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Association of sexual revictimization with sexuality and psychological function.

This study explores the associations of sexual revictimization (experiencing sexual abuse in childhood and adulthood) in a sample of 230 African American women who are low-income. Data indicate that women who experience sexual revictimization are more at risk for emotional stress and psychological pathology than women with no history of abuse. In addition, women who are revictimized appear to be at greater risk for emotional problems than women sexually abused only as a child or sexually assaulted only as adults. Revictimization also appears to be associated with an increased probability of engaging in prostitution, even higher than women with childhood- or adult-only victimization, who showed increased probability when compared to women never abused. Finally, women who are revictimized showed increased HIV risk, in that they were 4 times less likely than other women to consistently use condoms, but no more likely to be in monogamous relationships or less likely to have multiple partners.

Adult↗

Sexual violence and reproductive health among young people in three communities in Jamaica.

A secondary analysis of data collected from 1,130 young people ages 15 to 24 in a population-based household survey to assess the reproductive health needs of young people in three communities in Jamaica was conducted to determine the relationships among three measures of sexual violence, background variables, three measures of sexual risk taking (early sexual debut, multiple partners, and no condom at last sex), and two reproductive health outcomes (genital discharge within the past 12 months and pregnancy). In the multivariate analyses, forced first sex increased the likelihood of genital discharge among males (odds ratio, OR = 5.33) and females (OR = 2.02) and pregnancy among females (OR = 2.05), controlling for background characteristics and sexual risk taking. Associations between sexual violence and reported genital discharge and pregnancy that were not mediated by our measures of sexual risk taking were found. More research into the causal mechanisms for this association is needed.

Adolescent↗

Current smoking habits and genital infections in women.

A study was undertaken to assess the relationship between current cigarette smoking and genital infections. Four hundred women attending a sexually transmitted disease clinic were the subjects of the study; of these 212 (53%) were cigarette smokers. In women under 20 years of age 70% were smokers. Women who smoked were more likely to have multiple partners and be in a lower socio-economic class or unemployed. The presence of genital warts was commoner in smokers. No association was shown between smoking and cervical inflammation or dysplasia. The findings suggest that cigarette smoking is a behavioural factor which should routinely be identified in the demographic details of women attending sexually transmitted disease clinics.

Adolescent↗

A domain-oriented approach to the reduction of combinatorial complexity in signal transduction networks.

BACKGROUND: Receptors and scaffold proteins possess a number of distinct domains and bind multiple partners. A common problem in modeling signaling systems arises from a combinatorial explosion of different states generated by feasible molecular species. The number of possible species grows exponentially with the number of different docking sites and can easily reach several millions. Models accounting for this combinatorial variety become impractical for many applications. RESULTS: Our results show that under realistic assumptions on domain interactions, the dynamics of signaling pathways can be exactly described by reduced, hierarchically structured models. The method presented here provides a rigorous way to model a large class of signaling networks using macro-states (macroscopic quantities such as the levels of occupancy of the binding domains) instead of micro-states (concentrations of individual species). The method is described using generic multidomain proteins and is applied to the molecule LAT. CONCLUSION: The presented method is a systematic and powerful tool to derive reduced model structures describing the dynamics of multiprotein complex formation accurately.

Binding Sites↗

Vulnerability to HIV infection among sex worker and non-sex worker female injecting drug users in Dhaka, Bangladesh: evidence from the baseline survey of a cohort study.

BACKGROUND: Very little is known about female injecting drug users (IDU) in Bangladesh but anecdotal evidence suggests that they are hidden and very vulnerable to HIV through both their injection sharing and sexual risk behaviors. In order to better understand the risks and vulnerability to HIV of female IDU, a cohort study was initiated through which HIV prevalence and risk behaviors was determined. METHODS: All female IDU (those who had injected in the last six months and were 15 years or older) who could be identified from three cities in the Dhaka region were enrolled at the baseline of a cohort study. The study was designed to determine risk behaviors through interviews using a semi-structured questionnaire and measure prevalence of HIV, hepatitis C and syphilis semiannually. At the baseline of the cohort study 130 female IDU were recruited and female IDU selling sex in the last year (sex workers) versus those not selling sex (non-sex workers) were compared using descriptive statistics and logistic regression. RESULTS: Of the 130 female IDU enrolled 82 were sex workers and 48 were non-sex workers. None had HIV but more sex workers (60%) had lifetime syphilis than non-sex workers (37%). Fewer sex worker than non-sex worker IDU lived with families (54.9% and 81.3% respectively), but more reported lending needles/syringes (29.3% and 14.6% respectively) and sharing other injection paraphernalia (74.4% and 56.3% respectively) in the past six months. Although more sex workers used condoms during last sex than non-sex workers (74.4% and 43.3% respectively), more reported anal sex (15.9% and 2.1% respectively) and serial sex with multiple partners (70.7% and 0% respectively). Lifetime sexual violence and being jailed in the last year was more common in sex workers. CONCLUSION: Female IDU are vulnerable to HIV through their injection and sexual risk behaviors and sex worker IDU appear especially vulnerable. Services such as needle exchange programs should become more comprehensive to address the needs of female IDU.

