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PubMedDate not supplied

Six school-based clinics: their reproductive health services and impact on sexual behavior.

An evaluation of the reproductive health programs of six diverse school-based clinics measured the impact of the clinics on sexual behavior and contraceptive use. All six clinics served low-income populations; at five of them, the great majority of the students served were black. An analysis of student visits by type of care given found that these clinics were not primarily family planning facilities; rather, they provided reproductive health care as one component of a comprehensive health program. Student survey data collected in the clinic schools and nearby comparison schools (four sites) or collected both before the clinic opened and two years later (two sites) indicated that the clinics neither hastened the onset of sexual activity nor increased its frequency. The clinics had varying effects on contraceptive use. Providing contraceptives on site was not enough to significantly increase their use; in only one of the three sites that did so were students in the clinic school significantly more likely than students in the comparison school to have used birth control during last intercourse. However, condom use rose sharply at one clinic school that had a strong AIDS education program and was located in a community where AIDS was a salient issue. At another clinic school, where pregnancy prevention was a high priority and staff issued vouchers for contraceptives, the use of condoms and pills was significantly higher than in the comparison school. A third clinic school--which focused on high-risk youth, emphasized pregnancy prevention and dispensed birth control pills--recorded a significantly higher use of pills than its comparison school. Although the data suggest that the clinics probably prevented small numbers of pregnancies at some schools, none of the clinics had a statistically significant effect on school-wide pregnancy rates.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Self-efficacy and AIDS prevention for pregnant teens.

AIDS education, the only immediate solution to containment of AIDS, encourages active risk reduction among high-risk populations. Self-efficacy is a construct that can measure the likelihood preventive behaviors will be performed, and thus could be applied to identify specific areas where AIDS education should be augmented. In this study, pregnant, mostly black, teens (N = 58) attending an alternative school in a large, midwestern city completed a self-efficacy scale to identify self-perceived areas of vulnerability to participating in preventive behaviors and avoiding high-risk behaviors concerning AIDS. The AIDS Self-efficacy Scale identified four areas of greatest vulnerability: using condoms, discussing previous homosexual activity, discussing previous bisexual activity, and telling a partner about an experience with a bisexual. The last three situations result from an inability to discuss a partner's past sexual history, indicating a need to be very specific in these areas. School health interventions should recognize and deal with issues sexually active teens have identified as most difficult, particularly specific aspects of sexual histories, and provide these adolescents with prevention skills necessary to reduce high-risk behaviors.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The social construction of premenstrual syndrome.

In 1931 a physician coined the term Premenstrual Tension, thereby commencing an extensive biomedical inquiry into the relationship between women's menstrual cycle and the occurrence of physical, emotional and behavioral changes. However, despite 58 years of scientific research, fundamental questions remain unanswered. For example, there is still no consensus on the definition of PMS. This, in turn, has led to disagreement among researchers about which medical specialty is best suited for diagnosing and treating PMS. Is PMS a disease whose pathology is best understood by physicians in reproductive medicine or in psychiatry? This paper argues that the inconclusiveness surrounding PMS is symptomatic of the persistence of cultural beliefs in the production (and reproduction) of medical knowledge. The roots of these cultural beliefs and their 'naturalness' in the context of Western ideas about reason, rationality and women are explored in the first section. The second section discusses the ubiquity of these same cultural beliefs in contemporary scientific research of PMS and in the controversy surrounding the proposed psychiatric diagnostic category of Late Luteal Phase Dysphoric Disorder (LLPDD). Finally, a new, anthropologically and sociologically informed approach to understanding the phenomenon of PMS is suggested.

Attitude to Health↗
PubMed1977

Adolescent pregnancy: an interpersonal skill training approach to prevention.

The research literature reports numerous negative consequences of adolescent pregnancy. Unfortunately, contemporary approaches to preventing teenage pregnancies have been largely unsuccessful. Recent evidence, however, suggests that interpersonal communication skill training may represent an important step in helping adolescents deal with their sexual and contraceptive behavior. This describes a pilot study of an interpersonal skill training model for sexually active inner-city teenagers. Results show that this training model is a feasible and attractive approach to modifying the youths' communication patterns. Findings indicate that such training is a fruitful direction for future pregnancy prevention research with the adolescent target population.

Adolescent↗
PubMed1990

Morphine treatment and reproductive condition alter olfactory preferences for pup and adult male odors in female rats.

