in younger and younger women.(ABSTRACT TRUNCATED AT 400 WORDS)

Anus Neoplasms↗

PubMed2005

HIV risk behavior among adults with severe mental illness: a systematic review.

Adults with severe mental illness (SMI) have been disproportionately affected by the HIV/AIDS epidemic. This systematic review of the empirical literature on SMI documents the prevalence and correlates of HIV risk behaviors, discusses clinical implications for HIV prevention, and recommends directions for future research. Prevalence rates of HIV risk behaviors were estimated using weighted means, and findings on correlates were synthesized. Across reviewed studies (N=52), the majority of adults with SMI were sexually active, and many engaged in risk behaviors associated with HIV transmission (e.g., unprotected intercourse, multiple partners, injection drug use). HIV risk behaviors were correlated with factors from the following domains: psychiatric illness, substance use, childhood abuse, cognitive-behavioral factors, and social relationships. A proposed model illustrates the multiple pathways linking these domains to HIV risk behavior. Further research using improved methodologies (e.g., longitudinal designs, standardized measures, multivariate analyses) is needed to examine the broader social context in which HIV risk behavior occurs and identify underlying processes. HIV prevention efforts targeting adults with SMI must occur on multiple levels (e.g., individual, group, community, structural/policy), address several domains of influence (e.g., psychiatric illness, trauma history, social relationships), and be integrated into existing services (e.g., psychotherapy, substance abuse treatment, housing programs).

Adult↗

PubMed2007

Paternal indirect genetic effects on offspring viability and the benefits of polyandry.

Although females are expected to maximize their reproductive success with only one or a few matings, the females of many species mate with multiple partners. Experimental studies have found evidence for an increase in egg or embryo viability when females mate polyandrously. These studies have been interpreted in the context of genetic-benefit models that propose that multiple mating increases offspring viability because it allows females to select male genotypes that influence viability directly or because it allows females to avoid genetic incompatibility. However, no studies have examined directly the precise mechanisms by which parents influence embryo viability. Using a morphological marker that enabled us to determine paternity and survival of embryos sired by individual male crickets in both sperm-competitive and -noncompetitive situations, we show that males inducing high embryo viability enhance the viability of embryos sired by inferior males. These results indicate that paternal effects and interacting phenotypes determine embryo viability. They show that a male's reproductive success is modified by the interaction between indirect genetic effects of sperm competitors. Importantly, our findings show that the benefits accruing to offspring of multiply mated females need not be transmitted genetically.

Animals↗

PubMed2004

Condom use in multi-partnered males: importance of HIV and hepatitis B status.

The objective of the research was to determine the demographic, sexual and social risk factors associated with condom use in 7,089 multi-partnered men attending the Sydney Sexual Health Centre. A review of computerized medical records from 1991 to 1999 was carried out. Males with two or more partners in the last three months were divided into three condom use groups: consistent, sometimes and never. Men reporting sex with men (MSM) were more likely to use condoms than men having sex with only women (p=0.001). HIV positive men were more likely to use condoms consistently than those who were negative (p=0.001). In HIV negative non-hepatitis-B carriers, factors independently associated with inconsistent condom use included alcohol consumption, intravenous drug use (odds ratio (OR) 0.6 (95% confidence interval (CI) 0.47-0.77)) and being married (OR 0.2 (95% CI 0.21-0.31)). Factors associated with consistent condom use were MSM (OR 1.8 (95% CI 1.26-2.49)) and having three or more partners in the last 3 months (OR 2.4 (95% CI 2.023-2.83)). In the 508 hepatitis B carriers, consistent condom users were less likely to be married or intravenous drug users (OR 0.4 (95% CI 0.23-0.85)). In the 200 HIV antibody positive men, those with three or more partners were less likely to be consistent condom users than those with two (OR 0.3 (95% CI 0.11-0.82)). The conclusions are that a small number of HIV positive men report unsafe sex with multiple partners. Health promotion activities should be directed at this group.

Adolescent↗

PubMed1999

HIV prevalence, sexual risk behaviour and sexual mixing patterns among migrants in Amsterdam, The Netherlands.

