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Sexual Contact (sexual + contact)

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Medical Sciences	58%

Selected Abstracts

Sexual activity as a risk factor for hepatitis C

HEPATOLOGY, Issue S1 2002
M.P.H., Norah A. Terrault M.D.
The accumulated evidence indicates that hepatitis C virus (HCV) can be transmitted by sexual contact but much less efficiently than other sexually transmitted viruses, including hepatitis B virus and human immunodeficiency virus (HIV). However, because sex is such a common behavior and the reservoir of HCV-infected individuals is sizable, sexual transmission of HCV likely contributes to the total burden of infection in the United States. Risk of HCV transmission by sexual contact differs by the type of sexual relationship. Persons in long-term monogamous partnerships are at lower risk of HCV acquisition (0% to 0.6% per year) than persons with multiple partners or those at risk for sexually transmitted diseases (0.4% to 1.8% per year). This difference may reflect differences in sexual risk behaviors or differences in rates of exposure to nonsexual sources of HCV, such as injection drug use or shared razors and toothbrushes. In seroprevalence studies in monogamous, heterosexual partners of HCV-infected, HIV-negative persons, the frequency of antibody-positive and genotype-concordant couples is 2.8% to 11% in Southeast Asia, 0% to 6.3% in Northern Europe, and 2.7% in the United States. Among individuals at risk for sexually transmitted diseases (STDs), the median seroprevalence of antibody to HCV (anti-HCV) is 4% (range, 1.6% to 25.5%). HIV coinfection appears to increase the rate of HCV transmission by sexual contact. Current recommendations about sexual practices are different for persons with chronic HCV infection who are in steady monogamous partnerships versus those with multiple partners or who are in short-term sexual relationships. (HEPATOLOGY 2002;36:S99,S105). [source]

Trends of mortality and causes of death among HIV-infected patients in Taiwan, 1984,2005

HIV MEDICINE, Issue 7 2008
C-H Yang
Background The aim of this study was to analyse the trends of mortality and causes of death among HIV-infected patients in Taiwan from 1984 to 2005. Methods Registered data and death certificates for HIV-infected patients from Taiwan Centers for Disease Control were reviewed. Mortality rate and causes of deaths were compared among patients whose HIV diagnosis was made in three different study periods: before the introduction of highly active antiretroviral therapy (HAART) (pre-HAART: from 1 January 1984 to 31 March 1997), in the early HAART period (from 1 April 1997 to 31 December 2001), and in the late HAART period (from 1 January 2002 to 31 December 2005). A subgroup of 1161 HIV-infected patients (11.4%) followed at a university hospital were analysed to investigate the trends of and risk factors for mortality. Results For 10 162 HIV-infected patients with a mean follow-up of 1.97 years, the mortality rate of HIV-infected patients declined from 10.2 deaths per 100 person-years (PY) in the pre-HAART period to 6.5 deaths and 3.7 deaths per 100 PY in the early and late HAART periods, respectively (P<0.0001). For the 1161 patients followed at a university hospital (66.8% with CD4 count <200 cells/,L), HAART reduced mortality by 89% in multivariate analysis, and the adjusted hazard ratio for death was 0.28 (95% confidence interval 0.24, 0.33) in patients enrolled in the late HAART period compared with those in the pre-HAART period. Seventy-six per cent of the deaths in the pre-HAART period were attributable to AIDS-defining conditions, compared with 36% in the late HAART period (P<0.0001). The leading causes of non-AIDS-related deaths were sepsis (14.7%) and accidental death (8.3%), both of which increased significantly throughout the three study periods. Compared with patients acquiring HIV infection through sexual contact, injecting drug users were more likely to die from non-AIDS-related causes. Conclusions The mortality of HIV-infected patients declined significantly after the introduction of HAART in Taiwan. In the HAART era, AIDS-related deaths decreased significantly while deaths from non-AIDS-related conditions increased. [source]

