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PubMed1994

The risk of HIV infection in a national sample of women with injection drug-using partners.

OBJECTIVES: This study reports on a large, national cohort of women with injection drug-using sex partners. Information is provided on demographic characteristics; human immunodeficiency virus (HIV) risk factors, including unprotected sex and incidence of sexually transmitted diseases; use of noninjected drugs; HIV serostatus; and other selected health variables. METHODS: A sample of 5162 heterosexual women was recruited for a national acquired immunodeficiency syndrome (AIDS) research and demonstration project. A structured interview was administered, and the women had the option of undergoing HIV testing. Statistical analyses compared three groups on variables of interest: women with single sex partners, women with multiple partners, and women with multiple partners who exchanged sex for drugs and/or money. RESULTS: These groups differed significantly on virtually all of the demographic and risk variables examined. Women with multiple partners who exchanged sex for drugs and/or money were at higher risk for HIV than women in the other groups, even when selected demographic variables were controlled. CONCLUSIONS: Research is needed on the efficacy of prevention efforts involving these diverse groups of women at risk for AIDS.

Adult↗

PubMedDate not supplied

Data from the National AIDS Behavioral Surveys. II. Multiple sexual partners among Hispanics in high-risk cities.

Data from a random sample of 4,658 heterosexual Hispanics from 23 high-risk cities in the 1990-1991 National AIDS Behavioral Surveys reveal that 11% of Hispanics have had multiple partners in the past year-17% of men and 4% of women. The study shows a higher proportion of multiple sexual partners in the past year among Hispanic men who are unmarried (31%), Cuban (28%), aged 18-29 (25%), better educated (21%), of lower income (23%) and highly acculturated (20%). Among Hispanic women, marital status, age, Hispanic subgroup and level of acculturation are significant predictors of having multiple partners. Among highly acculturated Hispanic men, income, Hispanic subgroup and marital status are significant predictors of having multiple partners; among less acculturated Hispanic men, marital status is the only significant predictor. Only 20% of Hispanics with multiple partners report using a condom regularly with their primary partner, and 29% report regular condom use with their secondary partner. Among men, condom use tends to decrease as the number of partners increases.

Acculturation↗

PubMed1978

Cancer of the cervix--a sexually transmitted disease. Cytologic screening in a prostitute population.

The epidemiology of cervical cancer has been the subject of many articles centered around the question, "Is cancer of the cervix a sexually transmitted disease? A group of 750 Taiwan prostitutes had cervical cytology performed at the time of required gonorrhea screening. The prostitutes represented a unique group in which the variables of frequent intercourse with multiple partners and multiple infection can be separated from early coital experience. Cervical cytology was obtained and processed by the Pathology Department at Navy Medical Research Unit No. 2. A bilingual questionnaire was completed with the aid of a medical interpreter. The results included only eight of the 750 specimens in the "dysplasia plus" category for a rate of 10.7 per 1,000. The low yield of abnormal cytology suggests the factors of multiple partners, frequent intercourse, and high gonorrhea infection rate are not significant epidemiologically if they occur after the phase of active metaplasia, occurring during the first pregnancy or early adolescence.

Adolescent↗

PubMed1994

Regional distribution and incidence of human papillomavirus infections among heterosexual men and women with multiple sexual partners: a prospective study.

OBJECTIVE: To assess prevalence, incidence and potential risk factors of human papillomavirus (HPV) infection among heterosexual men and women with multiple partners and to identify niches of HPV-infection. DESIGN: A prospective study of heterosexual men and women with multiple partners attending an STD clinic as participants in a study on HIV from May 1988 until January 1991. Routine STD examination and physical examination using colposcopy were performed, interviews with standardised questionnaires were administered. Specimens for HPV DNA detection by polymerase chain reaction were collected from multiple sites of the genital, anorectal and oral regions. In women cervical cytology was performed. SETTING: The STD Clinic of the Municipal Health Service of Amsterdam. PARTICIPANTS: 162 women and 85 men entered the study, 110 women and 48 men were followed up. RESULTS: At entry of the study 37 (23%) women and 24 (28%) men were found positive for HPV DNA at any site. Only in one woman was oral presence of HPV DNA found during follow-up. Abnormal cervical cytology was observed in four women. In multivariate analysis, diagnosis of condylomata [odds ratio (OR) 5.61, 95% confidence interval (CI) 1.86 to 16.90)], reporting genital dermatological abnormalities (OR 3.72, 95% CI 1.38 to 9.99) and age (OR per year 0.93, 95% CI 0.88 to 0.99) predicted independently the presence of HPV DNA in women at entry of the study. In women 59 of the 99 (60%) HPV infections were observed in the genital region and 40% in the anorectal region: in men these figures were 65% and 35%, respectively. The incidence of HPV infection was 47.1 and 50.5 per 100 person-years for women and men respectively. At least 20/99 (20%) infections in women were intermediate or long persistent and only 3/48 (6%) HPV infections in men (P = 0.03). No risk factor for persistency could be determined, either in women or in men. CONCLUSIONS: HPV infection was found to be a multicentric genital and/or anorectal event both in women and men. The oral presence of HPV DNA was detected only once in one of the participants. In women persistent HPV infection was more common than in men. Independent predictors for presence of HPV DNA in women were diagnosis of condylomata acuminata, reporting genital dermatologic abnormalities and age. Incidence of HPV infection in women turned out to be 47.1 infections per 100 person-years and for men 50.5 per 100 person-years.

