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Evaluation of urinary cytology of male sexual partners of women with cervical intraepithelial neoplasia and human papilloma virus infection.

Condylomas of the genital tract can be found in 70% of patients who have cytologic evidence of human papilloma virus (HPV) infection or mild epithelial dysplasia (CIN I). Most male sexual partners of women with overt or subclinical HPV infections have no visible condylomas. Presently, there is no therapy for subclinically infected male partners. A screening test capable of detecting such HPV infections in males would be of value should effective therapy be discovered. Fifty-four men who were the current sexual partners of women with visible condylomata acuminata or with cytologic evidence of subclinical HPV infection or cervical neoplasia were asked to give a urine specimen for cytologic examination. The cytologist had no knowledge of the cytologic or histopathologic findings in the female partners. Of the 54 women, 39 (72%) had either visible genital condylomas or cytologic evidence of mild dysplasia or of HPV infection with or without mild dysplasia (CIN I). Twenty-five (63%) had histologic evidence of HPV infection with or without mild dysplasia. With one exception, urinary cytologic preparations from the study and from the control males were negative. No correlation could be found between cervical cytology and histology in the females and urinary cytologic findings in their current male partners. At the present time there is no screening test that can be utilized to detect male carriers with subclinical disease.

Carrier State↗

Management of sexually transmitted diseases and HIV prevention in men at high risk: targeting clients and non-paying sexual partners of female sex workers in Benin.

OBJECTIVES: Male clients of female sex workers have rarely been specific targets for HIV/sexually transmitted diseases (STD) interventions in sub-Saharan Africa. We assessed the effectiveness of outreach methodology for contacting sexual partners of female sex workers for purposes of HIV/STD prevention in Cotonou, Benin. DESIGN AND METHODS: In collaboration with owners/managers, outreach personnel and female sex workers, 404 clients were recruited on-site at prostitution venues, and provided urine samples for leukocyte esterase dipstick (LED), STD and HIV testing before having sex with female sex workers. After having sex they underwent an interview and physical examination. No payment was made for study participation. Prostitution site personnel (n = 41) and boyfriends of female sex workers (n = 56) were also recruited. RESULTS: In all 68% of the clients approached agreed to participate. On-site LED testing and free STD treatment were important factors in participation. HIV-1 prevalence was several-fold higher than in the general population in Cotonou, at 8.4, 12.2 and 16.1% in clients, personnel and boyfriends respectively, and was associated with increasing age and lack of condom use with female sex workers. Condom use rates by clients with female sex workers were non-negligible but sub-optimal, and low with regular partners. Approximately one-third of clients with regular partners also had other non-female sex worker sex partners. Boyfriends of female sex workers are of particular concern due to high numbers of partners, very low condom use rates and high HIV prevalence. CONCLUSIONS: Study findings indicate that male sex partners of female sex workers form a 'bridging population' for HIV/STD transmission both to female sex workers, as well as from female sex workers to the general population of women, particularly regular female partners.

Adult↗

Enrollment of minority women and their main sexual partners in an HIV/STI prevention trial.

There is a paucity of empirical reports that quantitatively assess the success of recruitment strategies in randomized clinical trials (RCTs) using sampling units other than the individual. As innovations in HIV and sexually transmitted infection (STI) preventive intervention protocols and targets of change evolve, there is a need to examine the efficacy of attendant adaptations to recruitment protocols and strategies in the enrollment of study participants. This article examines factors related to enrollment of women and their main, male sexual partners in an RCT of a relationship-based HIV/STI preventive intervention conducted from 1997 to 2001. Among eligible participants (N = 388), findings indicate that race/ethnicity, employment status, marital status, and language preference were significantly associated with enrollment among eligible, potential participants. Additionally, being HIV-positive and having a past or current STI were significantly associated with enrollment. These findings underscore the need to ensure sufficient representation of all risk groups in RCTs, especially those testing innovative HIV/STI preventive intervention approaches or using novel enrollment strategies.

Adolescent↗

Child and adolescent sexual abuse history in a sample of 1,490 women sexual partners of injection drug-using men.

