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PubMedDate not supplied

HIV-1 infection in a Ugandan town on the trans-African highway: prevalence and risk factors.

All adult residents (aged 13 years or more) of 154 randomly selected households in 3 urban and one semi-rural ward of a town in South West Uganda on the trans-African highway were invited to participate in a socio-demographic, behavioural and medical survey. An unambiguous HIV-1 serostatus was obtained for 389 (80%) adults. The overall sero-prevalence rate was 40.4%; all age groups except males aged 13-19 years had infection rates in excess of 20%. Rates above 50% were found in females aged 20-34 years and males aged 35-44 years. For females seropositivity rates increased steeply with increasing numbers of lifetime sexual partners up to a maximum of 3; in contrast, for males rates continued to increase with increasing numbers of partners. The risk of infection amongst those with only one reported partner was 17%. A high proportion of males (14%) and females (18%) reported a history of genital ulcer disease within the previous 6 months; on examination genital lesions were observed in 12% of all participants. Interventions with a single focus are unlikely to have much impact in such a situation and a strategy is suggested which includes 3 components, namely improved STD control, a reduction in partner change and an increase in condom utilization.

AIDS Serodiagnosis↗
PubMed1994

AIDS knowledge and sexual behavior among Mexican gay and bisexual men.

Little knowledge exists about AIDS and Human Immunodeficiency Virus (HIV) infection among Latin American gay males. In Latin America, sexual transmission from man to man is the leading cause of HIV infection. In Mexico, which ranks third in number of AIDS cases in the Americas, more than three-quarters of the cases are due to sexual transmission; among these cases, 35% and 23.7% are due to homosexual and bisexual male practices, respectively. A sample of 200 individuals from Juarez, Mexico, a city on the U.S. border, was interviewed. Information about their AIDS knowledge, sexual behavior, and condom use was obtained. Factory workers and individuals who meet sexual partners in the streets reported more sexual partners than workers in service or professional occupations and those who meet their partners in bars and discos. Number of sexual partners and respondents' age were inversely associated with condom use. Implications for HIV prevention are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Predictors of safer sex on the college campus: a social cognitive theory analysis.

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N = 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjunction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Long-term trends in self-reported HIV risk behavior: injection drug users in Los Angeles, 1987 through 1995.

This article reviews trends in self-reported HIV risk behaviors across serial samples of injection drug-using (IDU) arrestees interviewed in Los Angeles. Between 1987 and 1995, a gradual decrease occurred in the percentage who share needles. However, measured over a past-year recall period, the prevalence of needle sharing remained high until 1994 to 1995, when it abruptly declined. Needle sharing with strangers and needle sharing at shooting galleries declined gradually throughout the study period. Among IDUs who shared needles, bleach use increased rapidly until 1991 but leveled off thereafter. No change occurred in number of sex partners, but condom use gradually increased among IDUs with 2 or more partners. Concurrent change in local needle exchange policy and practice may explain the abrupt decline in past-year needle sharing. New strategies may be needed to promote further increases in bleach use and condom use.

Condoms↗
PubMed2006

Association of condom use, sexual behaviors, and sexually transmitted infections with the duration of genital human papillomavirus infection among adolescent women.

OBJECTIVE: To examine the association of potentially modifiable factors such as condom use, sexual behaviors, and concurrent sexually transmitted infections with duration of genital human papillomavirus (HPV) infections among adolescent women. DESIGN: Longitudinal observational study. SETTING: Study conducted at 3 inner-city clinics in Indianapolis, Ind. PARTICIPANTS: Forty-nine HPV-positive adolescents were tested frequently for HPV infection and provided sexual behavior diaries. Main Exposures Condom use, sexual behaviors, number of partners, and concurrent infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. MAIN OUTCOME MEASURES: Time from onset to clearance of type-specific HPV infections was analyzed with proportional hazard models. Adjusted hazard ratios (AHRs) were used to assess the effects of risk factors on the duration of HPV infection. Because viral clearance is a preferred outcome, a variable with an AHR less than 1 was considered a risk factor (ie, associated with reduced chance of viral clearance and prolonged infection). RESULTS: Prolonged HPV infection was associated with oncogenic HPV types (AHR, 0.58 [95% confidence interval (CI), 0.39-0.84]) less than median level of condom use during an HPV infection (AHR, 0.53 [95% CI, 0.33-0.84]) and coinfection with C trachomatis (AHR, 0.58 [95% CI, 0.31-0.89]) or T vaginalis (AHR, 0.32 [95% CI, 0.16-0.64]). Not having multiple sexual partners during an HPV infection was associated with early HPV clearance (AHR, 5.52 [95% CI, 3.28-9.30]). CONCLUSIONS: These findings support public health messages of reducing the number of sexual partners, promoting routine condom use, and frequent sexually transmitted infection screening that may be beneficial with HPV infections.

