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PubMed1992

Changes in sexual practices and some HIV related attitudes in New Zealand: 1987-9.

Two fully national samples of 1000 New Zealanders aged 16-60 were interviewed in 1987 and in 1989 about their sexual practices and related attitudes to HIV/AIDS matters. The data were gathered by means of a self completed questionnaire which was part of a larger interview undertaken in the respondents' own homes. Precautions were taken to ensure confidentiality, anonymity and privacy. There were significant differences in the reporting of sexual behaviour during the two year study period. The proportion of the sexually active reporting three or more sex partners in the previous year fell from 12% to 8%. The proportion reporting "always" or "often" using condoms rose from 13% to 18% and those reporting permanent changes to sexual behaviour because of AIDS rose from 16% to 26%. Changes towards safer sexual practices were more common amongst males, the young, the unmarried and those with multiple sex partners. Findings concerning attitudes to HIV/AIDS related matters showed an increase in the population's perceived risk of the virus to both themselves and others. For example the proportion who felt everyone was at risk rose from 71% in 1987 to 80% in 1989. There was also evidence of increased victim blaming of the person who caught HIV infection or other sexually transmitted diseases. Finally there was evidence of the need for more action on AIDS. In 1987 35% felt that enough was being done whereas this had dropped to 27% by 1989.

Acquired Immunodeficiency Syndrome↗

PubMed2006

Sexual risk among impoverished women: understanding the role of housing status.

HIV/AIDS increasingly affects women, and housing status is important to understanding HIV risk behaviors among women. The goal of this study is to enhance understanding of the association between housing status and a key sexual risk behavior, having multiple sex partners, by investigating the extent to which housing status differences can be accounted for by hypothesized explanatory factors. In a probability sample of 833 women in Los Angeles, results indicated that homeless African American and Hispanic women had from two to almost five times greater odds than low-income housed women of having multiple sex partners in the past 6 months. These disparities in risk behavior were accounted for by housing status differences in perceived susceptibility to HIV/AIDS, recent victimization by physical violence, drug use severity, and avoidant coping. Findings provide further evidence that interventions should address a multifaceted context of HIV risk for impoverished women.

Adult↗

PubMed2002

High prevalence of hepatitis C infection among patients receiving hemodialysis at an urban dialysis center.

OBJECTIVE: To determine the seroprevalence and risk factors for hepatitis C virus (HCV) infection among patients at an urban outpatient hemodialysis center. METHODS: This was a cross-sectional study of 227 patients undergoing hemodialysis at the Rogosin Kidney Center on December 15, 1998, with a response rate of 90% (227 of 253). Laboratory records were used to retrieve the total number of blood transfusions received and serologic study results. Univariate and multivariate analyses were used to examine the relationship among HCV serostatus, patient demographics, and HCV risk factors (eg, intravenous drug use [IVDU], intranasal cocaine use, multiple sexual partners, comorbidities, length of time receiving hemodialysis, and total number of blood transfusions received). RESULTS: The seroprevalence of antibody to HCV (anti-HCV) was 23.3% (53 of 227) in the population. In univariate analysis, factors associated with HCV seropositivity included male gender, younger age, history of IVDU, history of intranasal cocaine use, history of multiple sexual partners, human immunodeficiency virus coinfection, increased time receiving dialysis, history of renal transplant, and positive antibody to hepatitis B core antigen. Multivariate logistic regression analysis showed that longer duration receiving dialysis and a history of IVDU were the only risk factors that remained independently associated with HCV seropositivity CONCLUSIONS: HCV is markedly more common in our urban cohort of patients receiving hemodialysis compared with patients receiving dialysis nationally and is associated with a longer duration of receiving dialysis and a history of IVDU. Stricter and more frequent enforcement of universal precautions may be required in hemodialysis centers located in areas with a high prevalence of HCV infection or IVDU among the general population.

Adult↗

PubMed2003

Intimate partner violence and HIV risk among urban minority women in primary health care settings.

This study describes the associations between intimate partner violence (IPV) and HIV risk among urban, predominantly minority women. Interviews were conducted with 1,590 women, predominantly African American and Latina, attending hospital-based health care clinics. Approximately 1 in 5 women reported experiencing IPV in their current primary heterosexual relationships; about 1 in 8 women reported experiencing IPV in the preceding 6 months. Compared to women who reported no IPV in their primary relationships, women reporting past or current IPV perpetrated by their primary partners were more likely to report having multiple sexual partners, a past or current sexually transmitted infection (STI), inconsistent use or nonuse of condoms, and a partner with known HIV risk factors. These findings indicate that urban minority women experiencing IPV are at elevated risk for HIV infection, results that carry important implications in the efforts to improve HIV and IPV risk assessment protocols and intervention/prevention strategies for women in primary health care settings.

