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At least 973 records · Page 54Linked to original sources
PubMed2007

Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach.

Studies among normative samples generally demonstrate a positive impact of marriage on health behaviors and other related attitudes. In this study, we examine the impact of marriage on HIV/AIDS risk behaviors and attitudes among impoverished, highly stressed, homeless couples, many with severe substance abuse problems. A multilevel analysis of 368 high-risk sexually intimate married and unmarried heterosexual couples assessed individual and couple-level effects on social support, substance use problems, HIV/AIDS knowledge, perceived HIV/AIDS risk, needle-sharing, condom use, multiple sex partners, and HIV/AIDS testing. More variance was explained in the protective and risk variables by couple-level latent variable predictors than by individual latent variable predictors, although some gender effects were found (e.g., more alcohol problems among men). The couple-level variable of marriage predicted lower perceived risk, less deviant social support, and fewer sex partners but predicted more needle-sharing.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Sexual behavior, psychosocial and knowledge differences between consistent, inconsistent and non-users of condoms: a study of female bar and hotel workers in Moshi, Tanzania.

Understanding psychosocial, sexual behavior and knowledge differences between never, inconsistent and consistent condom users can improve interventions to increase condom use in resource-poor countries, but they have not been adequately studied. We examined these differences in a cohort of 961 female hotel and bar workers in Moshi, Tanzania. Forty-nine percent of women reported no condom use; 39% reported inconsistent use, and 12% reported consistent use. Women with multiple sexual partners in the past five years were less likely to be consistent rather than inconsistent users as were women who had ever exchanged sex for gifts or money. Inconsistent users had higher condom knowledge and higher perceived acceptability of condom use than did never users, but they did not differ from consistent users by these factors. There are important differences between women by level of condom use. These findings can help inform interventions to increase condom use.

Adolescent↗
PubMed2007

Subjective and objective measures of attractiveness and their relation to sexual behavior and sexual attitudes in university students.

This study examined both self-rated and objectively measured attractiveness in relation to sexual behaviors and attitudes in an undergraduate sample (N=456). About a quarter of the variance in self-ratings of attractiveness was predicted from combining standard objective measures of attractiveness, including face photo ratings, body mass index, and chest-to-waist ratio for men, and face photo ratings, body mass index, and waist-to-hip ratio for women. Correlations were investigated among self-rated attractiveness, measured attractiveness, the residual component of self-rated attractiveness (controlling for measured attractiveness), and a number of sexual and related variables. Measured attractiveness correlated moderately with sexual behaviors but not with sociosexuality or sexual moral attitudes, indicating that higher levels of observable attractiveness may serve to increase opportunities for sex with multiple desirable partners without affecting interests in or moral acceptance of casual sex. Self-rated attractiveness correlated positively with sexual behaviors and with sociosexuality, but the correlation with sociosexuality was based entirely on residual factors beyond the objective measures of attractiveness. Other predictors of sexual behavior were discussed in terms of their variable roles in affecting interest in, opportunities for, and social costs of promiscuous sexual activity.

Adult↗
PubMed2005

Early adversity and the prospective prediction of depressive and anxiety disorders in adolescents.

The current study was a prospective exploration of the specificity of early childhood adversities as predictors of anxiety and depressive disorders in adolescents. Participants were 816 adolescents (414 males, 402 females) with diagnostic information collected at age 15; information on early adversities had been collected from the mothers during pregnancy, at birth, age 6 months, and age 5 years for a related study. Adolescents with "pure" anxiety disorders were compared with adolescents with "pure" depressive disorders (major depressive disorder, dysthymia), and these groups were compared to never-ill controls. Analyses controlled for gender and maternal depression and anxiety disorders. Results indicated that adolescents with anxiety disorders were more likely than depressed youth to have been exposed to various early stressors, such as maternal prenatal stress, multiple maternal partner changes, and more total adversities, whereas few early childhood variables predicted depressive disorders. Even when current family stressors at age 15 were controlled, early adversity variables again significantly predicted anxiety disorders. Results suggest that anxiety disorders may be more strongly related to early stress exposure, while depressive disorders may be related to more proximal stressors or to early stressors not assessed in the current study.

Adolescent↗
PubMed2006

Effects of a school-based drug abuse prevention program for adolescents on HIV risk behavior in young adulthood.

