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Prevalence of hepatitis G virus in patients with hemophilia and their steady female sexual partners.

BACKGROUND: Hepatitis G virus (HGV), also known as GB virus C, is a newly discovered Flavivirus that is transmissible by blood transfusion and other possible routes. OBJECTIVE: To study the risk of sexual transmission of HGV in female sexual partners of men with hemophilia (n = 161 couples). METHODS: Blood samples obtained from 11 medical centers were analyzed for (1) HGV RNA by polymerase chain reaction; (2) antibodies to HGV by enzyme immunoassay; and (3) other viruses and T-cell counts by routine laboratory tests. Subjects completed a questionnaire that assessed sexual intercourse frequency, number of sexual partners, condom usage, sexually transmitted diseases, illicit drug usage, and needlestick or broken-glass injuries. RESULTS: The HGV infection (RNA +/- antibody positive) prevalence was 48% among men and 21% among women. Prevalence of hepatitis C virus, hepatitis B virus, and HIV among men was 99%, 94%, and 86%, compared with 3%, 11%, and 12% among women, respectively. The odds ratio for HGV infection for women with an HGV-positive male sexual partner was 2.14 (P = 0.06) without adjustment, and 2.77 (P = 0.03) with adjustment for other variables, none of which were independently significant. CONCLUSION: These results suggest a low level of HGV sexual transmission.

Antibodies, Viral↗

Patients responding to phosphodiesterase type 5 inhibitor therapy: what do their sexual partners know?

INTRODUCTION: Phosphodiesterase type 5 (PDE5) inhibitors are an efficacious therapy in men with erectile dysfunction (ED). There are only a few studies that also focus on the participating couples during PDE5 inhibitor therapy. AIM: To determine to what extent patients personally informed their sexual partners about their ongoing PDE5 inhibitor therapy. MAIN OUTCOME MEASURES: Likelihood of informing the female partner by the patient himself about the use of PDE5 inhibitors. METHODS: A total of 216 men (mean age 62.3 years) with ED were successfully treated with PDE5 inhibitors in three independent centers. After an interval of at least 3 months of successful ED therapy, all patients were asked by questionnaire whether their sexual partners were informed of their PDE5 inhibitor therapy. RESULTS: Eighty-two percent of the patients were exclusively involved in one stable sexual relationship, 9.7% of the men admitted to having changing sexual partners, and 6% did not give any information at all about their sexual partners. Twenty percent of the men had a severe ED (International Index of Erectile Function [IIEF-5] <11). Forty-nine percent showed a moderate ED (IIEF-5 11-16) and 31% suffered a mild ED (IIEF-5 >16). PDE5 inhibitor medication was used 1.2 times/month by men with a severe ED, 2.1 times/month by patients with a moderate ED, and 2.9 times/month by men with a mild ED. Forty-one (93%) of the 44 patients with a severe ED informed their sexual partners that they were taking PDE5 inhibitors. In the patient group with moderate ED, 49 (47%) of 105 patients and only 14 (21%) of 67 of the patients with mild ED shared this information with their partners. CONCLUSION: Less than 40% of the patients suffering a moderate or mild ED using PDE5 inhibitors shared this information with their partners. It seems that patients find ED so disturbing that many patients do not inform their partners of PDE5 inhibitor use.

Aged↗

Underlying factors in female sexual partner instability in Kampala.

Divorced or separated persons are more likely to be infected with HIV than those in marital unions: sexual partner instability appears to have significant implications in STD/HIV transmission. While this appears empirically true, most current STD/HIV preventive strategies do not seem to address partner instability as an important underlying factor in STD/HIV transmission and control. This paper describes reasons why young females may be motivated to change sexual partners or have more than one sexual partner. The problems appear to be dissatisfaction due to infidelity of the male partner, fear of getting STD from current partner, drunken or unattractive male partner, economic problems, lack of leisure time together, male partner's children with other women, and male partner's relatives' influence. STD/AIDS Control Programs should note that dissatisfaction with partner may be an underlying factor in HIV transmission.

Adolescent↗

Antibodies to hepatitis A antigen in relation to the number of lifetime sexual partners in patients attending an STD clinic.

