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Intercourse
Kinds of Intercourse Terms modified by Intercourse Selected AbstractsHigh Prevalence of Sexually Transmitted Infections Among Young Peruvians Who Have Sexual Intercourse With Foreign Travelers in CuzcoJOURNAL OF TRAVEL MEDICINE, Issue 5 2009Miguel M. Cabada MD Background Sexual networking in popular tourist destinations is a problem worldwide. In Peru, locals sexually interacting with travelers bridge high-risk groups, the general population, and travelers. Methods A cross-sectional study was conducted in Cuzco about sexual behavior among young Peruvians who admitted having sex with travelers. A subgroup of the participants had serologic testing for Chlamydia trachomatis, Herpes simplex virus (HSV) type 2, and Treponema pallidum. Results Eighty-eight subjects volunteered for blood sampling. Their mean age was 22.9 years (±4.1) and 53.4% were male. The majority were single (86.2%), but 12.6% had a stable relationship. The median number of sexual partners in the 3 months prior to the study was 2 [interquartile range (IQR): 1,4]. During that period, 43.1% reported foreign partners, 28.4% reported foreign and Peruvian partners, 17% reported Peruvian partners, and the remaining 11.5% reported combinations of Peruvian, foreign, and sex workers partners. The median number of foreign partners in the 12-month period prior to the study was 4 (IQR: 2,8). Only 25.3% reported consistent condom use. Alcohol (69%) and drugs (36.8%) were commonly used before sexual activity. Seventy-eight percent tested positive for HSV type 2, 25% for C trachomatis, and 1.1% for T pallidum. Conclusions The core group of young Peruvians we report on demonstrated a high-risk sexual behavior and a high prevalence of sexually transmitted infections. Our results underscore the need for education on safer sex practices among this group and among travelers. [source] New Method Is as Effective As Levonorgestrel After Unprotected IntercoursePERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 2 2010J. Thomas No abstract is available for this article. [source] Friends' Influence on Adolescents' First Sexual IntercoursePERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2006Renee E. Sieving CONTEXT: Social-psychological theories of health behavior suggest that adolescents' sexual behaviors are influenced by the sexual attitudes and behaviors of their friends. METHODS: Data on 2,436 participants in the National Longitudinal Study of Adolescent Health (Add Health) who were sexually inexperienced at Wave 1 (1994,1995) were analyzed to examine whether friend-related variables predicted initiation of vaginal intercourse by Wave 2 (1996). Analyses also assessed whether predictive relationships varied by level of involvement with friends. Odds ratios were generated by logistic regression analysis. RESULTS: In the 9,18 months between Waves 1 and 2, 18% of participants initiated intercourse. In analyses controlling for gender, family structure and romantic relationships, the higher the proportion of a youth's friends who were sexually experienced, the greater the odds of sexual debut (odds ratio, 1.01); the odds also were elevated among youth who believed that they would gain their friends' respect by having sex (1.2). Relationships between friend variables and sexual initiation did not vary by level of involvement with friends. CONCLUSIONS: To maximize the likelihood of success, programs focused on delaying teenage sexual intercourse should address norms for sexual behavior among adolescents' close friends as well as the perceptions, skills and behaviors of individual youth. [source] ORIGINAL ARTICLE: Timed Sexual Intercourse Facilitates the Recruitment of Uterine CD56bright Natural Killer Cells in Women with InfertilityAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2009Hidetaka Kimura Problem, The aim of this study was to investigate the influence of sexual intercourse on uterine NK cell subsets. Method of study, Mid-secretory endometrial samples obtained from 56 women were submitted for flow cytometric analysis. Basal body temperature was used to determine the day of ovulation. A total of 27 women had sexual intercourse before ovulation (pre-ovulation group) and eight women had only after ovulation (post-ovulation group) without any contraceptive devices. A total of 21 women did not have sexual intercourse during the experimental cycle (abstinence group). Endometrial NK cells were analyzed for the expression of CD16 and CD56 using 3-color flow cytometry. Results, CD16,/CD56bright cells were markedly increased in the pre-ovulation group as compared with that of the post-ovulation group (P < 0.01) and the abstinence group (P < 0.01). CD16+/CD56dim cells were significantly decreased in the pre-ovulation group as compared with that of the post-ovulation group (P < 0.01) and the abstinence group (P < 0.05). Conclusion, It is suggested that seminal plasma participates in the recruitment of CD56bright NK cells into endometrium. [source] ORIGINAL RESEARCH,ANATOMY/PHYSIOLOGY: Satisfaction (Sexual, Life, Relationship, and Mental Health) Is Associated Directly with Penile,Vaginal Intercourse, but Inversely with Other Sexual Behavior FrequenciesTHE JOURNAL OF SEXUAL MEDICINE, Issue 7 2009Stuart Brody PhD ABSTRACT Introduction., Some sex therapists and educators assume that many sexual behaviors provide comparable sexual satisfaction. Evidence is required to determine whether sexual behaviors differ in their associations with both sexual satisfaction and satisfaction with other aspects of life. Aims., To test the hypothesis that satisfaction with sex life, life in general, sexual partnership, and mental health correlates directly with frequency of penile,vaginal intercourse (PVI) and inversely with frequency of both masturbation and partnered sexual activity excluding PVI (noncoital sex). Methods., A representative sample of 2,810 Swedes reported frequency of PVI, noncoital sex, and masturbation during the past 30 days, and degree of satisfaction with their sex life, life in general, partnership, and mental health. Main Outcome Measures., Multivariate analyses (for the sexes separately and combined) considering the different satisfaction parameters as dependent variables, and the different types of sexual activities (and age) as putative predictors. Results., For both sexes, multivariate analyses revealed