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PubMed2006

Serine/arginine-rich splicing factors belong to a class of intrinsically disordered proteins.

Serine/arginine-rich (SR) splicing factors play an important role in constitutive and alternative splicing as well as during several steps of RNA metabolism. Despite the wealth of functional information about SR proteins accumulated to-date, structural knowledge about the members of this family is very limited. To gain a better insight into structure-function relationships of SR proteins, we performed extensive sequence analysis of SR protein family members and combined it with ordered/disordered structure predictions. We found that SR proteins have properties characteristic of intrinsically disordered (ID) proteins. The amino acid composition and sequence complexity of SR proteins were very similar to those of the disordered protein regions. More detailed analysis showed that the SR proteins, and their RS domains in particular, are enriched in the disorder-promoting residues and are depleted in the order-promoting residues as compared to the entire human proteome. Moreover, disorder predictions indicated that RS domains of SR proteins were completely unstructured. Two different classification methods, the charge-hydropathy measure and the cumulative distribution function (CDF) of the disorder scores, were in agreement with each other, and they both strongly predicted members of the SR protein family to be disordered. This study emphasizes the importance of the disordered structure for several functions of SR proteins, such as for spliceosome assembly and for interaction with multiple partners. In addition, it demonstrates the usefulness of order/disorder predictions for inferring protein structure from sequence.

Amino Acids↗

PubMed1982

An epidemic outbreak of hepatitis A among homosexual men in Stockholm. Hepatitis A, a special hazard for the male homosexual subpopulation in Sweden.

In 1979-1980, a distinct outbreak of hepatitis A occurred among homosexual men in Stockholm, Sweden, city and county area. The epidemic comprised 145 known cases. It began in December 1979 and progressed in waves during the following 10 months, with three distinct peaks separated by about six-week intervals. Actually, the incidence of hepatitis A in the Stockholm area showed a fivefold increase during 1980 as compared to the previous year. Clinical serologic, and social characteristics were studied more closely in 98 of the 145 homosexual men. Verification of hepatitis A was made by a solid-phase radioimmunoassay technique for detection of antibody to hepatitis A virus of the immunoglobulin M class. In addition, 64% of the men showed findings consistent with a prior hepatitis B (antibody to hepatitis B core antigen and/or antibody to hepatitis B surface antigen) and 34% were Treponema pallidum immobilization-positive from a prior or concomitant syphilis. Employment in risk professionals was common; thus, 19% worked in restaurants or otherwise handled food and 20% were engaged in medical care as compared to the 1% occupied in either branch of work among the general population in Sweden. Sexual habits with multiple partners and oral-anal sexual contacts were judged to be of major importance in the spread of this epidemic. Some spread of hepatitis A to the general population probably occurred due to the risk occupations of many homosexual men.

Adolescent↗

PubMed1990

Recreational drug use and sexual behavior change in a cohort of homosexual men. The Multicenter AIDS Cohort Study (MACS).

The relationship between use of recreational drugs and high-risk (HIV-transmitting) homosexual behavior was examined in the Multicenter AIDS Cohort Study (MACS) population. Among the 3916 men who completed both the baseline (1984) and first 6-month follow-up evaluations and were sexually active during the 6 months prior to enrollment, self-reported use of each of 10 classes of recreational drugs in conjunction with sexual activity was analyzed for both cross-sectional and prospective relationships with pattern of sexual behavior using a four-level sexual risk behavior index. At baseline, the proportion of men in the highest risk category (unprotected anal exposures with multiple partners) increased from 36 to 85% when men not using any drugs to men using three or more drugs plus volatile nitrites were examined. In multivariate logistical analyses, volatile nitrite use was significantly associated with failure to maintain or attain lower sexual risk levels after controlling for the effects of age, educational level and numbers of high-risk partners. These results suggest that volatile nitrite use may play an important role in the association between recreational drug use and high-risk sexual behavior among homosexual/bisexual men.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Factors associated with HIV seropositivity in European injecting drug users. The European Community Study Group on HIV in Injecting Drug Users.

