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PubMedDate not supplied

Demographic characteristics of heterosexuals with multiple partners: the National AIDS Behavioral Surveys.

In a study of risk behavior among heterosexuals, 9% of a national sample and 12% of a sample drawn from high-risk cities report having two or more sexual partners in the year before the survey. In both samples, sex with multiple partners is most common among men, younger people and the unmarried. Multivariate analyses show that racial and ethnic differences in the proportion of respondents with multiple partners vary by marital status. The results indicate that many heterosexuals are failing to protect themselves against sexually transmitted diseases: Among respondents with multiple partners, only 18% of men and 22% of women always use condoms with their primary partner, and 28% of men and 32% of women always use them with secondary partners. These proportions do not increase significantly with the number of partners; in general, almost half of men and women with multiple partners never use condoms.

Acquired Immunodeficiency Syndrome↗

PubMed1990

[HIV prevalence among heterosexual subjects with multiple partners in Amsterdam].

To study the prevalence of HIV-infection among heterosexuals with multiple partners, participants were recruited from a STD clinic in Amsterdam. In 1988, 785 visitors met the selection criteria, of whom 361 (46%) finally participated. An HIV prevalence of 2/361 (0.6%) was found among participants. To test representativity, participants and refusers were compared on demographic characteristics and prevalence of STDs. Male refusers were on average younger, had on average fewer partners and relatively more often had a foreign nationality. Female refusers had on average fewer partners. No differences were found in the prevalence of STDs between participants and refusers. Because of the high refusal rate and differences between participants and refusers, the HIV prevalence found is not representative of heterosexuals with multiple partners.

Adult↗

PubMed1992

Changing patterns in reported sexual practices in the population: multiple partners and condom use.

OBJECTIVE: To determine whether the pattern of change with regard to condom use and multiple sexual partners is influenced by gender or educational level. DESIGN: Findings from data collected from 1987 to 1990 about changes in condom use and multiple-partner activities are presented, based on telephone interviews with 9416 participants aged 18 to 44 years resident in central Scotland, UK. METHODS: Change in patterns over time were modelled in a multivariate logistic regression using a linear interactive modelling program. RESULTS: Several models showing changes in the proportion of multiple-partner respondents and condom users yielded a complicated pattern of behavioural change in educational status and gender. CONCLUSIONS: There is a large difference in reported condom use and multiple sexual partners by gender, but the difference is decreasing over time. Better educated respondents increased their use of condoms while less educated respondents showed a decrease in the proportion of multiple partners.

Adolescent↗

PubMed1993

[Investigations on hepatitis C virus infection among heterosexuals with multiple partners and patients with sexually transmitted diseases].

The seroprevalence of antibody against hepatitis C virus (HCV) was assessed by an enzyme-linked immunosorbent assay (ELISA) in 110 heterosexually transmitted diseases (STDs), 98 heterosexuals with multiple partners, and 107 blood donors. The serum samples were also tested for hepatitis B virus surface antigen (HBsAg) and antibody against hepatitis B core antigen (anti-HBc). Of the patients with STDs 12.7% (13/110) were anti-HCV antibody positive; of heterosexuals with multiple sexual partners, 4.1% (4/98) positive; of blood donors, 1.87% (2/107) positive. Among the 18 cases of HCV infection, 3 were positive for HBsAg and 10 were positive for anti-HBc antibody. There was no relationship among HCV infection, sex and age in observed objects. From the present data, we can conclude that HCV infection should not be ignored in heterosexuals with multiple partners and patients with STDs, and the risk factor for HCV infection appeared to be associated with a history of STDs and with HBV infection.

Adolescent↗

PubMed1994

Hepatitis B virus infection in a group of heterosexuals with multiple partners in Amsterdam, The Netherlands: implications for vaccination?