that PVI frequency was directly associated with all satisfaction measures (part correlation = 0.50 with sexual satisfaction), masturbation frequency was independently inversely associated with almost all satisfaction measures, and noncoital sex frequencies independently inversely associated with some satisfaction measures (and uncorrelated with the rest). Age did not confound the results. Conclusions., The results are consistent with evidence that specifically PVI frequency, rather than other sexual activities, is associated with sexual satisfaction, health, and well-being. Inverse associations between satisfaction and masturbation are not due simply to insufficient PVI. Brody S, and Costa RM. Satisfaction (sexual, life, relationship, and mental health) is associated directly with penile-vaginal intercourse, but inversely with other sexual behavior frequencies. J Sex Med 2009;6:1947,1954. [source] Female Urinary Incontinence During Intercourse: A Review on an Understudied Problem for Women's SexualityTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2009Maurizio Serati MD ABSTRACT Introduction., Coital urinary incontinence is a frequently underreported symptom, with a relevant impact on women's sexuality and quality of life. Aim., This article will review the available evidence on incidence, pathophysiology, and treatment of coital urinary incontinence with the attempt to present the current state of the art. Methods., PubMed was searched for reports about coital urinary incontinence that were published from 1970 to 2008, and the most relevant articles were reviewed. Main Outcome Measures., Review on epidemiology, pathophysiology, diagnosis, and treatment of coital incontinence. Results., The incidence of coital incontinence in incontinent women has been reported to range between 10% and 27%. At present, some evidence suggests an association between urinary leakage at penetration and urodynamic stress (USI) incontinence as well as urinary leakage during orgasm and detrusor overactivity (DO). When treatment for these conditions are based upon urodynamic findings, pelvic floor muscle training, surgery, and pharmacotherapy show satisfactory cure rates. Conclusions., Coital urinary incontinence deserves much more attention in clinical practice: women should be specifically interviewed for this disturbance because it has a very negative impact on their sexuality. If a reliable urodynamic diagnosis is made, coital urinary incontinence at penetration can be cured in more than 80% of cases by surgery in the presence of USI. The form of coital incontinence during orgasm is curable by antimuscarinic treatment in about 60% of cases when associated with DO. Serati M, Salvatore S, Uccella S, Nappi RE, and Bolis P. Female urinary incontinence during intercourse: A review on an understudied problem for women's sexuality. J Sex Med 2009;6:40,48. [source] ORIGINAL RESEARCH,PSYCHOLOGY: Women's Partnered Orgasm Consistency Is Associated with Greater Duration of Penile,Vaginal Intercourse but Not of ForeplayTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2009Petr Weiss PhD ABSTRACT Introduction., It has been asserted that women's likelihood or consistency of partnered orgasm (her orgasm as a result of sexual activities with a partner) is determined by duration of foreplay, but not by duration of penile,vaginal intercourse. Aims., The objective was to examine the extent to which women's likelihood or consistency of partnered orgasm is associated with duration of foreplay, duration of penile,vaginal intercourse, and age. Methods., In a representative sample of the Czech population, 2,360 women reported their consistency of orgasm with a partner (from "never" to "almost every time"), and estimates of their typical durations of foreplay and of penile,vaginal intercourse. Main Outcome Measures., The association of consistency of partnered orgasm with typical durations of both foreplay and penile,vaginal intercourse. Results., In univariate analyses, consistency of partnered orgasm was more associated with penile,vaginal intercourse duration than with foreplay duration (consistency also correlated negatively with age). In multivariate analysis, foreplay ceased to be a significant correlate of partnered orgasm consistency (the exclusion of respondents reporting a penile,vaginal intercourse duration of 1 minute or less did not alter the results). Conclusions., When both sexual activity categories are examined in tandem on a population level, women's likelihood or consistency of partnered orgasm is associated with penile,vaginal intercourse duration, but not with foreplay duration. In contrast to the assumptions of many sex therapists and educators, more attention should be given to improve the quality and duration of penile,vaginal intercourse rather than foreplay. Weiss P, and Brody S. Women's partnered orgasm consistency is associated with greater duration of penile,vaginal intercourse but not of foreplay. J Sex Med 2009;6:135,141. [source] ORIGINAL RESEARCH,PSYCHOLOGY: Age of First Sexual Intercourse and Acculturation: Effects on Adult Sexual RespondingTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2008Jane S.T. Woo MA ABSTRACT Introduction., Although age of first intercourse and the emotional aspects of that experience are often a target in assessment because they are thought to contribute to later sexual functioning, research to date on how sexual debut relates to adult sexual functioning has been limited and contradictory. Aim., The goal of this study was to explore the association between age of first intercourse and adult sexual function in a sample of Euro-Canadian and Asian Canadian university students. In addition, culture-based comparisons of sexual complaints were made to clarify the role of culture in sexual response. Methods., Euro-Canadian (N = 299) and Asian Canadian (N = 329) university students completed the Golombok-Rust Inventory of Sexual Satisfaction and the Vancouver Index of Acculturation. Main Outcome Measures., Self-reported sexual problems and bidimensional acculturation. Results., Ethnic group comparisons revealed that Asians reported more sexual complaints including sexual avoidance, dissatisfaction and non-sensuality. Among the women, Asians reported higher scores on the Vaginismus and Anorgasmia subscales whereas the ethnic groups did not differ on the male-specific measures of sexual complaints. In the