Adult↗

PubMed1996

Determinants of multiple sexual partners and condom use among sexually active Tanzanians.

This paper is based on the analyses of data collected in the Tanzania Demographic and Health Survey (TDHS). The TDHS national sample was obtained by using 1988 population census list of enumeration areas. Information about sexual behaviour and condom use was obtained from sexually active women (N = 4620) and men (N = 1440) reporting sexual activity during the period of four weeks preceding the survey. Univariate and multivariate (using logistic regression model) analyses were done to identify predictors of condom use and highrisk sexual behaviour. About 6% of women and 31% of men reported to have more than one sexual partner during the study period. Compared to respondents married once and in monogamous union, the tendency to have multiple partners was increased among never married women [OR 10.9, 95% CI (7.1-16.9)] and men [2.6 (1 7-3.9)], formerly married women [11.5 (7.3-17.9)], and among men in monogamous marriage reporting more than one marriage [12.4 (8.3-18.4)]. Occupation, residence, ever use of contraceptives, and AIDS knowledge were not associated with history of multiple sexual partners. Only 134 (9.3%) men and 173 (3.7%) women reported to have used condoms during the study period. After adjusting for other predictors of condom use, respondents reporting multiple sexual partners were more likely to have used condom among both women [3.4 (2.2-5.4)] and men [3.3 (2.3-6.0)]. Condom use was common in urban areas than rural areas and among unmarried respondents. These results show that high-risk sexual behaviour is common among men. Condom use was very low indicating that efforts to promote condom use has been less successful in Tanzania. More efforts are needed to promote safer sexual practices and condom use in Tanzania.

Adolescent↗

PubMed1992

Multiple sclerosis: will it come between us? Sexual concerns of clients and their partners.

Multiple sclerosis (MS), an unpredictable neurologic disease, is sometimes called the crippler of young adults. This crippling effect often involves sexual functioning. Sexuality is an issue that is frequently difficult for clients, their partners and health care providers to discuss. To address this difficulty, a teaching pamphlet entitled, MS ... Will it Come Between Us? was produced. Open communication and creativity are helpful in dealing with problems frequently encountered by clients with MS: fatigue, impotence, decreased vaginal lubrication, bladder and bowel dysfunction. The pamphlet helps clients with these issues as well as the basics of sexuality as a whole.

Adaptation, Psychological↗

PubMed1993

Multiple sexual partners and mother-to-child transmission of HIV-1.

OBJECTIVE: To investigate risk factors for mother-to-child transmission of HIV-1, particularly sexual behavior before and during pregnancy. DESIGN AND METHODS: This study is part of a prospective cohort study in Butare, Rwanda, of 318 HIV-1-seropositive and 309 HIV-1-seronegative women enrolled during pregnancy and followed for a mean duration of 21 months (range, 8-34 months). Clinical follow-up of the mother-infant pairs was performed at 6-week intervals during the first year of life and at 4-month intervals thereafter. Detailed sexual history interviews were conducted during pregnancy and at the first postnatal visit. RESULTS: Of 184 singleton infants born to HIV-1-infected mothers who survived the neonatal period, 32 (17%) children were classified as HIV-1-infected, 130 (71%) as not infected, and 22 (12%) died with indeterminate HIV-1 infection status. The vertical transmission rate was estimated to be between 20 and 29%. Unprotected sexual intercourse with increased number of partners during the past 5 years was strongly associated with mother-to-child transmission (P < 0.001), even after adjustment for maternal CD4/CD8 ratio, parity, history of sexually transmitted diseases, and evidence of genital infection during pregnancy. In a multivariate analysis, excluding children with indeterminate HIV-1 status, odds ratios for vertical transmission were 2.6 [95% confidence interval (CI), 1.0-6.9] for maternal CD4/CD8 ratio < 0.5 and 3.6 (95% CI, 1.1-11.8) for more than three sexual partners versus a single partner. Women with more than one sexual partner during the first trimester of pregnancy were at particularly high risk of transmitting the virus. CONCLUSION: Unprotected sexual intercourse with multiple partners before and during pregnancy in a population with high HIV-1 seroprevalence may well increase the likelihood of HIV-1 transmission from an infected mother to her child.