Epidemiology of hepatitis B virus infection in the Asia,Pacific region

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2000
Chien-Jen Chen
There is a wide variation of hepatitis B virus (HBV) infection in the Asia,Pacific region. The prevalence of chronic HBV infection is lowest (< 1%) in North America, Australia and New Zealand, 2,4% in Japan, 5,18% in China and highest (15,20%) in Taiwan as well as several other countries in South East Asia. Perinatal transmission is common in HBV-hyperendemic areas. Geographical clusters of horizontal HBV infection have been reported in both high- and low-risk countries. Common sources of infection, including iatrogenic and sexual transmission, have been implicated. Migrant studies indicate the importance of childhood environments in the determination of HBV infection. Rural,urban and ethnic differences in the prevalence of HBV infection have also been reported. There has been a decrease in the prevalence of HBV infection after mass HBV vaccination programmes in some Asia, Pacific countries, which may be due to the intervention of possible transmission routes through the use of disposable syringes and needles, screening of HBV infection markers in blood banks, and prevention of high-risk tattooing, acupuncture, ear-piercing and sexual contact. A striking decrease in the incidence of HBV infection and hepatocellular carcinoma has been observed among children in Taiwan and other areas where mass vaccination programmes have been implemented. [source]

Change of hepatitis B virus genotypes in acute and chronic infections in Japan

JOURNAL OF MEDICAL VIROLOGY, Issue 11 2008
Mariko Kobayashi
Abstract During 35 years from 1971 to 2005, 153 patients with acute and 4,277 with chronic HBV infection visited the Toranomon Hospital in Tokyo, Japan. They were grouped into seven 5-year periods, and HBV genotypes/subgenotypes were determined. Patients with acute HBV infection were younger (P,=,0.046), predominantly male (P,=,0.004), possessed higher alanine aminotransferase levels (P,<,0.001), positive more frequently for HBeAg (P,<,0.001), and had lower HBV DNA loads (P,=,0.014) than those with chronic infection. Sexual transmission was more frequent in patients with acute than chronic HBV infection (67% vs. 3%, P,<,0.001). The number of patients with acute infection increased throughout 1971,2005. Patients with chronic infection increased since 1971, peaked in 1986,1990 and then decreased. The number of patients increased since 1990,2000 again, however, reflecting recent boost of acute HBV infection. The distribution of HBV genotypes was considerably different between patients with acute and chronic infections (A, B, and C: 28.6%, 10.3%, and 59.5% vs. 3.0%, 12.3%, and 84.5%, respectively, P,<,0.001). Since 1991, genotype A foreign to Japan started to increase sharply in patients with acute infection, and gradually in those with chronic infection. There was a trend for the foreign subgenotype B2/Ba to increase recently (P,<,0.05). Despite immunoprophylaxis of high-risk babies born to carrier mothers with hepatitis B e antigen, implemented nationally since 1986, acute and chronic infections with HBV have been increasing in Japan. Based on genotypes/subgenotypes changing with time, the resurgence of hepatitis B could be attributed to infections, with foreign HBV genotypes/subgenotypes, spreading swiftly by sexual contact. J. Med. Virol. 80:1880,1884, 2008. © 2008 Wiley-Liss, Inc. [source]

Toxoplasma gondii, HCV, and HBV seroprevalence and co-infection among HIV-positive and -negative pregnant women in Burkina Faso