overall sample, older age of first intercourse was associated with more sexual problems as an adult, including more sexual infrequency, sexual avoidance, and non-sensuality. Among the Asian Canadians, less identification with Western culture was predictive of more sexual complaints overall, more sexual noncommunication, more sexual avoidance, and more non-sensuality. For Asian women, acculturation interacted with age of first intercourse to predict Vaginismus scores. Conclusions., Overall, these data replicate prior research that found that a university sample of individuals of Asian descent have higher rates of sexual problems and that this effect can be explained by acculturation. Earlier sexual debut was associated with fewer sexual complaints in adulthood. Woo JST, and Brotto LA. Age of first sexual intercourse and acculturation: Effects on adult sexual responding. J Sex Med 2008;5:571,582. [source] Associations Between Father Absence and Age of First Sexual IntercourseCHILD DEVELOPMENT, Issue 5 2009Jane Mendle Children raised without a biological father in the household have earlier average ages of first sexual intercourse than children raised in father-present households. Competing theoretical perspectives have attributed this either to effects of father absence on socialization and physical maturation or to nonrandom selection of children predisposed for early sexual intercourse into father-absent households. Genetically informative analyses of the children of sister dyads (N = 1,382, aged 14,21 years) support the selection hypothesis: This association seems attributable to confounded risks, most likely genetic in origin, which correlated both with likelihood of father absence and early sexual behavior. This holds implications for environmental theories of maturation and suggests that previous research may have inadvertently overestimated the role of family structure in reproductive maturation. [source] Infertility and assisted reproductive technologies: Bright and dark sidesCONGENITAL ANOMALIES, Issue 3 2001Kaoru Suzumori ABSTRACT, Infertility is defined as a couples failure to conceive following 2 years of unprotected sexual intercourse, affects 10% of reproductive age couples in Japan. There are 3 main causes: (1) ovarian failure-anovulation (29%); (2) tubal factor-anatomic defects of the female genital tract (36%); (3) male factor-abnormal spermatogenesis (31%). The goal of the infertility evaluation are to determine the probable cause of infertility regarding prognosis and to provide guidance regarding options for treatment In the event an obstruction of the fallopian tubes is discovered or spermatogenesis cannot be improved, assisted reproductive technologies (ART) such as gamete intrafallopian tube transfer (GIFT) and in vitro fertilization with embryo transfer (IVF-ET) are recommended. Since the successful birth of Louise Brown by this IVF-ET, an explosion of ART has occurred all over the world in the last decade. In this review we discuss the revolution brought about by ART focusing on results in Japan, and clarify ethical issues that must be resolved. [source] Childhood adversity in alcohol- and drug-dependent women presenting to out-patient treatmentDRUG AND ALCOHOL REVIEW, Issue 4 2001RAINE BERRY Abstract Eighty alcohol- and/or drug-dependent women who were consecutive admissions to a representative out-patient alcohol and drug service in Christchurch were interviewed with the aim of establishing the extent of exposure to childhood adversity including childhood sexual, physical and emotional abuse and parental problems. The results show that a sizeable percentage of the women came from backgrounds characterized by parental conflict and alcohol and drug problems. Within their first 15 years 51% were subjected to sexual abuse involving attempted or completed oral, anal or vaginal intercourse and 39% were exposed regularly to physical abuse perpetrated by their parents or main parental figures. Over half reported experiencing emotional abuse rated as being ,very distressing' and two-thirds had been exposed to ,very distressing' parental problems. The main implication for clinical practice arising from the results of this study is the need for the development of a broader approach to alcohol and drug service provision. In order to achieve positive treatment outcomes, alcohol and drug services may need to routinely screen and plan treatment for childhood adversity and associated problems in all clients presenting for alcohol and drug treatment. [source] Awareness of breast and cervical cancer risk factors and screening behaviours among nurses in rural region of TurkeyEUROPEAN JOURNAL OF CANCER CARE, Issue 3 2008A. YAREN md Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. There is limited data on breast and cervical cancer knowledge, screening practices and attitudes of nurses in Turkey. A self-administered questionnaire was used to investigate the knowledge and attitude of nurses on risk factors of the breast and cervical cancer as well as screening programmes such as breast self-examination (BSE), clinical breast examination, mammography (MMG) and papanicolaou (pap) smear test. In total, 125 out of 160 nurses participated in the study (overall response rate was 80.6%). The risk factors and symptoms of breast cancer was generally well known, except for early menarche (23.2%) and late menopause (28.8%). For cervical cancer, the correct risk factors mostly indicated by the nurses were early age at first sexual intercourse (56%), smoking (76%), multiple sexual partners (71.2%). As for screening methods, it was believed that BSE was a beneficial method to identify the early breast changes (84.8%) and MMG was able to detect the cancer without a palpable mass (57.6%). Little was known about the fact that women should begin cervical cancer screening approximately 3 years after the onset of sexual intercourse (23.2%) and if repeated pap smear test were normal, it could be done every 2,3 years. Most of the nurses considered that MMG decreases the mortality in breast cancer (65.6%) and also believed that pap smear test decreases the mortality in cervical cancer (75.2%). Despite high level of knowledge of breast cancer risk factors, symptoms and screening methods, inadequate knowledge of cervical cancer screening method were found among nurses. [source] Vulvar Pain: A Phenomenological Study of Couples in Search of Effective Diagnosis and TreatmentFAMILY PROCESS, Issue 2 2008JENNIFER J. CONNOR PH.D. Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of, the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships. RESUMEN Dolor vulvar: estudio fenomenológico de parejas que buscan un diagnóstico y tratamiento efectivos El síndrome de vestibulitis vulvar (svv), un trastono de dolor vulvar, continúa dejando perplejos a los profesionales de la salud física y mental debido a su etiología desconocida y a la inexistencia de un tratamiento efectivo. Este estudio utilizó metodología fenomenológica experimental para explorar las experiencias de parejas en que a la mujer se le ha diagnosticado el svv. Se llevaron a cabo dieciséis entrevistas (en profundidad y semiestructuradas) con 13 parejas heterosexuales y 3 mujeres, de las que se obtuvieron cuatro conclusiones esenciales: (1) En busca de , la investigación médica requería una búsqueda más exhaustiva de médicos eruditos y respetuosos que aportasen un tratamiento. (2) El proceso de desarrollar una comprensión personal del trastorno condujo a varias parejas a plantearse su papel en la causa y la prolongación del svv. (3) Desarrollar estrategias para afrontar un coito doloroso condujo a tres estrategias: prescindir del sexo, optar por alternativas al sexo vaginal y modificar o soportar el coito doloroso. (4) Se experimentaron sensaciones de aislamiento, pues el proceso de adaptación a este síndrome de dolor crónico resultó, a menudo, un proceso solitario. Entre los consejos clínicos se incluyen tratar a la pareja, y no sólo a la mujer con svv; animar a las parejas a ampliar las definiciones de la importancia y preferencia por el coito vaginal, así como sugerir actividades sexuales con menor riesgo de causar dolor vulvar; desarrollar un significado común como pareja; y ayudar a las parejas a encontrar médicos y recursos. Palabras clave: síndrome de vestibulitis vulvar; dolor vulvar; terapia de pareja. [source] Safer sex decision-making among men with haemophilia and HIV and their female partnersHAEMOPHILIA, Issue 1 2001K. L. Parish An exploratory qualitative study of adult heterosexual men with haemophilia and HIV and women who were their sexual partners was conducted as formative research to better understand cognitive factors involved in behavioural intentions and practices which comprise HIV risk-reduction for sexual transmission. The study sought to generate hypotheses, uncover themes, and develop a broad perspective on possible determinants of behaviours related to HIV transmission risk reduction. Qualitative analysis of these data served as a basis for developing a subsequent quantitative, hypothesis-testing survey and an intervention. Face-to-face interviews were conducted with 23 single men and 28 married men with haemophilia and HIV infection, and 28 married women partners selected through stratified, purposeful sampling. The interviews identified beliefs, attitudes, and values underlying decisions regarding target behaviours related to preventing sexual transmission of HIV, including (1) using condoms consistently during vaginal intercourse and (2) talking to partners about risk reduction. The interviews elicited information about perceived advantages and disadvantages of performing each of the targeted behaviours, and factors that facilitate or prevent performing them. Qualitative analysis of coded responses yielded important themes regarding how choices are made about sexual activity and safer sex. Most notably, communication between partners (1) plays a direct, key role in facilitating condom use and (2) forms the basis for maintaining emotional intimacy in these relationships. The link between condom use and communicating about safer sex was viewed as pivotal in achieving HIV prevention for individuals in serodiscordant couples. Recommendations for risk reduction intervention development are discussed. [source] Teacher training and HIV/AIDS prevention in West Africa: regression discontinuity design evidence from the CameroonHEALTH ECONOMICS, Issue S1 2010Jean-Louis Arcand Abstract We assess the impact on teenage childbearing as well as student knowledge, attitudes, and behavior of a typical HIV/AIDS teacher training program in the Cameroon. Applying a regression discontinuity design identification strategy based on the key administrative criterion that determined program deployment, we find that 15,17 year old girls in teacher training schools are between 7 and 10 percentage points less likely to have started childbearing, an objective proxy for the incidence of unprotected sex. They are also significantly more likely to have used a condom during their last sexual intercourse. For 12,13 year old girls, the likelihood of self-reported abstinence and condom use is also significantly higher in treated schools, while the likelihood of having multiple partners is significantly lower. Copyright © 2010 John Wiley & Sons, Ltd. [source] A preliminary investigation of the effects of restrictions on Medicaid funding for abortions on female STD ratesHEALTH ECONOMICS, Issue 6 2003Bisakha Sen Abstract There is evidence in the economics literature that restrictions on Medicaid funding for abortion reduces the demand for abortion. The unresolved question is whether such restrictions also increase safe sex (that is, pregnancy avoidance) behavior among women. This study explores that issue using state-level gonorrhea rates among women for 1975,1995. The rationale is that sexual behavior that leads to greater risk of accidental pregnancies is likely to be highly correlated with sexual behavior leading to greater risk of STD infection. Since gonorrhea has an incubation period of about a week, and is transmitted almost exclusively through sexual intercourse, a change in sexual behavior should soon be followed by a change in gonorrhea rates. The study used a partial adjustment model with lagged-dependent variables estimated using Arellano-Bond's GMM method. Results fail to find any statistically significant evidence that Medicaid funding restrictions are effective in reducing gonorrhea rates. This finding is robust to a variety of alternate specifications and tests. This suggests that restrictions on Medicaid funding for abortion fail to promote safe sex behavior among women. Copyright © 2002 John Wiley & Sons, Ltd. [source] Fertility among female hodgkin lymphoma survivors attempting pregnancy following