Samples of serum from 421 patients attending a clinic for sexually transmitted diseases (STDs) were tested by radioimmunoassay for determination of the prevalence of antibodies to hepatitis A antigen (anti-HA). It was found that 42 . 4% of 33 homosexual men, 39 . 4% of 218 heterosexual men, and 38 . 8% of 170 female patients had positive results for anti-HA. The association between serological results and data on STD patients, using the variables of age, sexual type and preference, number of sexual partners in the preceding six months, and number of lifetime sexual partners and age, was determined statistically. The results show that the number of lifetime sexual partners is another factor concerned in the high prevalence of anti-HA.

Adolescent↗

[Identification of meeting places of sexual partners in 2 cities of the Southern Mexican borders, using the PLACE method].

OBJECTIVE: To identify the meeting sites of new sexual partners in two Southern border cities in Mexico. MATERIAL AND METHODS: A descriptive epidemiologic study was carried out in May 2001, by surveying key informants in two border cities. Each reported site was visited to interview a resident subject. Subjects socializing in a subsample of sites were also interviewed. RESULTS: The key informants of the community reported 134 meeting sites in Chetumal and 111 in Ciudad Hidalgo. Both sites had scarce HIV/AIDS prevention activities. Characteristics were obtained for 89 sites in Chetumal and 42 in Ciudad Hidalgo. Almost 21% of interviewees reportedly met a new sexual partner in these sites in the past four weeks. CONCLUSIONS: Preventive actions are needed in meeting sites of new sexual partners. This method may provide information to plan for future interventions. The English version of this paper is available too at:http://www.insp.mx/salud/index.html.

Adult↗

Sexual partner preference, hypothalamic morphology and aromatase in rams.

The male-oriented ram is a unique and valuable animal model for the study of hormonal, developmental and genetic contributions to sexual partner preference. Unlike most other mammalian models that are in use currently, variations in sexual attraction occur spontaneously in domestic ram populations. It is estimated that as many as 8-10% of rams exhibit a sexual partner preference for other males, classifying them as male-oriented rams. Studies have failed to identify any compelling social factors that can predict or explain the variations in sexual partner preferences of rams. Nor is there consensus on the endocrine and sensory responsiveness of male-oriented rams to other rams. However, a number of studies have reported differences in brain structure and function between male-oriented and female-oriented rams, suggesting that sexual partner preferences are neurologically hard-wired. Recently, we identified a sexually dimorphic nucleus (oSDN) in the sheep preoptic area-anterior hypothalamus. The oSDN is larger in female-oriented rams than in male-oriented rams and similar in size in male-oriented rams and ewes. In addition, mRNA levels for aromatase in the oSDN were higher in males than in females and were higher in female-oriented rams than in male-oriented rams. These results suggest a relationship between steroid hormones, specifically estrogens and oSDN morphology. In this review, we provide an overview of sexual behavior in rams and discuss the multiple factors that may contribute to the development and adult expression of same-sex partner preferences in rams.

Animals↗

Where young people with multiple sexual partners seek medical care: implications for screening for chlamydial infection.

OBJECTIVE: To investigate among young people the relation between the number of sexual partners and use of medical services in order to guide planning of sexually transmitted disease screening. DESIGN: Cross sectional study within a birth cohort using a questionnaire presented by computer. SETTING: Dunedin, New Zealand in 1993-4. SUBJECTS: 477 men and 458 women aged 21 enrolled in the Dunedin Multidisciplinary Health and Development Study, comprising 91.7% of survivors of the cohort. RESULTS: Men with multiple sexual partners in the previous year were less likely to have a general practitioner than men with one or no partners (76.2% v 88.5%, p < 0.01). Among the women the respective proportions (83.1% and 88.4%) were not significantly different. Significantly more women than men (75.8% v 50.7%, p = 0.03) with five or more partners in the previous year had visited their own general practitioner over that period. Among the sexually experienced, more women than men attended any setting appropriate for sexually transmitted disease screening (93.6% v 71.6%, p < 0.001). CONCLUSIONS: In New Zealand a screening programme for sexually transmitted diseases among young adults reliant on invitation by their own general practitioner would be biased towards those at less risk. Opportunistic screening in general practice would potentially include only about half the most sexually active men and three quarters of such women over a 12 month period. The extension of opportunistic screening to other settings considered appropriate for discussion of sexual health issues could potentially engage the vast majority of women, but not men, at most risk. Any screening programme should incorporate an effective method of finding and treating the sexual partners of infected women.

