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PubMed2005

Investigating the relationship between HIV testing and risk behaviour in Britain: National Survey of Sexual Attitudes and Lifestyles 2000.

OBJECTIVES: To estimate the prevalence of, and identify factors associated with, HIV testing in Britain. DESIGN: A large, stratified probability sample survey of sexual attitudes and lifestyles. METHODS: A total of 12,110 16-44 year olds completed a computer-assisted face-to-face interview and self-interview. Self-reports of HIV testing, i.e. the timing, reasons for and location of testing, were included. RESULTS: A total of 32.4% of men and 31.7% of women reported ever having had an HIV test, the majority of whom were tested through blood donation. When screening for blood donation and pregnancy were excluded, 9.0% of men and 4.6% of women had had a voluntary confidential HIV test (VCT) in the past 5 years. However, one third of injecting drug users and men who have sex with men had a VCT in the past 5 years. VCT in the past 5 years was significantly associated with age, residence, ethnicity, self-perceived HIV risk, reporting greater numbers of sexual partners, new sexual partners from abroad, previous sexually transmitted infection diagnosis, and injecting non-prescribed drugs for men and women, and same-sex partners (men only). Whereas sexually transmitted disease clinics were important sites for VCT, general practice accounted for almost a quarter of VCT. CONCLUSION: HIV testing is relatively common in Britain; however, it remains largely associated with population-based blood donation and antenatal screening programmes. In contrast, VCT remains highly associated with high-risk (sexual or drug-injecting) behaviours or population sub-groups at high risk. Strategies to reduce undiagnosed prevalent HIV infection will require further normalization and wider uptake of HIV testing.

Adolescent↗
PubMedDate not supplied

Multiple partners and partner choice as risk factors for sexually transmitted disease among female college students.

Multiple sexual partners and partner choice are believed to increase the risk of sexually transmitted disease (STD), but these behaviors had not previously been assessed outside of clinical populations. In this study, a cross-sectional survey among single, white, female students in their senior year of college was conducted to measure the association between behavioral risk factors and the acquisition of self-reported STDs during college. The usable response rate was 47.2% (n = 467). The combined prevalence of chlamydial infection, gonorrhea, genital herpes, human papillomavirus (HPV) infection, syphilis, and trichomoniasis during a 3.5-year period was 11.7%. There was a strong association between number of sexual partners and having an STD: those women with 5 or more sexual partners were 8 times more likely to report having an STD than those with only 1 partner, even after adjusting for age at first intercourse (odds ratio = 8.1; 95% confidence interval = 1.99, 32.64). The prevalence of a history of STDs increased with more causal partner choice and earlier age at first intercourse, but neither factor was independently associated with a history of STDs. Of the respondents, 23% always used condoms. Future research should focus on identifying ways of effectively changing high-risk sexual behavior.

Adult↗
PubMed1998

Communication of sexual risk behavior among late adolescents.

A grounded theory approach was used to describe how males and females in late adolescence communicate with their sexual partners about sexual risk behaviors. Interviews were audiotaped with 18 women and 15 men from a university in the southeastern United States. Verbatim transcripts were analyzed using constant comparative analysis. Building trust was identified as the core variable for both men and women. For women, prerequisites for building trust were being involved in caring relationships and indirectly gathering information about potential sexual partners. For men, prerequisites were being involved in caring relationships and using their instincts. Women usually initiated safe-sex talk, but men were willing to discuss it, once the conversation was initiated. Findings can serve as a guide for developing nursing strategies that promote more effective communication about sexual risk behavior in this age group.

Adolescent↗
PubMedDate not supplied

[Survey on sexual behavior by Congolese and French high-school students in an AIDS context].