Early onset of substance use among adolescents has been found to be associated with later risky sexual behaviors. This study examined long-term follow-up data from a large randomized school-based drug prevention trial to (1) investigate the long-term impact of the prevention program on drug use and sexual behaviors that put one at elevated risk for HIV infection; and (2) use growth modeling procedures to examine potential mechanisms of intervention effects. Self-report survey data were collected from students in the 7th grade, prior to the intervention in 1985, and in grades 8, 9, 10, and 12. Participants in the intervention condition received a 30-session drug prevention program in 7th through 9th grades. Follow-up surveys were completed by 2042 young adults (mean age = 24) in 1998. As young adults, participants were considered to be engaging in high-risk behavior for HIV infection if they reported having multiple sex partners, having intercourse when drunk or very high, and recent high-risk substance use. The intervention had a direct protective effect on HIV risk behavior in the overall sample in young adulthood. Furthermore, among participants receiving 60% or more of the prevention program, analyses showed that the intervention significantly reduced growth in alcohol and marijuana intoxication over the course of adolescence, which in turn was associated with a reduction in later HIV risk behavior. The behavioral effects of competence-enhancement drug prevention programs can extend to risk behaviors including those that put one at risk for HIV infection.

Adolescent↗
PubMed2006

Sexual and injection risk among women who inject methamphetamine in San Francisco.

Methamphetamine (MA) use is on the rise in the United States, with many cities reporting increases of 100% or more in MA-related Emergency Department (ED) mentions. Women are keeping pace with this trend: in 2003, 40% of ED mentions and 45% of MA-related treatment admissions were female. Although there have been extensive examinations of MA use and HIV/STI risk among gay men in recent years, literature regarding female MA users is scarce. This paper examines female methamphetamine injectors in San Francisco, CA, from 2003-2005. We assessed sexual and injection related risk behaviors, comparing female MA injectors to female injectors of other drugs. We also examined whether MA use was independently associated with specific sexual and injection risk behaviors. We found that female MA injectors were significantly more likely than non-MA injectors to report unprotected anal intercourse, multiple sexual partners, receptive syringe sharing and sharing of syringes with more than one person in the past six months. In multivariate analysis, MA use among female injectors was significantly associated with anal sex, more than five sexual partners, receptive syringe sharing, and more than one syringe-sharing partner in the past six months. Deeper exploration of the relationship between MA use and sexual risk among women would benefit HIV/STI prevention efforts. In addition, existing interventions for drug-injecting women may need to be adapted to better meet the risks of female MA injectors.

Adult↗
PubMed1991

Hepatitis C: a sleeping giant?

In the United States, non-A, non-B hepatitis accounts for 20-40% of acute viral hepatitis. Although it has traditionally been considered a transfusion-associated disease, non-A, non-B hepatitis is more likely to occur outside the transfusion setting. Surveillance data from the Centers for Disease Control show that in 1988 6% of patients with non-A, non-B hepatitis reported a history of blood transfusion, 46% parenteral drug use, 10% household or sexual exposure to a contact who had had hepatitis or exposure to multiple sex partners, 2% medical or dental employment involving frequent blood contact, less than 1% hemodialysis, and 40% no known source. Antibody to hepatitis C virus (anti-HCV) is found in the majority of patients with non-A, non-B hepatitis independent of the source of infection; however, antibody may not appear for 6 to 9 months after exposure or onset of illness. Limited serologic studies of the prevalence of anti-HCV in various population groups have found high anti-HCV rates (50-80%) in parenteral drug users and hemophiliacs, intermediate rates among the sexually active (5-15%), and low rates among health care workers (1%). In persons with acute or chronic hepatitis C, the presence of anti-HCV appears to indicate infectivity. Persons with no history of hepatitis who are anti-HCV positive may or may not be infectious. More sensitive and specific markers for the detection of hepatitis C virus will be needed to resolve this question.

Hepacivirus↗
PubMed1994

History of long-term use of depot-medroxyprogesterone acetate in patients with cervical dysplasia; case-control analysis nested in a cohort study. The New Zealand Contraception and Health Study Group.

Histories of use of depot-medroxyprogesterone acetate (MPA) given by women entering a previously-reported prospective study of risk of cervical dysplasia, including carcinoma, have been evaluated. Over a six-year follow-up period, 348 of the 7199 enrolled women developed cervical dysplasia diagnosed by cytology and confirmed by histology or DNA analysis. Use of MPA prior to entry into the study was reported somewhat more commonly and for somewhat longer periods by the women who developed confirmed dysplasia than by those who did not. However, this association was accounted for entirely by the fact that women who reported use of MPA, particularly at an early age, tended to carry a number of known strong risk factors for dysplasia, specifically, first intercourse at an early age, multiple sex partners and cigarette smoking. These findings indicate that the lack of relationship of MPA use to risk of cervical dysplasia, noted previously for women whose median duration of use within the formal study period was about 2 years, extended to the same women who used MPA prior to the study period--even to those whose duration of prior use was 4 years or more.

Adult↗
PubMed1995

Compliance and oral contraceptives: a review.

