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PubMed1997

Communication types and sexual protective practices of college women.

Sexually transmitted disease, such as the fatal HIV disease, continues to threaten the health of young women. Adolescents have typically been inconsistent users of effective strategies that prevent the spread of disease during sexual activity. Communication practices related to disease-related sexual protection have received little attention as a variable separate from sexual protection. The purpose of this study was to explore the relationship among different types of interpersonal communication of young women and their new sexual partners and their implementation of disease-related sexual protection. A sample of 163 young women who had experienced sexual intercourse completed the Safe Sex Behavior Questionnaire. Interpersonal communication was explored using the general-information-seeking (getting to know a partner), sexual self-disclosure, and specific-disease risk-information-seeking scales. These scales were combined; factor analysis revealed three subscales closely related to the original scales. Findings suggest that young women who seek specific information about their new sexual partner's disease risk status are more likely to implement sexual protective practices. These findings provide guidance to nurses who work with adolescent women in advising on aspects of interpersonal relationships that need to be enhanced to protect one's health status.

Adolescent↗

PubMed1993

Female streetworker--prostitutes in Glasgow: a descriptive study of their lifestyle.

The objective of this study is to describe the lifestyle of a group of female prostitutes. The collection of information was achieved by: (i) using a self administered questionnaire; and (ii) conducting conversational type interviews. Of 85 women attending a health care drop-in centre for female street prostitutes in Glasgow, 63 completed the questionnaire and 72 participated in conversational interviews. For 63 women the mean age of commencement of prostitution was 21 years. Fifty-one (81%) were injecting drug users, their most commonly used drugs being heroin and temazepam. They worked a mean of 5.5 evenings per week and provided sexual services to a mean of 6.4 clients per working day. Less than half of these services were estimated to be vaginal intercourse. While 59/60 women indicated that they always used condoms during vaginal intercourse, this only applied to commercial sex; only 8/47 (17%) always used condoms with their regular sexual partners. Unconventional sexual services, e.g. voyeurism and physical abuse, were commonly provided and clients were often violent. A typical female streetworking-prostitute in Glasgow was aged 25, unemployed, an injecting drug user and had commenced prostitution 4 years before. Her knowledge of HIV/AIDS was good and for vaginal intercourse she almost always used condoms with clients, though probably not with her regular partner. Her main concern was likely to be violence from clients.

Adolescent↗

PubMed1993

Association of Mycoplasma genitalium with acute non-gonococcal urethritis.

Chlamydia trachomatis is known to be a cause of acute non-gonococcal urethritis (NGU), though the aetiology of this disorder is not fully understood. Mycoplasma genitalium has been isolated from a few men with NGU, but culture has remained difficult and reliable detection became possible only with a specific polymerase chain reaction (PCR). We have used the PCR to examine the role of M genitalium in NGU. M genitalium was detected in urethral samples from 24 (23%) of 103 men with symptoms, signs, or both, of acute NGU, but from only 3 (6%) of 53 men without NGU (p < 0.006). This association was independent of the presence of C trachomatis and could not be explained by differences in age, ethnic, origin, lifetime number of sexual partners or a change in sexual partner during the previous 3 months. The clinical response of the mycoplasma-positive men to doxycycline treatment was at least as satisfactory as that of the chlamydia-positive men. These findings suggest that the association of M genitalium with NGU is likely to be causal, a notion consistent with the known virulence characteristics of this microorganism and its ability to cause urethritis in male sub-human primates.

Acute Disease↗

PubMedDate not supplied

Associations between number of lifetime partners and other health behaviors.

OBJECTIVE: To examine associations between health behaviors and lifetime sexual partners among college students. METHODS: Data from the 1995 National College Health Risk Behavior Survey were analyzed. RESULTS: After adjusting for age, sex, and race, having 2 or more lifetime sexual partners was associated with infrequently using seat belts, driving after drinking, having a physical fight, considering suicide, and using chewing tobacco and marijuana. Significant sex interactions occurred with cigarette smoking and fruit and vegetable consumption, and significant age interactions occurred with binge drinking. CONCLUSIONS: Having multiple lifetime sexual partners (> or = 2) was associated with several negative health behaviors.

Age Factors↗

PubMed2002

Relative risk of HIV infection among young men and women in a South African township.

