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PubMed1997

Sexual behavior and contraceptive use. Changes from 1975 to 1995 in college women.

OBJECTIVE: The objective of this study was to compare the sexual practices and contraceptive use in a sample of college women in 1995 with women surveyed in 1975, 1986 and 1989. STUDY DESIGN: We surveyed 336 college women seen at a university student health service or on campus and compared their responses to those of women surveyed at the university in 1975, 1986 and 1989. RESULTS: The proportions of women who were sexually experienced, number of life-time male sexual partners, number of male sexual partners in the past year and frequencies of specific sexual practices were similar over the four survey times. Condom use was reported as the usual method of contraception in 7% of sexually experienced women in 1975, 14% in 1986, 25% in 1989 and 46% in 1995 (P < .00001, linear trend). CONCLUSION: We found little change in sexual practices in this college population over the four survey years, with the exception of an increase in the self-reported use of condoms. Increased educational efforts should emphasize safe sexual practices (barrier methods) to prevent sexually transmitted diseases and highly efficacious methods of contraception (hormonal contraception) to avoid unintended pregnancy.

Adult↗

PubMed2000

Tracing a syphilis outbreak through cyberspace.

CONTEXT: A recent outbreak of syphilis among users of an Internet chat room challenged traditional methods of partner notification and community education because locating information on sexual partners was limited to screen names and privacy concerns precluded identifying sexual partners through the Internet service provider. OBJECTIVES: To determine the association of Internet use and acquisition of syphilis and to describe innovative methods of partner notification in cyberspace. DESIGN, SETTING, AND PATIENTS: Outbreak investigation conducted at the San Francisco (Calif) Department of Public Health (SFDPH) in June-August 1999 of 7 cases of early syphilis among gay men linked to an online chat room; case-control study of 6 gay men with syphilis reported to SFDPH in July-August 1999 (cases) and 32 gay men without syphilis who presented to a city clinic in April-July 1999 (controls). MAIN OUTCOME MEASURES: Association of syphilis infection with Internet use, Internet use among cases vs controls, and partner notification methods and partner evaluation indexes. RESULTS: During the outbreak, cases were significantly more likely than controls to have met their sexual partners through use of the Internet (67% vs 19%; odds ratio, 8.7; P =.03). We notified and confirmed testing for 42% of named partners; the mean number of sexual partners medically evaluated per index case was 5.9. CONCLUSIONS: In this study, meeting sexual partners through the Internet was associated with acquisition of syphilis among gay men. Public health efforts must continually adapt disease control procedures to new venues, carefully weighing the rights to privacy vs the need to protect public health. JAMA. 2000;284:447-449

Adult↗

PubMed1977

Distinction between male and female invested partners in sexual disorders.

Using the SCL-90, a self-administered symptom inventory, the authors evaluated 48 sexually asymptomatic male and female partners (invested partners) of sexually dysfunctional men and women. They found that the male invested partners showed significantly more psychological symptoms than the female invested partners but about the same symptom distress levels as sexually dysfunctional men. The authors hypothesize that the reason for this gender-specific difference in distress levels of invested partners is society's definition of the male's role as the responsibe partner regarding satisfaction in sexual relationships.

Adult↗

PubMed1994

Social support and sexual risk taking among women on methadone.

This study examines the social support network of 109 female methadone patients and explores the relationship between social support and background variables, attitudes toward safer sex and sexual risk behavior. Subjects reported small supportive networks consisting primarily of drug users. Women who felt more loved by, respected by, and involved with a network of communication and mutual obligation, were more likely to feel comfortable talking about safer sex with their sexual partners and asking their sexual partners about their HIV status. They were also less likely to believe that their sexual partners would be upset if they suggested using a condom. No association was found between social support and frequency of condom use or frequency of sex with IV drug users during the last six months. Findings suggest the plausibility of multifaceted social support network interventions designed for methadone maintained women at high risk for HIV infection.

