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MSM in HIV-prevention trials are sexual partners with each other: An ancillary study to the EXPLORE intervention.

The EXPLORE study evaluated a behavioral intervention to prevent HIV seroconversion among men who have sex with men (MSM). The present ancillary study enrolled 345 EXPLORE participants at one study site (Boston) and assessed high-risk sexual behavior with other EXPLORE participants. It also assessed sexual intentions across other EXPLORE participants, HIV-negative individuals, and unknown HIV serostatus partners. Thirty-one percent reported having sex with another EXPLORE participant: 27% unprotected receptive oral sex with ejaculation (UO), 30% unprotected insertive anal sex (UIA), and 34% reported unprotected receptive anal sex (URA). Significant relationships between intentions to engage in UO, UIA, and URA, and type of partner emerged with intentions to engage in UO, UIA, and URA higher in HIV-negative partners, other EXPLORE participants, and unknown-HIV serostatus partners. Future HIV-prevention studies recruiting MSM at increased sexual risk of HIV infection should address participants potentially becoming sexual partners with each other.

Adolescent↗

New sexual partners and readiness to seek screening for chlamydia and gonorrhoea: predictors among minority young women.

OBJECTIVES: To determine (1) level of readiness and (2) demographic and behavioural predictors of readiness to seek chlamydia (CT) and gonorrhoea (NGC) screening in the absence of symptoms after sex with a "new" partner. METHODS: Baseline data, obtained as part of a larger randomised controlled clinical trial in young women, were analysed. Readiness to seek screening for CT and NGC after sex with a "new" partner was assessed using the stages of change framework from the transtheoretical model of change-precontemplation, contemplation, preparation, and action. Ordinal logistic regression, using the proportional odds model, was used to determine predictors of being in action for or having already been screened for CT and NGC after sex with a "new" partner. RESULTS: The sample consisted of 376 predominantly African American (67%) young women (mean age 18.5 (SD 1.4) years). The distribution of readiness to seek CT and NGC screening was 4% precontemplation, 11% contemplation, 28% preparation, and 57% action. The best fitting logistic model that predicted being in action for seeking screening after sex with a "new" partner included high perceived seriousness of acquiring a sexually transmitted infection (OR = 2.02, 95% CI 1.05 to 3.89), and having "other" (not steady) partners in the last 6 months (OR = 0.50, 95% C.I. 0.32 to 0.78) CONCLUSIONS: Many young women report that they were not getting screened for CT and NGC after sex with a "new" partner and therefore may be at increased risk of an untreated STI. Enhancing level of perceived seriousness of acquiring an STI from a "new" partner may increase a young woman's readiness to seek screening after initiating a new sexual relationship.

Adolescent↗

Estimation of a preference matrix for women's choice of male sexual partner according to rate of partner change, using partner notification data.

Data from a study of partner notification for venereal chlamydial infection are used to estimate the contact preference matrix, according to sexual contact activity levels of the male partners, of young heterosexual women. A method for correcting data for the bias introduced by studying infected women only is presented. Results indicate that an overall proportional mixing model is not an adequate description of the mixing pattern.

Bias↗

Prevalence of wife rape and other intimate partner sexual coercion in a nationally representative sample of women.

This article provides a national estimate of wife rape and various other types of sexual coercion by a spouse or intimate partner. Findings from a 1997 national probability sample revealed that 34% of women were victims of some type of sexual coercion with a husband or partner in their lifetime. Of these women, 10% experienced rape by a current partner. This rate increased to 13% when only victims of rape by a current husband were included, which is consistent with previous studies on wife rape. Other findings reveal that women had unwanted sex with a current spouse or partner in return for a partner's spending money on them (24%), because they thought it was their "duty" (43%), after a romantic situation (29%), after the partner begged and pleaded with them (26%), and after their partner said things to bully them (9%). The importance of examining a continuum of sexual coercion is discussed and findings are compared and contrasted with other prevalence rates for sexual coercion in marriage.

Adolescent↗

[Chlamydia trachomatis infection in men and its association with gynecologic alterations in their sexual partners].

