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PubMed1994

Epidemiologic factors correlated with multiple sexual partners among women receiving prenatal care.

A cross-sectional survey methodology was used to respond to the need of a local health department to identify correlates of high-risk behaviors related to human immunodeficiency virus (HIV) transmission among pregnant women attending prenatal care clinics. This study of 488 maternity patients was conducted at two public health clients in Tampa, Florida, in 1991. The prevalence of high-risk behaviors was assessed using a self-administered questionnaire. Out of 428 respondents, 25% reported having had intercourse with two or more male partners in the past year. Following multiple logistic regression analysis, four variables remained consistently and significantly associated (P < 0.05) with having two or more sexual partners: (1) annual household income of less than $10,000/y (prevalence odds ratio (POR) = 4.5; 95% confidence limits (CL): 1.5, 13.1); (2) history of prostitution (POR = 8.1; 95% CL: 1.5, 42.1); (3) history of rape or forcible intercourse (POR = 2.2; 95% CL: 1.0, 4.6); and (4) an expressed desire for confidentiality among women seeking further information about acquired immunodeficiency syndrome (AIDS) prevention (POR = 2.1; 95% CL: 1.1, 4.0). Assessment of these factors may lead to better direction of HIV education programs, as well as identification and counseling of specific individuals at high risk for engaging in behaviors that can lead to HIV infection. Short, self-administered questionnaires provide confidential, rapid, and inexpensive means of generating baseline data for further interventions.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Sexual activity and risk of HIV infection among patients with schizophrenia.

OBJECTIVE: This study sought to determine the frequency and types of sexual behavior among patients with schizophrenia and to assess the behavior with respect to risk of HIV infection. METHOD: Ninety-five inpatients and outpatients with a research diagnosis of schizophrenia underwent a series of face-to-face interviews to determine their sexual activity and correlate it with demographic characteristics, psychopathology, and medication side effects. RESULTS: Forty-four percent of the patients had been sexually active in the preceding 6 months, and 62% of these had had multiple partners. Sexual activity was associated with greater general psychopathology. Having multiple sexual partners was associated with younger age, a lower level of functioning, the presence of delusions, and more positive symptoms. Of the sexually active patients, 12% reported at least one partner who was HIV positive or injected drugs, or both, and 50% had exchanged sex for money or goods. Ten percent of the patients had engaged in homosexual activity in the preceding 6 months and 22% during their lifetime; the frequency was similar among men and women. Consistent condom use was uncommon. CONCLUSIONS: A substantial proportion of schizophrenic patients had recent histories of sexual abstinence, but an almost equal number were sexually active. Sexual activity was usually accompanied by behavior related to HIV risk. Sexual activity and having multiple partners were associated with certain measures of more severe illness. Younger patients were more likely to have multiple partners but were also more likely to use condoms. There is a need for aggressive prevention strategies with this population.

Adolescent↗

PubMed1996

Multiple sexual partners and condom use among long-distance truck drivers in Thailand.

Sexual behaviors of long-distance truck drivers in Thailand were investigated to define patterns and determinants critical to the transmission of HIV. This article reports on commercial, spousal, and other sexual partners and on condom use among 327 drivers interviewed in 1992. Forty-eight percent reported a commercial sex worker (CSW) as their first partner and 87% had contact with a CSW at some time. Median lifetime number of all partners was 29. In the 6 months prior to interview, 35% had two or more partners. Among the currently married, 23% had CSW contact within the past 6 months; 13% had contact with a nonmarital, noncommercial partner; and about 8% reported marital as well as both CSW and noncommercial relationships in the same time period. Over half the unmarried reported sexual relations in the 6 months; 25% reported contacts with both CSW and noncommercial partners. About 40% of subjects visiting CSWs used condoms inconsistently or not at all. Drivers were knowledgeable about AIDS and prevention measures, with some important misconceptions, but self-assessment of risk of HIV showed a negligible sense of their personal vulnerability.

Adolescent↗

PubMed1993

Factors associated with multiple sex partners among junior high school students.