Adult↗

PubMed2003

Brain injury in battered women.

The goals of the present study were to examine (a) whether battered women in a sample of both shelter and nonshelter women are sustaining brain injuries from their partners and (b) if so, whether such brain injuries are associated with partner abuse severity, cognitive functioning, or psychopathology. Ninety-nine battered women were assessed using neuropsychological, psychopathology, and abuse history measures. Almost three quarters of the sample sustained at least 1 partner-related brain injury and half sustained multiple partner-related brain injuries. Further, in a subset of women (n = 57), brain injury severity was negatively associated with measures of memory, learning, and cognitive flexibility and was positively associated with partner abuse severity, general distress, anhedonic depression, worry, anxious arousal, and posttraumatic stress disorder symptomatology.

Adolescent↗

PubMed2004

Substance use and high-risk sex among men who have sex with men: a national online study in the USA.

This paper describes drug and sexual risk behaviors during a six-month period in 2001 of 2,916 gay and bisexual men who were recruited online. Bivariate and multivariate analyses examined correlates of unprotected anal intercourse (UAI). Drug and alcohol use were also examined by US region. UAI was associated with using alcohol or drugs, including poppers, crystal methamphetamine, cocaine, marijuana and Viagra before or during sex. Meeting sex partners both online and offline and having multiple sex partners were also predictive of UAI. Significant regional differences were seen in the prevalence of drug use and alcohol use. Findings are discussed in relation to the need to integrate messages about the relationship between drug use and sexual behavior into HIV prevention programs.

Adolescent↗

PubMed2006

HIV risk behaviour patterns, predictors, and sexually transmitted disease prevalence in the social networks of young men who have sex with men in St Petersburg, Russia.

HIV seroconversions and sexually transmitted diseases (STDs) are often clustered in social networks within community populations. The present study was carried out among men who have sex with men in Russia, where a major HIV epidemic is unfolding, and where social networks have played a historically important role. In all, 38 social networks were recruited into the study, and members of all networks (n = 187) completed risk behaviour assessments and were tested for STDs. About 17% of participants had STDs, and 10% of men had syphilis. Over 64% of men had recent unprotected anal intercourse (UAI), including 51% who did so with main partners, 30% who did so with casual partners, and 32% who had UAI with multiple male partners. The strongest predictor of all risk behaviour indicators and STDs was the social network, to which an individual belonged, supplemented by peer norm perceptions and intentions to practise safer sex. There was a high level of correspondence in behaviour between the social leader of a network and its other members. Social networks should be directly targeted in HIV prevention efforts.

Adult↗

PubMed2005

Alcohol intoxication and sexual risk behaviors among rural-to-urban migrants in China.

BACKGROUND: The migrant population in China is at high risk for sexual risk behavior and alcohol intoxication. Information about the prevalence of alcohol intoxication and its association with sexual risk behavior among migrants is needed for designing effective intervention prevention programs for reduction in alcohol abuse and HIV infection. METHODS: Cross-sectional data were collected from 2153 sexually experienced young rural-to-urban migrants in Beijing and Nanjing, China, in 2002. RESULTS: Approximately one-third of the participants had been intoxicated with alcohol at least once during the previous month, with more males than females reporting intoxication (40.2% versus 23.7%, p<0.001). Compared to non-intoxicated participants, respondents with alcohol intoxication in previous 30 days reported more psychological problems, including higher depression scores, lower levels of satisfaction with life and work, and higher perception of peer involvement in risk behavior. Intoxicated respondents were more likely to engage in premarital sex than non-intoxicated respondents (76% versus 60.2%, p<0.001), have multiple sexual partners (13.4% versus 5.2%, p<0.001), purchase sex (12.6% versus 4.9%, p<0.001), and sell sex (10.1% versus 3.7%, p<0.001). However, there was no association between alcohol intoxication and inconsistent/non-use of condoms. Multivariate analysis controlling for depression, peer risk involvement, age, gender, and other socio-demographic variables indicated that alcohol intoxication was independently correlated with premarital sex, multiple sexual partners, and buying and selling sex. CONCLUSIONS: Compared to the general Chinese population, levels of intoxication were elevated among Chinese rural-to-urban migrants. Alcohol intoxication was associated with sexual risk behaviors. HIV/AIDS prevention and intervention efforts should include components of alcohol use/abuse prevention for an effective reduction of sexual risk among young rural-to-urban migrants in China.