The aim of the study was to assess prevalence and incidence of hepatitis B virus (HBV) infection among heterosexual men and women with multiple partners attending a sexually transmitted disease (STD) clinic and to establish risk factors of HBV infection in order to consider immunisation for those subjects. A prospective study of heterosexual men and women selected on having multiple partners and presenting to an STD clinic as new patients was carried out from October 1987 through December 1989. Follow-up continued until December 1990 at the STD clinic of the Municipal Health Service of Amsterdam. Five hundred ninety-eight men and women entered the study. More than 70% of both women and men had had commercial sexual partners in the last 5 years. Three hundred eighty-one participants were born in HBV low endemic countries, 205 came from HBV intermediate endemicity regions. The prevalence of HBV markers in both men and women from low endemic regions was 10%, and for men and women from middle endemic regions 42% and 19%, respectively. Logistic regression analysis showed that number of years involved in commercial sex was an independent risk factor in male participants from HBV low endemic regions (odds ratio [OR] 1.10 per year) and for women sexual contact with men at high risk of HBV infection (OR 2.59).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Limited changes in sexual behaviour of heterosexual men and women with multiple partners in The Netherlands.

To study changes in sexual behaviour, heterosexuals with multiple sexual partners were recruited through an STD-clinic and asked to return every 4 months for follow-up. Between October 1987 and June 1989, 512 heterosexuals entered the study and 140 men and 200 women had at least one follow-up visit. No changes were found between 3 visits in the kind of sexual techniques practiced. Condom use during vaginal intercourse with commercial partners (prostitutes or clients) was relatively high and remained high, but was low and remained at that level with private partners. Men and women reduced their number of private sexual partners by 50%, but the decline in the number of commercial partners was nonsignificant. Although more information is needed about the underlying social-psychological aspects of behavioural change, it seems necessary to redesign prevention activities to stress the effectiveness of condoms and to encourage condom use especially among heterosexuals with multiple private partners.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Incidence and risk factors for acquisition of sexually transmitted diseases in heterosexuals with multiple partners.

BACKGROUND AND OBJECTIVES: The incidence of four STDs that are mainly transmitted during vaginal intercourse, and risk factors for acquisition during follow-up were studied in a cohort of heterosexuals with multiple partners in Amsterdam, the Netherlands. These heterosexuals with > or = 5 different sexual partners in the preceding 6 months were recruited from an STD clinic and participated voluntarily in a longitudinal HIV study between 1987 and 1991. STUDY DESIGN: Using survival techniques, the authors analyzed data on general characteristics, sexual behavior, reported and diagnosed STDs of 155 men and 234 women participating at least twice in the HIV study and returning regularly. RESULTS: The majority of women were prostitutes and the majority of men were clients of prostitutes. For men and women, the 2-year cumulative incidence were 2.7% (95% confidence interval [95% CI] 0.9-8.3) and 0.8% (95% CI 0.1-5.8), respectively, for syphilis, 8.5% (95% CI 3.9-18.0) and 5.3% (95% CI 2.6-10.8) for gonorrhea, 20.2% (95% CI 12.5-31.9) and 31.9% (95% CI 23.7-42.2) for Chlamydia trachomatis infection, and 24.5% (95% CI 17.3-34.2) for trichomoniasis (examination in women only). Among men, STD(s) diagnosed at entry was found to be an independent predictor of infection with any of these STDs during follow-up (relative hazard (RH) = 2.58, 95% CI 1.18-5.64). Among women, risk factors were age < or = 25 years (RH = 1.82, 95% CI 1.13-2.19) and current report of commercial unprotected vaginal contacts (RH = 2.19, 95% CI 1.11-4.13). Among women, trichomoniasis during follow-up was predicted by current report of commercial contacts (RH = 2.59, 95% CI 1.16-5.79). C. trachomatis infection in women was associated with native country outside the Netherlands (RH = 2.47, 95% CI 1.38-4.43), reported history of STDs in the 4 months before the study (RH = 2.92, 95% CI 1.39-6.14) and age < or = 25 years (RH = 1.90, 95% CI 1.06-3.40). CONCLUSIONS: This study shows that STDs were common among this group of heterosexuals, despite regularly participating in the HIV study in which consistent condom use was promoted. Prevention efforts should be intensified for men and women having commercial sexual contacts, young women, and individuals with a history of STDs.