The prevalence of HIV infection in Africa is substantially higher among young women than it is among young men. Biological explanations of this difference have been presented but there has been little exploration of social factors. In this paper we use data from Carletonville, South Africa to explore various social explanations for greater female infection rates. This paper reports on data from a random sample of 507 people between 13 and 24 years old. Subjects were tested for HIV, as well as other sexually transmitted infections (STIs), and answered a behavioural questionnaire. The age-prevalence of HIV infection differs between men and women with considerably higher rates of increase with age among young women. The age of sexual debut did not differ significantly between men and women (15.9 and 16.3 years, respectively) and below the age of 20 years there was no difference in the number or distribution of the number of sexual partners reported by men or women. The risk of infection per partnership was substantially higher among women than among men. Women have sexual partners who are, on average, about five years older than they are with some variation with age. Scaling the age-prevalence curve for men by the age of their sexual partners gives a curve whose shape is indistinguishable from that for women but is about 30% lower for men than for women. In terms of social explanations for HIV rates among women, the data indicates that this difference can be explained by the relative age of sexual partners, but not by other factors explored. In addressing the epidemic among young women it will be essential to deal with the social factors that lead young women to select their partners from older-age cohorts and that shape their sexual networking patterns.

Age Factors↗

PubMedDate not supplied

Predictors of condom acquisition after an STD clinic visit.

Data from a survey of 691 men and women who made patient visits to an inner-city, sexually transmitted disease (STD) clinic and were given coupons to redeem for condoms at a neighborhood pharmacy show that only 22% of the sample did so. Gender, ethnicity, marital status and education were not significant predictors of whether study participants redeemed their coupons. Factors that significantly predicted coupon redemption included the extent of acculturation and age, with those who were older and less acculturated more likely to do so. Other significant factors were having a primary sexual partner and having had more than one sexual partner in the last month; having ever had an STD was negatively associated with coupon redemption. A perception of being at high STD risk and a favorable attitude about condoms also significantly predicted condom acquisition. All these variables, except for attitude toward condoms and a history of an STD, remained significant when entered into a logistic regression controlling for the influence of all independently significant predictors.

Adolescent↗

PubMedDate not supplied

Determinants of genital human papillomavirus infection in low-income women in Washington, D.C.

OBJECTIVES: To confirm the risk factors for genital human papillomavirus (HPV) infection. GOAL OF THIS STUDY: To investigate risk factors for HPV detection independent of the correlated risk factors for cervical neoplasia, in a high-risk population. STUDY DESIGN: We investigated 404 cytologically normal women attending medical assistance clinics in the Washington, D.C. area. Risk factor information was obtained and a cervicovaginal lavage was collected and used for HPV detection and typing by a PCR-based technique. RESULTS: The point prevalence of HPV was 33.7%. This contrasts with the 17.7% and 44.3% observed in the companion reports published in this issue of the journal. HPV prevalence decreased with age and increased with greater numbers of sexual partners. Moreover, more recent sexual behavior was a better predictor of current HPV detection than lifetime number of sexual partners. Numbers of pregnancies and current pregnancy were positively associated with HPV prevalence and there was an indication that current oral contraceptive users had a higher prevalence of HPV compared to never users. Smoking was not associated with increased HPV prevalence. CONCLUSION: Findings support the sexual route of transmission of HPV and confirm the association of HPV detection with age, suggesting the host's ability to clear infection or the virus' ability to become latent.

Adolescent↗

PubMed1994

Attitudes to sex and sexual behaviour in rural Matabeleland, Zimbabwe.

Though HIV prevention campaigns in Zimbabwe have increased public awareness of HIV, they have not meaningfully changed sexual behaviour. Possibly these campaigns are based on wrong assumptions about sexual behaviour. By means of 111 structured interviews with hospital patients, secondary school students and teachers, and 11 focus group discussions with traditional healers, midwives, village community workers, secondary school students and teachers, and commercial sex workers in a rural district of Matabeleland in Zimbabwe, this low-budget study explores attitudes towards sex and sexual behaviour in order to define more appropriate health education messages. Results indicate that traditional sex education no longer takes place and that communication between sexual partners is limited. The almost ubiquitous expectation of women to get rewards for sex outside marriage motivates mostly single women out of economic necessity to meet the male demand for sexual partners, which is created by large scale migrant labour and men's professed 'biological' need for multiple partners. Types of sexual behaviour other than penetrative vaginal sex are uncommon and considered deviant. Safe sex messages from the West therefore are inappropriate in the Zimbabwean context. Recommendations are given to restore traditional communication about sexual matters across generations and to urge sexual partners to discuss sex. Women who, for economic reasons, engage in casual sex should at least learn to negotiate the use of condoms. Men seriously need to reconsider their attitudes to sex and sexual practices in view of the high HIV sero-prevalence. Faithfulness, rather than multiple sexual contacts, should become a reason to boast.

Adolescent↗

PubMed1994

Evaluation of a theory-based HIV prevention intervention for college students.