OBJECTIVE: To determinate the frequency of Chlamydia trachomatis infection in male partners of infertile couples who attend to the infertility clinic at Instituto Nacional de Perinatología, as well as to compare the clinical data and lifestyle between C. trachomatis-infected and uninfected men to establish a possible association with gynecological damage in their sexual female partners. METHODS: An open prospective study was performed in infertile couples, whose follow up was carried out at Instituto Nacional de Perinatología between June 2000 and April 2001. Urethral and cervical swabs were obtained from each couple and the specimens were subjected to a C. trachomatis-specific liquid-phase hybridization test (PACE-2) and routine microbiological analysis. Semen analysis were also included. A relative risk (RR) test was done to analyze variables and square chi test was used to analyze clinical and gynecological data from female partners and data from semen examination. Statistical differences were considered as significant when the p value was below 0.05. RESULTS: C. trachomatis active infection was found in 14 out of 384 urethral swabs (3.6%). No significant alterations were observed in semen samples of C. trachomatis-infected men, as compared to non-infected individuals. Microbiological analyses of semen showed a significant isolation of Mycoplasma sp (RR = 5.87, IC95% 1.4-24.7). Eight out of fourteen female partners of C. trachomatis-infected men were also infected with C. trachomatis (RR = 10.57, IC95% 5.67-19.7), Candida albicans was other pathogen isolated from 8/14 of those women (RR = 1.89, IC95% 1.17-3.05). Gynecological and obstetrical associations found among female partners of C. trachomatis-infected men were as follows: tubal adhesions in 10/14 (RR = 1.54, IC95% 1.08-2.18), salpingitis in 2/14 (RR = 2.2), history of ectopic pregnancies in 11/14 (RR = 2.94, IC95% 1.01-8.53) and abnormal pregnancy loss in 9/14 (RR = 1.5). CONCLUSION: A low prevalence of C. trachomatis infection was observed among male partners of infertile couples as compared with other reports, but this discrepancy could be attributable to the specimen collection and diagnostic assay used. Otherwise, this data suggests that a chronic pathogen's antigenic stimulation may result in an increased formation of tubal adhesions and/or in ectopic pregnancies among female partners of C. trachomatis-infected individuals. Thus, preventive and control measures must be introduced into men's healthcare services, through laboratory and clinical examination, since these subjects are the main reservoirs of C. trachomatis.

Abortion, Spontaneous↗

Use of the ligase chain reaction on urine of men and their female sexual partners for detection of genital Chlamydia trachomatis infection.

OBJECTIVE: The purpose of the present study was to evaluate an in vitro DNA amplification assay named the ligase chain reaction (LCR) for the detection of Chlamydia trachomatis cryptic plasmid DNA in urine from men and women, in comparison with urethral swab culture in men and cervical swab culture in women. METHODS: 591 patients (394 men with urethritis and 197 female sex partners) attending a center for sexually transmitted diseases in northern Italy between January 1994 and January 1995 were enrolled in this study. A cervical swab was collected from women and a urethral swab from men for standard tissue cell culture. From each patient 20 mL of the first stream of the urine (FVU), taken at least 2 h after the last urination, were collected for LCR analysis. Discrepant results were further analyzed by direct fluorescence and a LCR with alternative primers. RESULTS: In men the prevalence of C. trachomatis infection by urethral culture was 13.45% and, after resolution of discordant results, the LCR method performed on FVU showed a sensitivity, specificity, positive predictive value and negative predictive value of 89.4%, 100%, 100% and 98.2%, respectively; the sensitivity of tissue cell culture was 92.8%. In female sex partners, the prevalence of C. trachomatis infection by cervical culture was 3.04%; LCR detected eight true positive samples, two more than tissue cell culture, and no false-negative results. CONCLUSION: LCR analysis of FVU is a rapid, non-invasive technique and represents a good alternative to tissue cell culture. Further study is needed to investigate possible LCR inhibitors present in urine samples.

Journal Article↗

An assessment of sites where persons go to meet sexual partners in St. James, Jamaica, using the PLACE method.

OBJECTIVE: The objective of this study was to assess sexual behavior of persons at risk of HIV infection. GOAL: The goal of this study was to identify sites where HIV prevention is needed. STUDY DESIGN: Customers at sites where persons meet new sex partners in St. James, Jamaica, were surveyed. RESULTS: Of 421 sites, 282 men and 200 women (random sample, 23 sites) and 320 men and 265 women (special sample, 26 sites) were interviewed. Over one fourth of men and 14% (special) and 4% (random) of women had one or more new sex partners in the last 4 weeks. Seventy-eight percent of men reported condom use at last sex with a new partner compared with 66% of women. Approximately 50% of respondents reported condom use at last sex with a regular partner. CONCLUSION: Sites at which people meet new sex partners were diverse with significant opportunities for prevention. Commercial and transactional sex are features at many sites.

Adult↗

Gene-environment contributions to young adult sexual partnering.

To date, there has been relatively little work on gene-environment contributions to human sexuality, especially molecular analyses examining the potential contributions of specific polymorphisms in conjunction with life experiences. Using Wave III data from 717 heterozygous young adult sibling pairs included in the National Longitudinal Study of Adolescent Health, this article examined the combined contributions of attendance at religious services and three genetic polymorphisms (in the dopamine D4 receptor [DRD4]), dopamine D2 receptor [DRD2]), and the serotonin transporter promoter [5HTT]) to sensation seeking, a personality construct related to sexual behavior, and the number of vaginal sex partners participants had in the year before interview. Data analyses used an Allison mixed model approach to account for population stratification and correlated observations. DRD4 was unrelated to sensation seeking and to the number of sex partners in tests of both main effects and in interaction with religious attendance. Contrary to hypothesis, presence of the A1 DRD2 allele was associated with having had fewer sex partners in the past year. Associations between the 5HTT allele and sex partners varied by religious attendance, but again the patterns of associations were contrary to hypothesized relationships and were small in magnitude. These findings underscore the necessity of using more comprehensive multiple gene-multiple life experience approaches to investigations of complex behaviors such as sexual patterns.

Adult↗