The social and economic impact of AIDS add to those of a recent civil war in 1997. There were fratricidal confrontations before and after this period. Pointe-Noire, the second city of Congo and the economic Capital, was on the whole spared. We carried out a survey of 292 high-school students: 39% of girls and 61% of boys, from 14 old to 25 years old (average age of 19 years). They were from 5 general and technical schools, which are representative of the school recruitment of the city of Pointe-Noire. This study made in 1998 was the second part of a work achieved in France in 1997 with 1,859 high-school students: 70% of girls and 30% of boys, mean age 17.7 years, range 15-25 years. They came from 3 general, technical and professional schools of two departments of the region "Centre" ("Indre-et-Loire" and "Loir-et-Cher"). The material, corresponding to this study, is an anonymous self-questionnaire of 55 closed items presented in the form of assertions to which the student respond either yes or no. Items investigated: 1) pubertal maturation and subjective maturation; 2) different aspects of sexual experience in adolescence (components of sexual experience) [9] and 3) sexual behaviour (including sexual risk taking). All items have been formulated in the most accessible possible way for the youngsters. Previously, in 1996, we had made a pre-test with this material near sample of French people from 16 to 68 years old. The results of the study highlight that the Congolese youngsters present more risk than their French homologues. Although the pubertal status (the menarche and the spermarche) occurs slightly later, Congolese boys present a greater number of sexual partners and greater sexual precocity. Among 54% of Congolese pupils from the sample which had already had a sexual intercourse (68% of boys and 42% of girls) versus 52% of French pupils (58% of boys and 49% of girls), 88% of the Congolese boys have sexual intercourse at the age of 15, versus 72% of the girls at 16.5 versus 65% of the French boys in their 15.5 and 52% of the girls at 16. These differences are significant (p < 0.001) like all the following ones. Congolese students declare more sexual partners (4 during the last 12 months and 5 for all their life versus 3.2 and 4.4 for the French students); the boys more than the girls (6.5 sexual partners on the whole versus 3.7 for the girls in Congo and 5.7 versus 3.8 in France). Congolese girls generally have fewer sexual relations (over 12 months or during their entire life) than French high-school girls (respectively 5.9, 6.9 versus 8.7 and 9.3). We can see with French and Congolese students, a "traditional" dichotomy between boys and girls: that is to say girls tend to engage later in sexual relations and to favour the long and regular relations, while the boys have more short, and spaced sentimental relations. The relations of these last ones tend to evolve on a more preparatory mode, genital and intermittent, contrary to those girls who seem more sentimental and continuous. The use of the condom concerns 72% of the French pupils for the first sexual intercourse (74% of boys versus 72% of girls) - which is close to results of French reference surveys [1, 3]. On the other hand, they are only 39% to make use of it in Congo in this circumstance (36% of the boys and 34% of the girls). All Congolese young people present more STD (6% versus 4% for the French pupils) and more pregnancy (11% versus 3%). The other risky situations appear also more important in Congo: as the fact of having sexual intercourse after having drunk too much (6% of case where it arrives systematically versus 2% in France); to have sexual intercourse with a injecting drug user (4% versus 1%); paying or to have been paid (in a systematic way 7% versus 1%). The Congolese answers concerning the recourse to prostitution are more dissimilar and alarming concerning Congolese young people, especially if one takes into account all the situations where it occurred at least once (29% of the boys and 13% of the Congolese girls who declare to have had a sexual intercourse by paying (with money). Homosexual relations are more frequent in Congo (4 and 6% versus 2 and 3% for France). Homosexual experience concerned 13% of the Congolese pupils versus less than 5% of the French ones. The answers concerning a sexual partner who is "not sure" (20% in Congo versus 2% in France) can get clearer in the Congolese context with an elevated prevalence rate of infection by HIV. However, other cultural factors should not be neglected. The same applies for the answers relative to the sexual intercourse under duress (29% for Congo versus less than 7% in France). The answers relative to the fact of having a sexual intercourse with a much older partner (21% versus 13%) do not seem surprising for Congo. But it does not free risks. All these elements are not associated with a better estimate of the personal risk. (ABSTRACT TRUNCATED)

Acquired Immunodeficiency Syndrome↗
PubMed1987

Risk factors for human immunodeficiency virus (HIV) infections in homosexual men.