Adult↗

PubMed2006

Effect of coitus on recurrent preterm birth.

OBJECTIVE: To estimate the impact of sexual behavior on the risk of recurrent spontaneous preterm birth at less than 37 weeks of gestation. METHODS: This is a secondary analysis of a multicenter, blinded observational study of endovaginal sonographic examinations performed at 16-18 weeks of gestation on 187 women with singleton gestations who were at high risk for recurrent spontaneous preterm birth (prior spontaneous preterm birth at < 32 weeks of gestation). At the time of enrollment, each woman was interviewed by a research nurse with regard to her sexual history. The patient was asked about the number of sexual partners in her lifetime, the number of sexual partners since the start of her pregnancy, and, on average, the frequency of intercourse per week in the preceding month. RESULTS: A total of 165 pregnancies were available for this analysis. The population incidence of spontaneous preterm birth at less than 37 weeks of gestation in the study pregnancy was 36%. An increasing number of sexual partners in a woman's lifetime was associated with an increased risk of spontaneous preterm delivery (one partner 19%, 2-3 partners 29%, >or= 4 partners 44%, P = .007), whereas the number of sexual partners since the start of pregnancy was not (P = .42). Women who reported infrequent sexual intercourse during early pregnancy had an incidence of recurrent spontaneous preterm birth of 28% compared with 38% in those women who reported some intercourse (P = .35). CONCLUSION: Self-reported coitus during early pregnancy was not associated with an increased risk of recurrent preterm delivery. There was an association between increasing number of sexual partners in a woman's lifetime and recurrent preterm delivery. LEVEL OF EVIDENCE: II-2.

Adolescent↗

PubMed1990

Effects of potential partners' physical attractiveness and socioeconomic status on sexuality and partner selection.

Male (n = 170) and female (n = 212) college students viewed photographs, which had been prerated for physical attractiveness, of three opposite-sex individuals. These photographs were paired with three levels of occupational status and income. Subjects indicated their willingness to engage in relationships of varying levels of sexual intimacy and marital potential with the portrayed individuals. Analyses of variance, correlations, and trend analyses supported the hypotheses. Compared to men, women are more likely to prefer or insist that sexual intercourse occur in relationships that involve affection and marital potential, and women place more emphasis than men do on partners' SES in such relationships. Consequently, men's SES and their willingness and ability to invest affection and resources in relationships may often outweigh the effects of their physical attractiveness in women's actual selection of partners. These results and the literature reviewed are more consistent with parental investment theory than with the view that these sex differences are solely the result of differential access to resources and differential socialization.

Adolescent↗

PubMed2006

Herpes simplex virus infection in women in the WIHS: epidemiology and effect of antiretroviral therapy on clinical manifestations.

OBJECTIVE: To determine the prevalence of infection with herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) among women with and at high risk for HIV infection, and to evaluate the effect of HAART on the recurrence of genital lesions. METHODS: We evaluated the epidemiology and clinical manifestations associated with HSV-1 and HSV-2 among 1796 HIV-infected and 476 HIV-uninfected women enrolled in a multisite cohort study. Serum antibodies to HSV-1 and HSV-2 at baseline and self-reported history of genital herpes, reports of recent genital sores and presence of genital ulcers on examination, and use of HAART regimen at each study visit were analyzed. RESULTS: Reactivity to HSV-1 only and HSV-2 only was detected in 18% and 20% of HIV-infected, and in 28% and 18% of HIV-uninfected participants respectively; 58% of HIV-infected women and 45% of HIV-uninfected women were seropositive for both HSV types. Reactivity to HSV-2 was associated with increasing age, more male sexual partners, earlier sexual debut, African-American race, Latina ethnicity, less education and lower income. HIV-uninfected women reported significantly fewer genital sores than HIV-infected women who had used HAART for at least 1 year and had optimal CD4 cell gain and viral suppression (adjusted odds ratio (OR), 0.19; 95% confidence interval (CI), 0.13-0.28). CONCLUSION: Use of HAART and subsequent immune recovery does not completely eliminate the effect of HIV infection on genital lesions among women with concurrent HSV-2 infection.