Subjects for this study were 1490 community-recruited women sexual partners of injection drug-using men who were interviewed in three U.S. cities during 1990-'92. Data were collected on respondents' childhood and adolescent sexual abuse history, identity of abuse perpetrators and duration of abuse. Over 56 percent of respondents reported a history of sexual victimization by age 18, including 39 percent who were abused before age 12 and over 53 percent who were victimized by abuse involving bodily contact by age 18. One in three women were victimized by unwanted penetration by age 18. White women more likely than African-American and Hispanic women to have been the victims of virtually every type of abusive act investigated here. Overall, nearly two out of three White women had experienced some form of sexual abuse by age 18, including almost 42 percent who were the victims of unwanted penetration by this age. Acts of forced sexual touching and penetration occurring in childhood were most likely to have been carried out by an uncle or other relative of the victim; family members were much less likely to be the perpetrators of adolescent contact abuse. Based on these findings, it appears that many in this special population of women are likely to be at substantial risk for some of the long-term effects of early life sexual abuse, including those that may reduce victims' ability to take preventive action against HIV risk. Recommendations are offered for those who function as caregivers to this population, including drug treatment personnel.

Adolescent↗

Perceptions regarding preventive sexual practices and communication with sexual partners among Chinese college students.

PURPOSE: To assess the relation between Chinese college students' perceptions and attitudes regarding preventive sexual behaviors, their sexual knowledge, and their use of protective sexual behaviors. METHODS: A subsample of 133 sexually active college students (18-25 years old) was obtained to identify factors related to protective sexual behaviors (e.g., knowledge of partner's sexual history, condom use). RESULTS: Seventy-five percent of the sexually active students were male. Significantly more females had discussed AIDS and sexually transmitted diseases (STDs) issues with their partners and had asked their partners about their sexual histories than males. Students endorsing the use of preventive behaviors were more likely to have discussed AIDS issues with their partners, used condoms, and known their partner's sexual history. CONCLUSIONS: Student perceptions about preventive behaviors have a significant impact on their knowledge of their sexual partners and their own sexual behaviors. These findings, as well as the presence of significant gender differences in perceptions and communications with their partners, have major implications for risk reduction programs.

Adolescent↗

Correlates of condom use and number of sexual partners among high school adolescents.

Factors associated with condom use and number of sexual partners were examined in a statewide sample of public high school students in grades 9-12 (N = 3,893). Data were collected in spring 1990 using the 70-item, self-report Youth Risk Behavior Survey, developed and piloted by the Centers for Disease Control. Composite scores were constructed to measure aggression, physical recklessness, alcohol use, illegal drug use, cigarette use, lack of exercise, and academic self-image. Since simple polychotomous logistic regression models revealed a significant race by gender interaction, multivariate models were run separately for each race-gender group. Odds ratios and 95% confidence intervals were calculated from polychotomous logistic regression of lifetime sexual activity and condom use with their potential correlates. Risky sexual behavior appears to be correlated with a complex of other behaviors that place students at risk. A pattern of declining condom use with increasing number of partners was evident, especially for White students.

Adolescent↗

Knowledge of sexual partner's HIV serostatus and serosorting practices in a California population-based sample of men who have sex with men.

OBJECTIVES: To describe knowledge of primary and secondary sexual partner's HIV serostatus and sexual practices, including serosorting, among men who have sex with men (MSM) living in California. METHODS: Men who self-identified as gay/bisexual in the 2001 California Health Interview Survey, a statewide biennial random-digit-dial survey interviewing more than 50,000 adults on a variety of health topics, were recontacted in 2002 and interviewed by telephone about injection drug use, their own and partner's HIV serostatus, and sexual risk behaviors. RESULTS: Among 220 men who reported a primary partner, 86% [95% confidence interval (CI): 77-92] knew their primary partner's serostatus; 62% (95% CI, 52-70) of the 250 men who reported a secondary partner knew their most recent secondary partner's HIV serostatus. Knowledge of one's most recent secondary partner's HIV serostatus was inversely related to history of injecting recreational drugs (odds ratio, 0.22; P < 0.01), and reporting a primary partner in the past year (odds ratio, 0.37; P < 0.05). Two-fifths (41%) of HIV-positive men and three-fifths (62%) of HIV-negative men engaged in serosorting (serocordant unprotected anal intercourse) with their primary partners, whereas 33% HIV-positive men and 20% HIV-negative men did so with their most recent secondary partners. CONCLUSIONS: This population-based survey documented the extent to which MSM know their partners' serostatus and practice serosorting behaviors. The findings emphasize the need for studies to report serocordant and serodiscordant unprotected anal intercourse separately, as the former presents significant lower risk of HIV transmission.

Adult↗

The value of treating the sexual partners of women with recurrent vaginal candidiasis with ketoconazole.

OBJECTIVE: To determine whether treatment of the sexual partners of women with chronic vulvovaginal candidiasis with oral ketoconazole can reduce the recurrence rate of candida vaginitis. DESIGN: Single blind randomised study where all the women were treated with ketoconazole 400 mg daily for 7 days after an acute episode of candida vaginitis and half the male partners were treated with ketoconazole 200 mg daily for 5 days. SETTING: Women's Candida Clinic of St. Michael's Hospital, a University of Toronto teaching Hospital, Toronto, Ontario, Canada. SUBJECTS: Fifty-four women attending the clinic with at least four proven episodes of candida vaginitis and their male sex partners (stable monogamous relationships) were enrolled in the study. MAIN OUTCOME MEASURES: Clinical recurrence of candida vaginitis with confirmation by smear and culture. Follow-up was obtained one to two weeks after initial treatment, then monthly for one year. RESULTS: In the control group (untreated partners), 20 of 28 (71%) patients had recurrences in six months, versus 17 of 26 (65%) patients in the treated group (treated partners) (95% Confidence Interval (CI) for the difference in recurrence rate = -19% to 31%). At one year, 23 of 28 (82%) patients in the control group had recurrences, versus 22 of 26 (85%) in the treated group (CI = -23% to 17%). CONCLUSION: Treatment of the male partners, with a brief course of ketoconazole, is not of value in reducing the incidence of relapse in women with recurrent vaginal candidiasis. It is unlikely that a larger study would show a clinical important difference.

Administration, Oral↗

[Genital papillomavirus lesions. Coexistence in sexual partners, role in cancer of the cervix and value of colposcopy].

Since the human papillomavirus is transmissible sexually, an ever increasing number of male patients is seen in dermatology departments. It therefore seems to be important to evaluate the frequency of HPV-related genital lesions in both males and females. Several recent studies have made it clear that concomitant lesions are very often observed in sexual partners. We have tried here to summarize the different data reported in the literature concerning the frequency of HPV lesions and their probable role in cervical cancer. Some human papillomaviruses (types 6 and 11) produce benign lesions while others possess an oncogenic potential (types 16 and 18). Thus, men with venereal condylomas may constitute a group at risk of cervical neoplasia for their female partners. Some authors even consider cancer of the cervix as a sexually transmitted disease. It now becomes necessary to undertake systematic examination of male partners in order to detect viral lesions invisible to the naked eye, particularly before and after acetic acid application on the penis and by means of a colposcope. However, for several reasons given in the conclusion, such an epidemiological study remains difficult to perform.

Adult↗

High risk of HIV disease progression after infection through a sexual partner with AIDS.

OBJECTIVE: To investigate whether HIV-1 infection acquired through a severely immunodepressed sexual partner increases the risk of disease progression. DESIGN: A prospective cohort of patients infected through sexual contact at a known date and enrolled a few months (median, 2 months) after their first HIV-positive test. At enrolment, 12 subjects stated having had unprotected intercourse (anal or vaginal penetration) with a partner with AIDS within the 6 months prior to their first HIV-positive test. For the same period, 60 subjects stated having had unprotected intercourse with a partner, known to be HIV-positive, but who had not developed AIDS. METHOD: The endpoint was the first occurrence of an HIV-related illness (group IV or AIDS, 1987 Centers for Disease Control and Prevention revised classification). Event-free survival curves since infection were constructed using the Kaplan-Meier method and compared by the log-rank test. The Cox model was used for multivariate analysis. RESULTS: Disease progression was more rapid among the 12 subjects who stated having sex with a person with AIDS at a time close to infection, than among the other subjects (P = 0.03). Homosexuality and age at infection were also related to HIV disease progression. The adjusted relative risk of developing an HIV-related illness among those 12 subjects was 3.9 (95% confidence interval, 1.5-9.9). CONCLUSION: Our results confirm the influence of virus-related factors on the onset of immunodepression in subjects infected through sexual contact.