To clarify risk factors for infection with the human immunodeficiency virus (HIV) we selected at random 785 homosexual men who had participated in studies of hepatitis B in San Francisco in 1978-80 for a follow-up study of the acquired immunodeficiency syndrome. Although most had not been contacted in over five years, 492 (63 per cent) were located and enrolled. The 240 (67 per cent) who had developed antibodies to HIV, as measured by an enzyme-linked immunosorbent assay (ELISA), were compared with 119 who had remained seronegative. In multivariate analyses, receptive anal intercourse with ejaculation by nonsteady sexual partners, many sexual partners per month, and other indicators of high levels of sexual activity were highly associated with seroconversions. None of the sexual practices that we studied appeared to offer protection against HIV infection.

Adult↗
PubMed2006

The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study.

BACKGROUND: The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual. METHODS: We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that of 373 heterosexual classified men. Our outcomes of interest were: General health questionnaire; CAGE questionnaire; short form12; smoking status; sexual experiences during childhood; number of sexual partners and sexual function and satisfaction. RESULTS: In comparison to people classified as heterosexuals: men classified as gay reported higher levels of psychological symptoms (OR 2.48, CI 1.05-5.90); women classified as bisexual were more likely to misuse alcohol (OR 2.73, 1.70-4.40); women classified as bisexual (OR 2.53, 1.60-4.00) and lesbian (OR 3.13, 1.41-6.97) and men classified as bisexual (OR 2.48, 1,04, 5.86) were more likely to be smokers and women classified as bisexual (OR 3.27, 1.97-5.43) and men classified as gay (OR 4.86, 2.28-10.34) were much more likely to report childhood sexual experiences in childhood. Psychological distress was associated with reporting sexual experiences in childhood in men classified as gay and bisexual and women classified as heterosexual. Men classified as bisexual (OR 5.00, 1.73-14.51) and women classified as bisexual (OR 2.88, 1.24- 6.56) were more likely than heterosexuals to report more than one sexual partner in the preceding four weeks. Lesbian, gay and bisexual classified people encountered no more sexual function problems than heterosexuals but men classified as bisexual (OR 2.74, 1.12-6.70) were more dissatisfied with their sex lives. CONCLUSION: Bisexual and lesbian classified people attending London general practices were more likely to be smokers and gay classified men were at increased risk of psychological distress in comparison to heterosexual classified people. Increased awareness of the sexuality of people seen in primary care can provide opportunities for health promotion.

Adult↗
PubMed2006

Exhibitionistic and voyeuristic behavior in a Swedish national population survey.

We examined the prevalence and correlates of self-reported sexual arousal from exposing one's genitals to a stranger (exhibitionistic behavior) and spying on others having sex (voyeuristic behavior) in a representative national sample. In 1996, 2,450 randomly selected 18-60 year-olds from the general population of Sweden were interviewed in a broad survey of sexuality and health. A total of 76 (3.1%) respondents reported at least one incident of being sexually aroused by exposing their genitals to a stranger and 191 (7.7%) respondents reported at least one incident of being sexually aroused by spying on others having sex. Exhibitionistic and voyeuristic behaviors were examined for possible associations with 9 sociodemographic, 5 health, 4 risk-taking, and 17 sexuality variables. Both paraphilia-like behaviors were positively associated with being male and having more psychological problems, lower satisfaction with life, greater alcohol and drug use, and greater sexual interest and activity in general, including more sexual partners, greater sexual arousability, higher frequency of masturbation, higher frequency of pornography use, and greater likelihood of having had a same-sex sexual partner. Consistent with previous research in clinical samples of men with paraphilias, respondents who reported either exhibitionistic or voyeuristic behavior had substantially greater odds of reporting other atypical sexual behavior (sadomasochistic or cross-dressing behavior). There was evidence both for general and specific associations between sexual fantasies and their corresponding paraphilia-like behaviors. The implications of these findings for research on atypical sexual interests, atypical sexual behavior, and paraphilias are discussed.

Adult↗
PubMedDate not supplied

[The homosexual transmission of HIV/AIDS in Mexico].

