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PubMedDate not supplied

Human immunodeficiency virus-related risk behavior among Italian psychiatric inpatients.

This study evaluated at-risk behavior for human immunodeficiency virus (HIV) infection among Italian psychiatric inpatients. One hundred patients with mental disorders consecutively admitted to an acute psychiatric unit over a 1-year period were studied using a self-report questionnaire. In these patients, 53.1% reported sex with multiple partners, 35.4% with occasional partners, 57% with prostitutes, and 6.7% with intravenous (i.v.) drug users (i.v.DUs). Forty-three percent never used condoms during sexual intercourse, 23% used drugs intravenously, and 20% shared needles. Only one third of the patients were tested for HIV, and two tested seropositive ([HIV+] prevalence, 5.8%). Most patients (62%) reported no concern about the risk of HIV infection. The rate of HIV risk behaviors was higher among psychiatric patients versus a control group of 90 healthy people. These findings indicate an alarming rate of HIV risk behaviors among Italian psychiatric inpatients and the need for closer attention to HIV assessment and education in mental health settings.

Adolescent↗

PubMed2003

Determinants of contraceptive method among young women at risk for unintended pregnancy and sexually transmitted infections.

The objective of this study was to examine the relationship between contraceptive method choice, sexual risk and various demographic and social factors. Data were collected on 378, 15- to 24-year-old women, recruited from health clinics and through community outreach in Northern California. Logistic regression analysis was used to estimate the association of predictors with contraceptive method used at last sex. Asian and Latina women were less likely to use any method. Women who were raised with a religion, or thought they were infertile, were also less likely to use any method. Women with multiple partners were generally less likely to use any method, but were more likely to use barrier methods when they did use one. Few women (7%) were dual method users. Women appear to act in a rational fashion within their own social context and may use no methods at all or use methods that are less effective for pregnancy prevention but offer more protection from sexually transmitted infections.

Adolescent↗

PubMed2000

Prevalence and risk factors for hepatitis C virus (HCV) infection among pregnant Brazilian women.

OBJECTIVES: To determine the prevalence and the risk factors associated with HCV infection among women at childbirth, and to assess potential for infectivity of anti-HCV-positive women. METHODS: A total of 6995 women were interviewed and screened for HCV antibodies. Association and logistic regression analyses were conducted. RESULTS: The anti-HCV prevalence was 1.5% by EIA-3 and 0.8% by RIBA-3; HCV-RNA (RT-PCR) was detected in 74% of the RIBA-positive samples. Blood transfusion, race (blacks), alcohol abuse, a history of STD and anti-HBc positivity were independent risk factors for HCV positivity. Except for parenteral exposure, independent predictors of anti-HCV were a history of STD, anti-HBc positivity, a sex partner with multiple sex partners and a sex partner with a history of hepatitis. CONCLUSIONS: The prevalence of anti-HCV is higher in pregnant women than in blood donors. Sexual exposure may facilitate the spread of HCV and there is a high potential for mother-to-infant transmission.

Adult↗

PubMed1998

Atomic structure of clathrin: a beta propeller terminal domain joins an alpha zigzag linker.

Clathrin triskelions form the lattice that organizes recruitment of proteins to coated pits and helps drive vesiculation of the lipid bilayer. We report the crystal structure at 2.6 A resolution of a 55 kDa N-terminal fragment from the 190 kDa clathrin heavy chain. The structure comprises the globular "terminal domain" and the linker that joins it to the end of a triskelion leg. The terminal domain is a seven-blade beta propeller, a structure well adapted to interaction with multiple partners, such as the AP-1 and AP-2 sorting adaptor complexes and the nonvisual arrestins. The linker is an alpha-helical zigzag emanating from the propeller domain. We propose that this simple motif may extend into the rest of the clathrin leg.

Amino Acid Sequence↗

PubMed1999

Counselling patients with hepatitis C.