Twenty-one percent of a sample of inner-city junior high school students were found to be sexually active (n = 403). Only 31% of them reported a single lifetime sexual partner, 25% reported two partners, and 43% reported three or more partners. Logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on the adolescents' lifetime number of sex partners. Respondents whose sexual debut occurred before age 13 years were nine times more likely to report three or more sex partners compared with those whose first sexual intercourse was at age 15 or 16 years, blacks were four times more likely than non-Hispanic whites to report three or more sex partners; and males were four times as likely as females to report this number of sexual partners. Factors not independently associated with the number of sex partners included: age, Asian or Hispanic ethnicity, human immunodeficiency virus (HIV) knowledge, self-efficacy (belief that one can protect oneself from the virus), condom use, and alcohol and drug use. We conclude that a significant proportion of school-based middle adolescents are sexually active and that most of these are at risk for contracting HIV because of behaviors such as having multiple sexual partners. Topics often stressed in school-based HIV education, such as factual knowledge about HIV, avoiding drugs and alcohol, and condom use are not associated with adolescents' choice about their number of sex partners. Intervention programs will have to identify and then target each specific HIV risk behavior and its motivations in order to reduce adolescents' risks of contracting and transmitting the disease.

Adolescent↗

PubMed1996

Alcohol misuse and adolescent sexual behaviors and risk taking.

OBJECTIVE: The aims of this study were to examine the associations between alcohol misuse and measures of early onset sexual activity and sexual risk-taking behaviors during adolescence and the extent to which any association between these two sets of behaviors could be explained by common risk factors that predisposed individuals to both outcomes. METHODS: Data were gathered during the course of a 16-year longitudinal study of a birth cohort of 953 New Zealand children and included: (1) self-report measures of early onset sexual activity (before the age of 16 years), multiple partners (three or more), and unprotected intercourse during the interval from 15 to 16 years; and (2) prospectively measured risk factors, including social background, childhood adversity, novelty seeking, and affiliations with delinquent peers. RESULTS: Adolescents who reported misusing alcohol had odds of early onset sexual activity, multiple partners, and unprotected intercourse that were 6.1 to 23.0 times those of young people who did not misuse alcohol. After adjustment for common or correlated risk factors, the adjusted odds ratios between alcohol misuse and early onset sexual activity and unprotected intercourse were reduced but remained statistically significant. However, no significant association between alcohol misuse and multiple partners was found after adjustment for common or correlated risk factors. CONCLUSIONS: Much of the apparent association between alcohol misuse and teenage sexual activity and risk taking seems to arise through the influence of common family, individual, and peer factors. However, alcohol misuse may also place teenagers at greater risk of initiating early onset sexual intercourse and engaging in unprotected intercourse.

Adolescent↗

PubMed1994

Does the promotion and distribution of condoms increase teen sexual activity? Evidence from an HIV prevention program for Latino youth.

OBJECTIVES: Opponents of condom availability programs argue that the promotion and distribution of condoms increases adolescent sexual activity. This assertion was tested empirically with data from the evaluation of a human immunodeficiency virus (HIV) prevention program for Latino adolescents. METHODS: The onset of sexual activity, changes in the frequency of sex, and changes in the proportion of respondents with multiple partners were compared for intervention and comparison groups. Multivariate regression analysis was used to assess the effect of the intervention on these outcomes after adjustment for baseline differences between the intervention and comparison groups. RESULTS: Male respondents in the intervention city were less likely than those in the comparison city to initiate first sexual activity (odds ratio [OR] = 0.08). Female respondents in the intervention city were less likely to have multiple partners (OR = 0.06). The program promoting and distributing condoms had no effect on the onset of sexual activity for females, the chances of multiple partners for males, or the frequency of sex for either males or females. CONCLUSIONS: An HIV prevention program that included the promotion and distribution of condoms did not increase sexual activity among the adolescents in this study.

Adolescent↗

PubMed1989

Prevalence of HIV antibody in high and low risk groups in England. Public Health Laboratory Service Working Group.

Most studies of the spread of HIV infection have centred on homosexuals and intravenous drug users. To estimate the extent of infection in different groups, including heterosexuals, the prevalence of HIV antibody was studied in 34,222 subjects tested with consent between October 1986 and December 1987 in England. These included subjects in high risk groups for HIV infection, heterosexuals with partners in the high risk groups and heterosexuals with multiple partners or with no identifiable risk factors. The prevalence was highest in homosexual or bisexual men in London (15.1%; 213/1412), being 4.0% (146/3607) outside London. The yearly incidence of infection in 632 homosexual or bisexual men without HIV antibody when retested during the study period was 3%. Among intravenous drug users the prevalence of HIV antibody was 5.7% (36/633) in London and 1.5% (39/2562) outside. Of 3272 heterosexual subjects tested, whose partner was in a risk group, eight of 515 (1.6%) in London and six of 2757 (0.2%) outside were positive for the antibody. Among 20,455 heterosexuals with a history of multiple partners or with no declared risk, only six subjects with HIV antibody were identified, two of whom had been infected abroad. Heterosexual spread of infection in England is evidently still largely confined to subjects whose partner has an identifiable risk.