Adolescent↗

Hepatitis C virus among self declared non-injecting sexual partners of injecting drug users.

While much is known about hepatitis C virus (HCV) among injecting drug users (IDUs), there is scant information about the risk of HCV infection to non-injecting sexual partners of injecting drug users; it is possible that such individuals may have a greater risk of acquiring HCV than any other group barring injecting drug users. This study examines the prevalence of HCV among a population of non-injecting sexual partners of injecting drug users. Unlinked anonymous testing for anti-HCV of residual sera stored following the named HIV testing of specimens originally from persons who had indicated to their attending clinicians that they were non-injecting sexual partners of injecting drug users. The prevalence of anti-HCV among the sexual partners was 4.1% (25/611) overall, 6.4% (13/202) among heterosexual male and 3.0% (12/397) among the heterosexual female partners. None of the homosexual/bisexual partners were HCV antibody positive (0/12). Although we cannot be sure how non-injecting partners of injecting drug users acquire their HCV infection, having a relationship with someone who injects drugs may place an individual at appreciable risk of being infected; such individuals should consider being tested for HCV.

Adult↗

Age-dependent choice of sexual partners and the transmission dynamics of HIV in Sub-Saharan Africa.

A mathematical model of the transmission of HIV-1 within heterosexual populations in Sub-Saharan Africa is described and its properties analysed. The model incorporates epidemiological and demographic processes and extends previous work in this area via the inclusion of age and sex dependency in rates of sexual partner change, and sexual partner choice dependent on age. Parameter assignments are made on the basis of current data on the transmission dynamics of HIV-1 and the demography of human populations in Africa. Both age-dependent rates of sexual activity and the sexual contact of males with females younger than themselves act to enhance the predicted demographic impact. With realistic parameter values, the model suggests AIDS is able to reverse the sign of population growth rates from positive to negative values over a timescale of a few decades. The sensitivity of this prediction is examined in relation to changes in the pattern of sexual contact between different age classes of females and males, different patterns of change in the age-dependent rate of sexual partner change, different assumptions concerning the doubling time of the epidemic in its early stages, and the relative efficiencies of viral transmission between men and women, and vice versa. The impact AIDS is predicted to have on the number of young and elderly persons as a fraction of the number of productive adults (the dependancy ratio) is examined under various assumptions concerning the weighting to be applied to mirror the burden imposed by the care of those with AIDS. The paper includes an assessment of the influence of the timing of changes in sexual behaviour, or the promotion of the use of condoms, on the predicted course of the epidemic. The paper concludes with a discussion of data needs and the model refinements required to more accurately mirror current understanding of the epidemiology of HIV-1.

Acquired Immunodeficiency Syndrome↗

Role of male behavior in cervical carcinogenesis among women with one lifetime sexual partner.

BACKGROUND: The role of male behavior in the genesis of cervical cancer was examined. In India, where the incidence of cervical cancer is among the highest in the world, promiscuity among women is virtually unknown. In this study, the authors investigated the role of male behavior in cervical carcinogenesis among Indian women who had one lifetime sexual partner. METHODS: A case-control study was used. RESULTS: Premarital sexual relationships (relative risk [RR], 1.9; confidence interval, 1.2-3.2) and extramarital sexual relationships (RR, 2.7; confidence interval, 1.5-4.9) of husbands were risk factors. When husbands had sexual relationships both before and during the marriage, their wives' risk of getting cervical cancer increased by 6.9 (CI, 2.3-20.7). Risk also increased with husbands having three or more extramarital sexual partners (RR, 3.05; CI, 1.25-12.6). Sexual contact with prostitutes before or after marriage, however, did not increase the risk. History of sexually transmitted disease before marriage (RR, 2.9) or after marriage (RR, 5.9) was an important risk factor, which persisted after controlling for other factors. Sexual abstinence for 40 or more days after a wife's giving birth or having an abortion provided protection. Sex with uncircumcised men or men circumcised after age 1 year increased the risk of cervical cancer (RR, 4.1). Bidi smoking (bidi is a cheap smoking stick of 4-8 cm, consisting of a rolled piece of dried temburni leaf [Diospyres melanoxylon] containing 0.15-0.25 g of coarsely ground tobacco) for more than 20 years was a significant risk factor (RR = 2.4), whereas cigarette smoking was not a risk factor. CONCLUSIONS: Male sexual partners play a role in cervical carcinogenesis.