OBJECTIVE: To study factors associated with HIV seropositivity among European injecting drug users (IDU). METHODS: Data on behavioural and other factors potentially associated with HIV status were collected retrospectively by personal interview with IDU (n = 2330) in a multicentre cross-sectional survey conducted in 12 European countries from 1989 to 1990. HIV status tested at the time of the survey was examined in relation to demographic data, history of imprisonment, travel to foreign countries, high-risk drug-using practices in the previous 6 months (re-using other IDU's injecting equipment without effective disinfection) and high-risk sexual behaviour in the last 6 months (multiple partners, unless none was IDU and condoms were always used). Analysis excluded IDU who claimed to be seropositive from previous testing. RESULTS: Imprisonment was significantly associated with current HIV status [odds ratio (OR), 1.70; 95% confidence interval (CI), 1.2-2.87]. High-risk drug-use practices were significantly associated with current HIV status in respondents not previously tested (OR, 2.86; 95% CI, 1.09-7.35) but not in respondents claiming to be seronegative. No significant association was found for high-risk sexual behaviour. CONCLUSIONS: Our experience supports the validity of retrospective investigation of behaviour in a population that is notoriously difficult to study. However, any interpretation of the apparently different associations of HIV status with high-risk sexual behaviour and high-risk drug-use practices must consider that factors tending to attenuate the correlations may operate differently in these two areas.

Adolescent↗

PubMed1995

Sexual behaviour in developing countries: implications for HIV control.

OBJECTIVE: To provide basic information on pre- and extramarital sex in the general population and other factors related to HIV transmission. DESIGN: Cross-sectional household survey in 18 countries of the developing world, mainly in Africa and Asia. RESPONDENTS: Representative samples of 1300-6995 individuals aged 15-49 years, interviewed in 1989-1993. METHODS: Face-to-face interviewing. RESULTS: We observed a huge variability between study sites, with the proportion of men reporting sexual contact outside regular partnerships in the last year ranging from 4 to 47%. Contacts with sex workers range from 1 to 25%. Women were much less likely to report non-marital sex than men. CONCLUSIONS: This first cross-cultural attempt to examine aspects of sexual lifestyles suggests that broad generalizations about multiple-partner sexual networking in particular regions are misleading. Gender, marital status, age and a few other demographic correlates were disclosed as powerful determinants of sexual behaviour, although the strength of associations varied greatly between specific locations. Condom use was very low in most study sites.

Adolescent↗

PubMed1997

Concurrent partnerships and the spread of HIV.

OBJECTIVE: To examine how concurrent partnerships amplify the rate of HIV spread, using methods that can be supported by feasible data collection. METHODS: A fully stochastic simulation is used to represent a population of individuals, the sexual partnerships that they form and dissolve over time, and the spread of an infectious disease. Sequential monogamy is compared with various levels of concurrency, holding all other features of the infection process constant. Effective summary measures of concurrency are developed that can be estimated on the basis of simple local network data. RESULTS: Concurrent partnerships exponentially increase the number of infected individuals and the growth rate of the epidemic during its initial phase. For example, when one-half of the partnerships in a population are concurrent, the size of the epidemic after 5 years is 10 times as large as under sequential monogamy. The primary cause of this amplification is the growth in the number of people connected in the network at any point in time: the size of the largest "component'. Concurrency increases the size of this component, and the result is that the infectious agent is no longer trapped in a monogamous partnership after transmission occurs, but can spread immediately beyond this partnership to infect others. The summary measure of concurrency developed here does a good job in predicting the size of the amplification effect, and may therefore be a useful and practical tool for evaluation and intervention at the beginning of an epidemic. CONCLUSION: Concurrent partnerships may be as important as multiple partners or cofactor infections in amplifying the spread of HIV. The public health implications are that data must be collected properly to measure the levels of concurrency in a population, and that messages promoting one partner at a time are as important as messages promoting fewer partners.

Computer Simulation↗

PubMed1997

Adolescents, sexual behaviour and HIV-1 in rural Rakai district, Uganda.