CD4-CD8 Ratio↗

PubMed1992

Women with multiple sexual partners: united states, 1988.

Women who have multiple sexual partners in a short time period are appropriate targets for sexually transmitted disease (STD) prevention. We analyzed survey data collected in 1988 from a nationally representative sample of 8450 American women aged 15 to 44 to identify markers of such behavior. Among sexually active persons, 0.4% of married women and 8.4% of unmarried women had two or more sexual partners in the 3 months preceding the interview; unmarried marital status, early age at first sexual intercourse, lack of religious affiliation, and young age were associated with this behavior. All except young age were predictive after multivariate analysis. Such factors may help define women at elevated STD risk and allow better targeting of STD prevention.

Adolescent↗

PubMedDate not supplied

Data from the National AIDS Behavioral Surveys. III. Multiple sexual partners among blacks in high-risk cities.

The National AIDS Behavioral Surveys collected data between June 1990 and February 1991 on the prevalence of multiple sex partners and condom use among 2, 166 blacks living in cities with a high prevalence of AIDS cases. Almost one-fifth (19%) of respondents report having had two or more partners in the year preceding the survey. More men (30%) than women (10%), and more single (25%) than married or cohabiting adults (8%), report that they have had multiple sexual partners in the previous year. Although respondents are more likely to use condoms with secondary than main sexual partners, substantial proportions of blacks with multiple sex partners used no condoms in the previous year with either their main (47%) or their secondary partners (35%).

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

American women's sexual behavior and exposure to risk of sexually transmitted diseases.

According to nationally representative data from the 1988 National Survey of Family Growth and the 1988 and 1989 General Social Surveys, 67% of all women aged 15-44 who have ever had intercourse have had more than one partner, 41% have had four or more, 23% six or more and 8% more than 10; 71% have had one or more nonmarital partners. Fewer than 1% of currently married women report having had more than one partner in the previous three months, compared with 13% of formerly married women and 9% of single women who are sexually active. For the most part, women with multiple partners do not have characteristics that set them apart from other women; women in all age-groups and racial or ethnic groups appear equally likely to have multiple partners while unmarried. Fifty-seven percent of women who report multiple partners have never been married, and another one-quarter are currently divorced. Twenty-one percent are teenagers, 46% are aged 20-29 and 24% are in their 30s. Between 27% and 39% of all sexually active women aged 18-44 are estimated to have had direct or indirect contact with more than one sexual partner during the preceding 12 months (including women with only one partner whose partner had multiple partners). About 20% of currently sexually active women reported using the condom, but one in five condom users had not used one at last intercourse. Once social and demographic factors are controlled, condom users with multiple partners are less likely than other condom users to have used a condom at last intercourse.

Adolescent↗

PubMed1993

Multiple sexual partners: results of a national HIV/AIDS survey in the Central African Republic.

OBJECTIVES: To determine the prevalence and characteristics of individuals with more than one sexual partner in the Central African Republic during the previous 12 months. DESIGN: A national survey. METHODS: A stratified sample of 2589 individuals aged 15-50 years was interviewed in late 1989. The 157-question survey questionnaire was a modified version of a questionnaire developed by the World Health Organization Global Programme on AIDS. RESULTS: Thirty-four per cent of men and 17% of women reported having sex with more than one partner during the previous 12 months. For both men and women, logistic regression indicated that the risk of having multiple partners increased with being single compared with being married; being employed in a profession other than agriculture compared with being a farmer, unemployed, a housewife, or a student; living in an urban rather than a rural area; rape being part of their first sexual encounter; and combining sex with alcohol. Risk increased with increasing ability to read for men and with decreasing age and drinking alcohol for women. CONCLUSIONS: These findings can be used to develop and target HIV/AIDS prevention and control programmes and to improve mathematical models of the epidemic.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Demographic and behavioral predictors of knowledge and HIV seropositivity: results of a survey conducted in three anonymous and free counselling and testing centers.

