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PubMed1990

Improved sexual function during recombinant human erythropoietin therapy.

In seven male haemodialysis patients, living with a constant sexual partner, sexual life (self-administered questionnaire) and sex hormones were evaluated before and 3 or 10 months after commencement of recombinant human erythropoietin (rHuEpo) therapy respectively. Haematocrit increased from 22.2 +/- 2.1% to 30.6 +/- 1% with a maintenance dose of 140 +/- 55 U/kg per week. Two patients were hypertensive before and after rHuEpo therapy; antihypertensive medication was kept constant during the study. Self-reported sexual function improved in four of seven patients, including libido and erection. This was paralleled by improved indices of wellbeing (physical fitness, mental alertness). In contrast, serum values of sexual hormones (testosterone or oestradiol) and of basal and stimulated (LHRH/TRH), prolactin and LH, and FSH were not significantly changed during rHuEpo therapy.

Adult↗

PubMed1998

Adult physical health outcomes of adolescent girls with conduct disorder, depression, and anxiety.

OBJECTIVE: To examine the young adult physical health outcomes of adolescent girls with behavior problems. METHOD: Girls with conduct disorder, girls with depression, girls with anxiety, and healthy girls (N = 459) who had been evaluated at age 15 years were followed up at age 21, when general physical health, substance dependence, and reproductive health were assessed. RESULTS: After control for potentially confounding variables including prior health, adolescent conduct disorder predicted more medical problems, poorer self-reported overall health, lower body mass index, alcohol and/or marijuana dependence, tobacco dependence, daily smoking, more lifetime sexual partners, sexually transmitted disease, and early pregnancy. Adolescent depression predicted only adult tobacco dependence and more medical problems; adolescent anxiety predicted more medical problems. CONCLUSIONS: The robust link between female adolescent conduct disorder and poor physical health in adulthood suggests that intervention with girls who have conduct disorder may be a strategy for preventing subsequent health problems.

Adolescent↗

PubMed1999

Outreach programmes for female commercial sex workers.

Female commercial sex workers are at higher risk of sexually transmitted infections (STI) and may be important in the transmission of infections because of their multiple sexual partners. Sexual health may not be their top priority and current STI services may not be seen as user-friendly. An outreach approach is therefore appropriate for this group. This should be in collaboration with the women and include other services that they feel are appropriate. If possible it should also incorporate the use of sex workers as peer educators.

Delivery of Health Care↗

PubMed2006

A model of sexual risk behaviors among young gay and bisexual men: longitudinal associations of mental health, substance abuse, sexual abuse, and the coming-out process.

Sexual risk behaviors of young gay and bisexual men must be understood within the context of other health concerns (e.g., anxiety, substance abuse), population specific factors (i.e., the coming-out process and gay-related stress), childhood sexual abuse, and other theoretical factors (e.g., safer-sex intentions). The current report proposes and longitudinally examines a model of risk factors for subsequent sexual risk behaviors among young gay and bisexual men in New York City. As hypothesized, more negative attitudes toward homosexuality, more substance abuse symptoms, and poorer intentions for safer sex were directly associated with a greater likelihood of unprotected anal sex over the following year. Furthermore, lower self-esteem, more anxious symptoms, and childhood sexual abuse were related to more unprotected anal sex indirectly through more sexual partners, sexual encounters, and substance abuse symptoms. These findings suggest that interventions targeting sexual risk behaviors of young gay and bisexual men may be more effective if they also address mental health concerns and aspects of the coming-out process.

Adolescent↗

PubMed1987

The impact of AIDS on gay male sexual behavior patterns in New York City.

A sample of 745 gay men, ages 20 to 65, were interviewed in 1985 as part of an effort to determine the impact of the AIDS (acquired immunodeficiency syndrome) epidemic on the non-ill but at-risk community. Measured in terms of the number of different sexual partners, sexual activity was reported to have declined by 78 per cent since hearing about AIDS. The frequency of sexual episodes involving the exchange of body fluids and mucous membrane contact declined by 70 per cent, and condom use during anal intercourse increased from 1.5 to 20 per cent. Abstinence from gay sex did not change over time.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Gynecologic symptoms and sexual function before and after liver transplantation.