OBJECTIVE: To study (1) HIV prevalence; (2) sexual risk behaviour; (3) sexual mixing patterns; (4) determinants of disassortative (between-group) mixing among migrant groups in Amsterdam, the Netherlands and to gain insight into the potential for heterosexual spread of HIV/sexually transmitted diseases. DESIGN: Cross-sectional study among 1660 Surinamese, Antilleans and sub-Saharan Africans, mainly recruited on the streets. METHODS: Saliva was tested for HIV and questions were asked about sociodemographic characteristics, sexual behaviour and the ethnicity of sexual partners. Multivariate logistic regression analysis was used to find predictors for disassortative mixing. RESULTS: HIV prevalence was 1.1% (95% confidence interval: 0.6-1.7). Compared with the Dutch population in general, our study group reported having multiple partners, concurrent partnerships and a history of sexually transmitted diseases much more frequently. Sex in the country of origin during a visit occurred frequently and there was a considerable degree of sexual mixing between different ethnic groups in the Netherlands. For men, disassortative mixing was associated with hard drug use, recent immigration, a high number of partners, being from Nigerian or Hindu-Surinamese origin, a recent sexually transmitted disease and, for steady relationships, consistent condom use. For women, determinants included: hard drug use, low income, being a-religious and, for Antillean and Ghanaian women, consistent condom use. CONCLUSION: Our data suggest a potential for heterosexual spread of sexually transmitted diseases within and between ethnic groups in the Netherlands. The potential for HIV spread is however limited by the low HIV prevalence at present among these groups. This situation may change when HIV prevalence increases in the countries of origin, as bridges exist between those countries and the Netherlands. Culturally appropriate AIDS prevention programmes remain important for these groups.

Adolescent↗

PubMed2002

Cancer risks in women who had children with different partners from the Swedish Family-Cancer Database.

We used the nationwide Swedish Family-Cancer Database to analyse cancer risks in women who have had children with different men. Cancer cases were retrieved from the Swedish Cancer Registry for 1961-1998. A total of 3 million women and 316 497 cancer cases were covered. For women having children with more than one partner, an increased risk was shown for upper aerodigestive tract, anal, liver, pancreatic, lung, cervical, other female genital, kidney and urinary bladder cancers. A decreased risk was observed for breast and endometrial cancer, and melanoma. In women who had at least three or more children with three or more partners, the increased risks were even more pronounced for pancreatic, lung and cervical cancer. Conversely, the risk for breast and endometrial cancer, and melanoma was decreased. The present results indicated that women who had children with multiple partners showed an excess of smoking-related and sexually transmitted cancers. The decreased risks for breast and endometrial cancer and for melanoma were possibly related to lifestyle factors connected with economic deprivation. The magnitude of the effects was so large that failure to consider the number of partners may introduce bias.

Databases, Factual↗

PubMedDate not supplied

The relationship of substance use to sexual activity among young adults in the United States.

Data on substance use and sexual activity from a nationally representative, probability-based sample of young adults aged 18-30 in 1990 indicate that 86% of respondents had had sex in the previous 12 months, with three-fourths reporting no more than one sexual partner. Seventy-five percent of respondents had consumed alcohol in the past 12 months, 40% had smoked cigarettes and 20% had used marijuana. After adjustment for demographic factors, both sexual activity and a history of multiple partners were positively associated with some measures of substance use. Respondents who drank more frequently, those who were heavy drinkers, those who smoked cigarettes and those who used marijuana in the past year were more likely than others to be sexually active. Those who consumed five or more drinks at a sitting and those who used marijuana were more likely than others to have had more than one sexual partner. Heavy drinkers were also less likely to use condoms; however, the results showed no association between having sex under the influence of alcohol and engaging in unsafe sexual practices.

Adolescent↗

PubMed1993

Anthropology and AIDS: the cultural context of sexual risk behavior among urban Baganda women in Kampala, Uganda.

One hundred and thirty Baganda women (65 HIV antibody positive and 65 HIV antibody negative), recruited from the Makerere University-Case Western Reserve University Collaborative Pediatric follow-up clinic in Kampala, Uganda were interviewed about cultural rules and norms for sexual behavior and HIV-specific risk behaviors. Interviews were analyzed for themes related to sexual risk, cultural rules regarding sex, and individual sexual practices. Statistical relationships were tested using chi 2 and t-test statistics. The mean age of the women was 21 years (range 15-30). Despite sexual norms prohibiting sex for women outside marriage, subjects reported that there are certain circumstances when a woman may take other partners, including economic need, desire for greater sexual satisfaction, or revenge on a husband with other partners. Cases were more likely to state that women may have outside partners for economic reasons (P < 0.05) and that women have outside partners for sexual satisfaction (P < 0.01). Women interviewed for this study are complying with Ugandan AIDS control messages to 'zerograze' and 'stick to one partner'. Fear of AIDS remains high, however, because women fear that their partners have not responded to risk reduction messages. Of those women stating fear of AIDS, 57% of cases and 62% of controls based their fear on their perceptions of their partners' activities. Therefore, women feel that they remain at risk of infection despite their own behavior change. We find that, while the potential for risk reduction is high for these women, cultural norms permitting males to have multiple partners limit a woman's ability to control her risk reduction. Important conclusions are: (1) a focus on women's behavior alone is not sufficient as both partners must respond to risk reduction messages; (2) knowledge about AIDS is not sufficient to achieve change in sexual behavior because sexual behavior is linked to economics, gender relations, and other complex socio-cultural factors; and (3) a study of Baganda male sexual values and behavior is urgently needed.

Acquired Immunodeficiency Syndrome↗