Adult↗

PubMedDate not supplied

Multiple partners and partner choice as risk factors for sexually transmitted disease among female college students.

Multiple sexual partners and partner choice are believed to increase the risk of sexually transmitted disease (STD), but these behaviors had not previously been assessed outside of clinical populations. In this study, a cross-sectional survey among single, white, female students in their senior year of college was conducted to measure the association between behavioral risk factors and the acquisition of self-reported STDs during college. The usable response rate was 47.2% (n = 467). The combined prevalence of chlamydial infection, gonorrhea, genital herpes, human papillomavirus (HPV) infection, syphilis, and trichomoniasis during a 3.5-year period was 11.7%. There was a strong association between number of sexual partners and having an STD: those women with 5 or more sexual partners were 8 times more likely to report having an STD than those with only 1 partner, even after adjusting for age at first intercourse (odds ratio = 8.1; 95% confidence interval = 1.99, 32.64). The prevalence of a history of STDs increased with more causal partner choice and earlier age at first intercourse, but neither factor was independently associated with a history of STDs. Of the respondents, 23% always used condoms. Future research should focus on identifying ways of effectively changing high-risk sexual behavior.

Adult↗

PubMed1991

Prevalence of hepatitis C virus infections among heterosexuals with multiple partners.

A study among heterosexual men and women with multiple sexual partners was carried out to assess the seroprevalence of antibody against hepatitis C virus (HCV). The 468 participants were recruited among visitors to the Clinic for Sexually Transmitted Diseases in Amsterdam. Sera were tested by an enzyme-linked immunosorbent assay (ELISA; Ortho), a recombinant-based immunoblot assay (RIBA; Chiron), and the polymerase chain reaction (PCR). A total of 468 persons were tested, and seven (1.5%) were found ELISA positive. Another 25 (5%) were ELISA indeterminate. Six of the seven ELISA-positive cases were RIBA positive. Further serum samples from five HCV ELISA-positive persons were tested by PCR, and four were found to be positive. The HCV ELISA-positive/RIBA-indeterminate reaction was PCR negative. None of the 17 RIBA-tested sera of the ELISA-indeterminate group yielded a positive result. There was a good correlation between an ELISA optical density/cut-off ratio greater than 2 and a positive RIBA result. The risk factor for HCV appeared to be the type of sexual partner, i.e., belonging to a "high-risk" group for human immunodeficiency virus infection and origin from hepatitis B-endemic countries. It is concluded that HCV may be transmitted through heterosexual contact but probably with low efficiency.

Adult↗

PubMed1986

Reproductive performance in women with repeated pregnancy losses and multiple partners.

We studied 20 patients with a history of multiple pregnancy losses who had more than one partner for differences in reproductive efficiency with different partners. On the basis of obstetric history, patients were classified as primary (no children) or secondary (abortions after having children or stillbirths) aborters with their mates. Of 16 women diagnosed as primary aborters, 5 were primary aborters with their first mates and 11 with their second; one became a secondary aborter with her second partner. Five women were secondary aborters with either mate, and one of these was a secondary aborter with both. In no instance did a secondary aborter become a normally reproducing woman. These findings indicate that pregnancy failure in primary aborters may be due to compatibility between mating partners and that secondary aborters seem to manifest an innate aberration.

Abortion, Habitual↗

PubMed1991

Determinants of condom use among French heterosexuals with multiple partners.

In September 1988, a sample of French individuals between 18 and 49 years of age, who reported more than one sexual partner in the past six months and who considered themselves heterosexuals (n = 1088), were interviewed at home about risk perception of human immunodeficiency virus (HIV) transmission, sexual behavior, and condom use. Systematic or occasional use of condoms during the previous 12 months was reported by 46.9 percent of respondents. Among condom users, 38.7 percent declared they had never used condoms before the last 12 months, fear of acquired immunodeficiency syndrome (AIDS) rather than contraception being the main motivation of these recent users. Multivariate analysis indicates that voluntary testing for HIV, average or more than average fear of sexually transmitted diseases (STDs), and knowledge of HIV carrier in personal relations are associated with condom use.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Data from the National AIDS Behavioral Surveys. IV. Multiple sexual partners among young adults in high-risk cities.