OBJECTIVE: To determine gynecologic symptoms and sexual function in a group of patients awaiting liver transplantation and a second group after liver transplantation. STUDY DESIGN: A questionnaire was mailed to 524 women. Of these, 233 had had transplants, and 291 were on a waiting list. The Transplant Database was used to obtain demographic information regarding these patients, and data were analyzed based on population age, Child's classification, type of liver disease, and pretransplant or posttransplant status. RESULTS: The response rate was 53%. There was no difference in ethnic or age distribution between pretransplant and posttransplant patients. There were no significant differences in rates of amenorrhea, but there was a greater prevalence of amenorrhea in patients with hepatocellular vs. cholestatic diseases (60% vs. 19%, p = 0.009). There was a higher incidence of pad use for urinary incontinence in pretransplant vs. posttransplant patients (14% vs. 7%, p = 0.04). There was no difference in availability of a sexual partner, sexual activity, orgasm experience, dyspareunia, satisfaction with sex life, symptoms of organ prolapse or dysmenorrhea based on transplant status, disease etiology or Child's classification. CONCLUSION: Liver failure patients differed in some of their gynecologic symptoms depending on their disease etiology and transplant status, but sexuality remained unchanged.

Amenorrhea↗

PubMed1988

Prevention of sexually transmitted diseases in women.

The frequency and severity of sexually transmitted diseases (STDs) and their sequelae, including sterility, numerous perinatal infections, genital tract neoplasia and possibly death (from ectopic pregnancy, ruptured tuboovarian abscess, human immunodeficiency virus-1 and hepatitis B virus infection), should be acknowledged by all sexually active individuals. Aspects of sexuality that place individuals at risk of STDs must be reexamined. Health care providers must effectively inform patients and the public of these often-ill-appreciated risks in a straightforward fashion, free of judgmental and punitive attitudes. New, more-effective means of prevention, diagnosis and treatment are being sought using research techniques in microbiology, immunology and behavioral science. In the meantime, medical screening, treatment and contact tracing should be carried out for patients and their sexual partners. Sexually active individuals must be empowered with knowledge and emboldened to protect themselves and their established or potential families from these common infections. Existing means of screening and treating must be utilized fully.

Contraception↗

PubMed1996

Sexually induced dermatoses.

Sexually induced dermatoses (SID) are conditions resulting from sexual activity. Sometimes this can be modified by bacterial infection or systemic disease. Many materials such as medications, cosmetics, perfumes, pads, hygiene, sprays, condoms, etc, may cause sexually induced dermatoses in sexual partners. Sexually induced dermatoses are noninfectious, self-limited conditions.

Allergens↗

PubMed1997

Design and results of the Women's Health Study.

The Women's Health Study was a methodological experiment carried out in Chicago. More than 1,000 women took part; a comparison sample of 100 men was also included. The sample was selected from two sources. Most of the women and all of the men were selected from an area probability sample that had been screened to identify women in the eligible age range; the rest of the women were selected from rosters at cooperating abortion clinics and were known to have had an abortion. Questionnaires based on the one used in the National Survey of Family Growth were administered to the sample; the questionnaire included items on abortion, sexual behavior, and illicit drug use. The experiment examined five variables: whether the questionnaire began with a series of medical questions or with questions on pregnancy; whether the interview was conducted by a nurse or field interviewer; whether the interview was done at the respondent's home or outside the home; whether the interviewer or respondent administered the questions; and whether the data were collected on paper or via computer. Of the five experimental factors, the one with the most consistent effect was the method of administering the questions. Self-administration significantly increased the reported number of sexual partners, sexually transmitted diseases, and the level of condom use compared to administration by an interviewer. Computer assistance occasionally interacted with the site of the interview to effect reporting. The other two experimental variables-the version of the questionnaire and the data collection staff-had few discernible effects. None of the variables affected reported drug use over the lifetime.

Chicago↗

PubMed1998

[Aids in Madagascar. II. Intervention policy for maintaining low HIV infection prevalence].

