摘要:

ObjectiveTo determine the factors that influence condom use among prostitutes and their clients in The Gambia.DesignA cohort of 181 prostitutes working in seven bars and several rural markets in The Gambia were monitored daily for 14 months. A sample of 747 clients of these prostitutes was also questioned.Main outcome measureProportion of sexual contacts for which a condom was used.ResultsData on 24 181 sexual contacts reported by the prostitutes indicated condom use varied according to type of partner (from 84% with clients to only 4% with regular partners). Condom use with clients varied according to location (from 91% in high-class bars to 59% in rural markets), decreased from 91% with the first client of the evening to 37% with the tenth client, and from 75% with clients paying higher charges (> D19) to 52% with those paying lower charges (< D20). Condom use was not related to the socio-demographic characteristics of the prostitutes. Clients reported lower condom use than prostitutes. Clients aged 20–24 years were least likely to use condoms, while white collar workers, traders, and those paying higher charges, were more likely to use condoms.ConclusionsThe level of condom use in this cohort of prostitutes was high but not consistent. Condom use was determined more by the type of establishment and the characteristics of clients, than by any fixed tendency among the prostitutes. Thus, education campaigns should be directed as much to clients as to prostitutes. In The Gambia, ‘lower-class' bars and those in rural areas where prostitutes work should be a priority target.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectivesTo evaluate the mortality pattern observed in relation to the AIDS epidemic, and to estimate the current and future demographic impact of AIDS among the population aged between 20 and 39 years in Catalonia, Spain.DesignSpain has the highest cumulative incidence rate of AIDS in Europe. One-third of Spanish AIDS cases have been consistently reported from Catalonia, an autonomous region in northeastern Spain with a population of 6 million, and with Pattern I HIV transmission. In this study data from the population-based AIDS registry and death certificates in Catalonia were used.MethodsSince 1981 AIDS data have been collected routinely from all hospitals using an active surveillance system. All causes of death are coded from death certificates (ICD-9). Mortality rates since 1981 were analysed by age and sex. To assess the relative importance of premature mortality due to AIDS, years of potential life lost (YPLL) before age 65 were used.ResultsSince 1982 there has been a continuous increase in crude mortality rates, particularly significant for men aged 20–39 years after 1986 (F < 0.001). While AIDS was the fourth most likely cause of death among people aged 20–39 years in 1988, by 1991 it was the second most likely. In 1990 AIDS contributed to 13213 YPLL (8.7%) for men and 2579 YPLL (4%) for women. During the last few years AIDS-related deaths have had the highest mortality rate progression among young adults.ConclusionAccording to the current available data, AIDS might become the leading cause of death for the population aged 20–39 years in the near future. AIDS is having an important impact on the demography of European countries with Pattern I transmission and high HIV prevalence rates.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo assess the importance of community-recruited drug injectors with no treatment experience and no previous testing history when estimating HIV prevalence among drug injectors.DesignHIV testing behaviour and prevalence were measured in a serial point prevalence study of drug injectors recruited in community-based non-treatment and treatment settings.MethodsPearson's χ2and Fisher's exact tests were used to measure differences between treatment groups and non-treatment groups in demographic characteristics, including age and length of injecting career, recent drug use, recent syringe sharing, uptake of previous HIV testing, confirmed HIV-antibody status by saliva and self-reported HIV status.ResultsRates of HIV-antibody testing were significantly lower in community-recruited drug injectors with no experience of treatment than those previously or currently in treatment. Confirmed HIV prevalence by saliva was highest in drug injectors with no experience of treatment. HIV-antibody-positive drug injectors with no treatment experience were less likely to be aware of their antibody status than injectors who were, or who had been, in treatment.ConclusionsPrevious studies of HIV prevalence among drug injectors may be biased by drawing on samples primarily from treatment settings. Drug injectors with no treatment experience and no previous history of HIV testing should be included in HIV prevalence studies. Regular and repeat HIV testing in low-threshold community-based programmes should be considered a necessary part of interventions which seek to provide better access to treatment and other HIV prevention services.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo assess predictors of relapse into unprotected anogenital intercourse with casual partners among homosexual men in Amsterdam, The Netherlands.DesignA prospective study ongoing since October 1984.MethodsSelf-reported data on sexual behaviour were obtained at 12 semi-annual intervals. Participants who reported unprotected anogenital intercourse with casual partners at wave 12 but not at wave 11 were considered to have relapsed into unsafe sex (n = 47). Men who did not report unprotected anogenital intercourse at wave 11 or at wave 12 were considered to have maintained behaviour change (n = 197).ResultsRelapse into unsafe sex with casual partners occurred more frequently among men with a less positive attitude towards condom use, lower personal efficacy with respect to using condoms with casual partners, a weaker intention to avoid anogenital intercourse with casual partners and those who were not involved in a primary relationship. Intention to avoid anogenital intercourse with casual partners was related to an individual's attitude, normative beliefs and personal efficacy with respect to avoiding anogenital intercourse.ConclusionsIn order to improve motivation it is important to support homosexual men in their personal decision-making process, which may be more resolute when the outcome is in accordance with individual preferences. Therefore, health education should be community-based and sensitive to individual needs.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectivesTo determine the prevalence of HIV infection and its relationship to age, sex and other factors.Design and settingCross-sectional survey of a rural community in Guinea-Bissau.MethodsQuestionnaire-administration and screening of sera from subjects aged >m; 15 years.ResultsOf the 2770 subjects tested, 220 (7.9%) were HIV-2-seropositive, four (0.1%) were HIV-1-seropositive and 10 (0.4%) were dually reactive. Overall prevalence of HIV-2 was 9.3% in women, peaking at 17.2% in the 35–44 age group, and 6.6% in men, peaking at 19.1% in the 45–54 age group. The mean age of the four subjects with HIV-1 infection was 24 years, which was significantly lower than those with HIV-2 infection. HIV-2 infection was more prevalent among women who were widowed or divorced, women whose husbands were living away from the study area, and women who had lived in the capital, Bissau. The majority of subjects with an infected spouse remained uninfected and none of the women aged < 25 years whose husbands were infected were seropositive. The prevalence varied significantly between settlements within the study area.ConclusionsThe pattern of HIV-2 infection in this rural community has similarities to that found in urban Bissau, and prevalence in both areas peaks in older subjects than in HIV-1 foci. The findings support previous suggestions that HIV-2 is not a recent introduction to Guinea-Bissau, and that it is less pathogenic and less readily transmitted than HIV-1.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID