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Physical violence against impoverished women: a longitudinal analysis of risk and protective factors.

Violence represents a significant threat to the health of impoverished women. Few studies have examined what characteristics might be associated with increased risk of violence or protection from physical violence directed at such women, although this information is important in informing violence prevention and intervention efforts. This is the first study to our knowledge that has prospectively examined, in representative probability samples of impoverished women, multiple risk and protective factors to understand their relative importance to physical victimization. Study participants were 810 women in Los Angeles County, 402 in shelters and 408 in Section 8 low-income housing, who completed structured interviews at baseline and 6-month follow-up. Significant (p < .05) multivariate predictors of physical violence experienced during the 6 months prior to follow-up interview were physical or sexual violence experienced as a child, physical violence experienced during the 6 months prior to baseline interview, having multiple sexual partners, psychological distress, and poor social support. Results of this study highlight the persistence of physical violence in the lives of impoverished women and plausible, prospective risk factors for this violence. Findings also highlight opportunities to reduce women's risk of experiencing violence through enhancing women's social support and mental health.

Adult↗
PubMed2004

Comparative analysis of characteristics of women with cervical cancer in high- versus low-incidence regions.

OBJECTIVE: To identify particular characteristics that might help explain the markedly higher rate of invasive cervical cancer in southern China as compared with Australia. METHODS: One hundred eighty-five women with cervical cancer were recruited between 1999 and 2001: 106 from Guangzhou and Changsha (southern China), and 79 from Sydney (southeast Australia). Demographic and risk factor information was obtained by questionnaire; clinicopathologic data were extracted from hospital records. The human papillomavirus (HPV) status of cancer biopsies was ascertained by consensus PCR assays, direct sequencing and/or Amplicor trade mark hybridisation. RESULTS: The mean age of the Chinese was significantly lower than the Australians (44 versus 53 years), although mean age at first sexual intercourse was similar. Australian women were more likely to smoke, to report multiple sexual partners and to have a history of sexually transmitted diseases (but not of genital warts). However, they were better educated, were more frequent users of barrier contraception and were far more likely to report regular Pap smears before diagnosis. The HPV positivity rate of Chinese cancers (83%) was less than Australian tumours (90%); but HPV 16 and 18 were the most common genotypes in both populations (59% and 77%), and predominated in cancers from younger women. HPV types 58 or 59 were amplified from 12 (14%) of the Chinese but from only one Australian cancer. CONCLUSIONS: Cervical cancer is not only more common in China but also develops at a younger age than in Australia. While significant differences in some risk factors were observed, the much lower participation in cervical screening in southern China is likely to be of greatest consequence.

Adult↗
PubMed2005

Correlates of condom failure among adolescent males: an exploratory study.

OBJECTIVE: To identify the prevalence and correlates of condom failure (defined as breakage or slipping off in the past 90 days) among a sample of adolescent males (15 to 21 years of age). DESIGN: A cross-sectional study of 481 condom-using males residing in three US cities (Atlanta, GA, Providence RI, Miami FL). Data were collected, in the years 2000 and 2001, using audio computer-assisted self-interviewing technology. Prevalence ratios were used to determine the strength and significance of bivariate associations between ten assessed correlates and condom failure. Correlates achieving a screening level of significance were entered into a multivariate model that was used to calculate adjusted odds ratios (AOR). RESULTS: Recent condom failure was reported by 34.1%. Younger adolescents were about one-third less likely to report condom failure (AOR = 0.66; P = 0.4). Adolescents reporting multiple sex partners were about 80% more likely to report failure (AOR = 1.84; P = 0.09). Adolescents indicating they had sex with someone on the same day they met the person were about 80% more likely to report failure (AOR = 1.77; P = 0.02). Finally, adolescents indicating recent problems obtaining condoms were about 70% more likely to report failure (AOR = 1.69; P = 0.1). Failure was not less common among those reporting a history of STD infection or those ever impregnating a partner. CONCLUSION: Because adolescent males may commonly experience condom failure, targeted clinic- and community-based programs designed to reduce user error could be an important aspect of preventing pregnancy and the spread of STDs.

Adolescent↗
PubMed2026

From human papillomavirus (HPV) infection to HPV-associated cancers in systemic lupus erythematosus: A systematic review and Meta-analysis.