OBJECTIVE: To analyze HIV homosexual transmission in Mexico, epidemic trends and biological and social risk factors. METHODS: This analysis is based on 19,090 notifications of AIDS cases and on a review of two previous studies that include 3,029 behavioral interviews (together with HIV serological screening tests) carried out at the Information Center of the Mexican Council for Control and Prevention of AIDS (CONASIDA) (1988-89) and during a 1988 study in six Mexican cities. Cities were included because they were the larger in the country and/or because they were the larger in the country and/or because they were touristic places (Mexico City, Guadalajara, Monterrey, Acapulco, Tijuana and Merida). Logistic regressions were used to estimate the odds ratios for HIV seropositivity and for condom use. RESULTS: Seventy-two percent of the total reported AIDS cases (19,090) up to June 30, 1994, were associated with male homosexual behaviors. In absolute numbers, cases under this category exhibited a rising trend until the end of 1993. HIV seroprevalence was 31% in 2,314 men with homosexual practices who attended "FLORA", the AIDS Information Center in Mexico, from January 1988 to June 30, 1989. The main predictive variables for seropositivity were exclusive homosexual behavior, more than 40 lifetime sexual partners, mixed sexual behavior (both insertive and receptive and intercourse), sex with a person with AIDS, history of syphilis, and anal or genital warts. In general, these risk factors (data from the Information Center) are similar to those found in the six Mexican cities study. There were significant differences in HIV prevalence among the high-risk city samples (the highest in Mexico City with 25% and the lowest in Monterrey with 2.4%). Reported condom use was very low in both studies: only 5% used a condom in all of their sexual relationships. A statistically significant protective effect for HIV infection was found only for those who reported using a condom in all sexual encounters. In the six cities study, city of residence was a strong predictor of condom use. CONCLUSIONS: HIV homosexual transmission is steadily increasing; the recent decline in the percentage of homosexual cases is artificial because of the increment of cases under other categories. Men who report exclusive homosexual behavior have higher prevalence rates of infection than bisexual men. Individuals with insertive/receptive behavior (mixed) have the highest risk for HIV seropositivity, mainly because of sociological, rather than biological reasons. This difference in risks for HIV and condom use may be related to the selection of sexual partners from specific social networks. Condom use was demonstrated to be an effective method for preventing HIV seropositivity among those who always use condoms. However, it is alarming that only 5% of respondents reported condom use in all sexual encounters. Social and geographic differences in the cumulative numbers of cases, HIV prevalence, sexual practices and condom use must be taken into account in the planning of preventive programs.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Assortative sexual mixing in a heterosexual clinic population--a limiting factor in HIV spread?

OBJECTIVE: To assess the degree of sexual mixing in a sexually transmitted disease clinic population stratified by country of birth. DESIGN: Prospective linked HIV serosurvey incorporating demographic and sexual risk data gathered by a doctor-administered questionnaire. SETTING: The Department of Genitourinary Medicine at St Thomas' Hospital, London, UK. SUBJECTS: Fifteen thousand eight hundred and seventy-eight heterosexuals who attended between April 1992 and February 1995. MAIN OUTCOME MEASURE: The degree of assortative (like-with-like) mixing, after stratification of the population by country of birth, of index patients, their parents and their sexual partners. RESULTS: Sexual mixing in this population of sexually transmitted disease clinic attenders is highly assortative when the CoB of parents (family origin) of index patients is taken into account. CONCLUSION: Our findings help to explain the low spread of heterosexual HIV infection in the UK to date, and may help future projections, and health targeting of those at risk. This model can be applied to other mixed population.

Ambulatory Care Facilities↗
PubMed2002

CD4+ and CD8+ lymphocytes and clinical features of HIV seropositive Nigerians on presentation.