Hepatitis C virus (HCV) is usually but not exclusively transmitted by the parenteral route. Some precautions are recommended for infected patients as well as his/her close contacts and family members. The risk of sexual transmission and from household contacts is very low. Use of condoms is only recommended in cases of multiple partners and for those at high risk of transmission. Some personal objects should not be shared, i.e. razors, toothbrushes and nail clippers, but it is not necessary to avoid sharing eating utensils. Sexual partners may be tested for anti-HCV HCV-positive individuals should refrain from donating blood, organs and tissue. Clear and evidenced-based information should be provided to patients as to the means of prevention with special attention to individual risk groups such as IV drug abusers. The risk of HCV transmission after needlestick injury, although low, justifies universal precaution measurements for health-care workers. Nosocomial transmission has been described after medical procedures, especially haemodialysis and endoscopy. Thus, disinfection procedures as well as universal precautions are essential for all health-care workers. It is also important for HCV patients to inform health-care workers beforehand about their HCV status. Perinatal transmission is rare and is usually related to the degree of maternal viral load. Pregnancy is not contra-indicated in HCV. infected individuals and breast-feeding is allowed. Finally, HCV patients with active disease should be advised to refrain from alcohol intake, especially during antiviral therapy. After HCV infection it is necessary to consider not only diagnostic and therapeutic steps but also the risk of transmission in the patient's circle and consequences for the patient.

Counseling↗

PubMed1998

Why the Scandinavian countries have not implemented universal vaccination against hepatitis B.

Within the 50 member states of the WHO European region, HBsAg carriage rates vary from a high of approximately 20% to a low of 0.05%. The Scandinavian countries have the lowest carriage rates in the region (0.05%). The situation in Sweden is representative of the situation throughout Scandinavia: although a substantial number of immigrants to Sweden are HBsAg-positive, acute cases of hepatitis B continue to be seen mainly in drug addicts and their contacts and to a certain extent, in male homosexuals with multiple partners. Public health officials and governments in Scandinavia are unwilling to introduce universal vaccination of infants because hepatitis B infection is viewed as a limited public health problem that does not justify the expense and other efforts of universal immunization.

Acute Disease↗

PubMed2002

Multi-male mating, probability of conception, and litter size in the prairie vole (Microtus ochrogaster).

We conducted a mating experiment in the laboratory using prairie voles, Microtus ochrogaster, to document that multi-male mating (MMM) can occur in this supposedly monogamous species and to test two hypotheses for the advantages of MMM in female mammals. The two hypotheses are that MMM (1) increases the probability of pregnancy and (2) increases litter size. We also tested the hypothesis that multiple copulations, rather than multiple partners, increases litter size and/or probability of pregnancy. Females were given a choice of mating with any of three males, each of which was tethered in a separate compartment. The mate choice bouts were recorded on videotape. We recorded the number of copulations and number of males with which females mated over a 24 h period. Litter size and probability of pregnancy were not significantly different for females that mated with one, two or three males. Increasing numbers of copulations, independent from the number of males, also did not increase litter size but did significantly increase the probability of pregnancy. MMM, at least in prairie voles, must serve some function other than increasing litter size and probability of conception.

Journal Article↗

PubMed2006

HIV sexual risk behaviors among injection drug users in Shanghai.

PURPOSE: This study investigated the sexual risk behaviors among injection drug users. (IDUs) in order to inform the development of sexual risk reduction interventions for IDUs. METHODS: A cross-sectional survey of IDUs (n=141) was conducted in an in-patient detoxification treatment center in Shanghai, China, to collect information on demographics; drug use history; sexual risk behavior; HIV/AIDS knowledge, attitudes, and other psychosocial variables; and HIV, HBV, and HCV seroprevalence. Factors associated with HIV sexual risk behaviors and HBV and/or HCV infection were analyzed. RESULTS: Sexual risk behaviors among IDUs were common: the majority (77%) of the participants had not used a condon consistently in the previous 3 months, 25.5% had multiple partners, 48.2% had IDU partners, and 75.9% did not know their partner's HIV status. IDUs who were married (OR=4.83, p<0.05) or did not intent to use condoms in the future (OR=0.21, p<0.05) were more likely to have unprotected sex. The prevalence of HBV and HCV infection was 31.9% and 51.8%, respectively, but no one tested positive for HIV.IDUs with an injection history of 3 years or more (OR=5.86, p<0.05) and with an overdose history (OR=3.21, p<0.05) were more likely to be infected with HBV and/or HCV. CONCLUSIONS: Sexual risk behaviors among IDUs in Shanghai are common, and many IDUs are vulnerable for transmission of disease. Prevention efforts with IDUs should address sexual risk behaviors in addition to needle-sharing behaviors.

Adult↗

PubMedDate not supplied

Methadone maintenance and other factors associated with intraindividual temporal trends in injection-drug use.