OBJECTIVES: To describe the epidemiology of HIV-1 infection among adolescents aged 13-19 years, in rural Rakai district, Uganda. STUDY DESIGN: Baseline survey and 2-year follow-up (1990-1992) of adolescents in a population-based, open rural cohort. METHODS: Annual enumeration and behavioral/serological survey of all consenting adolescents aged 13-19 years at recruitment, residing in 31 randomly selected community clusters. RESULTS: At baseline, of 909 adolescents present in study clusters, 824 (90.6%) provided interview data and serological samples. No adolescents aged 13-14 years were HIV-infected. Among those aged 15-19 years, 1.8% of men and 19.0% of women were HIV-positive. Among young women aged 15-19 years in marital/consensual union, 21.3% were HIV-positive; this rate did not differ significantly from the 29.1% prevalence in those reporting non-permanent relationships; prevalence was significantly lower in women reporting no current relationship (4.3%). After multivariate adjustment, female sex, age 17-19 years, residence in trading centers/trading villages and a history of sexually transmitted disease symptoms remained significantly associated with HIV infection. Seventy-nine per cent of adolescents provided a follow-up serological sample. No young men aged 13-14 years seroconverted during the study; in young women aged 13-14 years, HIV seroincidence was 0.6 per 100 person-years (PY) of observation. Among young men aged 15-19 years, there were 1.1 +/- 0.6 seroconversions per 100 PY of observation prior to age 21 years; among women 15-19 years, the incidence rate was 3.9 +/- 1.0 per 100 PY of observation prior to age 21 years. The mortality rate among HIV-positive adolescents aged 15-19 years, at 3.9 per 100 PY of observation, was 13-fold higher than that among the HIV-uninfected. By 1992, knowledge of sexual transmission was almost universal, the proportions reporting multiple partners had decreased and condom use had increased over baseline. CONCLUSIONS: Adolescents, and young women in particular, are vulnerable to HIV infection. Despite reported behavioral changes, HIV incidence rates remain substantial, and there is a need for innovative HIV preventive measures.

Adolescent↗

PubMed2003

Acceptability of male circumcision as a tool for preventing HIV infection in a highly infected community in South Africa.

BACKGROUND: Because a growing body of evidence suggests that male circumcision (MC) is associated with a reduced risk of HIV infection in Africa, it is being considered as a potential prevention tool to reduce the spread of infection. Its feasibility must therefore be assessed. METHODS: A community-based cross-sectional study was conducted among a random sample of 482 men aged 19-29 years and 302 women aged 14-25 years, all living in the Westonaria district, South Africa. The prevalence of HIV infection was 11% among the men and 30% among the women. Trained personnel administered standardized questionnaires. RESULTS: Two-thirds of the 108 circumcised men (CM) were circumcised during a traditional ceremony and one-third in a clinical setting; the latter reported less pain and adverse outcomes. More than 70% of the non-circumcised men (NCM) stated that they would want to be circumcised if MC were proved to protect against sexually transmitted diseases (STD). Twenty-nine per cent of the CM and 22% of the NCM believed that MC protects against HIV and other STD. Moreover, 30% and 18%, respectively, believed that CM could safely have sex with multiple partners. Multivariate analysis showed that CM were more likely to report many lifetime partners. CONCLUSION: Although the level of MC in the area is relatively low, it is perceived positively. A significant proportion of the CM felt protected by their circumcision, a feeling unfortunately translated into unsafe practices. Our results strongly suggest that interventions including MC should carefully address the false sense of security that it may provide.

Adolescent↗

PubMedDate not supplied

HIV-risk behaviors and mental health characteristics among homeless or drug-recovering women and their closest sources of social support.

This article describes risky drug and sexual behavior and mental health characteristics in a sample of 240 homeless or drug-recovering women and their most immediate sources of social support. Women and their closest support sources both reported a great deal of recent noninjection drug use (56% and 52%, respectively) and lesser, though similar amounts of recent injection drug use (12% and 14%, respectively). More than one third of both groups reported a history of sexually transmitted disease and sexual activity with multiple partners. Fifty-one percent of the women and 31% of their support sources had Center for Epidemiological Studies Depression Scale (CES-D) scores of 27 or greater, suggesting a high level of depressive disorders in both samples. Similarly, 76% of the women and 59% of their support sources had psychological well-being scores below a standard clinical cutoff point. These data suggest that homeless and impoverished women turn to individuals who are themselves at high risk for emotional distress and risky behaviors as their main sources of support.

Adult↗

PubMed1992

Syphilis: a review and update of this 'new' infection of the '90s.

Reported cases of primary, secondary and congenital syphilis are reaching epidemic proportions in the United States. Several factors have been associated with this increase, including budget reductions for syphilis-control programs, the growing use of cocaine among women of childbearing age and the practice of trading sex with multiple partners for illegal drugs. This article reviews the pathogenesis, clinical stages and presentation, serologic testing, treatment, and pertinent patient education for syphilis. Recommendations for the identification and prevention of syphilis are provided.

Adolescent↗

PubMed1998

High-risk sexual behavior among drug users. The utility of a typology of alcohol variables.