Acquired Immunodeficiency Syndrome↗

Sexual partners and use of emergency contraception.

OBJECTIVE: This study investigates the role of male sexual partners and relationships in determining whether women seek emergency contraception (EC) when needed. STUDY DESIGN: Data on EC use from a clinic-based sample of sexually active women, aged 15 to 30 years, in the San Francisco Bay area (n=497) were analyzed with multivariate logistic regression analysis. RESULTS: Results show that factors measuring power dynamics, such as male dominant decision making (odds ratio [OR]=4.1, P=.035) and pressure for sex (OR=2.7, P=.006), as well as a strong desire to avoid pregnancy on the part of the male partner (OR=4.2, P <or=.001), have a significant association with the use of EC. However, relationship factors known to be associated with use of other contraceptive methods, such as communication, satisfaction, and commitment, show no association with EC use. CONCLUSION: Factors predicting EC use, including male partner and relationship factors, may not always be evident to a clinician, so it is important to include EC as part of routine counseling.

Adolescent↗

Selectivity in paternal and infanticidal responses by male mice: effects of relatedness, location, and previous sexual partners.

Male mice tend to be infanticidal to unrelated infants but parental to their own offspring. The present study examines three hypotheses that might explain this apparent discrimination. There was no evidence of selective infanticide toward infants encountered for the first time on the basis of kinship, location, or cues associated with previous sexual partners. However, males tended to direct more paternal responses toward their own unfamiliar infants than toward unrelated infants, infants encountered in the male's home cage than those in the cage of another male, and when cues associated with a previous sexual partner were present. Data suggested that the responses of females to male intruders might influence the responses of those males. It was concluded that the infanticidal responses of male mice are mediated by a particular state of the male but that males in a noninfanticidal state may vary their paternal responsiveness on the basis of direct and indirect cues concerning relatedness.

Animals↗

Masculinized sexual partner preference in female zebra finches with sex-reversed gonads.

Previous research in the zebra finch, a socially monogamous pair-bonding species, suggests that the preference for opposite-sex partners may arise in part through the organizing actions of sex steroids. To further investigate this process, zebra finch eggs were injected with 20 microg fadrozole, a potent estrogen synthesis inhibitor, or with the saline vehicle on embryonic day 5. As adults they were given two-choice sexual partner preference tests followed by group aviary tests. Fadrozole females had masculinized beak color and had testes or ovotestes instead of ovaries. Males were not affected by fadrozole; they did not differ from controls on any measure. In contrast, sexual partner preference was substantially masculinized in fadrozole females in the group aviary tests. Untreated males given a choice between fadrozole and untreated females preferred the untreated females, but this was equally the case when they were given a choice between saline-treated and untreated females. These results suggest that males do not specifically avoid females with testes and that male avoidance is unlikely to explain why fadrozole-treated females pair with other females. The present data add to the evidence that actions of gonadal steroids during development contribute to adult sex differences in partner preference in this pair-bonding species. Furthermore, because fadrozole-treated females do not produce audible song, the mechanisms regulating partner preference and song system development are dissociated.

Animals↗

Stress reduction training changed number of sexual partners but not immune function in men with HIV.

We tested the impact of stress management training on sexual behavior and immune functioning in 64 gay men infected with human immunodeficiency virus (HIV). Subjects randomized to the stress management group met for eight two-hour sessions and one all day retreat to learn systematic relaxation, health behavior change, and stress management skills. Compared to those randomized to a wait list control, treatment subjects reported significantly fewer sexual partners in the prior month at post-test (1.10 vs 2.29 for controls). There were no differences between groups in lymphocyte numbers and function.

Adult↗

[Human papillomavirus (HPV) infection in sexual partners of women with condylomatous cervical dysplasia].

OBJECTIVES: Human papillomavirus (HPV) genital infection is a sexually transmitted disease that appears to be involved in the pathogenesis of various tumors of the genitourinary system, especially carcinoma of the uterine cervix. Diagnosis and treatment of sexual partners of female carriers is fundamental in preventing reinfection after treatment. METHODS: A prospective study was conducted on 118 male partners of females diagnosed as having HPV infection by cytology and, in some cases, dysplasia or carcinoma in situ of the cervix. RESULTS: Patient mean age was 38.5 years; 40 had a history of other sexually transmitted diseases. Peneoscopy was performed in all cases, 44 were biopsied and 47 had a urethral cytology. The infection rate was 55%. Peneoscopy and biopsy were the best diagnostic methods. CONCLUSIONS: HPV infection in male partners of female carriers can be diagnosed by peneoscopy and biopsy of the suspected lesions. Treatment and complete eradication of the infection are fundamental since HPV has been implicated in the pathogenesis of carcinoma of the cervix and other urogenital tumors.