The objective of this study was to determine what sociodemographic, lifestyle, or drug-related characteristics predict temporal changes in self reported drug injection frequencies among HIV-seronegative injection-drug users (IDUs) who were being given HIV testing and risk reduction counseling. The 277 subjects were given 4-11 quarterly interviews including detailed history of drug use and other HIV risk factors, HIV risk reduction counseling, and venipuncture for HIV antibody testing. A regression slope of change over time in drug injection frequency was calculated for each subject, and categories were created of decreasing temporal slope, increasing slope, relapse (decrease initially, then increase), or no substantial change. Only 44% of subjects decreased their drug injection frequencies despite repetitive HIV testing and counseling. In multivariate logistic analyses, decreasing temporal trends were associated with consistent enrollment in methadone maintenance (p < .1), whereas increasing trends conversely were associated with inconsistent enrollment (p < .01) and also with an absence of crack use (p < .01). Relapses were significantly associated with needle sharing with multiple partners and a low frequency of smoking. The data suggest that methadone maintenance facilitates a positive response to HIV risk reduction counseling. However, the fact that only a minority of subjects displayed a decreasing temporal trend in drug injection frequencies emphasizes the need for improved therapeutic and counseling techniques.

Adult↗

PubMedDate not supplied

The lives of incarcerated women: violence, substance abuse, and at risk for HIV.

High rates of human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs) are seen in women prisoners. These high rates may be related to the nature of their lives, which may include violence, substance abuse, promiscuity, prostitution, and exchange of sex for drugs--all of which increase their risk for acquiring HIV. The purpose of this study was to examine the HIV-related risk behaviors and protective practices of women prisoners in a rural southern state and factors related to these behaviors. The sample included 57 women incarcerated in a medium-to-maximum security prison. Key findings included high rates of substance abuse, extensive past and current violent experiences including sexual abuse, high percentage of multiple partners, and low use of condoms. Additionally, women in this sample did not perceive themselves to be at risk for HIV infection. Practical suggestions for reducing the HIV risks of incarcerated women are offered.

Adolescent↗

PubMedDate not supplied

Knowledge, self-efficacy, coping, and condom use among urban women.

In this study, path analysis was used to test a model of the relationships among condom use knowledge, self-efficacy for condom use, coping, and condom use in a sample of 100 urban women. In the final model, the paths between condom use knowledge and self-efficacy, between self-efficacy and condom use, and between self-efficacy and problem-focused coping were significant. In addition, condom use knowledge was indirectly related to condom use through self-efficacy. The final model accounted for 43% of the variance in condom use. Although the women engaged in risky behaviors including having multiple partners, high-risk sexual partners, and unprotected intercourse, they did not worry about or perceive themselves at risk for HIV. To assist women to decrease their risk for sexually transmitted HIV infection, clinicians should conduct individualized assessments of each client's sexual behaviors to identify women at risk. Individualized interventions are recommended to increase both knowledge of how to use condoms and self-efficacy for condom use among women at risk for HIV.

Adaptation, Psychological↗

PubMed2000

Monitoring std prevalence and reproductive health care among high-risk adolescent women

Background: Urban adolescent women, particularly those in socially disadvantaged situations are at high risk for infections with Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (GC) and their sequelae. Non-invasive screening technologies, including ligase chain reaction (LCR) and polymerase chain reaction (PCR) urine tests for CT and GC allow for provision of screening services in settings frequented by high-risk adolescents where such services have not been traditionally provided. In 1999, the CDC lead a multi-site project monitoring STD prevalence and reproductive health service, collecting a standard set of variables in women <20 yrs in juvenile justice system, drug treatment centers, and school-based clinics. This report provides preliminary data from Alabama and Colorado. Methods: Adolescent women who present for intake/services at selected facilities are enrolled in the project. In collaboration with CDC, sites developed a set of standard variables to be collected, including demographics, risk behaviors, symptoms, test performed, and test results. Dependent on services already performed, sites added CT and/or GC urine PCR/LCR and pregnancy testing to existing screening protocols.Results: In first 3-months, 533 adolescent women were enrolled in this on-going study; 379 in juvenile institutions, 38 in drug treatment centers, and 116 in school-based clinics. Mean age was 16 yrs, over 90% were sexually experienced, nearly 50% did not use condom with the last sex, less than 40% reported "current" birth control use, over 2/3 had sexual intercourse in past 3 months, many with multiple partners. Prevalence rates for CT and GC are summarized in the table. Conclusions: Non-invasive (urine) LCR/PCR tests allow for easy monitoring of selected STDs among adolescent women in high-risk settings. These findings may contribute to a sentinel surveillance system among high-risk populations and, in turn, may provide the rationale for the development of health care/intervention priorities at policy level.