ABVD chemotherapyHEMATOLOGICAL ONCOLOGY, Issue 1 2007David C. Hodgson Abstract Although ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy is infrequently associated with premature amenorrhea, little is known about the success rate of women attempting pregnancy following ABVD. In the present study females treated for HL with ABVD chemotherapy without pelvic radiation therapy (RT) and who were alive without relapse ,3 years after treatment were identified from a clinical database and screened for inclusion. Using a standardized questionnaire, we determined the pregnancy rate (i.e. time-to-pregnancy, TTP) among survivors who had become pregnant, tried to become pregnant, or who had been sexually active for over 2 months without using contraception at any time following ABVD. The cumulative incidence of pregnancy was calculated using the Kaplan,Meier method. Cox proportional hazards models were constructed to compare the pregnancy rate among HL survivors to that reported by friend or sibling controls. Thirty-six female HL survivors, who had attempted pregnancy after ABVD treatment, and 29 controls, completed the survey. Eighteen patients (50%) received 2,4 cycles of ABVD, 16 (44%) received 4,6 cycles, and 2 (6%) received >6 cycles. The median TTP among both HL survivors and controls was 2.0 months. The 12-month pregnancy rates were 70% and 75%, respectively. The fertility ratio (FR) for HL survivors versus controls was 0.94 (95%CI,=,0.53,1.66; p,=,0.84) after adjusting for age and frequency of intercourse (where FR <,1 indicates subfertility). Age at treatment and the number of cycles of chemotherapy were not associated with pregnancy rate among HL survivors. Female HL patients who had survived without recurrence ,3 years and who had attempted pregnancy after ABVD did not experience significant sub-fertility. Copyright © 2006 John Wiley & Sons, Ltd. [source] Fertility needs and funding in couples with blood-borne viral infectionHIV MEDICINE, Issue 1 2010E Kalu Background Couples infected with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly seeking assisted conception. These couples avoid unprotected intercourse and use condoms at all times in order to minimize the risk of infecting their partner. As this practice inhibits pregnancy, assisted procreation is generally required for safe conception. For many couples, access to such services is restricted on ethical, geographical and financial grounds. Objective The aim of the study was to assess the fertility needs, geographical origin and state funding of patients with blood-borne viral infection. Methods A retrospective review of the medical records of couples referred for fertility treatment between January 1999 and December 2006, where one or both partners were infected with HIV, HBV and/or HCV, was carried out. Results Of the 205 couples included in the study, 44% lived in London, 51% came from elsewhere in the United Kingdom and 5% travelled from outside the United Kingdom to seek treatment. Genitourinary medicine clinics were the main source of referral. 85.8% of couples had HIV infection, 15.1% were infected with HBV and 13.6% had HCV infection. Fertility screening identified a high incidence of male factor infertility (33.3%) in HIV-infected men and tubal disease (40.8%) in HIV-infected women. Only 23.6% of HIV-infected couples, 20% of HBV-infected couples and 12.5% of HCV-infected couples obtained state funding for assisted conception. Conclusion Fertility screening identified a high incidence of male and tubal factor subfertility among couples living with HIV, HBV and HCV. Limited access to specialist clinics equipped to cater for these couples and restricted funding may impact negatively on couples obtaining risk-reducing assisted reproduction treatment. This may have long-term public health implications as individuals attempt to conceive through unprotected intercourse. [source] Acute hepatitis C in HIV-infected men who have sex with menHIV MEDICINE, Issue 4 2004J Ghosn Background Hepatitis C virus (HCV) is usually transmitted via the parenteral route, but there are widely discrepant findings on its possible sexual transmission. Thus there are no recommendations concerning protected sex for couples in which only one partner is HCV-infected. Whether HIV or other sexually transmitted diseases could favour HCV transmission remains unclear, but recent data suggesting an increasing incidence of acute HCV in HIV-infected men underline the major public health implications of this issue. Case reports Between June 2002 and July 2003, five HIV-infected homosexually active men presented with primary (n=4) and secondary (n=1) syphilis and concomitant abnormal liver function tests revealing acute asymptomatic HCV seroconversion. Other causes of acute viral hepatitis were inquired into and excluded. Highly at-risk sexual behaviour, including unprotected anal intercourse and unsafe oral sex, with concomitant syphilis, was found to be the only identifiable important risk factor for transmission of HCV. Conclusions Sexual transmission may be fuelling a significant increase in HCV seroconversions among HIV-infected men who have highly risky sexual behaviours. Given the recent data suggesting the spread of sexually transmitted infections among HIV-infected gay men, specific recommendations concerning safe sex are urgently needed. [source] Good outcome in HIV-infected refugees after resettlement in New Zealand: population studyINTERNAL MEDICINE JOURNAL, Issue 5 2007S. M. Nisbet Abstract Background: The aims of this study were to determine the clinical characteristics on arrival and the subsequent clinical outcome of HIV-infected UN quota refugees who settled in New Zealand during the last 11 years and to estimate their rate of HIV transmission. Methods: A population study was conducted. Data were provided by the Mangere Refugee Resettlement Centre, the infectious disease physicians caring for the subjects, the New Zealand AIDS Epidemiology Group and laboratories carrying out HIV viral load assays. Results: One hundred of 7732 (1.3%) UN quota refugees were HIV positive; mean age 30 years, 56% were men, median initial CD4 count was 320 (range 20,1358). HIV infection was most commonly acquired by heterosexual intercourse (74%). The median follow up was 5.0 years (range 1 month to 9.7 years). Five died and 15 subjects had 16 AIDS-defining illnesses, most commonly tuberculosis (n = 