OBJECTIVE: The current cervix-focused screening paradigm in systemic lupus erythematosus (SLE) may underestimate extra-cervical anogenital cancer risk. This meta-analysis aimed to quantify the risk of human papillomavirus (HPV) infection and HPV-associated cancers in SLE patients. METHODS: A comprehensive search was conducted in PubMed (2010), Embase (2010), and Cochrane Library (2010) to August 8, 2025. Odds Ratios (ORs) and Standardized Incidence Ratios (SIRs) with 95% Confidence Intervals (CIs) were calculated. The study protocol was registered with PROSPERO (CRD420251122192). RESULTS: SLE was associated with significantly increased odds of HPV infection (OR&#xa0;=&#xa0;4.12, 95% CI 2.03, 8.32). We further assessed the risk of HPV-associated malignancies in SLE patients. SLE patients exhibited substantially elevated risks across multiple HPV-associated cancers (SIR&#xa0;=&#xa0;1.90, 95% CI 1.51, 2.38). The risk of cervical cancer was more than doubled (SIR&#xa0;=&#xa0;2.25, 95% CI 1.75, 2.89). Notably, even higher risks were observed for extra-cervical anogenital cancers, namely vulvar/vaginal cancers (SIR&#xa0;=&#xa0;5.60, 95% CI 3.71, 8.43). CONCLUSIONS: SLE is associated with elevated risks of HPV infection and a broad spectrum of HPV-associated cancers. Subgroup analyses suggested that cyclophosphamide use, multiple sexual partners, and Asian populations may constitute higher-risk subgroups. These findings highlight the need for additional prospective evidence to better characterize HPV-associated cancer risks in SLE patients.

Humans↗
PubMed1997

Epidemiology of genital human papillomavirus infection.

Although it is difficult to estimate the overall prevalence of genital human papillomavirus (HPV) infection, current figures suggest that visible genital warts are present in approximately 1% of sexually active adults in the United States and that at least 15% have subclinical infection, as detected by HPV DNA assays. Genital HPV infection is thus extremely common. The highest rates of genital HPV infection are found in adults 18-28 years of age. Although risk factors for infection are difficult to assess because of the high frequency of subclinical infection, it is clear that major risk factors for acquiring genital HPV infection involve sexual behavior, particularly multiple sex partners. Other possible risk factors for acquisition of genital HPV infection include oral contraceptive use, pregnancy, and impairment of cell-mediated immunity. Strong epidemiologic and molecular data link HPV infection to cervical and other anogenital cancers. The types of HPV most commonly detected in cancers are HPV-16 and HPV-18. In summary, genital HPV infection is common among sexually active populations and causes both benign and malignant neoplasms of the genital tract.

Adolescent↗
PubMed1999

Causes and consequences of oral contraceptive noncompliance.

Compliance difficulties are more common among oral contraceptive users than is generally appreciated. Inconsistent use and method discontinuation are estimated to account for approximately 20% of the annual 3.5 million annual unintended pregnancies in the United States. In the past research focused on adolescents, for whom predictors of poor oral contraceptive compliance include multiple sex partners, low evaluation of personal health, low degree of concern about pregnancy, and previous abortion. More recent research confirms that compliance problems are common among all age groups, with 47% of women missing >/=1 pill per cycle and almost a quarter (22%) missing >/=2 pills per cycle. Good compliance has been linked to patient satisfaction with the clinician, the absence of certain side effects, establishing a regular daily routine to take oral contraceptives, and reading information distributed with oral contraceptive packaging. Clinicians are the focal point for improving oral contraceptive compliance. They should focus counseling on the transience of most side effects, instructions on dealing with a missed pill, provision of a backup method, and establishment of a daily pill-taking routine. Easy-to-understand literature should be given to patients to take home.

Adolescent↗
PubMed2001

Cervical neoplasia risk in women provided hormonal contraception without a Pap smear.

The study was conducted to determine whether women using a demonstration program providing hormonal birth control without concurrent pelvic examination (First Stop) are at higher risk of cervical neoplasia compared to women using traditional family planning clinics. Using retrospective ion of medical charts, we compared risk factors for cervical neoplasia among 400 First Stop clients and 400 traditional site clients matched on age, race, and contraceptive method. We determined prevalence of these factors: previous abnormal cervical smear, <16 years at first intercourse, multiple sexual partners, high parity, history of sexually transmitted infections, and current cigarette smoking. First Stop clients were not at greater likelihood of having any risk factor for cervical neoplasia except high parity. First Stop clients who failed to follow through on a referral to a traditional clinic were not more likely to be of higher risk than those who did follow through. Of 13 First Stop clients with the highest risk profiles (previous abnormal cervical smear plus one other risk factor), one did not follow through with referral. First Stop clients choosing hormonal contraception without a pelvic examination do not appear to be at substantially higher risk of cervical neoplasia. Future research should quantify more precisely the risks and benefits of the general application of this strategy on a population level.

Adolescent↗
PubMed1991

The relationship between female sexual practices and the development of antisperm antibodies.

OBJECTIVE: To determine if female sexual practices are associated with the development of antisperm antibodies. DESIGN: Anonymous questionnaire. SETTING: Tertiary care; private practice. PATIENTS: Thirty-nine consecutive patients undergoing antisperm antibody testing; 32 responded. INTERVENTIONS: Cervical mucus and serum obtained at midcycle. MAIN OUTCOME: Female sexual practices were found not to be related to the development of antisperm antibodies. RESULTS: The percent (44.4) of women with antisperm antibodies who practice anal intercourse was not different from the percent (35.7) without these antibodies who engage in the same practice, and the percent (94.4) of women with antisperm antibodies who practice oral intercourse was not different from the percent (92.8) without these antibodies who engage in this practice. CONCLUSION: Female sexual practices do not appear to be related to the development of antisperm antibodies.

Adult↗
PubMed1996

Cytomegalovirus reinfection in young children.

OBJECTIVE: To determine the frequency of reinfection with new cytomegalovirus (CMV) strains in children in group child-care environments. METHODS: Ninety-two CMV strains isolated serially from children attending child care centers were analyzed. Strains were obtained from 1986 to 1994, from 37 children attending one of six centers in the area of Cedar Rapids and Iowa City, Iowa. The CMV isolates were analyzed by a polymerase chain reaction-based algorithm using primers for the a-sequence, glycoprotein B, and major immediate early (MIE) genes of human CMV. The a-sequence polymerase chain reaction products were compared on the basis of size, and products derived from glycoprotein B and MIE genes were compared according to restriction fragment length polymorphisms. RESULTS: Children were between 8 months and 5 years 7 months of age at the time of CMV isolation. The number of isolates ranged from 2 to 6 per child, and the intervals between the first and last CMV isolation ranged from 11 weeks to more than 3 years. At least 7 (19%) of the 37 children had evidence of infection with more than one CMV strain. In six of these children, reinfection with distinct strains was confirmed by analysis of the MIE gene products of sequential CMV strains. CONCLUSIONS: Children who attend child care centers, like adults who are immunosuppressed or have multiple sexual partners, are at risk of being reinfected with distinct CMV strains.

Algorithms↗
PubMed2003

Bacterial vaginosis in sexually experienced and non-sexually experienced young women entering the military.

OBJECTIVE: To estimate the prevalence of bacterial vaginosis by Nugent Gram stain criteria in a nonclinic national sample of young women entering recruit training; to examine clinical associations with bacterial vaginosis; and to evaluate the performance of a pH test card and Papanicolaou smear against Gram stain as screening tools for bacterial vaginosis. METHODS: A cross-sectional study of 1938 women was conducted. Self-collected vaginal swabs were applied to a colorimetric pH test card and a glass slide for Gram stain evaluation according to the Nugent criteria. Papanicolaou smears and samples for sexually transmitted diseases screening were collected during routine entry pelvic examinations. RESULTS: Bacterial vaginosis prevalence was 27%, with 28% in sexually experienced and 18% in non-sexually experienced women (P = .001). Bacterial vaginosis prevalence was 11% in Asian/Pacific Islanders, which was lower than in other nonwhite ethnic groups (P = .004). Clinically, bacterial vaginosis was directly related to multiple sexual partners (P = .026), self-report of vaginal discharge (P = .001), self-report of vaginal odor (P < .001), and concurrent Chlamydia trachomatis infection (P = .002), and inversely related to hormonal contraceptive use (P = .013). Vaginal discharge did not achieve statistical significance in multivariate analysis. Compared with the Nugent criteria, the sensitivities and specificities for bacterial vaginosis diagnosis were as follows: colorimetric pH test: 72% and 67%; Papanicolaou smear: 72% and 79%, respectively. CONCLUSION: Among these diverse young women, bacterial vaginosis occurs commonly in both sexually experienced and inexperienced young women and differs by race and ethnicity. The pH colorimetric test and Papanicolaou smear performed moderately well as screening tools for bacterial vaginosis. The inverse relationship of bacterial vaginosis with hormonal contraceptive use and its direct relationship with C. trachomatis need further study.