Adolescent↗
PubMed1996

Sexual risk behavior among urban women of childbearing age: implications for clinical practice.

Cox's interaction model of client health behavior was used as an organizing framework to describe the demographic characteristics, motivation, problem-solving, self-esteem, and sexual risk behaviors among urban women of childbearing age (N = 125; average age = 32 years). Eighty-five percent of the women were African American. Sexual risk behaviors were defined as more than one sex partner and not using a condom. Eight women were at the highest risk in that they reported having more than one sex partner and not using condoms. Participants reported low self-esteem, intrinsic motivation, and adequate problem-solving abilities. Motivation scores were significantly different based on number of sex partners (t = 2.26, p = .03). Women with more than one partner had lower scores compared to women with only one partner. There was a significant variation in reported self-esteem among women who used condoms (t = 2.36; p = .22). Women who did not use condoms reported lower self-esteem than women who said that they used condoms.

Adult↗
PubMedDate not supplied

[Problems posed by HIV infection in women in tropical zones].

Retroviruses (mainly H.I.V. 1 and H.I.V. 2) are now largely spread over in Central Africa and Caribbean Islands, particularly in large cities. Their transmission is essentially horizontal and mainly sexual. As a matter of fact, sexual transmission is responsible in about 80% of the cases, leaving only a small percentage to transmission by needle (or by any aggressive material), blood or blood by-products. As far as sexual transmission is concerned, it is essentially heterosexual, in spite of the primary epidemic outbreak in the occidental world that focused interest toward male homosexual group, the first exposed to A.I.D.S. Nowadays we know that heterosexual transmission is important and bi-directionnal, even if transmission female to male has seemed to be more difficult to enlight, as it is common in sexually transmitted diseases. Transmission risk to an heterosexual partner is between 20 and 70%. Virus is present in semen, and in cervico-vaginalis secretions during all menstruation cycle. Vertical transmission, mother to child, through placenta or during delivery is frequent, and is of about 50%. First data on heterosexual transmission have been found in Central Africa, indicating high rates for prostitutes, their "customers", unmarried women with numerous partners, women with an other S.T.D. A.I.D.S. in child has been first described in Haïti and in Zaïre. The very important role played by heterosexual transmission imposed sanitary education and usage of contraceptives which are efficient but difficult to firmly recommended for social and cultural considerations.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Acceptability of female condom use among women exchanging street sex in New York City.

Greater access to alternative female-initiated barrier methods, such as the female condom, is needed among women exchanging street sex. This study describes knowledge of and experience with the female condom among 101 women exchanging sex for money and drugs on the streets of New York City, and examines the acceptability of female condom use as an alternative barrier method for HIV/STD prevention among this population. Female condom use among this sample of sex workers was found to be related to having a regular sexual partner, living with someone who is a drug or alcohol abuser, not being homeless, using alcohol or intravenous heroin, having heard of the device, and having discussed the device with other women or with a regular sexual partner. Despite decreased acceptability post-use, most sex workers indicated an intention for future female condom use.

Adult↗
PubMedDate not supplied

Selective screening for Chlamydia trachomatis infection in nonurban family planning clinics in Wisconsin.

To determine the prevalence of, and identify risk factors for, Chlamydia trachomatis infection, we studied 380 women attending four Wisconsin family planning clinics in October 1985. The patients completed self-administered sexual history questionnaires, were examined by nurse clinicians and had specimens taken for direct fluorescent antibody (DFA) testing for C. trachomatis. Of 335 women with adequate specimens, 10.7 percent had positive DFA tests. Selective screening criteria were developed based on the following risk factors for C. trachomatis: Age less than 20 years and recent exposure to either a new sexual partner or a partner with more than one partner; a partner with symptoms of urethritis; a diagnosis of cervicitis; and inflammatory changes on Pap smear. Thirty-six percent of patients met one or more of these screening criteria, and the criteria had a sensitivity of 72 percent.