The HIV seroprevalence per 100,000 adults Malagasy rose from 20 in 1989, to 30 in 1992, and to 70 in 1995. In that year, the total number of HIV infected people in the Big Island was estimated at 5,000, the number of people sick with AIDS at 130, and the people at risk at more than 1,000,000. The latter are the persons infected with other STDs and individuals (or their partners) with risky sexual behaviour (e.g. numerous sexual partners, occasional sexual partners, and/or sexual contacts with commercial sex workers). The HIV prevalence rate is low as compared with those of other countries. Nevertheless, the spread of the HIV infection is alarming in some parts of the country and the risk factors are also present, namely: the high prevalence of STDs, numerous sexual partners, the low use of condoms in all groups, the development of tourism, the development of prostitution associated with social and economical problems, and internal and international migrations (with risky sexual contacts). Therefore, the still low but rising HIV prevalence in 1995 does not warrant complacency. To estimate the trend of HIV prevalence within the population, it is useful to know two different assumptions, as follows: firstly, a controlled evolution of the epidemic (low epidemic) and secondly, a very fast spread of the epidemic (high epidemic). If we consider the 5,000 individuals seropositive in July 1995, the Aids Impact Model (AIM) projection model shows that HIV seroprevalence rates among adults in 2015 might be between 3% (when the progression course of HIV epidemic is low) and 15% (when the progression course of HIV epidemic is high). By 2015 AIDS could have severe demographic, social, and economic impacts. Then, it is necessary to take measures to prevent contamination. Five major interventions are required: public information about AIDS, HIV transmission mechanism, and its prevention, communities education via the respected people and the notabilities to promote moral values, reduce the number of sexual partners, delay visit of sexual activity, and advice for infected couples; screening of blood donors and the supposed high risk group; control of STDs; reduction of the number of sexual partners; promotion of condom use, abstinence, and fidelity. To sum up, the fight against AIDS is not only the health professional workers' problem. It concerns all Malagasy people. Therefore, successfullness in prevention efforts to slow the epidemic needs concerted, collective, and long lasting actions from all sectors of the society for the nation's future and the well-being of the rising generations.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Daily mood, partner support, sexual interest, and sexual activity among adolescent women.

The main objective of this study was to examine day-to-day associations of coitus, sexual interest, partner emotional support, negative mood, and positive mood among adolescent women. Diaries assessed partner interactions, sexual activity, substance use, and mood. Participants were 146 adolescent women who provided 28,376 diary days. Correlates of coitus on a given day included age, increased coital frequency in previous week, coitus on the previous day, partner support, increased same-day sexual interest, and decreased same-day negative mood. The data demonstrate complex associations of sexual interest, mood, partner interactions, and sexual activity. The findings extend understanding of the sexuality of adolescent women and have implications for a variety of interventions to reduce sexually transmitted infections and unplanned pregnancies.

Adolescent↗

PubMed2006

Characteristics of recently HIV-infected men who use the Internet to find male sex partners and sexual practices with those partners.

OBJECTIVE: To examine (1) characteristics of recently HIV-infected men who have sex with men (MSM) who find sex partners through the Internet and (2) differences in characteristics of and sexual behaviors practiced with Internet partners as compared to other partner types. METHODS: From May 2002 to 2005, a computer-assisted self-interview was administered to 194 recently HIV-infected MSM in southern California. MSM who used the Internet to find sex partners were compared with those who did not report Internet use, and partners found from the Internet were compared with those who were found from other venues using chi analyses, t tests, logistic regression, and generalized estimating equations. RESULTS: Seventy percent of participants reported using the Internet to find partners in the prior 3 months. In multivariate analysis, Internet users as compared to non-Internet users reported higher education levels (some college vs. high school: odds ratio [OR] = 5.04; P < 0.01 and college or greater vs. high school: OR = 9.61; P = 0.01), were more likely to be white (OR = 2.16; P = 0.04), reported more partners in the prior 3 months (OR = 1.05; P = 0.04), were more likely to have had sexual contact with all their last 3 partners after HIV diagnosis (OR = 3.43; P < 0.01), and were more likely to report that all their last 3 partners were HIV-negative (OR = 3.35; P = 0.02), but none were main partners (OR = 2.36; P = 0.02). When compared with partners who were found in other venues, Internet partners were less likely to be main partners (OR = 0.52; P < 0.01) and were more likely to be younger (OR = 0.98; P = 0.05), to be HIV-negative (OR = 1.88; P = 0.02), and to become sex partners after HIV diagnosis (OR = 1.58; P = 0.03). CONCLUSIONS: The Internet is a popular venue for recently HIV-infected MSM to find partners, many of whom are HIV-negative. Because finding sex partners through the Internet occurs after HIV diagnosis, the Internet could be a valuable target for new HIV prevention strategies.