Cross-Sectional Studies↗

PubMed1989

Sexual behaviour of injecting drug users and associated risks of HIV infection for non-injecting sexual partners.

The sexual behaviour of 142 clients of syringe-exchange schemes was measured using a questionnaire interview based survey method. Two to four months later the questionnaire was repeated to provide measures of behavioural change. The majority of these clients were sexually active, 77% having one or more sexual partners in the 3 months prior to the first interview. Many of these clients (46% of those sexually active) had sexual partners who did not inject drugs. There is evidence that this group modified their sexual behaviour towards reducing their own risk of HIV infection, with more having no sexual partners (from 23% to 31%), a reduction in those having multiple partners (from 26% to 21%) and a slight increase in those with regular partners (from 49% to 52%). Not all clients in this group reduced their risk of infection by modifying their sexual behaviour. Some clients continued to engage in high risk sexual behaviour, having multiple partners (21%) and not using condoms (79%). Whilst overall there is evidence of changes in the sexual behaviour of the clients towards a reduced risk of infection, we have identified an associated increase in risk of transmission from them to their sexual partners. Drug injectors who continued to have sexual partners were more likely to have sexual partners who did not inject drugs.

Adult↗

PubMed1993

Risks of human immunodeficiency virus infection among adolescents attending three diverse clinics.

This study was performed to identify specific high-risk behaviors, such as unprotected oral, anal, and vaginal intercourse and substance abuse, associated with human immunodeficiency virus infection among adolescents attending three diverse clinics located in a localized geographic area: a university-based clinic, a Planned Parenthood clinic, and an inner-city public health clinic (PHC). Six hundred seventy-one female and 207 male adolescents attending one of the three clinics completed a structured questionnaire. Similarities among patients at the clinic sites included high rates of anal intercourse (21%), unprotected vaginal sex (95%), oral sex (73%), and poor communication skills (42%). Some differences appeared as well, including higher rates of homosexual experiences, no birth control use, and having multiple partners among adolescents attending the PHC (p < 0.001). In contrast, adolescents attending either the university-based clinic or the Planned Parenthood Clinic had higher rates of substance abuse around sexual activity than those who attended the PHC (p < 0.001). We conclude that adolescents attending general medical clinics in the San Francisco Bay area engage in high-risk behaviors that place them at risk for transmission of human immunodeficiency virus even though many have had previous education about acquired immunodeficiency syndrome and sexually transmitted disease. Specific risk factors include unprotected receptive anal intercourse, unprotected vaginal intercourse with new and unknown partners, experience in homosexual behavior, high rates of oral sex, multiple partners, poor communication skills, and frequent use of illicit substances in conjunction with sex. The differences found among sites indicate the need for health care providers and prevention programs to provide emphasis on practices specific to the adolescents in their service area.

Acquired Immunodeficiency Syndrome↗

PubMed1997

[A survey on sexual awareness and behaviour of residents of a provincial city].

For better understanding of the sexual behaviours that are high-risk in terms of HIV infection, a random sample of 200 people aged above 20 and below 60 years, from a population of 23,700, was selected in the provincial city of Nagano and surveyed by visitation. The responses of 156 people (a rate of response of 78%) were collected and the results were statistically analyzed. The methods employed in conducting a survey on sexual behaviour were also evaluated. The number of sexual partners is an indicator of high-risk sexual behaviour for HIV infection. The data reveals that 65.3% of the men and 37% of the women had two or more partners in the past, with 37.5% of the men and 12.5% of the women having two or more partners in the last 5 years, and 19.1% of the men and 4.2% of the women having two or more partners in the last year, revealing that a higher percentage of men than women have multiple partners. Comparison by age group reveals that young men and women in their 20s have the highest percentage of multiple partners. For both men and women first sexual intercourse before the age of 18, for men self-employment, being a craftsmen or in agriculture, and for women, higher education, were all factors in having greater numbers of partners. In conducting a survey on sexual behaviour the following should be kept in mind. 1) The psychological background of the respondent; Sex counseling skills are required on the part of the interviewer when taking a survey on sex since it is a very private and personal topic for people. Respondents have a tendency to be those who are open-minded about sex and are active in life, and these factors can exaggerate the survey results. 2) Conduct of a survey on sexual behaviour; The survey should be taken only after the purpose of the survey has been fully explained to the respondents and trust has been established. In principle, therefore, mailing of a letter of request and the actual questions should not be the method utilized prior to the collection of responses.