Adolescent↗

PubMedDate not supplied

Epidemiology of trichomonas vaginalis. A prospective study in China.

BACKGROUND AND OBJECTIVES: Trichomonas vaginalis infection is probably one of the most common sexually transmitted diseases. The epidemiology of this disease has long been ignored, and not much is known about its natural history and risk factors. GOALS: The authors conducted this study to define the incidence rates of T. vaginalis infection and to investigate risk factors for the infection. STUDY DESIGN: A prospective study was carried out on a cohort of 16,797 women followed up from 1974 to 1985 within the framework of a cervical screening program in Jingan, China. Personal interviews were conducted by trained interviewers. RESULTS: A total of 1489 new cases of T. vaginalis infection were diagnosed with 132,946 person-years of observation. In a multivariate analysis, the increased risk was associated with multiple sexual partners (P = 0.0124) and greater number of induced abortions (P = 0.0028). The relative risks were 1.3 (95% confidence interval [CI], 1.1 to 1.5) for smokers and 1.5 (95% CI, 1.2 to 2.0) for those who drink alcohol. An inverse relationship was observed in older women and in women with cervical atrophy. CONCLUSIONS: This study confirmed the relationship between T. vaginalis and multiple sexual partners and suggests that the risk for T. vaginalis also may be related to life-style risk factors.

Adult↗

PubMed1993

The epidemiology of AIDS in the Vellore region, southern India.

OBJECTIVE: To describe the epidemiology of patients with AIDS in Vellore region, Southern India. DESIGN AND METHODS: Sixty-one patients with AIDS were diagnosed and treated between July 1987 and June 1992. Information on their demographic characteristics and probable modes of acquiring HIV infection was collected at interviews with them and their spouses. RESULTS: There was a progressive increase in the number of patients seen over the 5 years. The mean ages of the 51 men and the 10 women were 33 and 29 years, respectively. Of the 44 patients from our district (population, 5 million), 28 were from Vellore town and 10 from rural areas. Forty-seven (92%) men had frequently used prostitutes. Of the women, four were prostitutes, one had had multiple sex partners and five had not had extramarital sexual contact. One man and one woman had no other risk factor except blood transfusion. Thirty-one (51%) patients had died by August 1992. CONCLUSION: The AIDS epidemic in this region is in its early ascending phase, with a doubling time of approximately 1 year. Most men with AIDS were infected by heterosexual contact with prostitutes, while some women were prostitutes themselves. Together with the male-to-female ratio of 5:1, these results suggest that the male population at risk has sex with a much smaller population of female prostitutes, constituting the major chain of transmission. HIV infection is occurring in both urban and rural populations.

Acquired Immunodeficiency Syndrome↗

PubMed2003

The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900.

BACKGROUND: We examined the relationship of the number of adverse childhood experiences (ACE score) to six health problems among four successive birth cohorts dating back to 1900 to assess the strength and consistency of these relationships in face of secular influences the 20th century brought in changing health behaviors and conditions. We hypothesized that the ACE score/health problem relationship would be relatively "immune" to secular influences, in support of recent studies documenting the negative neurobiologic effects of childhood stressors on the developing brain. METHODS: A retrospective cohort study of 17,337 adult health maintenance organization (HMO) members who completed a survey about childhood abuse and household dysfunction, as well as their health. We used logistic regression to examine the relationships between ACE score and six health problems (depressed affect, suicide attempts, multiple sexual partners, sexually transmitted diseases, smoking, and alcoholism) across four successive birth cohorts: 1900-1931, 1932-1946, 1947-1961, and 1962-1978. RESULTS: The ACE score increased the risk for each health problem in a consistent, strong, and graded manner across four birth cohorts (P < 0.05). For each unit increase in the ACE score (range: 0-8), the adjusted odds ratios (ORs) for depressed affect, STDs, and multiple sexual partners were increased within a narrow range (ORs: 1.2-1.3 per unit increase) for each of the birth cohorts; the increase in risk for suicide attempts was stronger but also in a narrow range (ORs: 1.5-1.7). CONCLUSIONS: Growing up with ACEs increased the risk of numerous health behaviors and outcomes for 20th century birth cohorts, suggesting that the effects of ACEs on the risk of various health problems are unaffected by social or secular changes. Research showing detrimental and lasting neurobiologic effects of child abuse on the developing brain provides a plausible explanation for the consistency and dose-response relationships found for each health problem across birth cohorts, despite changing secular influences.