OBJECTIVES: The purpose of this study was to develop a typology of drug users based on alcohol use variables and then determine the utility of this typology for predicting high-risk sexual behavior, controlling for the personality traits of sensation seeking and risk proneness. METHODS: A sample of 283 out-of-treatment drug users in Anchorage, Alaska, were interviewed regarding their alcohol and drug use, sexual behavior, sensation seeking, and risk proneness. The sample was 66% male; 44% white, 26% black, and 24% Native American; had a median age of 36 years; and a median monthly income of $500 to $999. RESULTS: Cluster analyses of alcohol variables showed the presence of two clusters, one of which is characterized by relatively high alcohol consumption and early age of first alcohol use. This alcohol typology was significantly related to several sexual risk behaviors, including having sex with multiple partners without consistent condom use (chi 2(1) = 10.47, p < .01), having sex with an injection drug user (IDU) without consistent condom use (chi 2(1) = 4.87, p < .05), number of sex partners (t(281) = -2.16, p < .05), STD history (chi 2(1) = 7.86, p < .01), and having traded sex for drugs or money recently (chi 2(1) = 6.91, p < .01) or in one's lifetime (chi 2(1) = 9.20, p < .01). All but one of these associations remained significant after controlling for sensation seeking and risk proneness. CONCLUSIONS: Among this sample of out-of-treatment drug users, a typology based on patterns of alcohol use was found to be associated with several measures of high-risk sexual behavior. Drug users who were classified as high risk on the basis of their lifetime and current alcohol use patterns were found to be significantly more likely than low-risk drug users to have engaged in risky sexual behavior. Risk proneness does not appear to account for this pattern of associations.

Adult↗

PubMed2000

Pattern of sexually transmitted diseases and risk factors among women attending an STD referral clinic in Nairobi, Kenya.

BACKGROUND: In Kenya, sexually transmitted disease (STD) clinics care for large numbers of patients with STD-related signs and symptoms. Yet, the etiologic fraction of the different STD pathogens remains to be determined, particularly in women. GOAL: The aim of the study was to determine the prevalence of STDs and of cervical dysplasia and their risk markers among women attending the STD clinic in Nairobi. STUDY DESIGN: A cross-section of women were interviewed and examined; samples were taken. RESULTS: The mean age of 520 women was 26 years, 54% had a stable relationship, 38% were pregnant, 47% had ever used condoms (1% as a method of contraception), 11% reported multiple partners in the previous 3 months, and 32% had a history of STDs. The prevalence of STDs was 29% for HIV type 1, 35% for candidiasis, 25% for trichomoniasis, 16% for bacterial vaginosis, 6% for gonorrhea, 4% for chlamydia, 6% for a positive syphilis serology, 6% for genital warts, 12% for genital ulcers, and 13% for cervical dysplasia. Factors related to sexual behavior, especially the number of sex partners, were associated with several STDs. Gonorrhea, bacterial vaginosis, cervical dysplasia, and genital warts or ulcers were independently associated with HIV infection. Partners of circumcised men had less-prevalent HIV infection. CONCLUSION: Most women reported low-risk sexual behavior and were likely to be infected by their regular partner. HIV and STD prevention campaigns will not have a significant impact if the transmission between partners is not addressed.

Adolescent↗

PubMed2001

Sexually transmitted infections and reproductive health in Azerbaijan.

BACKGROUND: Little is known about the prevalence of sexually transmitted infections (STIs) and about sexual and reproductive health in Central and Eastern Europe. However, it is clear that major epidemics of STIs currently exist. GOAL: To provide baseline information for the development of national guidelines on the management of STIs in Azerbaijan. STUDY DESIGN: A prevalence study on STIs, including a questionnaire on sexual and reproductive health, in two regions of Azerbaijan targeted three groups: (1) pregnant women, (2) gynecology patients, and (3) men attending a dermatovenereology clinic. RESULTS: The 407 pregnant women in this study had a mean of 1.47 abortions and 1.40 births per woman. Of these women, 12% reported condom use and 41% previous symptoms of a sexually transmitted infection. Active syphilis was found in 1.7% of the women. The 326 gynecology patients had a mean of 2.54 abortions and 2.63 births per woman. Of these patients, 11% reported use of modern contraceptives, 18.3% previous condom use, and 63% previous symptoms of an STI. The prevalence of active syphilis was 2.2%, Chlamydia trachomatis 3.1%, Neisseria gonorrhoeae 2.8%, Trichomonas vaginalis 7.1%, Candida 33.1%, and bacterial vaginosis 32.5%. Of the 197 male patients, 67% reported multiple partners in the past 3 months, 62% money exchanged for sex, 37% condom use ever, and 40% a history of STIs. Active syphilis was found in 9.5% of the men, C trachomatis in 5.9%, N gonorrhoeae in 17%, and T vaginalis in 4.4%. CONCLUSIONS: The data show high-risk behavior in the men attending STI clinics, poor sexual and reproductive health status in the women, and underreporting of official data.