Eighty of 200 HIV seropositive patients admitted in the medical wards of Ahmadu Bello University Teaching Hospital, Zaria from year 1995 to 1997 were studied on presentation and compared to 40 age and sex matched controls. The main clinical features observed included weight loss, pyrexia, diarrhoea, lymphadenopathy, anaemia and pruritic dermatosis. Sixty-two of the 80 patients (73.2%) presented at stages 3 and 4 of WHO Clinical and Laboratory staging. Thirty (30) percent of these patients died between a period of one to four months after presentation. The main diseases complicating HIV infection at presentation of the 80 patients were Mycobacterium tuberculosis infection (30%), acute bacterial infections (with Salmonella typhi, Streptococcus pneumoniae and Staphylococcus aureus) (24%), candidiasis (14%) and Kaposi sarcoma (2%). Seropositivity for HIV types was found to be HIV-I alone in 43.5% of cases; HIV-II alone in 14% and both HIV-I and II in 42% of cases. Risk factors associated with HIV infection were multiple sexual partners (73%), sexually transmitted disease (70%), and unscreened blood transfusion (1%). HIV positive patients had a mean CD4+ T-cells of 0.24 x 10(9) +/- 0.17 which was significantly lower than the mean of 0.6 +/- 0. 17 x 10(9)/L for controls (P < 0.05 students t-test). Thirty (35%) of the patients had CD4+ counts of less than 0.2 x 10(9)/L (200 cells/microl) at presentation. The mean CD3+ lymphocytes count was 0.51 +/- 0.24 x 10(9)/L for patients and 1.04 +/- 0.71 x 10(9)/L for controls. The mean CD8+ lymphocyte count in patients was 0.29 +/- 0.19 x 10(9)/L and 0.44 x 10(9)/L for controls. Both CD3+ and CD8+ lymphocyte populations were statistically lower in patients than controls (P < 0.05).

AIDS-Related Opportunistic Infections↗
PubMed1999

Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.

PURPOSE: To examine the relationship between number of sexual partners and selected health risk behaviors in a statewide sample of public high school students. METHODS: The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to secure usable sexual risk-taking, substance use, and violence/aggression data from 3805 respondents. Because simple polychotomous logistic regression analysis revealed a significant Race x Gender interaction, subsequent multivariate models were constructed separately for each race-gender group. Odds ratios and 95% confidence intervals was calculated from polychotomous logistic regression models for number of sexual intercourse partners and their potential risk behavior correlates. RESULTS: An increased number of sexual intercourse partners were correlated with a cluster of risk behaviors that place adolescents at risk for unintended pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and other sexually transmitted infections. For Black females, alcohol, tobacco, marijuana use, and dating violence behaviors were the strongest predictors of an increased number of sexual partners; white females had similar predictors with the addition of physical fighting. For white males, alcohol, tobacco, marijuana use, physical fighting, carrying weapons, and dating violence were the strongest predictors of an increased number of sexual intercourse partners. Black males had similar predictors with the addition of binge alcohol use. CONCLUSION: Prevention of adolescent sexual and other health risk behaviors calls for creative approaches in school and community settings and will require long-term intervention strategies focused on adolescent behavior changes and environmental modifications.

Adolescent↗
PubMed1986

Sexual function and somatopsychic reactions in vulvectomy-operated women and their partners.

Sexual function and somatopsychic reactions were examined in 25 women following vulvectomy and in 15 of their partners. More than half of the women had both sexual dysfunction and psychological problems. Their partners had no sexual dysfunction but almost half had psychological problems. An important reason for this seems to be insufficient information and advice both pre- and postoperatively and failure to recognize a developing stricture of the introitus vaginae. Frequent control and advice to both partners both pre- and postoperatively is desirable. Less extensive surgical procedures in selected cases should be considered.

Adult↗
PubMed1990

Sexual function in patients with Parkinson's disease and their partners.

Sexual function in patients with Parkinson's disease has received virtually no attention. There are many reasons (physical, psychological and social), why such patients might experience problems within their sexual relationships. A group of patients and their partners completed a series of self-report measures, aimed at assessing sexual function and a range of factors which might be associated with any difficulties. The results revealed a high level of dysfunction, not just in the patients but also in their partners. Most effected were the couples in which the patient was male. A range of problems were reported by both patients and their partners. These were, in turn, associated with a range of variables relating to the disease, psychological and social factors. No simple causal model was suggested, and a multimodal therapeutic approach might be expected to have most benefit.

Activities of Daily Living↗
PubMed2003

HIV sexual risk behavior among Puerto Rican women.