Administration of morphine sulfate (MS) to pregnancy-terminated and postpartum lactating female rats disrupts both maternal behavior and postpartum aggression. Since the display of these behaviors may be heavily dependent on olfactory cues provided by the stimulus animals (rat pups and adult male rats, respectively), we examined whether MS was affecting the perception of the olfactory stimuli, and whether olfactory perception was modified by reproductive condition. In Experiment 1, lactating rats had their pups removed and were injected with MS (5.0 mg/kg, sc.) or saline. 60 min later they were placed into a two-choice apparatus, one side of which contained bedding soiled by neonates and the other clean bedding. Time spent on each side was recorded for a total of 5 min (300 s; chance = 150 s). Saline-treated mothers spent significantly more time on the pup-odor side, whereas MS-treated females spent significantly less. In Experiment 2, lactating females were treated with MS or saline and exposed to male odors (soiled bedding). MS significantly increased time spent on the side with male odors; when treated with saline, time spent was significantly reduced. Thus, in lactating rats. MS creates an aversion for pup odors while reducing the female's normal aversion toward male odors. In Experiment 3, ovariectomized (ovx) virgin females expressed neither an aversion nor a preference for the odor of pups following saline administration. After MS treatment, however, the virgins showed a distinct preference for pup odors. When exposed to male odors in Experiment 4 ovx virgins showed a marked preference for male odors after MS treatment, and neither a preference nor an aversion after saline. Experiment 5 examined pup odor preferences in intact virgins, early (Day 7), middle (Day 14), late-pregnant (Day 21), and prepartum (Day 22) rats. The pup odor preferences of virgin, Day 7, Day 14, and Day 21 pregnant rats were not different and generally were at chance levels. Day 22 pregnant females exhibited a marked preference for pup odors compared to chance levels, as well as compared to the other four groups. These findings suggest that opiates and endogenous opioids may regulate olfactory preferences and that alterations in this system may underlie normal behavioral changes toward conspecifics prepartum as well as during lactation.

Animals↗
PubMedDate not supplied

Current CDC efforts to prevent and control human immunodeficiency virus infection and AIDS in the United States through information and education.

The human immunodeficiency virus (HIV) is estimated to have infected more than a million people in the United States and millions more in other countries. Even though there is no vaccine or effective treatment, HIV infection can be prevented through behavioral change. As the lead Public Health Service Agency for disease prevention, the Centers for Disease Control (CDC) has designed and implemented information and education activities with the ultimate goal of preventing HIV infection and AIDS in the United States. The target populations include the general public, school- and college-aged populations, persons infected or at increased risk of infection, minorities, and health workers. Because AIDS will be with us for a long time, CDC views educating the public as a long-term undertaking. The agency has initiated an intensive continuing national public information campaign, an informational brochure to be distributed to every U.S. household, a national AIDS information toll-free hotline, and a clearinghouse system that will maintain a comprehensive inventory of AIDS information resources and services. CDC also supports public information and education efforts by State and local health agencies. To reach school- and college-age youth, CDC, in consultation with governmental and national private sector organizations, developed guidelines for effective school health education to assist school health personnel in determining the scope and content of AIDS education. CDC also works with State and local education agencies to help carry out and evaluate educational efforts to prevent the spread of HIV among school- and college-age youth. The populations with the highest priority for AIDS information and education efforts are those who are at increased risk of acquiring or transmitting the AIDS virus because they use illicit intravenous drugs and share needles, engage in anal intercourse, have many sexual partners, practice prostitution, or engage in sex with those who practice these behaviors. Another high-priority population, because they can infect their offspring,is reproductive age women engaging in high-risk behavior and women infected with HIV who become pregnant. CDC programs targeted to these groups include community health education and risk reduction interventions, counseling and testing for HIV infection, AIDS community demonstration projects, perinatal AIDS prevention projects,and programs focused on preventing AIDS in minority populations. CDC is developing a variety of educational approaches for health workers in clinical settings because they are an important channel for providing accurate AIDS information, helping to assess risk, and counseling to actively reduce risk for the patient, sex partners of the patient, friends, and family members of the patient. CDC has conducted research and provided information and training on the use of HIV laboratory tests. CDC has also developed numerous scientific and technical guidelines and recommendations in consultation with practitioners, public health officials, and others and disseminated these through the Morbidity and Mortality Weekly Report. In addition,CDC has provided information about the risk of HIV transmission in the workplace and about methods of prevention. CDC will continue to evaluate these activities and support research in education and related interventions that may be necessary to prevent infection by the HIV virus. By providing educational support for behavior changes that decrease HIV transmission, we can contribute to AIDS prevention in the 1990s.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The why, when and whether of condom use among female and male drug users.