Adolescent↗

PubMed2002

Association of adolescents' history of sexually transmitted disease (STD) and their current high-risk behavior and STD status: a case for intensifying clinic-based prevention efforts.

BACKGROUND: Adolescents are at high risk of sexually transmitted disease (STD)/HIV infection, and one vulnerable subgroup is African American females. The association between adolescents' previous experience of STD and recent sexual risk behaviors has been ill-defined. GOAL: The goal was to examine the associations between adolescents' self-reported history of STD diagnosis and current sexual risk behaviors, prevention knowledge and attitudes, and STD infection status. STUDY DESIGN: This was a cross-sectional survey. Recruitment sites were in low-income neighborhoods of Birmingham, Alabama, characterized by high rates of unemployment, substance abuse, violence, and STDs. Participants were sexually active adolescent females (N = 522) 14 to 18 years of age. Information on STD history and current sexual behaviors (within the 30 days before assessment) was collected in face-to-face interviews. Less sensitive topics, such as STD prevention knowledge, attitudes about condom use, and perceived barriers to condom use, were addressed via self-administered survey. DNA amplification of vaginal swab specimens provided by the adolescents was performed to determine current STD status. Outcomes associated with past STD diagnosis were determined by means of logistic regression to calculate adjusted odds ratios (AORs) in the presence of observed covariates. RESULTS: Twenty-six percent of adolescents reported ever having an STD diagnosed. Although past STD diagnosis was associated with increased STD prevention knowledge, it was not associated with increased motivation to use condoms. Compared with adolescents who had never had an STD, adolescents with a history of diagnosed STD were more likely to report not using a condom at most recent intercourse (AOR = 2.54; 95% CI = 1.64-3.93; = 0.0001), recent unprotected vaginal intercourse (AOR = 1.79; 95% CI = 1.15-2.79; = 0.010), inconsistent condom use (AOR = 2.27; 95% CI = 1.46-3.51; < .0001), sexual intercourse while drinking alcohol (AOR = 2.09; 95% CI = 1.33-3.28; = 0.001), and unprotected intercourse with multiple partners (AOR = 3.29; 95% CI = 1.09-9.89; = 0.034). Past STD diagnosis was associated with increased risk for current biologically confirmed gonorrhea and trichomoniasis (AOR = 2.48; 95% CI = 1.09-5.23; = 0.030; and AOR = 2.05; 95% CI = 1.18-3.59; = 0.011, respectively). Past STD diagnosis was not significantly associated with increased risk of current biologically confirmed chlamydia (AOR = 0.78; 95% CI = 0.45-1.37; = 0.38). CONCLUSION: Among this sample of female adolescents, past STD diagnosis was an indicator of current high-risk sexual activity and increased risk for two common STDs: gonorrhea and trichomoniasis. Although adolescents may gain factual knowledge from the experience of having an STD diagnosed, they are not applying that knowledge to their current sexual behaviors. Thus, these adolescents remain at risk for subsequent STD infection. Therefore, the findings suggest that there is a need to intensify clinic-based prevention efforts directed toward adolescents with a history of STDs, as a strategy for reducing STD-associated risk behaviors and, consequently, the likelihood of new STD infections.

Adolescent↗

PubMed2002

NAAT-identified and self-reported gonorrhea and chlamydial infections: different at-risk population subgroups?

BACKGROUND: Information on the characteristics and behaviors of persons at high risk for gonorrhea and chlamydial infection has typically been derived from studies of sexually transmitted disease (STD) clinic populations. The Baltimore STD and Behavior Survey (BSBS) used urine-based nucleic acid amplification testing (NAAT) to assess the prevalence and behavioral correlates of gonorrhea and chlamydial infection in a population-based cross-sectional survey of adults in Baltimore, Maryland. GOAL: The goal of this study was to examine the demographic characteristics and behavioral markers of gonorrhea and chlamydial infection as reported by adults with a self-reported history of gonorrhea and chlamydial infection and to compare these to the characteristics and behaviors of individuals with current NAAT-identified gonorrhea and/or chlamydial infection. STUDY DESIGN: A probability sample of adults aged 18 to 35 years residing in Baltimore was evaluated with collection of urine specimens and administration of a health and behavior survey. Data and specimens were collected between January 1997 and September 1998. RESULTS: Respondents with NAAT-detected gonorrhea and/or chlamydial infection (7.9%) did not report a history of high-risk behaviors or more recent occurrences of those behaviors, and the majority were asymptomatic. However, adults in our study who self-reported a history of infection (26.0%) were more likely than those with no history of infection to report multiple partners, paid sex, partners with prior STDs, and STD symptoms-a pattern consistent with findings described in previous clinic-based reports. CONCLUSION: The risk profile generated from studies of clinic populations, with a focus on symptomatic disease, may not characterize the broader population with current, untreated, largely asymptomatic infection.