Journal Article↗

Body piercing: lifestyle indicator or fashion accessory?

A study was undertaken to assess the prevalence of body piercing (BP) in women attending a sexually transmitted disease (STD) clinic, and any associated demographic, socioeconomic and sexual indicators. One hundred and fifty-two new female patients attending the Southampton clinic were the subjects of the study; of these 52 (32%) had BP, the most common site being the navel (25%). BP was more common in women who had their ears pierced more than once (35:71, 49%). It was less common in women who were non-smokers, being present in 17:77 (22%), and in older women, only one of 18 (6%) women aged 35 or older having had BP done. The presence of BP was not associated with socioeconomic class, method of contraception, multiple partners, or the presence of any genital infection. The study supports the suggestion that most BP is done for fashion reasons.

Adolescent↗

Voluntary HIV antibody testing amongst youth in Hong Kong.

We performed a study to estimate the prevalence of and factors associated with human immunodeficiency virus (HIV) antibody-testing behaviour among youth in Hong Kong. It was a population-based cross-sectional study. Questions on HIV testing were asked as part of a youth sexuality study conducted in July to December 1996 among young adults in Hong Kong. A total of 517 (53.6%) males and 447 (46.4%) females aged 17 to 28 years completed an anonymous structured self-administered questionnaire. Respondents had good knowledge about correct modes of HIV transmission and prevention. 9.4% (95% confidence interval [CI]: 7.0, 12.3) of males and 6.4% (95% CI: 4.3, 9.1) of females had been tested for HIV through blood donation. Excluding blood donation, 3.7% (95% CI: 2.2, 5.7) of males and 3.6% (95% CI: 2.1, 5.9) of females had been tested (voluntary testing). 47.5% (95% CI: 44.4, 50.7) of subjects reported at least one major risk factor for HIV infection. In multivariate analyses, factors independently associated with both voluntary HIV testing and HIV testing by blood donation were age and having had sex with multiple partners. A higher educational level was a predictor of HIV testing by blood donation. Self-assessment of having sufficient sex education was also significantly associated with voluntary HIV testing. HIV testing is not widespread in Hong Kong and those at risk are more likely to have been tested. It is of concern, however, that many of those reporting risk factors have not been tested.

AIDS Serodiagnosis↗

Female methamphetamine users: social characteristics and sexual risk behavior.

The primary objective of this research was to expand our knowledge regarding the personal and social characteristics of female methamphetamine (meth) users, their motivations for using meth, patterns of meth use, medical and social problems associated with meth use, and the relationship between meth use and sexual risk behaviors. The sample consisted of 98 HIV-negative, heterosexually-identified, meth-using females residing in San Diego, California. Female meth users were characterized by personal and social disadvantage, high rates of psychiatric symptomatology, and high levels of sexual risk behavior, including multiple partners, risky partner types (e.g., anonymous sex partners), and high rates of unprotected vaginal and oral sex. Meth use was also associated with the subjective positive experience of sex. These finding suggest that behavioral interventions should be tailored to the social characteristics of female meth users, and program content should reflect the intertwining of women's sexual experience and meth use.

Adult↗

Facing the challenge of a changing system: training child welfare workers in a privatized environment.

The state of Kansas' implementation of a privatized child welfare system is arguably an ambitious shift in child welfare service delivery. In an attempt to drastically improve services to vulnerable families, privatization resulted in intended and unintended consequences for the child welfare workforce. Some of these consequences, including the influx of inexperienced new workers, high worker turnover, and managing relationships with multiple partners, are issues that affect training needs of child welfare professionals. The following paper offers one approach to addressing these needs as well as identifying the challenges involved in training in a privatized environment.

Child↗

Perspectives from the front lines of tobacco control.

This research is designed to share valuable experiences and transferable principles from program staff of the Legacy/Community Voices initiative who have been involved in planning, implementing, evaluating, and sustaining tobacco control activities in underserved communities. Interviews were conducted with 13 front line staff from 9 sites: Alameda County, California; Detroit, Michigan; El Paso, Texas; Ingham County, Michigan; Miami, Florida; New Mexico; North Carolina; Northern Manhattan; and West Virginia. A model emerged from these interviews that places the life cycle of a program in a central position, with many of the identified themes (working with local champions, obtaining support from multiple partners, increasing organizational capacity) repeated throughout, albeit in different forms at different stages. Reflecting upon wisdom gained and identifying best processes for such work may help ensure that tobacco control programs are developed that are culturally safe and effective in meeting the needs of diverse communities throughout the United States.