This study tested the effectiveness of a workshop for college students designed to increase HIV-preventive behavior by increasing participants' self-efficacy concerning HIV-preventive behavior. The Safer Sex Efficacy Workshop (SSE workshop) was compared with a lecture on HIV (HIV lecture) and a lecture on an unrelated topic, family violence (FV lecture); the effect of each condition on self-efficacy, behavioral intentions, and HIV-preventive behavior was assessed. Participants in the SSE workshop and the HIV lecture increased more from pretest to posttest in self-efficacy and the intention to use a condom than participants in the FV lecture. Participants in the SSE workshop increased their frequency of condom use from pretest to two-month follow-up more than participants in either of the two control conditions. Changes in the frequency of participants' discussion of AIDS and past partners with sexual partners and the intention to discuss did not differ among the three intervention conditions.

Adult↗

PubMed1996

Behavioral intervention to increase condom use among high-risk female adolescents.

OBJECTIVE: To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention, with the use of infection with Chlamydia trachomatis as a biomarker of condom practices. DESIGN: Prospective, randomized, controlled intervention. SETTING: Urban family planning and sexually transmitted disease clinics. PARTICIPANTS: Two hundred nine female adolescents, aged 15 through 19 years, who were treated for C. trachomatis genitourinary infection, were randomly assigned to standard (control) or experimental (behavioral intervention) groups. One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects. MEASUREMENTS: Subjects completed a multiinstrument questionnaire measuring sexual behavior, condom practices, attitudes and beliefs, cognitive complexity, sociodemographics, and motivation at enrollment and follow-up. Endourethral and endocervical sites were sampled for C. trachomatis. RESULTS: Among the 112 subjects who returned for repeated examination, those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases (odds ratio = 2.4; p = 0.02) and for vaginal intercourse (odds ratio = 3.1; p = 0.005) at the 6-month follow-up. Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention (odds ratio = 2.8; p = 0.03) and the higher cognitive complexity (odds ratio = 4.6; p = 0.02) independently contributed to greater condom use at follow-up. Despite greater use of condoms among the group who had received the intervention, use remained inconsistent and rates of reinfection with C. trachomatis were not significantly different (26% vs 17%; p = 0.3). CONCLUSION: Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners, incident infection does not appear to be reduced, because condom use remained inconsistent.

Adolescent↗

PubMed2001

Sexual behaviour and sexually transmitted diseases among young men in Zambia.

Sexually transmitted diseases (STDs) are an increasing public health problem in Zambia. About 200 000 cases of STDs are treated annually in the formal health sector. Young people are the most affected by STDs. High-risk sexual behaviour has been identified as the major risk factor for STDs among young people. We conducted interviews and focus group discussions with a purposely selected sample of 126 young men aged between 16 and 26 in Chiawa, rural Zambia. The aim of the interviews and focus group discussions was to explore views about sexual practices and attitudes towards STD. Fifty-eight (59%) young men reported having had pre-marital or extra-marital sexual partners during the past year. The maximum number was five partners for six individuals. Forty-two (43%) had pre-marital or extra-marital sexual partners at the time of the interviews. Focus group discussions revealed that perceptions of manhood encouraged multiple sexual relationships. Twenty-two (23%) reported having suffered from an STD in the past. Seventy-nine (81%) said they were likely to inform their sexual partners if they had an STD. Although condoms were believed to give protection against STDs by the majority (94%), only 6% said they always used condoms. The data suggest that condoms were perceived to affect male potency. These results show that STDs, multiple sexual relationships and unprotected sex are common among the young men of Chiawa. Perceptions that emphasize manhood are widespread and these may negatively affect efforts for positive behavioural change. Health messages that target the young men should take into account the local perceptions and values that seem to sustain risky sexual behaviour.

Adolescent↗

PubMed2003

Self, friends, and lovers: structural relations among Beck Depression Inventory scores and perceived mate values.