Adult↗

Child sexual abuse and number of sexual partners in young women: the role of abuse severity, coping style, and sexual functioning.

The authors proposed and tested a model describing distinct pathways through which childhood sexual abuse (CSA) may lead to relatively low or high numbers of sexual partners in adulthood. Path analyses were conducted on survey responses of young female US Navy recruits who reported CSA (N=547). Use of avoidant strategies to cope with CSA was expected to produce higher levels of sexual problems and fewer heterosexual sex partners, whereas use of self-destructive coping strategies was expected to result in more dysfunctional sexual behavior and more heterosexual sex partners. As predicted, the effect of CSA on number of sex partners was largely mediated by coping strategies and dysfunctional sexual behavior.

Adaptation, Psychological↗

Factors affecting individuals dissuading sexual partners from using condoms: a comment on McDermott and Noland.

Undergraduate students at an urban, public university were asked if they had ever attempted to dissuade a sexual partner from using condoms. Over 17% of the men and nearly 15% of the women admitted to having done so, and twice as many said that a sexual partner had attempted to dissuade them. Responses to a questionnaire indicated that individuals who had attempted to dissuade use of condoms did not show a greater tendency to engage in nonsexual risk-taking behaviors. Despite their claims that attempts to dissuade partners from using condoms occurred in committed relationships, condom dissuaders did show evidence of engaging in other high-risk sexual behaviors, e.g., greater number of sexual partners, greater number of sexually transmitted diseases.

Adult↗

Does the treatment of genital condylomata in men decrease the treatment failure rate of cervical dysplasia in the female sexual partner?

Three hundred ninety women treated for cervical dysplasia by local tissue ablation were studied retrospectively to test the hypothesis that the treatment failure rate is lower if the male sexual partner is also treated. In 190 cases, the male sexual partner was examined and treated successfully for genital condylomata. Controls were 200 women treated during the same time period and closely matched to the study group regarding age, race, socioeconomic status, histologic grade of dysplasia, distribution of the lesions, and methods of therapy, but the male partner was neither examined nor treated. The treatment failure rate for women whose partners were also treated was not significantly different from that for women whose partners were not treated (6.8 versus 7.5%; P greater than .05), suggesting that treating genital condylomata in men does not affect the failure rate of cervical dysplasia in female sexual partners.

Adult↗

High prevalence of papillomavirus-associated penile intraepithelial neoplasia in sexual partners of women with cervical intraepithelial neoplasia.

To determine whether neoplastic cervical lesions in women are associated with papillomavirus infections in their sexual partners, we used a colposcope to examine male sexual partners of women with cervical flat condyloma (294 cases) or cervical intraepithelial neoplasia (186 cases), before and after 5 percent acetic acid was applied to the penis and the anogenital area. Condylomata acuminata, papules, and macules were observed in 309 of the 480 men (64.4 percent). In 204 of them (42.5 percent), macules or slightly elevated papules were detected only after application of acetic acid. Condylomata acuminata or lesions showing histologic features of condyloma were found in 121 partners (41.2 percent) of women with condyloma, but in only 10 partners (5.4 percent) of women with cervical intraepithelial neoplasia. Penile lesions showing histologic features of intraepithelial neoplasia were found in 61 partners (32.8 percent) of women with cervical intraepithelial neoplasia, but in only 4 partners (1.4 percent) of women with flat condyloma. Thirty-six (60 percent) of the 60 macules or papules tested contained papillomavirus DNA sequences. Human papillomavirus types 16 and 33 were almost exclusively found in penile intraepithelial neoplasia. Type 6, type 11, and the recently recognized type 42 were found in lesions showing features of condyloma or minimal histologic changes. As yet uncharacterized papillomaviruses were found in 15 percent of the specimens. These data support the concept that cervical carcinomas and precancerous lesions in women may be associated with genital papillomavirus infection in their male sexual partners.

Adolescent↗

Psychosocial determinants for sexual partner referral in Uganda: qualitative results.