Adolescent↗
PubMed1990

Patterns of behaviour amongst injecting drug users--implications for HIV.

HIV-related behaviour was studied in a sample of 187 injecting drug users in Stockport, most of whom were not regular users of health services. 174 of the group had shared needles, most of them within the last 4 weeks. Among the 174, more than a quarter were under 20 years of age; most had had multiple sexual partners, and only a minority ever used condoms. Most perceived themselves to be at low or no risk of HIV infection. Perception of risk was related to changes in reported sexual behaviour, but not to needle-sharing. Implications for existing control programmes are considered.

Adolescent↗
PubMed1995

Epidemiologic differences between candidial and trichomonal infections as detected in cytologic smears in Taiwan.

The epidemiologic differences between cytology-detected candidial and trichomonal infections were assessed in 15,933 women attending the 12 district health centres in the Taipei area and a consecutive 1114 patients, visiting venereal disease clinics, whose smears were screened for cervical cancer between July 1991 and December 1992 in Taipei. The Pap smears were examined for the presence of specific organisms, such as trichomonas vaginalis, vaginal candida, herpes simplex virus, human papillomavirus, actinomyces, leptothrix, aspergillu, gardnerella and others. More emphasis was placed on the candidial and trichomonal infection in inflammatory Pap smears. The overall prevalence of candidial and trichomonal infections was 3.40% and 1.88%, respectively. There were striking differences in the prevalence of trichomoniasis ranging from 1.74% in the district health centre population to 3.77% in the venereal disease clinic patients; however, the prevalence of candidial infection remained the same (3.40%) in these two distinct population groups. Indices of socioeconomic status--education and personal hygiene--showed an inverse association with the prevalence of trichomoniasis but a positive correlation with candidiasis. Among participants, younger age (< 20 years old) was independently associated with candidial (OR = 1.95) and trichomonal (OR = 3.87) infections. No sexual behavioural factors were associated with candidial infection in this study; however, having multiple sexual partners (OR = 5.07) was associated with a significantly elevated risk of trichomoniasis, while using condoms was associated with a diminished risk (OR = 0.38). The presence of candidiasis and trichomoniasis was highly associated with abnormal cytologic findings, particularly those indicative of inflammation. There was little evidence that findings suggestive of cervical cancer could be attributed to either candidial or trichomonal infections. These data suggest that trichomoniasis is consistent with venereal transmission of the disease, but transmission by contaminated objects cannot be ruled out because there is an increased relation between trichomoniasis infection and socioeconomic conditions and personal hygiene. Elucidation of such differences may be helpful in designing different strategies to control these infections. Furthermore, the findings can provide a good baseline of prevalence for investigating the relationship between these two pathogens and cervical dysplasia.

Adolescent↗
PubMed2006

Intracellular targeting of phosphodiesterase-4 underpins compartmentalized cAMP signaling.

The phosphodiesterase-4 (PDE4) enzyme belongs to a family of cAMP-dependent phosphodiesterases that provide the major means of hydrolyzing and, thereby, inactivating the key intracellular second messenger, cAMP. As such, PDE4s are central to the regulation of many diverse signaling processes that allow cells to respond to external stimuli. Four genes (4A, 4B, 4C, and 4D) encode around 20 distinct isoform members of the PDE4 family. Each isoform is characterized by a unique N-terminal region. PDE4s are multidomain metallohydrolases with each domain serving particular roles allowing them to be targeted to varying regions and organelles of intracellular space and regulated in distinct fashions by phosphorylation and protein-protein interaction. Although identical in catalytic function, each isoform locates to distinct regions within the cell so as to create and manage spatially distinct pools of cAMP. The multiplicity of partners associating with members of the four gene PDE4 family places these enzymes in key regulatory positions, permitting them to channel complex biological signals via fundamental signaling cohorts such as G-protein-coupled receptors (GPCRs), arrestins, A-kinase-anchoring proteins (AKAPs), and tyrosyl family kinases. The cAMP cascade has long been linked to cellular growth and embryogenesis and with this comes the implication that PDE4 may play considerable roles in the regulation of progeny development in maturing cells and tissues.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1989

Female to male transmission of human immunodeficiency virus type 1: risk factors for seroconversion in men.