Adolescent↗
PubMed1992

Attitudes, norms, and self-efficacy: a model of adolescents' HIV-related sexual risk behavior.

Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, a model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms, and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy ad condom use intentions were directly related to frequency of condom use.

Adolescent↗
PubMed1994

Attitudes, knowledge, and behavior regarding condom use in urban black adolescent males.

This study was conducted to determine male adolescent behavior, attitudes, and knowledge concerning the use of condoms. Subjects were 241 sexually active black adolescent males attending an inner-city adolescent medicine clinic who were surveyed using a structured interview technique. Factors associated with condom use included higher grade level, > or = 2 sexual partners in the past six months, communication about contraception with sexual partner(s), desire for sexually transmitted disease (STD) prevention when contracepting, and parental suggestion to use condoms. Variables not associated with condom use included older age, minimal level of knowledge about condom use, history of having impregnated a partner or of having contracted an STD, desire for pregnancy prevention, suggestion by friends to use condoms, or partner dissatisfaction with condoms. Using multivariate logistic regression analysis, the following variables in combination were able to correctly classify respondents as condom users or nonusers in 74% of cases: higher knowledge score, reported communication about contraception with one's partner(s), > or = 2 partners in the past six months, and higher socioeconomic status. These findings suggest that, for the study population, interventions directed toward improving knowledge about condoms, school achievement, and communication with parents and partners may be effective in increasing condom use.

Adolescent↗
PubMed1999

Relationship between number of sexual intercourse partners and selected health risk behaviors among public high school adolescents.

PURPOSE: To examine the relationship between number of sexual partners and selected health risk behaviors in a statewide sample of public high school students. METHODS: The Centers for Disease Control and Prevention Youth Risk Behavior Survey was used to secure usable sexual risk-taking, substance use, and violence/aggression data from 3805 respondents. Because simple polychotomous logistic regression analysis revealed a significant Race x Gender interaction, subsequent multivariate models were constructed separately for each race-gender group. Odds ratios and 95% confidence intervals was calculated from polychotomous logistic regression models for number of sexual intercourse partners and their potential risk behavior correlates. RESULTS: An increased number of sexual intercourse partners were correlated with a cluster of risk behaviors that place adolescents at risk for unintended pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and other sexually transmitted infections. For Black females, alcohol, tobacco, marijuana use, and dating violence behaviors were the strongest predictors of an increased number of sexual partners; white females had similar predictors with the addition of physical fighting. For white males, alcohol, tobacco, marijuana use, physical fighting, carrying weapons, and dating violence were the strongest predictors of an increased number of sexual intercourse partners. Black males had similar predictors with the addition of binge alcohol use. CONCLUSION: Prevention of adolescent sexual and other health risk behaviors calls for creative approaches in school and community settings and will require long-term intervention strategies focused on adolescent behavior changes and environmental modifications.

Adolescent↗
PubMed1998

Attenders at young people's clinics in Southampton: variations in contraceptive use.

This paper presents findings from a survey of 424 people attending nine young people's clinics within the Southampton Community Health NHS Trust. In addition to recording some descriptive background data on the people attending the clinics, one major aim of the study was to investigate whether talking to the sexual partner about contraception before their first intercourse together and delaying this first intercourse influenced contraceptive use. Overall, 40 per cent of people attending the clinics were aged 16 or under, although there was some variation between clinics in the age groups attracted. Most clients were female (88 per cent), had ever had sexual intercourse (92 per cent), reported four or more lifetime partners (42 per cent) but only one partner within the last six months (73 per cent) and were currently in a relationship (75 per cent). Potential for contraception and sexually transmitted infection was widespread; 46 per cent (of non-virgins) had had intercourse without contraception at least 'a few times' and 18 per cent used condoms 'rarely' or 'never'. In terms of first intercourse with current/most recent partner, 17 per cent had not used any contraception and 32 per cent had failed to use condoms. The most important findings from this study were that use of contraception (and condoms in particular) on the occasion of first intercourse with the current or most recent partner was significantly associated with the following; if partners had talked to each other about contraception before having intercourse together for the first time (p<0.001), and also if this first intercourse was delayed beyond four weeks as opposed to over a few days of first 'going-out' together (p<0.001). Suggestions for further in-depth research are made.