Community Health Planning↗

Gender and relationship differences in condom use among 15-24-year-olds in Angola.

CONTEXT: The sexual behavior of young people in Angola will play a major role in the future spread of HIV, yet few young people use condoms consistently, and reported rates of condom use are low. It is important to identify determinants of condom use among Angolan adolescents and young adults. METHODS: Data for analysis came from 1,995 sexually experienced youth aged 15-24 who participated in a 2001 knowledge, attitudes and practices survey in Luanda, Angola. Logistic regression analysis was performed to identify predictors of consistent condom use by gender and determinants of condom use at last intercourse by type of relationship. RESULTS: For both males and females, consistent condom use was positively associated with higher levels of education (odds ratios, 1.7-2.6) and believing that condoms did not diminish sexual pleasure (1.8 for both genders). It was negatively associated with being married or in a cohabiting relationship (0.1-0.5). Females who equated condom use with lack of trust were less likely to use condoms consistently (0.5), and males who believed that condoms were safe and those who had multiple partners were more likely to be consistent users (1.6 and 1.7, respectively). Urban residence, higher education, being in school and not equating condom use with lack of trust were important predictors of use at last intercourse in regular and casual relationships, whereas access to condoms was the most important factor in spousal relationships (4.5). CONCLUSIONS: Intervention programs aimed at less educated, periurban and unemployed young people should be part of an effective HIV-prevention strategy. Such programs must address misperceptions among youth about condom use and the need for protection from HIV and other STIs.

Adolescent↗

Perceived risk of chlamydial and gonococcal infection among sexually experienced young adults in the United States.

CONTEXT: Understanding young adults' perceived risk of chlamydial and gonococcal infection can inform interventions to reduce the prevalence of these sexually transmitted diseases. METHODS: Bivariate and multivariate analyses, using data from Wave 3 of the National Longitudinal Study of Adolescent Health (2001-2002), were conducted to examine relationships between perceived risk and selected characteristics in two groups: a nationally representative sample of sexually experienced 18-26-year-olds and a subsample of those who tested positive for chlamydia or gonorrhea. The relationship between current infection and perceived risk was also evaluated. RESULTS: Only 14% of all respondents and 33% of infected participants reported some perceived risk of chlamydial or gonococcal infection. In the overall sample, the odds of perceiving risk were significantly elevated among blacks, Hispanics, unmarried respondents, inconsistent condom users and nonusers, respondents who reported multiple partners in the past year, those who had received a diagnosis of chlamydia or gonorrhea in the past year, and those reporting current symptoms (odds ratios, 1.5-3.3). Currently infected participants were significantly more likely than those who were not infected to perceive some risk of infection (2.4). Among infected respondents, the factors positively associated with perceived risk were being black or Hispanic, using condoms inconsistently or not using them, having exchanged money for sex, having been tested in the past year but with no diagnosis, having received a diagnosis, and reporting current symptoms (2.5-5.2). CONCLUSIONS: Interventions to increase the accuracy of young adults' risk perceptions may influence sexual and health care-seeking behaviors in a way that will reduce rates of chlamydia and gonorrhea.

Adolescent↗

Social-cognitive predictors of consistent condom use among young people in Moscow.

CONTEXT: Russia is experiencing an explosive HIV epidemic, and young people aged 15-29 have the highest incidence of infection. Understanding factors associated with condom use in this age-group is important in developing effective prevention interventions. METHODS: Telephone interviews were conducted with 1,203 Muscovites aged 15-29 in September 2002 to assess condom use, HIV knowledge and sexual behavior. Multivariate logistic regression was used to determine independent predictors of consistent condom use. RESULTS: Forty-four percent of sexually experienced respondents reported using condoms consistently. In multivariate analysis, the likelihood of consistent use was elevated among single women and men (odds ratios, 1.8 and 2.6, respectively), those who considered condoms reliable protection against unwanted pregnancy (2.4 and 1.6) and those who believed that most of their peers use condoms (2.9 and 4.6). For women, having recently had multiple partners was associated with increased odds of consistent use, and consistent use declined with age. CONCLUSIONS: Strategies to promote condom use should increase awareness about their effectiveness against not only unwanted pregnancies but also HIV and other STDs. Condoms should be recommended for married couples and people with one permanent partner as a contraceptive option as well as for disease prevention.

Adolescent↗

XML-based synchronization of mobile medical devices.