Among a sample of 1,334 urban heterosexuals aged 18-25 from the 1990-1991 National AIDS Behavioral Surveys, 24% report having had more than one sexual partner during the past year. Young men are more than twice as likely as young women, and unmarried respondents are eight times as likely as married respondents, to have multiple partners. A multiple regression analysis of the interaction between race or ethnicity and education indicates that among whites, young people with 12 or more years of education are four times as likely to have multiple partners as are those with less than a high school education; among Hispanics and blacks, educational level is not related to having more than one partner. Among those with multiple partners, approximately 40% never use condoms with primary or secondary partners, and condom use decreases with increasing number of partners.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Multiple sexual partners and their psychosocial correlates: the population-based AIDS in multiethnic neighborhoods (AMEN) study.

In this study we examined multiple partners in a household probability sample of heterosexuals. Thirty-seven percent reported 2 or more partners in the past year, and 6% reported 5 or more partners. Significant interactions among gender, ethnicity, and relationship status revealed complex relations. African American men without a primary partner were the most likely to have multiple partners; ethnic minority women with primary partners were the least likely. Psychosocial factors associated with multiple partners were examined with the AIDS Risk Reduction Model (ARRM). Situational factors influenced how ARRM variables related to multiple partners. Perceived risk, commitment to monogamy, and communication were all important correlates. Prevention efforts must focus on increasing awareness of the risks of heterosexual transmission of HIV for people in dating relationships and on strengthening sexual communication skills with new partners.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Multiple heterosexual partners and condom use among Hispanics and non-Hispanic whites.

A telephone survey of 1,592 Hispanic and 629 non-Hispanic white men and women aged 18-49, randomly selected from nine states in the northeastern and southwestern United States, found that married Hispanic men are more likely to have had two or more heterosexual partners in the previous 12 months than are married non-Hispanic men (18% and 9%, respectively). A large proportion of unmarried men (60% of Hispanics and 54% of non-Hispanic whites) report having had more than one partner in the past 12 months. After adjusting for other variables, the odds of having multiple partners are 2.5 times higher among Hispanic men aged 18-24 than among those aged 41-49 and 1.8 times higher among those who live in the Northeast than among those in the Southwest. Highly acculturated Hispanic men are less likely to have multiple partners than are less acculturated men. Among Hispanic women, those who are moderately or highly acculturated are more likely to have multiple partners (odds ratios of 4.9 and 8.4, respectively) than are less acculturated women. About half of men and women with multiple partners report always using condoms with secondary heterosexual partners.

Acculturation↗

PubMed1994

The risk of HIV infection in a national sample of women with injection drug-using partners.

OBJECTIVES: This study reports on a large, national cohort of women with injection drug-using sex partners. Information is provided on demographic characteristics; human immunodeficiency virus (HIV) risk factors, including unprotected sex and incidence of sexually transmitted diseases; use of noninjected drugs; HIV serostatus; and other selected health variables. METHODS: A sample of 5162 heterosexual women was recruited for a national acquired immunodeficiency syndrome (AIDS) research and demonstration project. A structured interview was administered, and the women had the option of undergoing HIV testing. Statistical analyses compared three groups on variables of interest: women with single sex partners, women with multiple partners, and women with multiple partners who exchanged sex for drugs and/or money. RESULTS: These groups differed significantly on virtually all of the demographic and risk variables examined. Women with multiple partners who exchanged sex for drugs and/or money were at higher risk for HIV than women in the other groups, even when selected demographic variables were controlled. CONCLUSIONS: Research is needed on the efficacy of prevention efforts involving these diverse groups of women at risk for AIDS.

Adult↗

PubMedDate not supplied

Data from the National AIDS Behavioral Surveys. II. Multiple sexual partners among Hispanics in high-risk cities.