Eight focus groups consisting of all male, all female and mixed male and female drug users were conducted to gain an in-depth understanding of beliefs and behavior regarding the use of family planning services and contraceptives, particularly condom use in an effort to reduce the perinatal transmission of HIV. While participants often supported the use of condoms because of STDs and AIDS, their unplanned pregnancies and STD histories indicated in-consistent use, depending on the partner and the circumstances. The vast majority of both men and women did not like to use condoms because it interfered with the spontaneity and pleasure of sexual relations, though women seemed more willing to use condoms than their partners. Participants varied in their knowledge about the benefits of using a condom, in how and when to put it on, in the associations they made between condom use and trust and commitment, in the type of partner and conditions under which they would use condoms and in their willingness to consider condom use as an integral part of their lives. Issues of trust, commitment and condom use did not seem to have been resolved in the drug using community, particularly among younger people who appeared to have more difficulty in negotiating condom use. Promoting the use of condoms needs to be considered as part of a larger, multifaceted behavior change effort.

Condoms↗
PubMed1989

Central implants of diluted estradiol: independent effects on ingestive and reproductive behaviors of ovariectomized rats.

The present experiment was undertaken to evaluate the hypothesis that the effects of estrogens on feeding and sexual behaviors are organized separately within the brain. Thirty-three ovariectomized rats were implanted with bilateral guide cannulae aimed at either the paraventricular nucleus (PVN), medial preoptic area (MPOA), or posterior hypothalamus (PH). Subjects that received PVN implants were stimulated with either undiluted estradiol, a 3:1, or 10:1 mixture of cholesterol and estradiol. Animals in the other groups were treated with undiluted estradiol. All females were stimulated unilaterally with cholesterol and estradiol, yielding a total of 66 stimulation sites. Histological analysis revealed that, compared to cholesterol implants, undiluted estradiol in the PVN reduced food intake and body weight. More importantly, diluted estradiol implants in the PVN significantly lowered food intake and body weight. In contrast, undiluted estradiol in the MPOA, PH, or ventromedial hypothalamus (VMH) had no significant effects on feeding or body weight. Analyses of variance revealed significant main effects of implant location on female sexual behavior. Newman-Keuls tests indicated that diluted estradiol implants in the PVN produced lordosis quotients and quality scores that were significantly lower than those obtained with VMH implants. The possibility that the behavioral changes observed were due to peripheral rather than central effects of the hormone was evaluated by comparing the results of implants that produced vaginal cell cornification to those that did not. There were no significant differences between these groups on any of the other dependent variables, indicating that peripheral estradiol sufficient to induce vaginal cell cornification was neither necessary nor sufficient to account for the behavioral changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Daily variation of multiple behaviors in Aplysia fasciata: integration of feeding, reproduction, and locomotion.

Daily variations in feeding, reproductive behaviors, and activity level were examined under three conditions: (1) animals had access to food and mates; (2) there was access only to food; (3) neither food nor mates were present. Behaviors differed in amplitude of variations from their daily mean value. Egg-laying had the strongest tendency to be clustered. Amplitude of variations in courtship and swimming was larger than those of immobility, crawling, and feeding, while moving in place was the least clustered behavior. Changes in state affected the tendency to be clustered. When food and mates were present, amplitude of variations became progressively larger for immobility, moving in place, crawling, and swimming. Behaviors differed in the degree to which variations were patterned as a 1/day oscillation. Relatively little of the variability in crawling, moving in place, courtship, and egg-laying was due to a 1/day oscillation under any condition. By contrast, a large proportion of the variability of immobility, swimming, mating, and eating was modulated by a 1/day oscillation in at least one condition. The contribution of a 1/day oscillation to variability differed in the conditions examined. For immobility and swimming, when food and mates were present, the 1/day component of variability became smaller. By contrast, presence of mates led to an increase in the 1/day component of variability modulating feeding. Daily peaks of swimming and feeding were in phase with one another, and out of phase with mating and feeding. The ratio of locomotion to inactivity is constant, independent of change in external conditions. However, this ratio varied throughout the day. When food and mates were absent, variations of immobility and swimming were strongly related to variations in the inactivity ratio. When food and mates were added, this tendency decreased. The data suggest that daily variations in occurrence of behaviors can be accounted for by interactions between oscillators affecting Aplysia behavior and motivational variables. A 1/day oscillator has strong effects on mating, swimming, and immobility. The effect of the oscillator is modified by changes in motivational state.

Animals↗
PubMed1991

Ectopic expression of sex peptide alters reproductive behavior of female D. melanogaster.