Compliance difficulties are more common among oral contraceptive (OC) users than generally appreciated by clinicians, in part because unintended pregnancy is a relatively infrequent consequence and in part because more common manifestations such as spotting and bleeding may not be recognized as resulting from poor compliance. While improving compliance is a shared responsibility of patients, clinicians, and manufacturers, the clinician is the focal point for these efforts. Counseling must be individualized, which requires knowledge of factors that predict compliance and an understanding of the patient's decision-making process as it relates to medications. Most OC compliance research has focused on adolescents, where predictors of poor compliance include multiple sex partners, low evaluation of personal health, degree of concern about pregnancy, and previous abortion. Good compliance has been linked with patient satisfaction with the clinician, the absence of certain side effects, establishing a regular daily routine to take OCs, and reading information distributed with OC packaging.

Contraceptives, Oral↗
PubMed1991

Sexual activity, contraceptive practice and abortion among adolescents in Lagos, Nigeria.

Nine hundred fifty randomly selected secondary school girls were surveyed. Sexual activity was claimed by 29%, the youngest age was 12 years and age had no influence on the frequency of sexual intercourse. Multiple sexual partners, a high risk behaviour for contracting STD including AIDS was demonstrated in 33.7% and only 20.3% used orthodox methods of contraception. Induced abortion was procured by 23.5% and most were procured from unskilled personnel and by dangerous methods.

Abortion, Illegal↗
PubMed1992

Asymptotic worst-case mixing in simple demographic models of HIV/AIDS.

The majority of published modeling work regarding the impact of mixing patterns among subgroups on the spread of HIV infection assumes either that the overall population size remains constant, the aggregate immigration to the population occurs at a constant annual rate, or that no immigration occurs and the population in question declines due to HIV or other causes. In this paper, immigration rates are modeled as simple functions of population size and may be interpreted as aggregate birth rates. This assumption implies asymptotic exponential growth in the disease-free population as long as per capita birth rates exceed per capita mortality rates. The introduction of HIV infection to such a population may change this situation, and the asymptotic population growth rate can be reduced substantially as a result. The specific manner in which this occurs depends in part upon difficult to observe mixing patterns among those with different sexual activity rates. Rather than attempting to explicitly model a variety of mixing patterns, a bound on the impact of worst-case mixing is produced, where "worst case" refers to the mixing pattern that maximizes the asymptotic prevalence of infection, which is equivalent to minimizing the asymptotic population growth rate. These new techniques are illustrated with a numerical example.

Acquired Immunodeficiency Syndrome↗
PubMed1995

A randomized trial of prophylactic doxycycline for curettage in incomplete abortion.

OBJECTIVE: To determine whether prophylactic doxycycline at suction curettage for incomplete abortion decreases the rate of postoperative pelvic infection. METHODS: We randomized 240 patients to receive intravenous doxycycline or placebo at curettage. Cervical specimens for gonorrhea and chlamydia were obtained preoperatively. Two weeks post-procedure, we evaluated all patients for infectious morbidity and repeated gonorrhea and chlamydia cultures. Statistical analysis used Mann-Whitney U test, McNemar test, or Fisher exact test, as appropriate. RESULTS: There were no statistically significant differences in age, parity, gestational age, history of sexually transmitted disease, pelvic inflammatory disease, or multiple sex partners between the doxycycline and placebo groups. Preoperative gonorrhea or chlamydia isolates were positive in five (4.2%) and six (5%) of 120 doxycycline patients and four (3.3%) and eight (6.6%) of 120 controls (not significant). All preoperative gonorrhea isolates remained positive postoperatively. Seven (5.8%) controls had positive postoperative chlamydia isolates, as did one (0.8%) in the doxycycline group (P = .06). We diagnosed eight (6.6%) of 120 doxycycline patients and seven (5.8%) of 120 controls with infectious morbidity (not significant). CONCLUSION: In our population of patients with incomplete abortion, the prevalence of gonorrhea and chlamydia was low, and prophylactic doxycycline did not decrease the rate of postoperative febrile morbidity.

Abortion, Incomplete↗
PubMed1989

Survey of AIDS knowledge and behavior changes among Massachusetts adults.

In October 1987, 1,323 Massachusetts residents were randomly interviewed by telephone to explore their exposure to AIDS educational efforts, levels of knowledge about AIDS, and whether that knowledge modified their behavior. Gay/bisexual males, iv drug users and heterosexual respondents were compared as were blacks, Hispanics, and whites. While 81% of respondents had read or heard mass media stories about AIDS, in the previous week, only 5% had ever been counseled about AIDS by a physician. Over 97% of black (N = 152) and white respondents (N = 1,057), as well as gay/bisexual males (N = 21) and iv drug users (N = 33) were aware that HIV can be transmitted by homosexual or heterosexual intercourse and by sharing needles when injecting drugs. However, 9% of the 55 Hispanics interviewed were unaware of male homosexual transmission, and 7% did not know about heterosexual transmission or the risks of needle sharing. Twenty percent of Hispanics, compared with 9% of other respondents, did not know HIV can be transmitted sexually by someone who appears healthy. Fifty-two percent of gay/bisexual males, 27% of iv drug users, and 21% of those who had multiple heterosexual partners in recent years reported adopting abstinence, monogamous relations, or condom use to avoid HIV exposure. Those who continued risky behavior were just as knowledgeable about HIV transmission, but they were less likely to report that they worry a great deal about getting AIDS, 14% vs 32%. The results indicate that new strategies and resources are needed to educate Hispanics. Physicians need to counsel more persons about HIV transmission and further efforts are needed to translate knowledge about HIV transmission into behavior change to avoid the virus.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Self-control and ego identity development as predictors of unprotected sex in late adolescent males.