Adult↗

PubMed1985

Cancer of the cervix. Some aspects of epidemiology, screening, risk factors and survival.

Early statistics on the occurrence of cancer of the cervix are unreliable. What is certain is that between 1950 and 1965 incidence rates (IRs) and mortality rates (MRs) fell considerably in most Western populations. Recently, however, rates in the 15-35-year age group of some populations have risen two- to threefold. In some developing populations, especially in South America and Africa, rates are very high--up to eight times those in most Western populations. Risk factors include early age at first intercourse, low socio-economic state, having multiple partners, smoking, being widowed or divorced, and having a husband who has had multiple partners. The modus operandi of carcinogenesis is not known. Screening, using the Papanicolaou test, has markedly reduced the IRs and MRs, particularly in certain Scandinavian populations. In Western populations 40-60% of patients attain 5-year survival. Understandably, in individual patients the crucial regulating factor is the stage of disease when diagnosed. Among those at stage I, 70-90% survive for 5 years or more, whereas only 0-25% of patients diagnosed at stage IV do. In Soweto, Johannesburg, length of survival in a series of black patients whose staging pattern did not markedly differ from that in Western series was less than half that in the latter. Undoubtedly, as repeatedly urged, appropriate selective screening and health education could effectively reduce the toll of mortality, especially in high-risk developing populations.

Adolescent↗

PubMed1989

Mathematical formulation and studies of the risk parameters involved in HIV transmission.

The probability of becoming infected with HIV is formulated in terms of the total number of sexual contacts (N), the probability that a sexual act is infectious (r) and the prevalence (p). Using the appropriate equations we studied the effect of reducing each of the risk factors on lowering the probability of infection. We show that for many realistic situations the probability of becoming infected by multiple partners is equal to the probability of becoming infected by one partner in a monogamous relationship given that the prevalence is the same in both cases; however if the multiple partners are chosen over time from a pool of a growing prevalence, then one is better off in a monogamous relationship where that partner is chosen early in the epidemic.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Transmission of cervical human papillomavirus infection by sexual activity: differences between low and high oncogenic risk types.

Not all studies have proven that cervical human papillomavirus (HPV) infection is a sexually acquired condition. Determinants of HPV infection were analyzed in a survey of 718 asymptomatic women in northeastern Brazil. HPV DNA was detected and typed by polymerase chain reaction. HPV types were classified into low- and high-risk groups on the basis of their association with cervical carcinomas. Overall HPV prevalence (18.3%) was moderately associated with age at first intercourse (P = .111, trend) and number of lifetime sex partners (P = .005, trend). However, separate analyses by risk revealed different degrees of association with sexual activity. Except for a positive association with multiple partners among women < 40 years old (P = .034, trend), infection with low-risk types (9.7%) was not correlated with sexual behavior. On the other hand, infection with high-risk HPV types (11.6%) was strongly and independently associated with both multiple partners (P = .009, trend) and age at first intercourse (P = .007, trend) in all age groups.

Adult↗

PubMed1994

Longitudinal changes in injection behaviors in a cohort of injection drug users.

To determine how the injecting behaviors of injection drug users (IDUs) change over time in the context of the epidemic of acquired immunodeficiency syndrome (AIDS) and what factors may be associated with such changes, a cohort of IDUs (n = 313) initially in treatment provided structured interviews regarding drug injecting behaviors. Repeat interviews in 18 months assessed behavior change in subjects who could be contacted for follow-up (n = 220, 70.3%). The study occurred in a state where sterile syringes can be purchased without prescription in drug stores. Injection drug use occurred for 180 (81.8%) of the 220 subjects in the 12 months prior to the initial interview but in only 121 (55.0%) in the 10 months prior to the follow-up interview (p < 0.0001). Similarly, sharing of equipment decreased from 63.1% to 31.8% (p < 0.0001). Sharing with multiple partners declined from 41.9% to 10.6% (p < 0.0001). Factors associated with ongoing risk included use of injected and non-injected psychoactive substances, less time in drug dependence treatment during follow-up interval, having a sexual partner who was an IDU and not using a drug store as the primary source of syringes. Factors associated with multiple-partner sharing included use of psychoactive substances, younger age and nonwhite race.