Adolescent↗

PubMed1989

Problems of adolescents sexuality.

Recent discussions highlighted adolescents' sexual behaviour, but published studies concentrate on specific problems or subgroups of patients without addressing factors related to sexuality. To obtain a broad picture we studied two groups of adolescents attending genito-urinary medicine/sexually transmitted disease (STD) clinics in contrasting areas of Britain, inner London and Swansea. These were evaluated for referral pattern, sexual partner, contraception, obstetric history, sexually transmitted disease, and cervical cytology findings. Over half the adolescents referred themselves but few doctors other than general practitioners referred patients. Sexual partners were regarded by males as casual but by females as regular. Only 66% (81) of females practised contraception. Adolescents had more STD's than the total clinic population except for genital herpes simplex infection, and a high prevalence of genital warts in females has important future implications. The main conclusions were that there is a need for sexually related education targetted at adolescents and their health care providers, especially doctors.

Adolescent↗

PubMed1997

Trends in attitudes and behaviour relevant to AIDS in Ugandan community.

Behaviour-related preventive measures are still the main weapon against the spread of AIDS. Intensive AIDS prevention and control activities conducted over the last ten years need to be evaluated on the basis of their impact on attitudes and behaviour relevant to AIDS. The main objective of this study was to document and evaluate trends in attitudes and behaviour relevant to AIDS in a Ugandan community over a seven year follow up period. The study was a longitudinal community-based closed cohort. Periodic surveys were conducted on the study group and data on condom use, attitudes about condoms, rates of sexual partner change and reported frequency of sexually transmitted diseases were collected in all surveys. Data reported are from surveys conducted during 1987, 1992 and 1994 in which similar questions were asked and emerging trends identified. Reported condom use ever, increased from 3.9% in 1987 to 10.1% in 1992 and to 27.2% in 1994. This is a 7.3 fold increase over seven years. In females, reported use of condoms increased from 1.2% in 1987 to 18.2% in 1994 while in males it increased from 6.9% to 35.3% over the same period. In this study group there are still more people opposed to the ongoing intensive condom campaign than there are those supporting it. The percentage supporting the campaign was 28% in 1987, 26% in 1992 and 40.8% in 1994. This is a rising trend. The rate of sexual partner change has declined. During the baseline survey, 26.5% of the respondents reported that they had intercourse with two or more sexual partners in the six months period before the interview. This proportion decreased to 6.8% in 1992 but then increased to 17.1% in 1994. During the baseline survey, 2.6% of the study group reported that they had sexual intercourse with six or more partners during the six months period before the interview but during the 1992 and 1994 surveys, no one reported sexual intercourse with more than five partners during a similar period. The reported frequency of sexually transmitted diseases during a twelve month recall period, reflecting STD incidence, decreased from 3.5% in 1992 to 1.9% in 1994. In conclusion during the seven year followup period of this community-based closed cohort, we have identified a sharp increase in condom use, a reduced rate of sexual partner change and a decline in the reported frequency of sexually transmitted disease. The percentage of people supporting the condom campaign is rising. These are some of the outstanding outcomes of the AIDS prevention activities conducted in the country over the last 10 years.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Transmission of STIs/HIV at the partnership level: beyond individual-level analyses.