Adolescent↗

PubMed2003

Sexual behavior and sexually transmitted infections in men living in rural Madagascar: implications for HIV transmission.

BACKGROUND: Madagascar is in the midst of a large HIV epidemic. Therefore, it is important to obtain relevant epidemiologic data that can be used to develop a preventive strategy. GOAL: The goal of the study was to assess sexual behavior and sexually transmitted infections (STIs) among men living in two coastal villages and one highland village with different levels of endemicity of urogenital schistosomiasis. STUDY DESIGN: Data were obtained from cross-sectional studies on male reproductive health. All men aged 15 to 49 years were offered enrollment. RESULTS: Of 401 men evaluated, 6.5% had used a condom and 45.6% reported having multiple partners in the previous 3 months. Symptoms of urethritis during the previous 7 days were reported by 128 men (31.9%). Urethritis was associated with the youngest age group (15-19 years) and the coastal villages, in which HIV antibodies were found in 0.9% and 2.5%, respectively. The prevalence of Schistosoma hematobium was 31.0% and 55.0% in these two villages, whereas none of the men in the highland village were infected. In bivariate analyses, urogenital schistosomiasis was associated with reported symptoms of urethritis, but it acted as a confounder in multivariate analyses. CONCLUSION: Several risk factors for HIV propagation exist in these rural areas in Madagascar. Young men in particular should be targeted for HIV/STI prevention. Treatment of urogenital schistosomiasis could be considered part of the syndromic STI treatment in areas where S hematobium is endemic, for patients seeking primary care for urethritis.

Adolescent↗

PubMed1996

Risk factors for HIV infection at enrollment in an urban male factory cohort in Harare, Zimbabwe.

Between March 1993 and March 1995, volunteers at 40 Harare factories were interviewed regarding sociodemographic characteristics and behavior; HIV serostatus was also determined. Among 2,691 men enrolled, HIV prevalence was 19.4%. Prevalence rose 2-fold with each year of age in young men (< 23 years). In a multivariate logistic model that included sociodemographic and behavioral variables, compared with those between 25 and 44 years, both younger men (OR = 0.51) and older men (OR = 0.49) were less likely to be HIV positive. In addition, marriage (OR = 2.01), history of sexually transmitted disease (STD) (genital ulcer, OR = 4.93, urethral discharge OR = 1.75), multiple partners (OR = 1.58), cash payment for sex (OR = 2.55) and condom use (OR = 1.35) were all independent risk factors for HIV infection. Home ownership conferred lower risk. Self-reported condom use was seen as a marker of correct personal risk assessment men who used condoms reported more risk behavior and had a higher prevalence of HIV, either because condom use was not consistent or because infection occurred prior to adoption of condoms. This study confirms established risk factors in a general population sample not selected for high risk of HIV infection. It suggests rapid acquisition of infection among young men and the importance of marriage (and separation of spouses) as correlates of HIV infection.

Adolescent↗

PubMed2004

The near-term future for child health information systems.

The developmental process in children offers an opportunity to influence their health and well-being as adults. The information infrastructure of the future needs to support the multiple partners responsible for providing elements of the health protection and health care of children. In this partnership, public health plays simultaneously a supportive role and a leadership role. Five tasks need to guide near-term information systems thinking with respect to establishing a basis for building electronic linkages among various child health programs. First, the nation's vital records system must be reengineered to ensure that this key information asset can be integrated into other child health information systems. Second, through an appropriate governance structure, the key stakeholders in child health should endorse standards and requirements that define a longitudinal health record for children. Third, public health agencies should develop a thorough business case/value proposition that drives mutually developed and mutually endorsed requirements for the integration of presently fragmented systems. Fourth, public health should take the lead in ensuring that parents have convenient access to information that can support the coordination of their child's care and development. And fifth, provider groups and public health agencies should join research networks to study how information supports positive changes to children's health.

Child↗