Sex peptide, a secreted component of the male accessory glands, has been shown to induce behavioral and physiological changes in mated Drosophila. We transformed flies with a hybrid gene containing an hsp70 promoter fused to a cDNA encoding sex peptide. Heat-induced ectopic expression of the peptide in transgenic virgin females altered their reproductive behavior, in the presence of courting males, to that observed in mated females. This demonstrates that the peptide is functional as expected. Time course studies revealed that the behavioral change appeared earlier than the stimulated ovulation. We have also introduced a modified sex peptide gene that is driven by the yp1 enhancer, conferring expression in adult females, and shown that these flies refuse mating constitutively in the presence of courting males and lay unfertilized eggs at the rate of mated females.

Animals↗
PubMed1992

Human immunodeficiency virus/acquired immunodeficiency syndrome in pregnant women.

A pregnant woman experiences selective immunosuppression as a physiologic response to the presence of a genetically heterologous fetus. Case reports early in the acquired immunodeficiency syndrome (AIDS) epidemic suggested that adverse human immunodeficiency virus (HIV)-related clinical outcomes might be causally associated with pregnancy. A review of relevant published data indicates that: (1) Adverse clinical outcomes of pregnancy are common among HIV-infected pregnant women, but no studies to date have fully disentangled the many confounding factors. (2) HIV-related complications are common in pregnancy only among immunosuppressed (< 300 CD4+ cells/mm3) women. (3) The distinct effect of pregnancy on the expression of HIV infection cannot be evaluated in the absence of appropriately controlled observations. (4) Cofactors for perinatal transmission are poorly understood. (5) Research into the motives for reproductive decisions and behaviors is of critical importance for improving our health education and outreach efforts for high-risk women. (6) Adequate clinical treatment and prophylactic health care services must be made easily accessible and available to women at high risk of HIV disease. (7) Treatment with available antiviral and anti-Pneumocystis drugs is advisable for HIV-infected pregnant women with fewer than 300 to 350 CD4+ cells/mm3, though data to definitively guide therapeutic decision making are not available. (8) Large multicenter studies are needed to recruit patients and to retain them in sufficient numbers, allowing for better evaluation of the many variables determining clinical outcomes for HIV-infected mothers and their infants. The natural history of HIV in pregnant women must be studied to facilitate clinical decision making, and to design and implement interventions, including prevention (behavior change, vaccines) and treatment (chemotherapy, immunotherapy).

Acquired Immunodeficiency Syndrome↗
PubMed1992

Changing patterns of adolescent sexual behavior: consequences for health and development.

Sexuality is a fundamental quality of human life, important for health, happiness, individual development, and indeed for the preservation of the human race. During the dynamic period of adolescence in which the passage from childhood to maturity takes place, sexuality takes on new dimensions; feelings become more intense, relationships become more complex, and the consequences of sexual behavior are radically altered. This not only affects the behavior of young people but also of those who interact with them, their families and peers, and those who work in the health, education, youth, social welfare, and other sectors. In the contemporary world the conditions of life for many young people have also changed, and with it patterns of sexual behavior. In general, earlier puberty, later marriage, a decline in the family leading to less control and more autonomy, and intense exposure to sexual stimuli via the mass media and travel across cultural boundaries have made pre-marital adolescent sexual activity more common. This has added to traditional problems of early marriage, newer problems of early pregnancy, childbirth, and induced abortion outside of marriage, sexually transmitted diseases, and human immunodeficiency syndrome infection leading to acquired immunodeficiency syndrome. But the work of the World Health Organization (WHO), along with many others in the field, strongly suggests that given appropriate information and services, trust and equity between the sexes, young people will behave responsibly and well. In this paper some of the findings from methods developed by WHO for research, training, advocacy, and evaluation, and findings in relation to patterns and determinants of sexual and reproductive health and development will be described, and future directions suggested.

Adolescent↗
PubMed1990

Male knowledge of and attitudes and practices towards AIDS in Zimbabwe.

This paper presents findings from a survey on knowledge of and attitudes and practices towards AIDS among currently married Zimbabwean men conducted between April and June 1988. Findings indicated that knowledge was reasonably high: 89.7% reported having heard of AIDS. The young and middle-aged groups, the most educated, and the urban men were the most knowledgeable in identifying routes of transmission. However, 22% did not know that there could be asymptomatic carriers of the virus capable of transmitting the virus and infecting others. Furthermore, 38% did not know that all those affected with AIDS eventually die as a result, and only 55% knew that there is no cure for AIDS. Behavioral change in order to avoid contracting AIDS seems relatively low given this sample's history of sexually transmitted diseases and extramarital sexual relations during the year prior to the survey. Although condom use was the lowest percentage of the behavioral change categories, a high percentage reported ever using a condom.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Knowledge of AIDS among secondary school pupils in Bagamoyo and Dar-Es-Salaam, Tanzania.