Mathematical modeling of transmission dynamics of sexually transmitted infections (STIs) and HIV has considerably advanced HIV research by highlighting the importance of certain types of partnerships in epidemic spread. Notably, concurrent partnerships, defined as a sexual partnership in which one or more of the partnership members have other sexual partners while continuing sexual activity with the original partner, have been shown to play a fundamental role in potentiating the spread of STIs and HIV. Risk behaviors such as concurrency and sex without condoms as well as STI/HIV prevalence vary with physical, social, and emotional factors within partnerships. The efficiency of STI/HIV transmission appears to vary across types of concurrent partnerships according to the differing dynamics within them. Previous research on partnership dynamics has improved our understanding of the multidimensional aspects of sexual partnering, but little is understood of how these aspects of sexual partnering interact and increase risks for HIV, nor how types of partnerships, partnership dynamics, and concurrency work together to affect both the behavior of condom use and the biological transmission of disease. In this article, we discuss the need to extend our understanding of concurrency to include partnerships among men who have sex with men (MSM) and to differentiate between types of partnerships and to develop interventions to modify risk within partnerships. We also introduce a conceptual framework that reflects how individual and partner characteristics influence partnership dynamics that in turn influence risk behaviors, such as concurrency and not using condoms, and associated risks for STIs and HIV.

Communication↗

PubMed1991

Heterosexual co-transmission of hepatitis C virus (HCV) and human immunodeficiency virus (HIV).

OBJECTIVES: To determine the prevalence of antibodies to hepatitis C virus (HCV) in female sexual partners of multitransfused men with hemophilia and to compare the frequency of transmission of HCV and human immunodeficiency virus (HIV). STUDY DESIGN: Cross-sectional measurement of HCV and HIV antibodies. SETTING: Ten hemophilia treatment centers. PATIENTS: A total of 234 female sexual partners of 231 multitransfused men with hemophilia. MEASUREMENTS AND MAIN RESULTS: The prevalence of antibodies to HCV (anti-HCV) among female sexual partners of HCV-positive men was 5 of 194 (2.6%). Anti-HIV prevalence among female sexual partners of HIV-positive men was 25 of 196 (12.8%). Five (3%) of the 164 female sexual partners of HIV-positive/HCV-positive men were infected with HCV compared with none of the 30 female sexual partners of HIV-negative/HCV-positive men. Twenty-one (13%) of the 164 female sexual partners of HIV-positive/HCV-positive men were infected with HIV compared with 4 (13%) of 32 female sexual partners of HIV-positive/HCV-indeterminate men. The co-infected men were five times more likely to transmit both viruses than would be expected by chance (P = 0.01). When a single virus was transmitted to a female sexual partner, it was more often HIV than HCV (18 of 164 compared with 2 of 164, P = 0.001; odds ratio, 8.5; 95% Cl, 2.2 to 33.1). CONCLUSIONS: The higher prevalence of HCV in female sexual partners of men with hemophilia than in blood donor and other low-risk groups suggests that there is a low level of sexual transmission. Male to female sexual transmission of HCV is less efficient than that of HIV. The frequency of HCV transmission to sexual partners is five times higher when HIV is also transmitted, suggesting that HIV may be a cofactor for the sexual transmission of HCV.

Adult↗

PubMed2005

Childhood sexual abuse, relationship satisfaction, and sexual risk taking in a community sample of women.

Childhood sexual abuse (CSA) has been proposed to influence both women's adult sexual risk behaviors and the quality of their intimate relationships. Among a household sample of women (n = 732), good fit was obtained for a model in which CSA predicted Wave 1 male partner sexual risk and aggression characteristics, resulting in lower relationship satisfaction, and ultimately in higher numbers of Wave 2 sexual partners. The model was generally replicated among women who entered new relationships at Waves 2 and 3. Partner sexual risk characteristics also were associated with women's risk of sexually transmitted infection from current partner. Elevated sexual risk behaviors among CSA survivors reflect difficulty in establishing stable and safe relationships and may be reduced by interventions aimed at improving intimate relationships.

Adolescent↗

PubMed1989

[Risk factors for condylomata. A case control study].