Adolescent↗
PubMed1993

Sexually transmitted diseases in college men: a preliminary clinical investigation.

Continuing efforts to educate college students about the dangers of unprotected sexual intercourse have resulted in little evidence of positive change in sexual behavior. This clinical study examined the sexual behavior, perceived risk of human immunodeficiency virus, and pathology of 66 university men attending a health center's men's clinic for treatment of sexually transmitted disease (STD). The study demonstrated the existence of a high-risk group of men who, despite sexually transmitted disease pathology, high numbers of sexual partners, inconsistent condom use, and delays in seeking treatment, perceive their risk of contracting HIV/AIDS as being extremely low. This preliminary investigation suggests the need for specific education interventions and future in-depth studies of this population.

Adult↗
PubMed2003

Comparison of methods for detection of Chlamydia trachomatis and Neisseria gonorrhoeae using commercially available nucleic acid amplification tests and a liquid pap smear medium.

Annual screening for Chlamydia trachomatis infection is currently recommended for sexually active women 15 to 25 years old and for women older than 25 if they have a new or multiple sex partners and have not used condoms during the previous 3 months. Annual screening for cervical abnormalities using the Pap smear has achieved a substantial reduction in morbidity and mortality from cervical cancer. Screening for Neisseria gonorrhoeae infection has likely contributed significantly to the reduction in the rates of gonococcal infection. The introduction of liquid Pap smear methods using exfoliated cervical cells presents an opportunity to screen for these three conditions using one specimen. We evaluated the preservation of C. trachomatis and Neisseria gonorrhoeae DNAs from ThinPrep liquid media (PreservCyt; Cytyc Corp., Boxborough, Mass.); tested the feasibility of using a clinical specimen of this medium for the detection of cytologic abnormalities, C. trachomatis, and N. gonorrhoeae; evaluated the agreement between ligase chain reaction (LCR) performed on PreservCyt and LCR performed on a cervical specimen; and compared the performance of LCR performed on PreservCyt to those of LCR performed on a cervical specimen, culture, PCR performed on a cervical specimen, on urine, and on a vaginal specimen (a multiple-site infection status standard), and transcription-mediated amplification (for C. trachomatis only) from 255 sexually active adolescent women. The agreement between LCR performed on PreservCyt and LCR from a cervical swab in LCx transport medium was high (for C. trachomatis, agreement = 0.97 and kappa = 0.92; for N. gonorrhoeae, agreement = 0.99 and kappa = 0.96). Test performances were similar for LCR-urine, LCR-cervix, and LCR-ThinPrep, with sensitivities from 93 to 99% for C. trachomatis and 81 to 83% for N. gonorrhoeae and specificities from 95.5 to 99% for C. trachomatis and 99.1 to 99.6% for N. gonorrhoeae using a PCR-based multiple-site infection status standard. This is the first study to examine the agreement between liquid cytologic media and multiple nucleic acid amplification tests for the detection of C. trachomatis and N. gonorrhoeae from patient samples. Cytologic fluid shows promise for simultaneous screening for cytologic abnormalities and sexually transmitted infections.

Adolescent↗
PubMed1992

An update on knowledge and sexual behaviour among students in Greenland. Monitoring of the stop-AIDS campaign.

Greenland is a considered high risk area for a self-sustained heterosexual HIV-epidemic due to rather relaxed sexual norms in larger segments of the population and a high incidence of sexual transmitted diseases. However, the prevalence of HIV-positives is still low. As part of a monitoring programme longitudinal studies of young peoples' knowledge and sexual behaviour has been established. This paper presents results from the second survey among all students in vocational training and all 10th grade students in the public schools. Previous studies were performed in 1988 and 1989. The present study which took place in April 1991 involved a total of 1201 students, or about 85% of all students in the target groups (95% among students present on the day of surveying). Data collection was based upon standardized self-administered questionnaires. The study showed better knowledge than previously but no marked change in sexual habits. The age of sexual début even appeared to be decreasing. More than half reported a sexual début before the age of 15. More than 20% reported 10 sexual partners or more within the last year. HIV has still not reached the young population in Greenland but when it happens the present sexual behaviour carries a high risk of a self-sustained epidemic.

Adolescent↗