Today, mobile computing provides enough resources to be used in medical applications. Patient treatment is a process that involves multiple partners. All those partners need access to common patient-data and need to make changes to the patients' health record. Therefore, data that the partners collect and change with mobile devices has to be synchronized on a central server to form the master patient record. Data conflicts resulting from the synchronization have to be solved automatically. Our project describes a solution for XML-based data replication and synchronization for mobile health applications.

Computers, Handheld↗

HIV/AIDS in the Philippines.

HIV/AIDS has not yet caused a widespread epidemic in the Philippines. Rates in all the usual risk groups (sex workers, men who have sex with men, STD clients, returning overseas workers, etc.) have remained below 1%, except in a few areas, where they are still only 1-2% in some risk groups. The low level of HIV may be due in part to the low number of sex worker clients per night, the relatively low number of full-time sex workers, the low proportion of injectors among drug users, the early multisectoral response to the epidemic, and the presence of social hygiene clinics for sex workers. The incidence of STDs, multiple partners, and injection drug use with needle sharing, however, is increasing, suggesting that an explosive epidemic could occur if the virus is introduced into the appropriate risk groups. The Philippine government has confronted the problem of HIV/AIDS aggressively with an action plan that includes an emphasis on the response of the local government agencies, involvement and support of nongovernmental organizations (NGOs), incorporation of HIV/AIDS education into the school curriculum, and laws forbidding discrimination against persons with HIV/AIDS or belonging to risk groups. Local and international NGOs have been actively involved in prevention of HIV/AIDS and support of affected individuals. Although the Philippines is currently experiencing low rates of HIV/AIDS, the country needs to be prepared for the possibility of an explosive increase in the spread of HIV/AIDS. Vietnam and Indonesia provide examples of delayed epidemics of HIV/AIDS that could also occur in the Philippines.

Acquired Immunodeficiency Syndrome↗

Sexual behaviors and sexual risk in a prospective cohort of HIV-positive men and women in New York City, 1994-2002: implications for prevention.

As an ever-increasing number of people infected with HIV are living longer, healthier lives, concerns about continued transmission are growing along with an awareness of the need to develop "prevention for positives." This study of HIV-positive adults in New York City is the first examination of patterns of sexual behavior in a large, representative cohort of HIV-infected individuals followed over an extended time period. A total of 968 HIV-positive adults were interviewed every 6-12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many persons were not sexually active at all for months at a time; some continued to have multiple partners. Over one third of the cohort had one or more periods when they had engaged in unprotected sex with a partner who was HIV-negative or status unknown (unsafe sex) and one in five reported exchanging sex. Periods of unsafe sex alternated with periods of safer sex. Predictors of sexual risk varied by gender, and among men who had sex with men, and men sexually active with women only. Contextual factors such as partner relations, housing status, and receipt of HIV services were as important as individual attributes as predictors of unsafe sex and sex exchange. The variability observed in sexual risk behavior reported over time provides new insight into the importance of engaging persons living with HIV in ongoing prevention programs.

Adult↗

Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths.

OBJECTIVES: We examined relations between early alcohol use and subsequent alcohol and sexual risk behaviors among urban adolescents. METHODS: A total of 1034 African American and Hispanic youths completed surveys assessing alcohol and sexual behaviors at 7th and 10th grade. After we controlled for early sexual initiation, we examined relations between early drinking and subsequent alcohol and sexual behaviors. RESULTS: Early drinking was associated with alcohol and sexual risks through mid-adolescence. Early drinkers were more likely to report subsequent alcohol problems, unprotected sexual intercourse, multiple partners, being drunk or high during sexual intercourse, and pregnancy. Among females, early drinking was also related to sexual initiation and recent sexual intercourse. CONCLUSIONS: Prevention programs should address combined risks of early alcohol use and sexual intercourse, especially where levels of HIV and other sexually transmitted infections are elevated.

Adolescent↗

Reproductive health care and family planning needs among incarcerated women.

OBJECTIVES: Women in correctional institutions have substantial reproductive health problems, yet they are underserved in receipt of reproductive health care. We assessed the level of risk for sexually transmitted diseases (STDs) and the reproductive health needs of 484 incarcerated women in Rhode Island to plan an intervention for women returning to the community. METHODS: We used a 45-minute survey to assess medical histories, pregnancy and birth control use histories, current pregnancy intentions, substance use during the past 3 months, histories of childhood sexual abuse, and health attitudes and behaviors. RESULTS: Participants had extremely high risks for STDs and pregnancy, which was characterized by inconsistent birth control (66.5%) and condom use (80.4%), multiple partners (38%), and a high prevalence of unplanned pregnancies (83.6%) and STDs (49%). Only 15.4% said it was not likely that they would have sexual relations with a man within 6 months after release. CONCLUSION: Reproductive health services must be offered to incarcerated women. Such interventions will benefit the women, the criminal justice systems, and the communities to which the women will return.

Adult↗