The present study involves 214 patients whose cervical smear showed signs of human papilloma virus infection (HPV), matched with 1042 controls. We demonstrate increasing odds ratio with the total number of sexual partners since first sexual intercourse (p less than 0.0001). Moreover the cases have more often changed partners in the year preceding the diagnosis (odds ratio 2.6 p less than 0.0001). Their male partners more often have occupations that expose them to "extra-conjugal adventures" (p = 0.0005). Using a logistic regression analysis we demonstrate the independence of the masculine and feminine risk factors. After adjustment for age, reason for consulting and marital status the following factors are related to HPV infection: new partner, total number of sexual partners since first sexual intercourse and partner's occupation.

Adult↗

PubMedDate not supplied

[Multicenter study of intrafamilial transmission of hepatitis C virus in human immunodeficiency virus infection].

OBJECTIVE: Intrafamilial transmission of hepatitis C virus in human immunodeficiency virus and hepatitis C virus co-infections is not well documented. This cross-sectional study evaluated the transmission of hepatitis C virus in the sexual partners of hepatitis C virus and human immunodeficiency virus co-infected patients. METHODS: Hemophiliacs and transfused hepatitis C virus and human immunodeficiency virus co-infected patients who were being seen in three French university hospitals, and their sexual partners were studied by a face-to-face interview using an epidemiological questionnaire and by biological tests: antibodies against hepatitis C virus, hepatitis C virus RNA, and ALT activity. RESULT: Fifty-two subjects were included: 26 cases and their 26 sexual partners. Three sexual partners (11.5 %) had anti-hepatitis C virus antibodies, two of whom had an undetermined RIBA test. All three had a risk factor for hepatitis C virus infection (transfusion, intra-muscular injections with re-usable needles). Two of these three partners were also human immunodeficiency virus antibody positive. Hepatitis C virus RNA was negative in all sexual partners. CONCLUSION: This study provides evidence of a low prevalence of anti-hepatitis C virus antibodies in sexual partners of hepatitis C virus and human immunodeficiency virus co-infected patients. It does not support intra-familial transmission of hepatitis C virus.

Adult↗

PubMed2006

Number of sexual encounters involving intercourse and the transmission of sexually transmitted infections.

OBJECTIVE: To investigate the impact of the number of sexual encounters involving intercourse in combination with the number of sexual partners on the transmission dynamics of sexually transmitted infections (STIs). STUDY: A statistical model is used for predicting the basic reproductive rate, R(0), which takes both the number of sexual partners and the number of sexual encounters involving intercourse per partner into consideration. The model is then applied to Swedish survey data that includes data on the number of partners over the course of 1 year, as well as the number of encounters per partner during this time. RESULTS: The number of sexual encounters involving intercourse in combination with the number of sexual partners affects the number of secondary infections in a nonlinear way. The basic reproductive rate, R(0), is lower when the heterogeneity in number of encounters is modeled than when homogeneity is assumed. CONCLUSION: The results indicate that it is possible that individuals who have a large number of partners may not, as is often assumed, be the only ones to play a central role as spreaders of STIs. Individuals who have a large number of sexual encounters involving intercourse per partner and have several (but not necessarily a very large number of) partners may also play a significant role in the transmission of STIs.

Contact Tracing↗

PubMed1996

Is genital mycosis associated with HIV risk behaviors among heterosexuals? ACSF Investigators. Analyse des comportements sexuels en France.

OBJECTIVES: This study examined in both sexes whether genital mycosis is as strongly associated with human immunodeficiency virus (HIV) sexual risk behavior as are other sexually transmitted diseases. METHODS: Heterosexuals in the French National Survey of Sexual Behavior who reported a history of either mycosis or another sexually transmitted disease in the previous 5 years were compared with heterosexuals who reported no such disease. Odds ratios were adjusted for age, education, place of residence, and number of sexual partners. RESULTS: Among men, mycosis and other sexually transmitted diseases showed similar associations with age and number of sexual partners. Among women, mycosis was also associated with a high number of sexual partners, albeit to a lesser extent than other sexually transmitted diseases. Lifetime experience of heterosexual anal penetration was reported significantly more often by men with a history of mycosis. CONCLUSION: These results suggest that most male mycosis is sexually acquired and constitutes a self-reported indicator as good as other sexually transmitted diseases for high risk. Female mycosis may help define an intermediate HIV risk group.