In order to understand and elicit the psychosocial factors influencing compliance with sexual partner referral, 10 focus group discussions (FGDs) and 40 individual interviews based on the attitude-social influence-self efficacy (ASE) model were held in Mbarara District of Uganda. The focus groups were derived from both rural and urban areas. Informal interviews were held with 20 men and 20 women presenting with symptoms of a sexually transmitted disease (STD) at the outpatient department of Mbarara Hospital. The emerging outcome of attitudinal beliefs regarding health consequences of partner referral were mainly positive. However, outcome beliefs relating to the relationship with the partners were mainly negative. Social influence for sexual partner referral was from health-care providers, partner(s), friends and relatives. The self-efficacy beliefs were mainly negative especially among women. Barriers hampering sexual partner referral were related to poor quality of health care, gender relations and type of sexual partners. There is a need to target these beliefs and self-efficacy expectations in health education and STD counselling and for more research to evaluate the psychosocial determinants of sexual partner referral quantitatively.

Attitude to Health↗

Condom use promotes regression of human papillomavirus-associated penile lesions in male sexual partners of women with cervical intraepithelial neoplasia.

Penile HPV-associated lesions are frequently seen in male sexual partners of women with CIN. The natural course and clinical significance of these lesions are unclear. Women with CIN and their male sexual partners were randomized for condom use (condom group n = 68, noncondom group n = 68). Males were screened for the presence of penile lesions, i.e., flat lesions, papular lesions and condylomata acuminata, and of HPV in their penile swabs by PCR testing. Median follow-up time was 13.1 months (range 2.9-57.4). The outcome of our study was clinical regression of penile lesions defined as disappearance of lesions at penoscopy. Potentially prognostic factors, i.e., HPV status, lesion type and age, were studied as well. Outcomes were assessed in 57 men of the condom group and in 43 men of the noncondom group. Condom use shortened the median time to regression of flat penile lesions (7.4 months condom group vs. 13.9 months noncondom group; HR = 2.1, 95% CI 1.2-3.7). This effect was not found for papular lesions (HR = 0.5, 95% CI 0.1-2.8). HPV-negative men showed a significantly shorter median time to regression of flat lesions (3.8 months) compared to men with either HPV-positive status (8.5 months; HR = 0.4, 95% CI 0.2-0.9) or inconsistent HPV status (13.1 months; HR = 0.2, 95% CI 0.1-0.6). Regression of flat penile lesions is HPV-dependent and accelerated by condom use. This effect is probably the result of blocking viral transmission between sexual partners.

Adult↗

Prostitution and the sex discrepancy in reported number of sexual partners.

One of the most reliable and perplexing findings from surveys of sexual behavior is that men report substantially more sexual partners than women do. We use data from national sex surveys and studies of prostitutes and their clients in the United States to examine sampling bias as an explanation for this disparity. We find that prostitute women are underrepresented in the national surveys. Once their undersampling and very high numbers of sexual partners are factored in, the discrepancy disappears. Prostitution's role in the discrepancy is not readily apparent because men are reluctant to acknowledge that their reported partners include prostitutes.

Female↗

Human immunodeficiency virus (HIV) infection in the regular sexual partners of homosexual men with AIDS and persistent generalised lymphadenopathy.

Thirty-five homosexual men who had been the regular sexual partners (for at least 6 months) of anti-HIV-positive patients with AIDS (N = 18) or PGL (N = 17) were studied. Twenty-one (60%) were seropositive, but 14 (40%) were consistently anti-HIV-negative. The duration of relationship with the index case was not statistically different in seropositive compared to seronegative partners; median 26 months (range 7-60) vs 30 months (range 7-60). However, seropositive partners had a significantly higher monthly number of other sexual partners and sexually transmitted diseases and a higher frequency of insertive and receptive anal intercourse in the preceding five years. The risk of acquiring HIV infection was significantly increased by frequent receptive anal intercourse when the frequency of insertive was controlled for but not the converse. Seronegative partners had undetectable antibodies by live and fixed cell immunofluorescence and by radioimmunoprecipitation and were repeatedly negative by competitive enzyme immunoassay. Furthermore, the sera of seronegative partners lacked HIV neutralising activity. Peripheral blood mononuclear cells (PBMCs) from seronegative partners, stained with monoclonal antibodies to seven different CD4 epitopes, revealed no differences when compared to those from heterosexual controls and no qualitative differences from cells from seropositive individuals. In addition, PBMCs from seronegative partners could be productively infected by HIV in vitro. If resistance to infection in seronegative partners exists, then it is likely that mechanisms other than a specific humoral immunity or CD4 polymorphisms are involved.

AIDS-Related Complex↗