摘要:

BackgroundThe temporal pattern of partners and sexual encounters may be key factors in the acquisition and transmission of sexually transmitted diseases (STDs). Behavior among adolescent women is of particular interest because they frequently have the highest prevalence and incidence of infection.GoalTo examine coital diary data collected during a 7-month longitudinal study of young women at high risk of STDs and to describe their sexual behaviors, with particular attention to issues of partner sequence and overlap.Study DesignA 7-month longitudinal study of young women infected with or having a sexual contact infected withNeisseria gonorrhoeae, Chlamydia trachomatis,orTrichomonas vaginalisattending the STD clinic or one of four neighborhood adolescent health clinics. Data were collected at enrollment and at 1, 3, 5, and 7-month follow-up visits. Coital diaries were kept between visits.ResultsThe average frequency of coital events was 0.94 per week. The median number of sexual partners during the follow-up period was one, and overlapping of partnerships was an uncommon occurrence. The number of days between the last coital event of a current relationship and the first encounter of a new relationship differed for those choosing a new partner (mean, 20.6 days) and those who returned to a previous partner (mean, 7.9 days;P< 0.001).ConclusionAlthough at high risk for STDs, high-risk behavior was not common among the study population. Partner choice and the behavior of these partners may be more important elements than personal high-risk behavior in accounting for the high prevalence of sexually transmitted infections among inner-city adolescent women.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundChlamydia trachomatishas been recognized as a major sexually transmitted infection in North America and Western Europe during the past two decades. The incidence ofC trachomatisin Finland has been continuously high throughout the 1990s.ObjectivesAs the epidemic ofC trachomatisinfection continues in Finland, there is a need to obtain up-to-date information on the prevalence and patient profiles in the planning of preventive strategies.MethodsA nationwide sentinel clinic network consisting of seven sexually transmitted disease (STD) and five general student health clinics was established in 1995. Data were collected during a 3-year period (1995–1997) from 3,686 patients with and 32,230 patients withoutC trachomatisusing a self-administered questionnaire.ResultsThe prevalence of chlamydia was 8.4% in the STD clinics and 5.3% in the general clinics; 90% of the infections were endemic. The prevalence was highest in the youngest age group (15–19 years; 16% in females, 14% in males). The patients with chlamydia were significantly younger (mean age: men 26.6 years, women 23.7 years) than those without chlamydia. Women with chlamydia used oral contraceptives or intrauterine devices (IUD) significantly more often (59%) than women without chlamydia (42%). A high number of sex partners and a history of previous chlamydia during the preceding 12 months were also risk factors. Men contracted chlamydia frequently from a casual partner (61%) but rarely from a commercial sex worker (2%). For women, the source partner was most often a regular one (61%). The median time from exposure to attendance was 34 days, and was highest when the source partner was a spouse. One third of the patients could have spread chlamydia to a new partner before the diagnosis.ConclusionsC trachomatisinfection is spread all over Finland, and the risk factors include younger age, high number of sex partners, and use of oral contraceptives or IUDs. Source partner analysis focused attention on the importance of transmission from regular partners, especially in women. The time from transmission to diagnosis was long, and any effort to shorten this period would be an effective preventive strategy.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundCurrently, a number of different over-the-counter spermicides and potential microbicides under development are in various phases of clinical trials. It is difficult to know how the various formulations would compare with each other or how efficacious they would be because no existing microbicides are commercially available.GoalTo evaluate, in a standardized manner, various parameters of potential microbicides.Study DesignIn an effort to make a comprehensive comparison, several potential microbicides and over-the-counter vaginal products were assayed for their efficacy in protecting mice from infection by herpes simplex virus type 2 (HSV-2), for their cytotoxicity to human vaginal epithelial cells, for their effect on the growth rate ofL acidophilus,and for their spermicidal activity. Test formulations were K-Y Plus, Gynol II, Advantage S, Replens, BufferGel, No Fertil, Carrageenan, and PC-550. Additionally, several formulations were evaluated for their use as a possible placebo in microbicide clinical trials.ResultsThe formulations tested fell into three categories of efficacy in protecting mice from HSV-2 infection. The most efficacious were Carraguard and PC-550. All the other test formulations except methyl cellulose afforded varying degrees of protection against herpes simplex virus-2 infection. It was found that formulations containing the surfactant N9 had a cytotoxic effect on human vaginal cells, inhibited the growth rate ofL acidophilus,and exhibited spermicidal activity. In addition, it was found that Replens, BufferGel, No Fertil, and the Carbopol formulation might have some effect on sperm motility. Also, K-Y Jelly significantly inhibited the growth rate ofL acidophilus.ConclusionEvaluating formulations under the same testing conditions can help to distinguish among potential formulations that are likely to show promise as safe and effective microbicides.