We assessed knowledge of AIDS among pupils in selected schools in Tanzania in August 1989. Four hundred and eight-one pupils from four randomly selected secondary schools, two from Dar-Es-Salaam (a city) and two from Bagamoyo (a semi-rural town), were interviewed using a structured questionnaire. Of these, 476 (99.0%) had heard of AIDS, and 447 (92.9%) were able to mention spontaneously at least one sexually transmitted disease (STD), of whom 374 (83.7%) mentioned AIDS. Knowledge was found to increase with age and tended to be higher among women in Dar-Es-Salaam than in Bagamoyo. These data suggest that communication channels directed at women in rural areas should be strengthened. While knowledge of sexual transmission of HIV was generally high, and prevalence of reported misconceptions about modes of transmission was very low, knowledge of non-sexual means of transmission (transfusions, injections, vertical) was lacking. Although 80% of pupils mentioned reduction of number of sexual partners as a means of AIDS prevention, only 22% mentioned condom use, and less than 5% reported that they had ever used a condom. Future research should concentrate on means of promoting sexual behavior change, the ultimate aim of any AIDS prevention strategy.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Intrauterine infection of mice with St. Louis encephalitis virus: immunological, physiological, neurological, and behavioral effects on progeny.

Intravenous injection of pregnant mice with St. Louis encephalitis (SLE) virus at 8 days of gestation resulted in infection of the fetus. Progeny developed no antibody or tolerance to SLE virus since the viral antigen was cleared by maternal antibody before antibody-forming competence developed in the young. Temporary growth retardation was observed in a number of young at 3 weeks of age. After the initial setback the growth rate increased, indicating that early runting was due to an inability to adjust adequately to extrauterine life, which was subsequently overcome. In most other young there were no significant effects on growth, reproduction, or life expectancy. A few young died at or shortly after birth; in these, neurological changes ranging from gross defects such as encephaloceles and hydrocephalus to histological evidence of necrosis and congestion were observed. Neurologically related behavioral changes were detected by using the open field test and the rotating-rod test, which indicated neurological damage and memory impairment in the surviving intrauterinely infected animals.

Animals↗
PubMed1992

Time and sex in the male mouse: temporal regulation of infanticide and parental behavior.

Infanticide is a violent but successful reproductive strategy found in many mammals, particularly rodents. In male house mice (Mus domesticus and M. musculus), the act of ejaculation provides a reliable neural signal for timing the birth of their offspring. However, a unique chronobiological aspect of this phenomenon is the extraordinary temporal latency that can occur between the stimulus (coital ejaculation) and its adaptive neural response (male mice cease killing pups and behave parentally toward them instead). Specifically, the inhibition of infanticide is often time delayed for many days after a male ejaculates, but virtually always occurs before or around the time his own sired offspring would be born 18-20 days later. Furthermore, infanticide spontaneously reemerges 50-60 days after mating. In CF-1 stock male mice this entire behavioral sequence is synchronized with the female's reproductive cycle, and occurs even in the total absence of social cues or changes in pituitary or gonadal hormones after mating. When entrained and mated at 22 h (light:dark 11:11) or 27 h (light:dark 13.5:13.5) T-cycles, photoperiodic cues appeared to synchronize this dramatic shift in behavior, because a sudden transition from pup killing to parenting was matched with the number of light/dark cycles experienced after ejaculation rather than the amount of real time experienced, suggesting a circadian timing link. Housing in constant light accelerated the postmating transition to parenting, whereas constant dark significantly delayed the transition to parenting, but still occurred by 3 weeks after mating. Most males tend to oscillate between infanticide and parental behavior for several days before locking in to constant parenting, regardless of lighting conditions. Variation in the time delay between ejaculation and the inhibition of infanticide was consistent within young individuals (< 10 months of age), but in older males (> 18 months of age) the time interval between ejaculation and parenting was significantly prolonged and attenuated. Another unique aspect of this phenomenon is that variation among individuals in their timing and response to light cues is correlated with phenotypic variation in sex steroid exposure during late fetal development. So far, no simple physiological explanation can account for the neural mechanism triggered by ejaculation that coordinates these time-delayed behavioral changes toward pups.

Animals↗
PubMed1988

The ethics of safe sex.

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Acquired Immunodeficiency Syndrome↗