Adult↗

PubMed2004

Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships.

BACKGROUND AND OBJECTIVE: An individual's risk of sexually transmitted infections (STIs) has been associated empirically with the individual having concurrent sexual partners (individual's concurrency) and, theoretically, with the individual's partner having concurrent partners (partner's concurrency). GOALS: The goals of this study were to assess the relationship of STI to individual's concurrency, the partner's concurrency, and awareness of the partner's concurrency. STUDY DESIGN: We recruited 192 individuals aged 18 to 30 from sexually transmitted disease and family planning clinics in 96 partner dyads that reported first sexual contact during the previous 3 months. All individuals underwent computer interviews and testing for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Individuals' self-reports of concurrency and perceptions of partners' concurrency were compared within dyads by kappa statistic; associations of STI with individual's concurrency, partner's concurrency, and knowledge of partner's concurrency were examined using chi-squared analysis, t tests, and multivariate logistic regression. RESULTS: Only 26% of individuals whose partners had other partners were aware of this (kappa = 0.17 for agreement of perceptions vs. partners' reports of concurrency). In multivariate models, STI in individuals was independently associated with partners' concurrency (odds ratio [OR], 3.6), lack of awareness of partner's concurrency (OR, 4.5), perceiving a partner to have concurrent partners when the partner did not (OR, 4.7), living in south San Diego, and sexual contact within 1 week of acquaintance, but not with individuals' concurrency. CONCLUSION: This study demonstrates that STI is associated with partner's concurrency and with not knowing one's partner's behavior.

Adolescent↗

PubMed1993

Using drugs to facilitate sexual behavior is associated with sexual variety among injection drug users.

Little normative data exist about the frequency and variety of sexual behavior of injection drug users. Sexual behaviors of a group of 313 injection drug users (225 men and 88 women) were assessed by a structured interview at the start of an acquired immune deficiency syndrome prevention project. Celibacy was reported by 12.3% of men and 26.9% of women in the year before the initial interview. Male injection drug users who had been sexually active reported a mean number of 4.61 (median, 2.0) female sexual partners in the previous year; sexually active women reported a mean number of 5.28 (median, 1.0) male sexual partners. Sexually active men and women reported median condom use frequency at 0% of vaginal intercourse events (mean for men, 10.31%; mean for women, 14.48%). Male injection drug users who reported using drugs to help them relax for sex, to enhance sexual performance, or to meet sexual partners reported greater frequency of anal intercourse, fellatio, and cunnilingus, less relative frequency of vaginal intercourse, more sexual partners, and greater involvement in being paid for sex and paying for sex than did men who did not report using drugs to enhance sex. Men who used drugs to enhance sex also reported higher frequency of use of a number of different drug classes than men who did not use drugs to enhance sex. For women, using drugs to enhance sex was related to greater frequency of anal intercourse and having more sexual partners. Implications for treatment of drug abusers and future research are discussed.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Sexuality in patients with amyotrophic lateral sclerosis and their partners.

Sexuality in patients with amyotrophic lateral sclerosis (ALS) has received little attention so far. Although sexual function is not directly affected by the disease process, several patients have reported problems within their sexual relationship. We performed a questionnaire survey to ascertain the extent and clinical relevance of sexual problems experienced by patients with ALS and their partners. Of 91 patients and partners asked, 62 agreed to participate in the study. Compared with the time before disease onset, sexual interest had decreased from 72% to 44% for patients and from 78% to 44% for partners. Sexual activity had moderately decreased from 94% to 76% for the patients and from 100% to 79% for the partners. Before the disease, 19% of the patients and 20% of the partners reported sexual problems. This increased to 62% of the patients and 75% of the partners at time of survey. The problems reported were mainly decreased libido, passivity of the partner and own passivity. The most frequent reasons for these problems were the physical weakness and the body image changes due to ALS. The data show that sexuality is an important and problematic issue for a large proportion of ALS patients and their partners. This topic is rarely discussed in the medical setting. Counselling and information should be made available in order to better address this important aspect of quality of life.