This paper deals with subjects seeking counselling and testing for human immunodeficiency virus (HIV); it analyses which sociodemographic and behavioral characteristics are related to beliefs concerning HIV infection and to HIV seropositivity. A one month survey among individuals who attended HIV testing in three anonymous and free centers (CIDAGs) was carried out in Paris city, on March 1994. 2059 subjects completed a self-administered questionnaire. Data collected included demographic information, sexual and IVDU behavior, and HIV seropositivity. Subjects also had to evaluate their own risk of getting the acquired immunodeficiency syndrome (AIDS) and the perceived risk of getting AIDS in specific situations such as unprotected anal/vaginal intercourse with a casual partner, with multiple partners, with a seropositive partner, current dental treatment, French kiss, etc.... Multiple linear and logistic regressions have been used to model the dependent variables. Subjects correctly evaluated the risk level of HIV transmission associated with different situations, and women, young men and those engaged in homo/bisexual behavior were in general more conscious of the increased danger resulting from high risk sexual practices. Among males, homo/bisexuals, drug users and the less educated considered themselves to be more at risk. The most important factors related to HIV seropositivity were sexual orientation, intravenous drug use (IVDU), and the perceived risk of getting aids. Despite a good awareness of HIV contamination and an accurate perception of their own risk, many subjects continued to engage in high risk AIDS activities. Better targeted interventions need to be developed to promote and maintain behavior changes.

Adolescent↗

PubMed1992

Prevalence of human papillomavirus infections among heterosexual men and women with multiple sexual partners.

A prospective study of 65 men and 111 women with multiple heterosexual partners was designed to assess the prevalence and potential risk factors of genital human papillomavirus (HPV) infections. In addition, the HPV reservoir in genital, rectal, and oral mucosa was examined. The specimens for the detection of HPV DNA were taken from different sites such as the urethra and coronal sulcus (men), cervix and labia minora (women), anus, rectum, tongue, and buccal mucosa (both men and women). Women underwent speculum examination and colposcopic evaluation of the anogenital region, and a smear for routine cytological classification was also taken. In men, the anogenital region was examined clinically and colposcopically. The polymerase chain reaction (PCR) was used for the detection of HPV types 6/11, 16, 18, and 33. A high prevalence of HPV infection at one or more sites was detected, in 32% of the male and in 23% of the female participants. Seventeen percent of the male distal urethral specimens were positive for HPV DNA. From the female cervical specimens 14% were found positive. Ten proctal specimens (five men and five women) were positive for HPV DNA without any discernible lesion. The persons from whom these samples were taken denied anal insertive intercourse. No oral manifestation of HPV infection was detected. In both men and women a difference between HPV DNA-positive and -negative persons was not found in relation to known risk factors associated HPV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Condoms and coitus: adolescents attitudes to AIDS and safe sex behavior.

This study investigated the relationship between sexual risk taking and attitudes to AIDS precautions among a sample of approximately 1000 non-virgin adolescents attending 15 colleges and universities in Victoria, Australia. Four attitudinal dimensions were isolated: Antiprecautions, Risk Denial, Abrogation of Responsibility and Fatalism. These attitudes showed meaningful relationships with different types of sexual risk: risk with a casual partner, risk with a regular partner, and multiple partnering. Different patterns of association emerged for males and females, with female risk behavior being more strongly related to antiprecautions attitudes. These differences were discussed in the light of gender-stereotypic responses to sexual situations, and their implications for educational interventions were explored.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Condom use among Hispanic men with secondary female sexual partners.

Greater understanding of psychosocial predictors of the use of condoms among Hispanics is needed in prevention efforts related to the human immunodeficiency virus and sexually transmitted disease epidemics among Hispanics in the United States. A telephone survey was carried out in nine States that have large populations of Hispanics, using a stratified clustered random digit dialing sampling strategy. The survey yielded interviews with 968 Hispanic men ages 18-49 years. Of them, 361 (37.8 percent) reported at least one secondary female sexual partner in the 12 months prior to the interview. Predictors were identified of condom use by those men with their secondary sex partners. Key predictors of the subjects' condom use with secondary partners included carrying condoms; self-efficacy, or a measure of the subject's perceived ability to use condoms under difficult circumstances; positive attitude toward condom use; having friends who used condoms; and lack of symptoms of depression in the week before the interview (R2 = 0.35). Significant predictors of condom carrying were being comfortable in sexual situations, positive attitude toward condom use, and self-efficacy to use condoms. Less acculturated men had more positive attitudes toward condom use and carried them more than did more acculturated men. The researchers found encouraging levels of condom use with secondary sexual partners among Hispanic men with multiple partners. Because of the large proportion of Hispanic men who have multiple partners and the severity of the sexually transmitted disease epidemics in the Hispanic community,health care providers should recommend to Hispanic men that they carry and use condoms,point out the acceptability of men using condoms,and assess and teach basic sexual information in that group. Referral may be appropriate for high risk Hispanic men with symptoms of depression.