Adult↗

PubMed2000

Drug use and HIV risk--related sex behaviors: a street outreach study of black adults.

BACKGROUND: Our street outreach project investigated the relationship between use of noninjecting drugs (alcohol, marijuana, cocaine) and human immunodeficiency virus (HIV) risk-related sex behaviors of black adults. The study focused on three HIV-related risks: multiple sex partners, unprotected sex, and drugs during sex. METHODS: Data for this study were collected in a street outreach community survey for a drug abuse and HIV intervention study in Birmingham, Ala. A total of 780 black men and women completed the survey. RESULTS: High-risk sex behaviors were far more prevalent among cocaine users than marijuana or alcohol users. A greater number of cocaine users reported having multiple sex partners, not using condoms, and using drugs during sex. Female cocaine users showed the same risk level for HIV infection as male cocaine users. CONCLUSIONS: Increased risk of HIV infection through sexual transmission is associated with use of noninjecting cocaine for both men and women. Condom use should be considered as a major component of HIV prevention programs.

Adult↗

PubMedDate not supplied

A voluntary serosurvey and behavioral risk assessment for human immunodeficiency virus infection among college students.

The authors conducted a voluntary serosurvey and educational campaign among 3394 undergraduate students attending the University of Maryland at College Park to determine the prevalence of and risk factors for human immunodeficiency virus type 1 (HIV-1) infection. Two students were seropositive (0.06%, 95% confidence interval 0-0.15%). Both were homosexual men with multiple sexual partners. Despite the low prevalence of infection, potential risk factors for transmission of HIV-1 were common, as assessed by a self-administered anonymous questionnaire. These included a previous sexually transmitted disease (12.6%), male homosexual intercourse (4.8% of men), heterosexual anal intercourse (25.3%), heterosexual intercourse with a person at risk (an HIV-1 infected person, a bisexual man, a parenteral drug user, a female prostitute, or a hemophiliac) (5.2%), multiple sexual partners (21% reported 10 or more lifetime partners), and intravenous drug use (1.3%). Assessment of the efficacy of our program by comparing responses on pre- and post-test questionnaires showed gains in knowledge about heterosexual transmission of HIV-1 and an increase in the reported frequency of condom use 1-2 months after participating in the survey. The authors conclude that HIV-1 infections are occurring among college students but in our study group remain confined to persons with known high-risk behavior; however, practices that may support transmission are common, and programs designed to diminish these behaviors among college students are needed.

Adolescent↗

PubMed1992

[Epidemiological study on mycoplasmas colonization and infection in the female genital tract].

1309 cervical or vaginal specimens from females in various physiological periods and women with multiple sexual partners were examined for Ureaplasma urealyticum and Mycoplasma hominis from Feb. to May, 1990. Significantly, low carriage rates of U.urealyticum were found in the neonatal (28.57%), puerperium (26.51%) and postmenopause (30.00%) groups, whereas, pregnant women (more than 36 weeks) showed the highest incidence (73.20%). The recovery rate of U. urealyticum in girls with no history of sexual contact was significantly lower (38.30%) than that in married nonpregnant women (48.98%) and women with multiple sexual partners (71.74%). The incidence rate of the genital mycoplasmas was significantly affected by the type of contraception, the number of sexual partners, socioeconomic states, degree of cultural traditional, as well as hormonal status. Possible modes of transmission of genital mycoplasmas were also discussed.

Adolescent↗

PubMed2003

Has the HIV/AIDS epidemic changed sexual behaviour of high risk groups in Uganda?

BACKGROUND: Uganda, was the first country in sub-Saharan Africa to reverse its HIV/AIDS epidemic. Long distance drivers, prostitutes and barmaids have been identified as the groups that engage in risky sex, which promotes HIV transmission in Uganda and other countries across the continent. This paper investigates whether and why there were changes of sexual behaviour and practices among five risky groups in Uganda as a consequence of HIV/AIDS epidemic. METHODOLOGY: The paper is based on data generated from a survey on 'resistance to sexual behaviour change in the African AIDS epidemic', which was conducted in the districts of Kabale, Kampala and Lira in 1999. For purposes of this paper, only data from the focus group discussions with high-risk groups have been analysed. These include commercial sex workers, street children, long haul truck drivers, bar maids and adolescents in three towns of Uganda (Kabale, Kampala, Lira). RESULTS: Results indicate that despite the HIV/AIDS epidemic, these groups had only changed their sexual behaviour a little, and they reported to be continuing with multiple sexual partners for a variety of reasons. The adolescents and street children were under peer pressure and a lot of sexual urge; commercial sex workers and bar maids attributed their risky behaviour to the need to survive due to the existing poverty; and the truck drivers reflected on the need for female company to reduce their stress while on the long lonely travels across Africa. Nevertheless, they are all aware and perceive people with multiple sexual partners as being highly vulnerable to contracting HIV and they all reported to have adopted condom use as an HIV preventive strategy. They also observed that married people were at a high risk of contracting HIV due to non-use of condoms in marital relationships and unfaithfulness of spouses. CONCLUSIONS Females engage in high-risk sexual relations as a means of economic survival, and perceive their acts as a strategy to improve their socio-economic well being. On the contrary, men in these high-risk categories do such acts out of pleasure and as avenues for attaining fulfilled sexual lives. The search for money among women and the constant desire for men to have sexual pleasure, which are greatly facilitated by their financial status are the forces behind reckless sexual behaviour among high-risk groups.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Extramarital relations and perceptions of HIV/AIDS in Nigeria.