Male college students completed an anonymous self-report questionnaire assessing HIV-related knowledge, attitudes, moral development, personality factors and behaviors. Bivariate analyses were used to identify factors associated with high-risk sexual intercourse. Significant demographic psychosocial and behavioral predictors were entered into a logistic regression analysis to evaluate the independent influence of each predictor on unprotected sexual intercourse. Behavioral factors were the most powerful predictors of unprotected sexual intercourse. Adolescents reporting multiple sex partners, drinking and picking-up sex partners were significantly more likely to engage in sex without condoms. Examining psychosocial factors alone, it was found that adolescents who had low scores for ego-development (goal-directedness) and self-control were significantly more likely to engage in sex without condoms. Identification of two personality constructs as underlying predictors of high-risk behavior, while potentially important for the development of effective HIV prevention programs, needs corroboration to further define the interrelationships between these factors and other psychosocial constructs.

Adolescent↗
PubMed1992

Use of nonoxynol-9 and reduction in rate of gonococcal and chlamydial cervical infections.

The spermicide nonoxynol-9 (N-9) has been used as a contraceptive for over 30 years, but the use of a vaginal spermicide and condoms for the prevention of sexually transmitted infections has not been examined in randomised studies. We report a single-blind randomised field trial to assess the effect of N-9 film on the rate of gonococcal and chlamydial cervical infection in women at high risk of these diseases. 343 women were randomly assigned to use either condoms and N-9 (186 women) or condoms and a placebo (157). Compliance with condom use was much the same in the two groups. Overall, N-9 reduced the rate of cervical infection by 25% (rate ratio [RR] 0.75, 95% confidence interval [Cl] 0.5-1.1); in women who used N-9 for more than 75% of their coital acts the infection rate was reduced by 40% (RR 95% Cl 0.3-1.0). The rate of yeast vulvovaginitis or genital ulcers was not higher in N-9 users than in placebo users, but the rate of symptomatic irritation was increased by 70% (RR 95% Cl 1.1-2.6) among N-9 users. Condom use was more protective against cervical infection than N-9 use. The rate of infection was 50% (RR 95% Cl 0.3-0.7) lower with 75% than with 0-50% condom compliance. The use of a vaginal N-9 spermicide with condoms whenever possible seems to be a better strategy than the use of condoms only for prevention of gonococcal and chlamydial cervical infection.

Administration, Intravaginal↗
PubMed1989

Modifications of sexual behaviour related to AIDS: a survey in Paris region.

A survey on the effects of AIDS upon sexual behaviour has been carried out, in December 1987, in a representative sample (n = 900) of the population of 18 years of age and over of the Paris region. Among the sexually active population, 13.8% have been tested for HIV at least once in 1987, 10.7% denied some opportunity of sexual intercourse during the last 6 months of 1987 because of fear of AIDS, and 11.8% declared regular utilization of condoms. 53.4% of condom users are new users since the last 6 months, and, 46.6% of all condom users are mainly motivated by fear of AIDS. Multivariate analysis shows that being single, declaring multiple sexual partners and having being tested for HIV are the main predictors for use of condoms, suggesting adoption of a rather coherent preventive behaviour in a significant fraction of the sexually 'at risk' population.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Case-control study of risk factors for cervical intraepithelial neoplasia in young women.

A case-control study of 497 women under age 40 diagnosed with cervical intraepithelial neoplasia (CIN) and 833 controls was done in the London area between 1984 and 1988 to examine whether known risk factors for invasive cervical cancer produced similar risks for CIN of different grades in young women. Cases of CIN III had a risk profile similar to that seen for invasive disease whereas CIN I cases were similar to the controls in all risk factors examined except a history of genital warts. Cases of CIN II were intermediate between the two. Among several indicators of sexual and reproductive behaviour, age at first childbirth and a history of multiple sexual partners were the strongest risk factors for CIN II and CIN III. Smoking had a strong and independent effect on the risk of CIN II and CIN III, but had only a limited effect for CIN I. Use of oral contraceptives was widespread in cases and controls, but length of use of oral contraceptives was not found to be a risk factor. A small protective effect of barrier contraception was observed.

Adolescent↗