Adolescent↗

PubMed2003

Distribution of the Brief Male Sexual Inventory in community men.

The objectives of the study were to characterize male sexual functioning as related to age in community-dwelling older men. In 1989, a random sample of men aged 40-79 y (n=2115) without prior prostate surgery, prostate cancer, or other conditions known to affect voiding function (except benign prostatic hyperplasia) was invited (55% agreed) to participate in the Olmsted County Study of Urinary Symptoms and Health Status Among Men. In 1996, a previously validated male sexual function questionnaire was administered to the cohort. The questionnaire has 11 questions measuring sexual drive (two questions); erectile function (three) and ejaculatory function (two), as well as assessing problems with sex drive, erections, or ejaculation (three); and overall satisfaction with sex life (one). Each question is scored on a scale of 0-4, with higher scores indicating better functioning. Cross-sectional age-specific means (+/-s.d.) for drive, erections, ejaculation, problems, and overall satisfaction declined from 5.2 (+/-1.5), 9.8 (+/-2.5), 7.4 (+/-1.4), 10.7 (+/-2.2), and 2.6 (+/-1.0), respectively, for men in their 40s to 2.4 (+/-1.6), 3.3 (+/-3.4), 3.6 (+/-3.2), 7.7 (+/-3.8), and 2.1 (+/-1.2) for men 70 y and older (all P<0.001). The cross-sectional decline in function with age was not constant, with age-related patterns differing by domain. The percentage of men reporting erections firm enough to have intercourse in the past 30 days declined from 97% (454/468) among those in their 40s to 51% (180/354) among those in their 80s (P&<0.001). In age-adjusted analyses, men reporting regular sexual partners had statistically significantly higher levels of sex drive, erectile function, ejaculatory function, and overall satisfaction than those who did not report regular sexual partners. Sexual drive, erectile functioning, ejaculatory functioning, and overall sexual satisfaction in men show somewhat differing cross-sectional patterns of decline with advancing age. Active sexual functioning is maintained well into the 80s in a substantial minority of community-dwelling men.

Age Distribution↗

PubMed1997

Social differences in sexual behaviour and cervical cancer.

In this chapter we first describe the variation of cervical cancer in relation to social class. Thereafter we examine the causes for the occurrence of socioeconomic differences in invasive cervical cancer, using data from two case-control studies carried out in Colombia and Spain. Cervical cancer is the most common cancer in developing countries and the sixth most common in developed countries. In all areas, it is more frequent among women of low socioeconomic status, it is associated with multiple sexual partners and early age at first sexual intercourse, and both incidence and mortality are reduced by screening. According to population-based surveys in industrialized countries, men of low socioeconomic status report fewer sexual partners than men of high socioeconomic status but there is no clear indication that the same is true of women of low socioeconomic status. In the case-control studies in Spain and Colombia, the human papillomavirus and all other sexually transmitted diseases were more prevalent among women in low socioeconomic strata. Number of sexual partners and particularly contacts with prostitutes were higher among husbands of women of low socioeconomic status. Other potential risk factors for the disease, such as smoking and oral contraceptive use, and also cervical cancer screening (Pap smears), were more common in women of high social strata. Women with no schooling had a threefold higher risk in Spain and a fivefold higher risk in Colombia of having cervical cancer compared with women who had achieved a higher educational level. After adjustment for sexual behaviour, HPV DNA status, history of Pap smears and husband's contact with prostitutes, this association was considerably reduced. These results are indicative that socioeconomic differences in the incidence of cervical cancer can be partly explained by differences in the prevalence of HPV DNA. Men's sexual behaviour and particularly contacts with prostitutes might be a major contributor to the higher prevalence of HPV DNA among the poor.

Adolescent↗