To determine the frequency and risk factors for female to male sexual transmission of human immunodeficiency virus type 1 (HIV-1), a prospective study was carried out in 422 men who had acquired a sexually transmitted disease (STD) from a group of prostitutes with a prevalence of HIV-1 infection of 85%. The initial seroprevalence of HIV among the men was 12%. 24 of 293 (8.2%) initially seronegative men seroconverted to HIV-1. Newly acquired infection was independently associated with frequent prostitute contact (risk ratio 3.2, 95% confidence interval 1.2-8.1), with the acquisition of genital ulcer disease (risk ratio 4.7, 95% confidence interval 1.3-17.0), and with being uncircumcised (risk ratio 8.2, 95% confidence interval 3.0-23.0). 96% of documented seroconversions occurred in men with one or both of the latter two risk factors. In a subgroup of 73 seronegative men who reported a single prostitute sexual contact, the frequency of HIV-1 infection was 8.2% during 12 weeks of observation. No man without a genital ulcer seroconverted. A cumulative 43% of uncircumcised men who acquired an ulcer seroconverted to HIV-1 after a single sexual exposure. These data indicate an extremely high rate of female to male transmission of HIV-1 in the presence of STD and confirm a causal relation between lack of male circumcision, genital ulcer disease, and susceptibility to HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed2000

A history of abuse and negative life events in patients with a sexually transmitted disease and in a community sample.

OBJECTIVE: Our aim was to investigate the psychological impact of abuse and negative life events during childhood, adolescence and adulthood in patients recruited from a sexual health clinic. METHOD: Sixty-two patients with a sexually transmitted disease (STD) were matched on age and gender with a community sample. Forty-two patients without an STD formed another control group. Subjects self-reported their trauma histories and current psychological distress. RESULTS: Compared to controls, categories of abuse and negative life events were more prevalent in STD patients, particularly Physical/Sexual Abuse in adolescence and adulthood. Both within the STD and community samples, a negative life event category that measured illness/death of loved ones during childhood and adolescence predicted current psychological distress. In addition, Control Abuse (a subtype of psychological abuse involving selfish manipulation and deprivation) in childhood and adolescence strongly predicted current psychological distress in STD patients. In general, effects were stronger in females than in males. Psychological/Verbal Abuse did not independently predict current psychological distress, but accompanied other abuse types and possibly amplified their adverse effects. CONCLUSIONS: Our findings suggest that multiple types of abuse and negative life events increase the risk of STD infection, perhaps by increasing the likelihood of multiple sexual partners. These patients may ignore social conventions of sexual behaviour because they are bitter about past life experiences. Alternatively, they may persistently search for affection to compensate for a lack of affection in the past.

Adolescent↗
PubMed2002

Relationships between childhood abuse and neglect experience and HIV risk behaviors among methadone treatment drop-outs.

OBJECTIVE: The purpose of this study was to examine the relationships between childhood abuse/neglect experiences (sexual abuse, physical abuse, emotional abuse, and child neglect) and adult life functioning among Methadone Maintenance Treatment Program (MMTP) drop-outs. METHOD: 432 subjects who dropped out of MMTP were recruited in New York City in 1997-1999. Adult life functioning was measured by HIV drug and sex risk behaviors, Addiction Severity Index (ASI) composite scores, and depression. The chi(2) tests, t tests, correlation, and multiple logistic regressions were performed to examine the relationships between abuse experiences and adult life functioning. RESULTS: The prevalence of child abuse/neglect history was high among MMTP drop-outs: sexual abuse-36%; physical abuse-60%; emotional abuse-57%; child physical neglect-66%; all four experiences-25%. As assessed via ASI composite scores, those who had been abused in childhood had significantly more medical, legal, relationship, and psychological problems than those who had not. Overall, several significant associations were found between the abuse experiences and HIV risk behaviors. Those who had experienced child neglect were more likely to be HIV positive. In multivariate analyses, childhood physical abuse was a significant predictor of having multiple sex partners while depression was significantly related to injection drug use in adulthood (p<.05). There were trends for the relationships between childhood sexual abuse and HIV sex risk behavior (p<.10) and between gender and injection drug use (p<.10). CONCLUSIONS: The findings support a need for drug treatment programs that include specialized therapies for those who suffered childhood abuse and neglect experiences.

Adaptation, Psychological↗