Journal Article↗

PubMed1990

[The medical interview motivated by the discovery of markers of viral hepatitis permits the identification, in blood donors, of behavior at risk for HIV infection].

From December 1988 to September 1989, 973 blood donors, deferred for anti-HBc reactivity, Ag-HBs positivity, elevated ALT, isolated or associated, but negative for anti-HIV, were interviewed in our blood center in the weeks after donation. Among these 973 donors, 53 (5.4%, 46 males, 7 females) were found at risk for HIV infection: intravenous drug abuse: 24 cases; heterosexuality with multiple partners: 17 cases; homosexuality: 8 cases; sexual relations with persons at risk: 4 cases. These 53 donors did not recognize their risk behaviour during the medical talk before donation. 25 out of these 53 donors were seen afterwards and one of them, homosexual man, seroconverted for anti-HIV seven months after the anti HIV negative but anti-HBc positive blood donation. We conclude that, in our experience, director surrogate viral hepatitis markers help to identify donors at risk for HIV infection, and, in one case, earlier in the course of demonstrated HIV infection than the enzyme immunoassays currently licensed.

Alanine Transaminase↗

PubMed2006

ICAPS: a multilevel program to improve physical activity in adolescents.

OBJECTIVES: ICAPS (Intervention Centred on Adolescents' Physical activity and Sedentary behaviour) is aimed at preventing excessive weight gain and cardiovascular risk in adolescents by promoting physical activity (PA) with an emphasis on recreational and daily-life PA, with a lifelong perspective. DESIGN: Randomized study designed to last for four years. Study cohort constituted of 954 first-level students (91% of eligible pupils), aged 11.7 +/- 0.6 y (mean +/- SD) from four pairs of schools randomly selected in eastern France, after sociogeographical stratification. In each pair, intervention status was randomised at school-level. The program, not limited to school settings, involves multiple partners with three objectives: 1) changing attitudes through debates and access to attractive activities during breaks and after-school hours, 2) encouraging social support, 3) providing environmental conditions that enable PA. Adapted times and places, open participation, emphasis on fun, meeting with others and absence of competitive aspects are used to reduce usual barriers to PA. Accessibility and safety are permanent concerns. RESULTS: Prevalence of overweight was 23.7%. High participation rates were attained (50% participated in at least one weekly activity). At six-month, the proportion of intervention adolescents not performing supervised PA out of academic PA was reduced by half (36% to 17% vs 42% to 42% in controls P < 10-4); the proportion of those spending > 3 h/day in sedentary occupations decreased (34% to 28% vs 27% to 36%; P < 10-4). CONCLUSION: These data demonstrate the feasibility of implementing a multilevel PA intervention program in adolescents. Six-month results document increased PA and decreased sedentary behaviour.

Adolescent↗

PubMed2003

Cloning, expression and characterization of the murine Efemp1, a gene mutated in Doyne-Honeycomb retinal dystrophy.

Development of the bone and cartilage structures is one of the best-studied systems for epithelial-mesenchymal interaction as well as proliferation and differentiation. In a screen for genes differentially expressed in mice deficient for transcription factor AP-2alpha, we have identified a gene which, based on its homology to the human EFEMP-1 gene was designated Efemp1. It encodes for six repeats similar to the domain of the epidermal growth factor. Sequence comparison with EFEMP1 genes of human and rat revealed that the three proteins share a high amino acid identity (92%), suggesting a conserved function during vertebrate development. However, there is no EFEMP1ortholog annotated in sequence databases of other non-mammalian species indicating that it might have evolved in higher vertebrates only. Analysis of the murine genomic locus revealed that the gene is encoded by 11 exons, which are spread over 80 kb of distance on murine chromosome 11A4. The multidomain protein structure may indicate that Efemp1 protein interacts with extracellular matrix components and serves to connect and integrate the function of multiple partner molecules. The gene is expressed in the embryo proper starting from day 9.5 to day 18.5 of murine development. In situ analyses showed that Efemp1 is found in condensing mesenchyme, giving rise to bone and cartilage as well as in developing bone structures of the cranial and the axial skeleton. These results will help in further defining the role of Efemp1 during murine embryogenesis.