BACKGROUND: We used an economic model based on evolutionary theory to guide an examination of relations among self-reported depressive symptoms and ratings of mate values of self, social, and sexual partners. This model treats assortative mating as a form of social exchange between partners of socially and sexually desirable traits. METHODS: Two studies used variants of the Mate Value Inventory (MVI), a multivariate assessment of attributes desired in social or sexual partners. For study 1, 115 male and 124 female undergraduates provided self reports on four forms of the MVI-11 and on the Beck Depression Inventory (BDI); for study 2, 208 male and 277 female undergraduates provided self reports on seven forms of the MVI-7 and on the BDI-II. RESULTS: Both multisample structural equations models indicated that the parameters were statistically equivalent between female and male subsamples and provided an adequate fit to the data. The models revealed significant relations between the mate values ascribed to the self and those ascribed to short- and long-term partners as well as best friends. Furthermore, greater BDI scores significantly predicted lesser ratings of mate value for the self, and hence indirectly predicted lesser ratings of mate value for all types of partners evaluated. LIMITATIONS: Although the data obtained from the MVI demonstrated good psychometric validity, external validity has not yet been established. CONCLUSIONS: The results are consistent with models predicting: (1) assortative mating by mate value, (2) differential exchange rates of mate value for different types of partners, (3) a negative relation between depressive symptoms and assessment of one's own mate value, and (4) a possibly consequential mismatch of mate values when one partner exhibits or recovers from significant depressive symptoms. The results are inconsistent with models predicting (5) a generalized negativity bias due to depression.

Adolescent↗

PubMed1998

The influence of psychosocial factors, alcohol, drug use on African-American women's high-risk sexual behavior.

OBJECTIVE: The present study examines psychosocial and behavioral influences, particularly drug and alcohol use, as correlates of inconsistent condom use and having multiple sexual partners during the past months among African-American women. METHODS: The cross-sectional study, conducted between May and June 1996, recruited a convenience sample of 180 African-American women in Birmingham, Alabama. Women completed a face-to-face interview that assessed alcohol and drug use, sexual behaviors, depression, condom use, and negotiation skills. RESULTS: The majority of women, 51.6% (n = 93), had used either alcohol or drugs during the previous month. Many women, 31.1%, consumed alcohol, 18.3% used marijuana, and 8.3% had smoked crack within the past month. Nearly 42.7% of women used condoms inconsistently in the past month and 13.3% of women had multiple sexual partners within the past month. A logistic regression model predicting inconsistent condom use indicated that women were less likely to use condoms if they consumed alcohol between 20 and 30 days of the month (OR = 2.8, 90% CI = 1.3-5.9) and if they had not negotiated condom use (OR = 32.4, 90% CI = 7.9-131.6). The logistic regression model predicting multiple sexual partners indicated that women were more likely to have multiple sexual partners if they had smoked crack in the past month (OR = 5.3, 90% CI = 1.6-18.2). CONCLUSION: HIV sexual risk-reduction interventions for African-American women need to address the overlapping epidemics of drugs, alcohol, and STDs. Additionally, HIV sexual risk reduction efforts should be incorporated into existing drug and alcohol treatment programs and STD clinics.

Adult↗

PubMed2003

Pearly penile papules: still no reason for uneasiness.

BACKGROUND: Penile lesions and pearly penile papules (PPP) are frequently found in male sexual partners of women with cervical intraepithelial neoplasia (CIN). The former have been associated with human papillomavirus (HPV). OBJECTIVES: We estimated the prevalence of PPP in male sexual partners of women with CIN, and investigated the association between PPP and flat and papular penile lesions found in these men. We further evaluated a possible association between PPP and HPV, age, and CIN grade of the female partner. METHODS: We evaluated by penoscopy the presence of HPV-associated penile lesions and PPP in 226 male sexual partners of women with CIN. HPV was tested by polymerase chain reaction-enzyme immunoassay and in situ hybridization. RESULTS: The prevalence of PPP was 34% and was not associated with the presence of penile lesions or a positive HPV test. Age and CIN grade of the female partner were not related to the presence of PPP. CONCLUSION: The prevalence of PPP in male sexual partners of women with CIN is comparable with the prevalence described in men of more diverse populations. Our data do not support a causative role for HPV in the genesis of PPP.

Adult↗

PubMed1997

Factors associated with human papillomavirus infection detected by polymerase chain reaction among urban Canadian aboriginal and non-aboriginal women.