Adult↗

Human immunodeficiency virus seropositivity self-disclosure to sexual partners: a qualitative study.

The article examines the process of human immunodeficiency virus seropositivity self-disclosure to sexual partners. The few studies that have been done in regard to this topic are quantitative and epidemiologic in nature and concentrate on urban gay men. In contrast, the findings described here are qualitative, and they are from HIV-positive small-town southwesterners, heterosexuals included. Five basic topics emerged as salient in regard to the self-disclosure process: a disclosee's need to know, nondisclosure conjoined with safer sex practice, disbelief and denial among the seronegative and untested, strategies for evaluating potential disclosees, and rejection or acceptance by the disclosee. According to participants, self-disclosure does not necessarily lead to safer sex because partners often do not want it. Participants see a lack of prophylactic effort in partners as resulting from informed choice, even if self-disclosure, they also experienced rejection. Rejection can be direct or perfidious. Participants compared partners' often problematic reactions with those of children, which they praised. Future research will lead to the creation of formal guidelines for use by health care professionals in promoting secondary prevention practices, such as condom use, and in determining how best to serve HIV-positive clients.

Adult↗

Preventing HIV infection through peer education and condom promotion among truck drivers and their sexual partners in Tanzania, 1990-1993.

HIV prevention through peer education and condom promotion among truck drivers and their sexual partners is described. Trends during an initial 18-month intensive phase, followed by a 24-month maintenance phase, were monitored with surveys. Trends for self-reported condom use were: increase among men (56 to 74%) during the first phase with a decrease (72%) during the maintenance phase. Respective figures for women were 51%, 91% and 70%. Multivariate analyses revealed that men most likely to report using condoms were unmarried, had children, were more educated, had previously reported a genital ulcer, and perceived themselves at risk for HIV infection (OR = 1.95-3.47). Women tending to use condoms were unmarried, aware of the limitations of condoms, not in denial as to the existence of HIV, harboured inaccurate information about HIV transmission and were afraid (OR = 1.35-2.52). Both sets of results suggest that the most sexually experienced men and women who did not have a permanent stable relationship and who perceived themselves at risk, were most likely to use a condom. Peer education was an effective tool for increasing knowledge and encouraging appropriate behaviour change. It was most effective as an intensive high-input intervention and sustainable with the relatively stable population of truck drivers.

Adolescent↗

Choice of female-controlled barrier methods among young women and their male sexual partners.

CONTEXT: Little is known about the factors associated with the choice of female-controlled, over-the-counter barrier contraceptive methods among women and their male sexual partners. METHODS: Predictors of method choice were assessed following an educational presentation on contraceptive use and risk reduction among 510 sexually active females aged 15-30 who were recruited in the San Francisco Bay Area. In addition, the primary partners of 160 of these women participated in the survey RESULTS: Twenty-two percent of women who enrolled in the study alone, 25% of those who enrolled with their main partner and 18% of these male partners chose female-controlled, over-the-counter barrier methods alone. The strongest predictor of this choice was current use of a hormonal contraceptive both for women who participated in the study on their own (odds ratio, 2.1) and for those who enrolled their partner in the study (odds ratio, 6.3). Female-controlled methods were also chosen significantly more often by teenagers than by older women; for example, among those who enrolled with a male partner, the odds ratio for selection of a female-controlled barrier method by women younger than 18 was 6.0. Among women who enrolled without a partner, those who had had multiple partners in the previous six months and those who were current users of male condoms were less likely to choose female-controlled methods (odds ratios, 0.7 and 0.5, respectively). CONCLUSIONS: Although the majority of participants did not choose female-controlled, over-the-counter barrier methods without also choosing male condoms, such female-controlled methods appear to offer an acceptable alternative for prevention of sexually transmitted infections. They may be a particularly attractive option for individuals using hormonal contraceptives and for teenage women.

Adolescent↗