We examined the association of primary or nonprimary sexual partner relationship status on sexual risk behaviors, including condom use, among Latina women who are at self-disclosed increased heterosexual risk for human immunodeficiency virus (HIV) infection. Data were collected via structured interviews of 187 Puerto Rican women, aged 18-35, who attended a health clinic in the Bronx, New York. Approximately 13% of participants reported sexual activities with both primary and nonprimary sexual partners during the 6 months prior to the interview. Primary or nonprimary sexual partner status was associated with significant differences in frequency of condom use during anal sex and oral-penile sex, with more frequent condom use reported during these sexual activities with nonprimary sexual partners. Thus, potential contextual differences associated with primary or nonprimary relationship status may represent important factors to consider when designing interventions to facilitate HIV-protective behaviors among populations of urban women identified at increased heterosexual risk for HIV infection.

Adult↗
PubMed2001

Intimate relationship characteristics associated with condom use among drug users and their sex partners: a multilevel analysis.

Few studies have examined sexual risk behaviors among drug users in the context of their primary sexual relationships. The aim of this study is to examine characteristics of sexual partners associated with inconsistent condom use among a sample of 703 cocaine and opiate users from Baltimore, MD who participated in a network oriented intervention study of human immunodeficiency syndrome (HIV) risk behaviors among drug users. The current study examines relationship characteristics between drug users and their sexual partners (n=1003). Some of the study participants had more than one sexual partner, accounting for the greater number of sexual pairs than study participants. Study participants reported using multiple drugs (56% injected, 48% sniffed heroin, and 48% smoked crack) and that 70% of their sexual partners also used heroin and/or cocaine. Forty percent reported consistent condom use in the past 3 months. In multiple logistic regression, characteristics associated with consistent condom use were, the drug user being HIV infected; not living with their sexual partners; and not being financially interdependent. Previous research has demonstrated lower rates of condom use with main compared with casual and exchange partners. Primary sexual partners provide a sense of stability and introducing condoms may not be desirable or realistic. HIV prevention programs that target drug users should focus on the benefits, such as trust and a sense of security, and risks of not using condoms in primary relationships. Programs should also focus on enhancing communication and negotiation skills through targeting individuals as well as couples.

Adolescent↗
PubMed2005

Sexual abuse and reproductive health among unmarried young women seeking abortion in China.

OBJECTIVE: To investigate sexual violence and its impact on reproductive health in unmarried young women seeking abortion in China. METHODS: A total of 2002 participants were surveyed by questionnaire, gynecologic examination, and laboratory tests for sexually transmitted disease (STD). RESULTS: Overall, 14% of participants had experienced sexual violence and 43.4% were diagnosed with STD. Among victims of sexual abuse, 8.6% had their first sexual encounter when they were younger than 18 years; 42.7% had had 2 or more sexual partners; and 21.6% never used contraception. Multivariate analysis revealed that sexual abuse, multiple sexual partners, sexual activity before the age of 18 years, and not using contraception were important indicators of the presence of STD. CONCLUSION: The prevalence of sexual abuse is high in China; and among unmarried young women seeking abortion, those who experience sexual abuse are at significantly increased risk for STD.

Abortion, Induced↗
PubMedDate not supplied

Partner-specific sexual behaviors among persons with both main and other partners.

CONTEXT: If men and women engage in different sexual behavior with main partners than with other types of partners, then programs aimed at preventing the spread of sexually transmitted diseases (STDs) may need to address individuals' differential risk with each partner type. METHODS: Relationship characteristics, partner risk behaviors and sexual behaviors are examined among 123 male and 106 female STD clinic patients who had both main and other partners. Individual-level comparisons are made for two types of partner pairs: main vs. other frequent (side) partners and main vs. casual partners. RESULTS: Among men and women with both main and side partners, the proportion who had known only their main partner for at least a year (48% of men and 41% of women) was significantly higher than the proportion who had known only their side partner for that long (2% and 9%, respectively); no other variable differed significantly by partner type. Among those with main and casual partners, both men and women were more likely to use alcohol or drugs before or during sex with main partners only (15%) than with casual partners only (1-3%). Women with main and casual partners were more likely to have oral sex only with main partners than only with casual partners (37% vs. 3%), and were more likely to use condoms only with casual partners than only with main partners (33% vs. 4%). CONCLUSIONS: Providers need to ask individuals about their sexual behaviors with different partner types, and should tailor prevention messages to an individual's risks and reproductive intentions with each partner.

Chi-Square Distribution↗