10). Sixty subjects commenced highly active antiretroviral therapy of whom 36/59 (61%) had an undetectable HIV viral load after 1 year of treatment. None of the six children born to HIV-infected women in New Zealand were infected. There were two known cases of horizontal transmission of HIV infection. Conclusion: Although HIV-infected quota refugees often have to overcome severe social, cultural and financial handicaps, their clinical outcome is generally very good, with response rates to highly active antiretroviral therapy that are similar to other patient groups. Furthermore, they have not been a significant source of transmission of HIV infection after resettlement in New Zealand. [source] Infertility among couples in a population-based study in Iran: prevalence and associated risk factorsINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 3 2008Mohammad Reza Safarinejad Summary To explore the prevalence and risk factors of infertility in Iran, a total of 12 285 ever-married women aged 15,50 years old and their husbands (if available) were interviewed by 82 female general practitioners and answered a self-administered questionnaire on several aspects of infertility. They were identified from the national population in 30 counties, and invited to a confidential interview. Data were obtained about their age, education, marital status, toxic habits, medical history, disabilities and illnesses, help-seeking, economy, ethnicity, geographic location, contraceptive use and age at which they had first intercourse. This study used the definition of childlessness proposed by World Health Organization: ,the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 2 years'. The overall prevalence of infertility was 8% (95% CI: 3.2,15.0). The weighted national estimate of primary infertility was 4.6% (95% CI: 3.6,5.2). There was a pronounced regional pattern in the levels of primary infertility. The primary infertility increased significantly from 2.6 to 4.3 to 5.5% for the 1985,1989, 1990,1994 and 1995,2000 marriage cohorts. The prevalence of secondary infertility was 3.4% (95% CI: 2.4,5.1). Overall the prevalence of infertility falls within a relatively wide range being high in the Southern counties, and low in the Northern counties. The probability of first pregnancy at the end of 2 years of marriage was 0.78 for all ever-married women. The prevalence of infertility increased with age (linear chi-square 198.012, 1 d.f., p = 0.01). The age pattern of infertility also varies quite markedly across the counties analysed. No effect of race was detected; neither the intercept (analysis of covariance p = 0.36) nor the slope of the age relationship was influenced by race (analysis of covariance p = 0.41). Infertility were observed as significantly higher in the presence of history of tubo-ovarian surgery [odds ratio (OR): 1.43; 95% CI: 1.28,2.23; p = 0.01], salpingitis (OR: 2.34; 95% CI: 1.31,4.3; p = 0.016), ectopic pregnancy (OR: 2.45; 95% CI: 1.90,3.44; p = 0.04), varicocele (OR: 2.85; 95% CI: 1.61,5.20; p = 0.01) and cryptorchidism (OR: 3.81; 95% CI: 2.51,4.28; p = 0.031). This study provides a quantitative estimate of the prevalence and main risk factors for infertility in Iranian couples. Yet, further studies on the cause of primary and secondary infertility and geographical variations in the incidence and prevalence of infertility in Iran are needed. [source] Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: Collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studiesINTERNATIONAL JOURNAL OF CANCER, Issue 4 2007Article first published online: 27 NOV 200 Abstract Squamous cell carcinomas account for about 80% of cancers of the uterine cervix, and the majority of the remainder are adenocarcinomas. There is limited evidence on the extent to which these histological types share a common etiology. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 8,097 women with invasive squamous cell carcinoma, 1,374 women with invasive adenocarcinoma and 26,445 women without cervical cancer (controls) from 12 epidemiological studies. Compared to controls, the relative risk of each histological type of invasive cervical cancer was increased with increasing number of sexual partners, younger age at first intercourse, increasing parity, younger age at first full-term pregnancy and increasing duration of oral contraceptive use. Current smoking was associated with a significantly increased risk of squamous cell carcinoma (RR = 1.50, 95% CI: 1.35,1.66) but not of adenocarcinoma (RR = 0.86 (0.70,1.05)), and the difference between the two histological types was statistically significant (case-case comparison p < 0.001). A history of screening (assessed as having had at least one previous nondiagnostic cervical smear) was associated with a reduced risk of both histological types, but the reduction was significantly greater for squamous cell carcinoma than for adenocarcinoma (RR = 0.46 (0.42,0.50) and 0.68 (0.56,0.82), respectively; case,case comparison, p = 0.002). A positive test for cervical high-risk HPV-DNA was a strong risk factor for each histological type, with 74% of squamous cell carcinomas and 78% of adenocarcinomas testing positive for HPV types 16 or 18. Squamous cell and adenocarcinoma of the cervix share most risk factors, with the exception of smoking. © 2006 Wiley-Liss, Inc. [source] Carcinoma of the cervix and tobacco smoking: Collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies,INTERNATIONAL JOURNAL OF CANCER, Issue 6 2006Article first published online: 4 OCT 200 Abstract Tobacco smoking has been classified as a cause of cervical cancer, but the effect of different patterns of smoking on risk is unclear. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 13,541 women with and 23,017 women without cervical carcinoma, from 23 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of carcinoma of the cervix in relation to tobacco smoking were calculated with stratification by study, age, sexual partners, age at first intercourse, oral contraceptive use and parity. Current smokers had a significantly increased risk of squamous cell carcinoma of the cervix compared to never smokers (RR = 1.60 (95% CI: 1.48,1.73), p<0.001). There was increased risk for past smokers also, though to a lesser extent (RR = 1.12 (1.01,1.25)), and there was no clear trend with time since stopping smoking (p -trend = 0.6). There was no association between smoking and adenocarcinoma of the cervix (RR = 0.89 (0.74,1.06) and 0.89 (0.72,1.10) for current and past smokers respectively), and the differences between the RRs for smoking and squamous cell and adenocarcinoma were statistically significant (current smoking p<0.001 and past smoking p = 0.01). In current smokers, the RR of squamous cell carcinoma increased with increasing number of cigarettes smoked per day and also with younger age at starting smoking (p<0.001 for each trend), but not with duration of smoking (p -trend = 0.3). Eight of the studies had tested women for cervical HPV-DNA, and in analyses restricted to women who tested positive, there was a significantly increased risk in current compared to never smokers for squamous cell carcinoma (RR = 1.95 (1.43,2.65)), but not for adenocarcinoma (RR = 1.06 (0.14,7.96)). In summary, smokers are at an increased risk of squamous cell but not of adenocarcinoma of the cervix. The risk of squamous cell carcinoma increases in current smokers with the number of cigarettes smoked per day and with younger age at starting smoking. © 2005 Wiley-Liss, Inc. [source] Improvement in duration of erection following phosphodiesterase type 5 inhibitor therapy with vardenafil in men with erectile dysfunction: the ENDURANCE studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2009M. T. Rosenberg Summary Objective:, The ENDURANCE study evaluated the efficacy of vardenafil, a phosphodiesterase type 5 (PDE5) inhibitor, in men with erectile dysfunction (ED), by measuring the duration of erection leading to successful intercourse using a stopwatch as the assessment instrument. Methods:, This was a randomised, multicentre, double-blind, placebo-controlled, crossover study consisting of a 4-week treatment-free run-in phase after which patients were randomised to either fixed-dose vardenafil 10 mg or placebo (to be administered 60 min prior to intercourse) and entered the first of the two 4-week double-blind treatment periods, separated by a 1-week washout. The primary efficacy end-point was the stopwatch-assessed duration of erection, which was defined as the time from erection perceived hard enough for penetration until withdrawal from the partner's vagina leading to successful intercourse as measured by Sexual Encounter Profile Question 3 (SEP-3). Secondary efficacy end-points included SEP-2 and SEP-3 success rates, the erectile function domain of the International Index of Erectile Function, global assessment questionnaire, change from baseline in duration of erection and duration of erection not leading to successful intercourse. Safety was assessed by adverse events (AEs), laboratory samples, vital signs and ECGs. Results:, Of the 191 men included in the safety population, 40% had moderate ED and 33% had severe ED at baseline. The duration of erection (least squares mean ± SE) leading to successful intercourse was longer with vardenafil than with placebo (12.81 ± 1.00 min vs. 5.45 ± 1.00 min; p < 0.001). The differences recorded for all secondary end-points were statistically significant in favour of vardenafil compared with placebo (p < 0.001), with the exception of duration of erection not leading to successful intercourse. Vardenafil was well tolerated in this study; the majority of AEs being mild-to-moderate in intensity. Conclusion:, Vardenafil 10-mg therapy provided a statistically superior duration of erection leading to successful intercourse in men with ED compared with placebo. [source] First-dose success with vardenafil in men with erectile dysfunction and associated comorbidities: RELY-IINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2006L. VALIQUETTE Summary First-dose success of phosphodiesterase type 5 (PDE5) inhibitors may be adversely affected in patients with comorbidities. This article reports first-dose success rates for vardenafil 10 mg in men with erectile dysfunction (ED) and associated comorbidities who participated in the challenge phase of the Reliability , Vardenafil for Erectile Dysfunction I study. This study involved an open-label, single-dose, 1-week challenge period where patients who achieved SEP-2 (penetration) success were randomised to vardenafil 10 mg or placebo for 12 weeks in a double-blind manner. The first-dose success rates for SEP-2 and SEP-3 (maintenance of erection to completion of intercourse) were stratified according to comorbidities. Safety was assessed using adverse events (AEs). Of 600 men who received a single 10 mg dose of vardenafil, 32% had hypertension, 16% had diabetes and 19% had dyslipidaemia. Vardenafil demonstrated overall effectiveness, including first-dose SEP-2 and SEP-3 success rates in patients with and without specific comorbidities. Initial overall success rates for SEP-2 and SEP-3 during the challenge phase were 87% and 74% respectively. First-dose SEP-2 and SEP-3 success rates were 84% and 66% in men with hypertension (n = 191); 84% and 72% in men with dyslipidaemia (n = 116); and 75% and 58% in men with diabetes (n = 95). Vardenafil was well tolerated and most AEs, including the most frequently reported flushing (3.5%), were mild to moderate in intensity. Vardenafil 10 mg is generally well tolerated and efficacious, providing first-dose success with a consistently high rate of reliability of penetration and maintenance of erection in men with ED and associated comorbidities. [source] Current concepts in hypospadias surgeryINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2008Yutaro Hayashi Abstract: Anatomical anomalies in hypospadias are an abnormal ventral opening of the urethral meatus, abnormal ventral curvature of the penis and abnormal distribution of the foreskin around the glans with a ventrally deficient hooded foreskin. The techniques of hypospadias surgery continue to evolve. The current standard of care for hypospadias repair includes not only a functional penis adequate for sexual intercourse and urethral reconstruction offering the ability to stand to urinate, but also a satisfactory cosmetic result. Tubularized incised plate repair has been the mainstay for distal hypospadias. In cases of proximal hypospadias, one-stage repairs such as the Duckett repair or the Koyanagi repair have been well established, while two-stage repairs remain important alternatives. Whether dorsal plication or ventral lengthening should be used to correct penile curvature is still controversial, and long-term results