Aged↗

PubMed2006

HIV among pregnant women in Moshi Tanzania: the role of sexual behavior, male partner characteristics and sexually transmitted infections.

BACKGROUND: Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to this situation need to be identified. The objective of this study was to determine social, behavioral and biological risk factors of HIV infection among pregnant women in Moshi urban, Tanzania. In 2002-2004, consenting women (N = 2654), attending primary health clinics for routine antenatal care were interviewed, examined and biological samples collected for diagnosis of HIV and other sexually transmitted/reproductive tract infections. RESULTS: The prevalence of HIV was 6.9%. The risk for HIV was greater among women whose male partner; had other sexual partners (adjusted odds ratio [AOR], 15.11; 95% confidence interval [CI], 8.39-27.20), traveled frequently (AOR, 1.79; 95% CI, 1.22-2.65) or consumed alcohol daily (AOR, 1.68; 95% CI, 1.06-2.67). Other independent predictors of HIV were age, number of sex partners, recent migration, and presence of bacterial vaginosis, genital ulcer, active syphilis and herpes simplex virus type 2. CONCLUSION: Development of programs that actively involve men in HIV prevention is important in reducing transmission of HIV in this population. Further, interventions that focus on STI control, the mobile population, sexual risk behavior and responsible alcohol use are required.

Journal Article↗

PubMed1995

Gender differences of reported safer sex behaviors within a random sample of college students.

This study investigated the frequency of safer sex behaviors with a random sample of sexually active college students (N = 315) at a university in the Northwest. The most frequent safer sex behaviors were discussion of contraceptives (58.6%), being more selective (46.5%), and reducing the number of sexual partners (43.6%). The least frequent safer sex behaviors included discussion of partner's sexual health prior to sexual behavior (26.1%), using condoms or dental dams (24.4%), one sexual partner (22.6%), and abstaining from sex as a safer sex practice (12.3%). The only two behaviors which indicated gender differences were (a) if they were being more selective as a safer sex practice and (b) reducing number of sexual partners as a safer sex practice. Women were more likely to state that they were " almost always" more selective than their male peers. Findings from this study indicated that a substantial number of students reported "risk factors" sexual practices. These findings indicated a need for HIV-prevention efforts.

Adult↗

PubMed1992

Sexual practices in the transmission of hepatitis B virus and prevalence of hepatitis delta virus infection in female prostitutes in the United States.

OBJECTIVE: To evaluate heterosexual transmission of hepatitis B virus (HBV) and the prevalence of hepatitis delta virus (HDV) infection in female prostitutes. DESIGN: Survey. SETTING: Sexually transmitted disease clinics, drug treatment programs, detention centers, and/or outreach efforts in eight areas in the United States. PARTICIPANTS: A total of 1368 female prostitutes 18 years of age or older. OUTCOME MEASURES: Seropositivity for HBV and HDV infection. RESULTS: The overall prevalence of past or present HBV infection was 56%: 74% in women who were injecting-drug users (IDUs), 38% in women reporting no history of injecting-drug use (non-IDUs), 51% in whites, 55% in blacks, and 67% in Hispanics. Of 21 HBV carrier IDUs, 21% had HDV infection; of 18 HBV carrier non-IDUs, 6% had HDV infection. In non-IDUs (49%), risk factors for HBV infection were a history of having penile-anal intercourse (odds ratio [OR], 3.1; 95% confidence limits [CL], 1.3, 7.3) and seropositivity for syphilis and human immunodeficiency virus (HIV) infection. In IDUs, factors associated with an increased risk of infection, in addition to behaviors related to injecting-drug use, were the number of lifetime sexual partners, having sexual partners from groups at high risk for HBV infection, and seropositivity for syphilis and HIV infection; spermicide and/or diaphragm use was associated with a markedly decreased risk of HBV infection among blacks (OR, 0.1; 95% CL, 0.03, 0.4) and Hispanics (OR, 0.2; 95% CL, 0.06, 0.9). CONCLUSION: This is the first study to suggest that having anal intercourse and failing to use vaginal contraceptives may facilitate transmission of HBV to women. Our data support guidelines that recommend hepatitis B vaccination for prostitutes and persons with a history of sexually transmitted diseases or multiple sexual partners.

Adolescent↗