Data from a random sample of 4,658 heterosexual Hispanics from 23 high-risk cities in the 1990-1991 National AIDS Behavioral Surveys reveal that 11% of Hispanics have had multiple partners in the past year-17% of men and 4% of women. The study shows a higher proportion of multiple sexual partners in the past year among Hispanic men who are unmarried (31%), Cuban (28%), aged 18-29 (25%), better educated (21%), of lower income (23%) and highly acculturated (20%). Among Hispanic women, marital status, age, Hispanic subgroup and level of acculturation are significant predictors of having multiple partners. Among highly acculturated Hispanic men, income, Hispanic subgroup and marital status are significant predictors of having multiple partners; among less acculturated Hispanic men, marital status is the only significant predictor. Only 20% of Hispanics with multiple partners report using a condom regularly with their primary partner, and 29% report regular condom use with their secondary partner. Among men, condom use tends to decrease as the number of partners increases.

Acculturation↗

PubMed1978

Cancer of the cervix--a sexually transmitted disease. Cytologic screening in a prostitute population.

The epidemiology of cervical cancer has been the subject of many articles centered around the question, "Is cancer of the cervix a sexually transmitted disease? A group of 750 Taiwan prostitutes had cervical cytology performed at the time of required gonorrhea screening. The prostitutes represented a unique group in which the variables of frequent intercourse with multiple partners and multiple infection can be separated from early coital experience. Cervical cytology was obtained and processed by the Pathology Department at Navy Medical Research Unit No. 2. A bilingual questionnaire was completed with the aid of a medical interpreter. The results included only eight of the 750 specimens in the "dysplasia plus" category for a rate of 10.7 per 1,000. The low yield of abnormal cytology suggests the factors of multiple partners, frequent intercourse, and high gonorrhea infection rate are not significant epidemiologically if they occur after the phase of active metaplasia, occurring during the first pregnancy or early adolescence.

Adolescent↗

PubMed1994

Regional distribution and incidence of human papillomavirus infections among heterosexual men and women with multiple sexual partners: a prospective study.

OBJECTIVE: To assess prevalence, incidence and potential risk factors of human papillomavirus (HPV) infection among heterosexual men and women with multiple partners and to identify niches of HPV-infection. DESIGN: A prospective study of heterosexual men and women with multiple partners attending an STD clinic as participants in a study on HIV from May 1988 until January 1991. Routine STD examination and physical examination using colposcopy were performed, interviews with standardised questionnaires were administered. Specimens for HPV DNA detection by polymerase chain reaction were collected from multiple sites of the genital, anorectal and oral regions. In women cervical cytology was performed. SETTING: The STD Clinic of the Municipal Health Service of Amsterdam. PARTICIPANTS: 162 women and 85 men entered the study, 110 women and 48 men were followed up. RESULTS: At entry of the study 37 (23%) women and 24 (28%) men were found positive for HPV DNA at any site. Only in one woman was oral presence of HPV DNA found during follow-up. Abnormal cervical cytology was observed in four women. In multivariate analysis, diagnosis of condylomata [odds ratio (OR) 5.61, 95% confidence interval (CI) 1.86 to 16.90)], reporting genital dermatological abnormalities (OR 3.72, 95% CI 1.38 to 9.99) and age (OR per year 0.93, 95% CI 0.88 to 0.99) predicted independently the presence of HPV DNA in women at entry of the study. In women 59 of the 99 (60%) HPV infections were observed in the genital region and 40% in the anorectal region: in men these figures were 65% and 35%, respectively. The incidence of HPV infection was 47.1 and 50.5 per 100 person-years for women and men respectively. At least 20/99 (20%) infections in women were intermediate or long persistent and only 3/48 (6%) HPV infections in men (P = 0.03). No risk factor for persistency could be determined, either in women or in men. CONCLUSIONS: HPV infection was found to be a multicentric genital and/or anorectal event both in women and men. The oral presence of HPV DNA was detected only once in one of the participants. In women persistent HPV infection was more common than in men. Independent predictors for presence of HPV DNA in women were diagnosis of condylomata acuminata, reporting genital dermatologic abnormalities and age. Incidence of HPV infection in women turned out to be 47.1 infections per 100 person-years and for men 50.5 per 100 person-years.

Adult↗