are required. Efforts have been made in this decade to improve cosmetic appearance, constructing a slit-like meatus or performing foreskin reconstruction, and to prevent onerous complications. [source] Health-related quality of life and sexual function in women with stress urinary incontinence and overactive bladderINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2008Seung-June Oh Background: We evaluated the impact of stress urinary incontinence (SUI) and overactive bladder (OAB) on health-related quality of life (HRQOL) and sexual function. Methods: A total of 245 women (SUI; n = 123 and OAB; n = 122) from 21 to 79 years old (mean 50.4) were included in the primary analyses. To obtain HRQOL and sexual function assessments, patients were asked to fill in the ,Bristol Female Lower Urinary Tract Symptoms (BFLUTS)' and the ,Medical Outcomes Study Short Form (SF-36)' questionnaires. Results: Of the eight domains in the SF-36 questionnaire, only ,general health' was significantly different between the groups. Patients with SUI had a better general health than those with OAB (P = 0.016). When comparing the BFLUTS scores in the two groups, the score for ,BFLUTS-filling symptoms' was higher in the OAB group (P = 0.002) but that for ,BFLUTS-incontinence symptoms' was higher in the SUI group (P < 0.001). The score for ,BFLUTS-sex' was higher in the SUI group than in the OAB group but this was not statistically significant (P = 0.096). Of the 169 patients who had a sex life, the SUI group had experienced pain (P = 0.033) and leakage (P = 0.056) more frequently during intercourse than the OAB group. Conclusion: Both SUI and OAB have a detrimental impact on patient HRQOL in Korean women. In addition, our findings suggest that women with SUI had more frequently experienced pain during intercourse and coital incontinence than those with OAB. [source] Can sildenafil treat primary premature ejaculation?INTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2007A prospective clinical study Background: Recently, sildenafil has been demonstrated to be effective in treating premature ejaculation (PE). However, these studies ignored female factors and could not exclude the probability of drug interaction when combined with paroxetine. Therefore, the aim of this study was to evaluate the efficacy and safety of sildenafil alone in the treatment of primary PE, taking female factors into consideration. Methods: One hundred and eighty potent men with primary PE were randomly divided into three groups and followed up for 6 months. Group A were treated with 50 mg sildenafil as needed, group B with 20 mg paroxetine daily and group C with squeeze technique daily. Intravaginal ejaculatory latency time (IELT), PE grade, intercourse satisfactory score (ISS), frequency of intercourse, and adverse effects of drugs were recorded before treatment, and 3 and 6 months after treatment. Results: Compared with pretreatment, the three groups had significant differences in all the parameters after 3 or 6 months treatment, except the frequency of intercourse in Group C (all P = 0.00). However, there were no significant differences between 3 and 6 months. Compared with paroxetine and squeeze technique, after 3 or 6 months, sildenafil had significant differences in all the parameters (all P = 0.00). After 6 months, 1.7%, 18.3% and 36.7% patients in groups A, B and C, respectively, withdrew from the study and 86.7%, 60.0% and 45.0% patients, respectively, wanted to be treated further with the original administration, and this was statistically significant (both P = 0.00). Conclusion: Sildenafil is very effective and safe to treat PE, and has much higher efficacy than paroxetine and squeeze technique. [source] Sexual behavior survey and screening for chlamydia and gonorrhea in university students in South KoreaINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2005SEUNG-JU LEE Abstract Background: The purpose of the present study was to define the prevalence of genital Chlamydia trachomatis and Neisseria gonorrhoeae infections and status of sexual risk behavior among university students (18,25 years old) in the capital region of South Korea. Methods: Participants filled out a self-administered questionnaire related to sexuality. First-void urine was analyzed for chlamydial and gonococcal infection by strand displacement amplification (BDProbTecET, BD Diagnostic Systems, MD). Results: A total of 622 students from 15 colleges in three universities took part in the study. The median age was 21 and 39.1% of them reported having sexual intercourse at least once. The prevalence of C. trachomatis among sexually active men and women was 8.4% and 10.6%, respectively. Gonococcal infection was noted in one symptomatic male. Factors significantly associated with infection were the number of sexual partners during past year and lifetime and condom use. Conclusions: This is the first sexually transmitted infection (STI) screening in university students in South Korea. Urine-based STI screening was both feasible and acceptable in university students in South Korea. It should be considered a routine part of programs to control STI nationally. [source] Microsurgical vasoepididymostomy with sperm cryopreservation for future assisted reproductionINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2000Hatsuki Hibi Abstract Background Although obstructive azoospermia is treatable with microscopic seminal reconstruction, the number of patients who choose to undergo vasoepididymostomy is limited because of recent advances in assisted reproductive technology (ART). We attempted to define the outcome of surgical reconstruction in patients with suspected epididymal obstruction and no previous history of vasectomy. Methods We described 40 eligible end-to-side vasoepididymostomy procedures performed on 24 azoospermic patients who had either bilateral or unilateral epididymal obstruction. Results The overall patency rate following surgery was 54% (13/24) and for four patients (17%), natural intercourse resulted in pregnancy. Two pregnancies were initiated with intracytoplasmic sperm injections using frozen sperm collected during vasoepididymostomy. Conclusions In the era of modern ART, microsurgical vasoepididymostomy with cryopreservation of sperm collected during the operation is recommended for patients with epididymal obstructions. [source] | |||||||||||||||||||||||||||||||||||||