Acculturation↗

PubMed1989

STD patients' knowledge about AIDS and attitudes toward condom use.

Patients (N = 71) from a sexually transmitted disease (STD) clinic in an urban setting were surveyed to determine their knowledge about acquired immune deficiency syndrome (AIDS) and attitudes toward condom use. Overall knowledge scores were high with a mean score of 22 on the 28-item true-false questionnaire. No statistical significance was found between AIDS-knowledge scores and condom-use behavior. The majority of subjects or their partners had STD symptoms and multiple partners within a 6-month period. Thirty percent of the respondents reported using condoms at least 25% of the time. In response to open-ended statements about condoms, 10 beliefs were mentioned most frequently. The majority of subjects reported protection against sexually transmitted disease and preventing pregnancy as the most important reasons for condom use. "Avoids getting AIDS" only ranked as the eighth most salient belief and few subjects with multiple partners in the previous 6-month period even cited this belief. Other significant beliefs about condom use included decreased feeling, worry about breakage, decreased pleasure for partner, uncomfortable, feeling safe, inconvenient, and not romantic. The most significant referent (normative belief) influencing condom-use decision making was "mother" in younger subjects and "sexual partner" for older subjects. The sexual partner had unfavorable attitudes toward condom use. These results indicate the need to incorporate attitudes and normative beliefs to change condom-use behavior.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Relationship of sexual mixing across age and ethnic groups to herpes simplex virus-2 among unmarried heterosexual adults with multiple sexual partners.

Sexual mixing is important to understanding how sexually transmitted diseases (STDs) spread in the general population, and, identifying people who mix across social groups aids HIV-STD prevention. The authors examined (a) the extent to which people have sexual partners from other sexual networks (disassortative mixing) in a probability sample of unmarried heterosexual adults reporting multiple sexual partners (N = 545) and (b) the relationship between mixing and Herpes Simplex Virus-2 (HSV-2). After demographic variables and number of lifetime sexual partners were controlled for, heavy mixers were significantly more likely to be HSV-2 positive. Degree of mixing down produced the most powerful relationship to HSV-2. Age, education, ethnicity, and a history of incarceration or IV drug use were found to distinguish between light and heavy mixers, although differences between ethnic and age mixing were observed. The results have implications for understanding HIV-STD transmission and for directing interventions toward population segments at high risk for transmitting HIV-STDs.

Adult↗

PubMed1994

Epidemiologic factors correlated with multiple sexual partners among women receiving prenatal care.

A cross-sectional survey methodology was used to respond to the need of a local health department to identify correlates of high-risk behaviors related to human immunodeficiency virus (HIV) transmission among pregnant women attending prenatal care clinics. This study of 488 maternity patients was conducted at two public health clients in Tampa, Florida, in 1991. The prevalence of high-risk behaviors was assessed using a self-administered questionnaire. Out of 428 respondents, 25% reported having had intercourse with two or more male partners in the past year. Following multiple logistic regression analysis, four variables remained consistently and significantly associated (P < 0.05) with having two or more sexual partners: (1) annual household income of less than $10,000/y (prevalence odds ratio (POR) = 4.5; 95% confidence limits (CL): 1.5, 13.1); (2) history of prostitution (POR = 8.1; 95% CL: 1.5, 42.1); (3) history of rape or forcible intercourse (POR = 2.2; 95% CL: 1.0, 4.6); and (4) an expressed desire for confidentiality among women seeking further information about acquired immunodeficiency syndrome (AIDS) prevention (POR = 2.1; 95% CL: 1.1, 4.0). Assessment of these factors may lead to better direction of HIV education programs, as well as identification and counseling of specific individuals at high risk for engaging in behaviors that can lead to HIV infection. Short, self-administered questionnaires provide confidential, rapid, and inexpensive means of generating baseline data for further interventions.

Acquired Immunodeficiency Syndrome↗