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundSubstance use, including alcohol and illicit drugs, increases the risk for the acquisition and transmission of sexually transmitted infection (STI).GoalTo determine the prevalence of bloodborne STI including HIV, human T-cell lymphotrophic virus type 1, hepatitis B virus, and syphilis in residents of a detoxification and rehabilitation unit in Jamaica.Study DesignThe demographic characteristics and the results of laboratory investigations for STI in 301 substance abusers presenting during a 5-year period were reviewed. The laboratory results were compared with those of 131 blood donors.ResultsThe substances used by participants were alcohol, cannabis, and cocaine. None of the clients was an IV drug user. Female substance abusers were at higher risk for STI. The prevalence of STI in substance abusers did not differ significantly from that in blood donors (12% versus 10%); however, the prevalence of syphilis in substance abusers was significantly higher than that in blood donors (6% versus 3%,P< 0.05). The prevalence of syphilis was dramatically increased in female substance abusers and female blood donors (30%,P< 0.001 and 13%,P< 0.05, respectively). An excess of human T-cell lymphotrophic virus type 1 was also observed in female compared with male substance abusers. Unemployment was identified also as a risk factor for sexually transmitted disease in substance abusers.ConclusionThe results endorsed the policy of screening detoxification clients for STI and indicate a need for gender-specific approaches to the control of substance abuse and STI in Jamaica.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundHerpes simplex virus type 2 (HSV-2) is among the most prevalent sexually transmitted diseases worldwide. In Mexico there is a lack of population-based HSV-2 surveys.GoalsTo determine population-based HSV-2 seroprevalence and risk factors among women in Mexico City.Study DesignA random sample of 730 women was identified among the residents of Mexico City. Women ages 25 to 85 years were selected from 3694 households. Western blot serology testing was conducted on serum samples to determine HSV-2 type-specific serostatus. A structured questionnaire was administered, and multivariate analyses were performed to identify risk factors for HSV-2 seropositivity, which were stratified into two age categories: younger than 50 years of age and 50 years of age or older.ResultsThe HSV-2 seroprevalence among female participants was 29.8%, with a significant trend of increasing HSV-2 prevalence for each higher level of age (P< 0.001). Female participants had a median age of 46 years and were predominantly monogamous (82.6%). The overall population-based seroprevalence estimated in Mexico City among women was 35.8%. The independent risk factors for HSV-2 seropositivity included a history of two or more sexual partners (odds ratio [OR], 2.2; 95% CI, 1.4–3.4), two or more sexual partners before first pregnancy (OR, 2.3; 95% CI, 1.4–3.7), cohabitation with partner (OR, 2.5; 95% CI, 1.3–4.7), and current vaginal douching (OR, 1.7; 95% CI, 1.2–2.6).ConclusionsPopulation-based HSV-2 seroprevalence is endemically high among middle-age women in Mexico City, and clearly is correlated with higher-risk sexual behavior. This elevated HSV-2 seroprevalence may reflect unrecognized HSV-2 transmission throughout life.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundAlthough extensive information has been gathered about the prevalence and determinants of human papillomavirus infection among women, little is known about the prevalence and natural history of this infection among males.GoalTo investigate the potential usefulness of urine specimens to assess the presence of genital human papillomavirus DNA infection.Study DesignThe authors conducted a study of 120 healthy men from Cuernavaca, Mexico. A urine specimen and urethral and coronal sulcus swab samples were collected and tested for human papillomavirus using the GP5+/6+ polymerase chain reaction enzyme immunoassay method.ResultsIn 95% of the urethral-coronal sulcus samples, the &bgr;-globin gene was detectable, indicating adequacy of the specimen for DNA amplification; however, only 14% of the urine specimens had detectable &bgr;-globin. Removal of inhibitors by DNA purification in a sample of subjects produced &bgr;-globin amplification, but no increase in human papillomavirus DNA positivity was detected. Human papillomavirus DNA was not detectable in penile-urethral swab samples in any of the subjects who reported not having engaged in sexual activity but was present in 43% of men who reported sexual activity, a strong indication of the sexual transmission of human papillomavirus.ConclusionsHuman papillomavirus is a common sexually transmitted infection among Mexican males, and urine sample specimens cannot adequately detect the presence of this infection in males.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundDepressed mood syndromes may limit the ability of patients with sexually transmitted diseases (STDs) to process risk reduction messages and change behavior. We undertook screening for depression in an urban STD clinic.GoalTo define the prevalence of depressed mood among STD patients in Baltimore, Maryland.Study DesignA convenience sample of 125 patients presenting to an STD clinic completed the 30-item General Health Questionnaire (GHQ). Endorsement of ≥ 6 depressive symptom items on the GHQ was considered probable depression.ResultsOf 125 patients screened, 39.2% had GHQ scores above the threshold. Women were more likely to have probable depression than men (51.9% versus 31.9%,P= 0.023). There was no association of substance use and depressed mood, nor of a diagnosed STD and depressed mood.ConclusionsDepressive symptom rates are extremely high among STD patients, which may compromise the success of risk reduction counseling.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundSexually transmitted diseases (STDs) in persons older than 50 years are rarely studied because STDs are more common in young people. Understanding the epidemiology of STDs in older persons is important for reducing STD morbidity and for improving STD care.GoalTo understand the epidemiology of STDs in older persons.MethodsWashington State’s STD surveillance data from 1992 to 1998 were analyzed to describe the burden of STDs and source of care for these diseases in older persons.ResultsFrom 1992 to 1998, 1535 episodes of STDs were reported for 50- to 80-year-olds in Washington State, accounting for 1.3% of all reported STDs. The most common STDs were nongonococcal urethritis in men and genital herpes in women. As compared with younger persons, older individuals more frequently sought care at private clinics and had symptoms at the time of the clinic visit.ConclusionsSexually transmitted diseases are reported among older persons, although at lower rates than among younger persons. Services for STD and counseling regarding safe sex should be available to persons of all ages.

ISSN:0148-5717    

出版商:OVID    

年代:2001

数据来源: OVID