OBJECTIVES: To determine the prevalence and correlates of human papillomavirus (HPV) infection among women attending an ethnically mixed, predominantly low-income, inner-city primary care clinic. STUDY DESIGN: Cross-sectional survey (N = 1,477). Demographic, behavioral, and reproductive history data were collected by questionnaire. Cervical swabs were analyzed for gonorrhea and chlamydial infections, abnormal cytology, and HPV infection assessed by PCR followed by hybridization for types 6, 11, 16, 18, 31, 33, and 35. RESULTS: Human papillomavirus was detected in 33% of specimens, with no significant difference between Aboriginal (AB) and non-Aboriginal women. Adjusting for AB status, HPV infection was associated with marital status, condom use, number of sexual partners (last year and lifetime), age at first sexual intercourse, a history of sexual abuse, and current abnormal Papanicolaou (Pap) smear. In multivariate analyses excluding abnormal Pap smear as an independent variable, marital status and the number of lifetime sexual partners were found to be significant independent predictors of HPV infection. Comparing individuals with 20+ lifetime sexual partners and those with 1 or fewer partners, the odds ratio (OR) for HPV infection was 1.90 (95% confidence interval [CI] 1.66-2.17) among AB women and 1.54 among non-AB women (95% CI 1.36-1.73). The OR for infection with HPV types 6 and 11 was 1.39 (95% CI 1.22-1.58), whereas for the high oncogenic risk types of 16, 18, 31, 33, and 35, the OR was 1.82 (95% CI 1.65-2.01). CONCLUSIONS: No differences were found between AB and non-AB women in the detection of HPV DNA, despite the higher risk for cervical cancer and the prevalence of recognized behavioral and reproductive risk factors among AB women. This study also indicates that the association of sexual activity with HPV infection holds true for both high- and low-oncogenic HPV types.

American Indian or Alaska Native↗

PubMed1997

Purity and passion: risk and morality in Latina immigrants' and physicians' beliefs about cervical cancer.

This paper examines how physicians' beliefs about risk factors for cervical cancer compare with Mexican and Salvadoran immigrant women's views (hereafter Latina immigrants). Between August 15, 1991 and August 15, 1992, we conducted ethnographic interviews with 39 Mexican immigrant women, 28 Salvadoran immigrant women, and 30 physicians in northern Orange County, California. Physicians and Latina immigrants converge on their beliefs that sexual behavior is a predominant risk factor for cervical cancer. They diverge, however, on their reasons. Latina immigrants' perceptions of health risks are embedded in a larger set of cultural values centering around gender relations, sexuality, and morality. Latina immigrants also emphasized men's behavior as risk factors. Physicians' views, on the other hand, are largely based on the epidemiology of cervical cancer risk factors. They emphasized beginning sexual relations at an early age, multiple sexual partners, and infection with sexually transmitted viruses. Some physicians, however, displayed moral interpretations of the sex-based risk factors for cervical cancer through the use of the culturally-loaded term "promiscuous" in place of "multiple sexual partners," through specific references to morality, and through characterizations of women at risk for cervical cancer. Both the physicians and the Latina immigrants in our study paid considerably less attention to socioeconomic factors. Our results have important implications for physicians who provide health care for Latina immigrants. Physicians should be clear to point out that women need not be "promiscuous" to get cervical cancer.

Adult↗

PubMed2006

Classic Kaposi sarcoma. Which KSHV-seropositive individuals are at risk?

BACKGROUND: Classic Kaposi sarcoma (CKS) is a relatively rare vascular disease primarily affecting human immunodeficiency virus (HIV)-uninfected elderly men. The infection with Kaposi sarcoma-associated herpesvirus (KSHV) is necessary for the establishment of Kaposi sarcoma (KS), although it is not sufficient. Thus, only a small fraction of KSHV-infected individuals develops KS. The cofactors that influence risk of KS among HIV-uninfected individuals are yet to be determined. The objective of the current study was to assess potential risk factors for CKS in the KSHV-infected Jewish population in Israel. METHODS: A case-control study involved 35 CKS cases and 48 matched KSHV-infected controls. Lifestyle and medical history data from case patients and controls were compared by logistic regression analysis. RESULTS: In a multivariate analysis, the authors identified an age-related small increased risk for CKS in subjects originating from Asia and Africa. The risk for CKS increased, although not significantly statistically, in subjects who reported alcohol consumption, diabetes mellitus, herpes simplex, and asthma. No relation was found with cigarette smoking, family size, number of lifetime sexual partners, or sexually transmitted disease. CONCLUSIONS: A borderline increase in CKS risk among elderly subjects originating from Africa or Asia was identified. These results need to be further evaluated by larger studies. The authors believe that genetic and immunologic parameters may alter risk for CKS and, therefore, should also be investigated.

Adult↗

PubMed2006

Eroticizing creates safer sex: a research synthesis.

This meta-analytic review examined the effectiveness of sexual risk reduction interventions in 21 studies (N=5,015) that integrated a safer sex eroticization component. Compared to controls, intervention participants exhibited lower sexual risk on 6 dimensions: HIV-related knowledge, attitudes toward condoms, condom use, overall behavioral risk, communication with sexual partners, and sexual frequency. Additional analyses examined pre- to post-test outcomes and showed significant improvement in condom use in the intervention compared to the control groups. Overall, findings suggest that eroticizing safer sex leads to more risk-preventive attitudes, which in turn facilitates less risky sexual behavior.

Female↗