Cohort Studies↗

PubMedDate not supplied

The relationships between sexual behavior, alcohol use, and personal network characteristics among injecting drug users in Baltimore, Maryland.

BACKGROUND AND OBJECTIVES: Studies on the relationship between alcohol consumption and HIV-related risk behaviors report inconclusive and contradictory results. GOAL OF THIS STUDY: This study sought to examine the relationship between drug and alcohol use, personal network characteristics, and sexual risk behaviors. STUDY DESIGN: A sample of 290 injecting drug users in Baltimore, Maryland, were interviewed. RESULTS: More than half the males and 28% of the females reported multiple partners within the prior 6 months, and 33% of the males reported exchanging money or drugs for sex. For males, heavy drinking was significantly associated with multiple partners, exchanging money or drugs for sex, and casual sex. The personal network characteristics of size and density, as measured by the percentage of network members who knew each other, were associated with sexual risk behaviors. CONCLUSION: These results indicate that among injecting drug users in Baltimore, heavy drinkers, and those with larger, lower density personal networks have increased levels of sexual risk behaviors.

Adult↗

PubMed1997

Different demographic and sexual correlates for chlamydial infection and gonorrhoea in Rotterdam.

BACKGROUND: The objective of the study was to estimate the prevalence of gonorrhoea and chlamydial infections and to determine sexual and demographic correlates for these sexually transmitted diseases (STD) among visitors of an STD clinic. METHODS: In 1994, a cross-sectional study was carried out among 2984 consecutive visitors of the STD clinic of the University Hospital Rotterdam. RESULTS: The prevalence of chlamydial infection was 12.1% for women and 12.3% for men. For gonorrhoea, prevalence was 3.2% and 6.0%, respectively. For men, gonorrhoea was independently associated with multiple partners in the last month, homosexual activities, a history of gonorrhoea, last sexual contact in the past 4-14 days and casual partners. In contrast, chlamydial infection was less likely to be found in homosexual men and male intravenous drug users. Additionally, chlamydial infection was independently associated with young age, multiple partners in the last 6 months and with last sexual contact in the past 2 months. For women, intravenous drug use (associated with commercial sex work) and a history of trichomoniasis were independent risk factors for gonorrhoea. Independent risk factors for chlamydial infection in women were: young age, two or three sexual partners during life and last sexual contact within 2 months. Chlamydial infection was uncommon in commercial sex workers. CONCLUSIONS: The differences in the epidemiological correlates suggest that chlamydial infection is more diffusely spread into the general population than gonorrhoea. Additionally, it is hypothesized that men acquire their chlamydial infection through less stable relationships and subsequently infect their regular female partner.

Adolescent↗

PubMedDate not supplied

Data from the National AIDS Behavioral Surveys. I. Sexual risk for human immunodeficiency virus infection among women in high-risk cities.

Data from 3,482 women aged 18-49 living in 23 urban areas of the United States who participated in the 1990-1991 National AIDS Behavioral Surveys show that in the preceding year, approximately 15% engaged in sexual behavior that might expose them to the human immunodeficiency virus (HIV). Risk behaviors include having multiple sexual partners, having a risky main sexual partner or having both multiple partners and a risky main partner. An additional 17% of women with no other risk factor report that they do not know their main partner's HIV risk status. Predictors of risk factors vary by ethnicity, and having multiple partners and having a risky main partner appear to have distinct sets of predictors. Single women are more likely than others to have multiple partners, and among white women, those with more than 12 years of education are more likely to have multiple partners. Among blacks and Hispanics, younger women are more likely than older women to have multiple partners. Among Hispanic women, married respondents and those with more than 12 years of education are more likely than others to have a risky main sexual partner; the latter pattern is reversed among white women, however, with those having less than 12 years of education being more likely to have a risky main sexual partner. In general, women with a risky main partner are the least likely to use condoms consistently.

Adolescent↗

PubMed1995

Infectivity and risk factors of hepatitis C virus transmission through sexual contact.

HCV infection among heterosexuals with multiple partners and family members of patients with hepatitis C, and HCV RNA in the body fluid of these patients were investigated. The results showed that the HCV infection in heterosexuals with multiple partners, which was related to sexual activity, was much higher than that of healthy pregnant women. The HCV RNA in the saliva, semen or vaginal discharge of patients with hepatitis C was at detectable level. Among the patient's relatives, none of the children but 2 spouses were found to be infected with HCV. We concluded that sexual contact might play some role in HCV transmission.

Adolescent↗