Data from a 1991 survey of five Nigerian towns are used to examine currently married men's and women's perceptions of AIDS which, together with other socioeconomic factors, are then related to extramarital sexual behaviour. An overwhelming majority of the respondents have accurate information about AIDS. In particular, most associate HIV/AIDS transmission with multiple sexual partners, though only one-third of them think that the fear of AIDS has limited casual sex in their communities. About 54 per cent of men and 39 per cent of women have had extramarital relations, with 18 per cent of men and 11 per cent of women having done so in the previous week. The incidence of extramarital relations varies considerably by respondents' level of education, type of marriage, religion, and spousal closeness. More importantly, knowledge of multiple sexual partners as a risk factor for HIV/AIDS is inversely related to extramarital affairs. The study underscores the link between knowledge and behaviour, and calls for a well-articulated campaign designed to educate the populace about the threat of AIDS, with the aim of modifying both premarital and extramarital sexual behaviour, thereby reducing the risk factor for HIV through heterosexual relations which is the main mode of transmission in Nigeria.

Adult↗

PubMed2000

Risk factors for pre-cancerous lesions of the cervix.

Studies on risk factors for pre-cancerous lesions of the uterine cervix have shown strong association with sexual practice. Women with multiple sexual partners and intercourse at early age are at high risk. A role of male partners in further enhancing the risk has been identified. All these support the hypothesis relating to a sexually transmissible aetiological agent. An extensive review of the literature on the risk factors for pre-cancerous lesions of cervix has been carried out. The risk factors were grouped into genital, sexual, chemical, dietary and life factors. Human papilloma virus (HPV) is the major infectious aetiological agent associated with the development of pre-cancerous lesions of cervix. Other co-factors such as multiple sexual partners of the male as well as the female and early age of first intercourse are also involved at the critical aetiological step of progression from low-grade to high-grade lesions. The role of other infectious agents in terms of supportive or interactive effects is not clear. No independent effect for herpes simplex virus 2 on risk is observed. Other risk factors include cigarette smoking, oral contraceptive usage, certain nutritional deficiencies and poor personal hygiene. However, it is not clear whether these factors operate independently from HPV. There is no consistency in the independent effect of these factors on the development of low- to high-grade lesions of cervix. There is a similarity in the patterns of risk between pre-cancerous lesions of the cervix and cervical cancer. Monogamy, late commencement of sexual activity, personal hygiene and use of barrier contraceptive methods help towards primary prevention. In the long-term, primary prevention of cervical neoplasia through HPV immunization of population may be a possibility.

Coitus↗

PubMed1992

AIDS in sub-Saharan Africa: implications for health education.

This paper reviews the current epidemiologic status of AIDS in sub-Saharan Africa, focusing on what is currently understood about the distinctive features of heterosexual transmission in young men, women, and children. Epidemiologic data show that AIDS is transmitted primarily through heterosexual vaginal intercourse. Heterosexual transmission is highlighted both as the principal mode of spread of AIDS in east, central, and southern Africa and as the primary focus for AIDS education and control of the epidemic. The transmission of AIDS, like that of other sexually transmissible diseases, results from sexual behaviors that are rooted in social and cultural values that are not easily changed. The primary risk factors--including multiple sex partners, prostitution, and unprotected intercourse--are examined. The perceived obstacles to control of the epidemic include unfavorable government reactions to the epidemic, poor public knowledge, prevailing sexual attitudes, and reluctance to use condoms. These and other immediate and competing risk factors like unemployment and poverty combine to complicate the task of AIDS education.

Acquired Immunodeficiency Syndrome↗