Amino Acid Sequence↗

PubMed1999

HIV-risk behaviour and knowledge about HIV/AIDS among patients with schizophrenia.

BACKGROUND: Recent literature has demonstrated that psychiatric patients, particularly those with a diagnosis of schizophrenia, may be at high risk for HIV infection. In fact, HIV-risk behaviour, such as intravenous drug with sharing needles, promiscuity associated with unprotected sex and high-risk sexual activity after using drugs has been reported by a substantial proportion of mentally ill patients. METHODS: In order to examine this problem in Italy, HIV-risk taking behaviour and knowledge about HIV/AIDS was investigated among 91 schizophrenic patients by using two self-report questionnaires (HIV-Risk Behaviour Questionnaire; AIDS-Risk Behaviour Knowledge Test). RESULTS: One-third of the patients reported having been tested for HIV infection and one tested seropositive (prevalence 3.4%). A high proportion of patients reported HIV-risk behaviour, such as injected drugs use (22.4%) and engaging in high risk sexual activity (e.g. multiple partners, 58%; prostitutes, 45%; occasional partners, 37%). Condoms were 'never used' by 41% of the patients and 'almost never used' by another 25%. In spite of these behaviours, 65% reported no concern of HIV infection. Knowledge about AIDS was lower among psychiatric patients than a healthy control group. Patients with long-lasting illness and numerous psychiatric admissions were less acknowledgeable about HIV infection. Certain misconceptions on HIV transmission were related to HIV risk behaviour. CONCLUSIONS: These results indicate the urgent need for HIV educational programmes within mental health community-care settings.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Methods for estimating HIV prevalence: A comparison of extrapolation from surveys on infection rate and risk behaviour with back-calculation for the Netherlands.

OBJECTIVES: To compare HIV prevalence estimates (total number infected) by using extrapolation from surveys on infection rate and risk behaviour (EIR) in specific segments of the population and back-calculation (BC) on reported AIDS cases. To discuss potential sources of bias and error, and to identify areas for improvement of the methodology. DESIGN: Systematic comparison and epidemiological assessment of data input, underlying assumptions, and output. METHODS: Low, possibly unbiased and high estimates of HIV prevalence as of January 1996 for homo/bisexual men, injecting drug users. heterosexual men and women with multiple partners, and blood transfusion recipients and haemophiliacs were derived from surveys and continuous data collections on HIV infection rate and risk behaviour in the Netherlands between 1992 and 1996. These were compared with estimates (point and 95 % CI) by empirical Bayesian BC on AIDS cases 1982-1995. RESULTS AND CONCLUSIONS: The estimate of HIV prevalence by EIR was 13,806 with low and high estimates of 9619 and 17,700, respectively. The HIV prevalence estimate by BC was 8812 (95% CI: 7759-9867). The available data from EIR are too limited for accurate estimates of HIV prevalence. EIR estimates could be improved considerably with more precise data on prevalence of risk behaviours and HIV prevalence rate for homosexual men. More confidence can be put in the BC estimates, but these could be underestimates because of the age effect on incubation time, pre-AIDS treatment and relapse of risk behaviour. BC estimates could be improved by a better representation of the incubation time distribution (including the effect of age there-upon), better data on the effectiveness and uptake of pre-AIDS antiretroviral treatment and prophylaxis of opportunistic infections, and on the level of underreporting.

Adult↗

PubMed1998

Ethnic differences in sexual decisions and sexual behavior.

Previous investigators have reported ethnic differences in the expression of sexual decision making and sexual behaviors in women. In a sample of women of low socioeconomic status between ages 18 and 45, we examined the influence of ethnicity and other variables (age, education, marital status, and comfort in discussing sex) on (i) who makes decisions on the timing and type of sex, (ii) whether a woman engages in vaginal, oral, and anal sex, (iii) the frequencies of each type of sex, and (iv) whether or not a woman has multiple partners. Multivariate analyses showed that, independent of other independent variables, ethnicity had little direct effect on most variables. The notable exception was that ethnicity influenced joint decision making regarding the timing and type of sexual activities for Hispanic but not for African American women. We conclude that ethnicity contributes to differences in sexual behaviors but that other variables are equally important.

Adult↗