JOURNAL OF MEDICAL VIROLOGY, Issue 6 2006
Jacques Simpore
Abstract Toxoplasma gondii (T. gondii) infections can cause serious complications in HIV-infected pregnant women, leading to miscarriage, stillbirth, birth defects (e.g., mental retardation, blindness, epilepsy etc.) and could favor or enhance the mother-to-child transmission of HCV, HBV, and HIV vertical transmission. From May 20, 2004 to August 3, 2005, 336 18,45 years aged pregnant women, were enrolled for an investigation of the prevalence of serum antibodies against T. gondii, HCV, HBV, and HIV using ELISA. The prevalence of T. gondii, HCV, and HBV in pregnant women was 25.3%, 5.4%, and 9.8%, respectively and the HIV serostatus (61.6%) seems to be associated with greater prevalence rates of both T. gondii (28.5% vs. 20.2%) and HBV (11.6% vs. 7.0%). Without taking into account HIV, only 65.5% (220 of 336) of the women were not infected with these agents. The co-infection rate between HIV-infected and -negative women was different statistically: T. gondii/HBV 0.048 versus 0.015, T. gondii/HCV 0.014 versus 0.008, and HCV/HBV 0.005 versus 0.008, respectively. The elevated co-infection rate in HIV-positive women demonstrated that they are exposed to T. gondii, HCV, and HBV infections prevalently by sexual contact. J. Med. Virol. 78:730,733, 2006. © 2006 Wiley-Liss, Inc. [source]

Induction of dendritic cell-mediated immune responses against HIV-1 by antigen-capturing nanospheres in mice

JOURNAL OF MEDICAL VIROLOGY, Issue 1 2005
Masaki Kawamura
Abstract Prophylactic vaccines, designed to elicit potent humoral and cellular immune responses to human immunodeficiency virus type 1 (HIV-1) antigens in mucosa, are the important approach to the protection of individuals against HIV-1 infection, since HIV-1 transmission is largely a result of sexual contact. In this study, a novel strategy has been developed to induce HIV-1-specific immune responses, which involves inactivated HIV-1-caputring concanavalin A (Con A)-immobilized nanospheres (HIV-NS) and their interaction with bone marrow (BM)-derived dendritic cells. HIV-NS were taken up by dendritic cells via cytoskeleton-dependent but mannose-binding site-independent phagocytosis. Serial stimulations to unprimed T-cells with HIV-1 gp120-capturing NS-pulsed dendritic cells could induce antigen-specific T-cell response. Intranasal administration of fluorescein isothiocyanate-labeled nanospheres (NS) in mice proved that the particles were taken up into pulmonary dendritic cells. Analysis of mice receiving intranasal immunizations with HIV-NS revealed that the mice efficiently induced the antibodies against HIV-1 in the genital tract and specific cytotoxic T-cells in the spleen. These results suggest that the use of HIV-1-NS may provide a novel and promising approach for the induction of humoral and cellular immune responses to HIV-1. J. Med. Virol. 76:7,15, 2005. © 2005 Wiley-Liss, Inc. [source]

Sexual Risk Behavior of Travelers who Consulted a Pretravel Clinic

JOURNAL OF TRAVEL MEDICINE, Issue 1 2008
Mieke Croughs MD
Objective The objective of this study was to determine to which degree travelers who received pretravel advice at a travel clinic have protected or unprotected sexual contact with a new partner and what factors influence this behavior. Method An anonymous questionnaire was sent to travelers who came to a pretravel clinic between June 1 and August 31, 2005. Risk factors for casual travel sex and predictors of protected sex were studied in a multivariate model. Results A total of 1,907 travelers were included (response rate 55%) in the study. Only 4.7% of the respondents had sexual contact with a new partner, and 63.1% of these new partners were from the country of destination. Of those who had casual travel sex, 52.4% did not expect this (women 75%), 30.9% did not always use condoms, and 41% were not protected against hepatitis B. Independent risk factors for casual travel sex were traveling without steady partner (OR 14.4), expecting casual travel sex (OR 9.2), having casual sexual contacts in the home country (OR 2.4), non-tourist journeys (OR 2.2), being male (OR 2.1), the fact that the information on sexually transmitted infections (STI) had been read (OR 2.0), and traveling to South and Central America (OR 2.0). Taking condoms along (OR 5.4) and reading the information on STI (OR 3.3) were identified as independent predictors of protected sex. Conclusions Travelers have substantial sexual risk behavior. Casual sex is usually not expected, and the most important predictor is traveling without a steady partner. We would advice every client of a travel clinic who will travel without a steady partner to read the STI information, to take condoms along, and to be vaccinated against hepatitis B. [source]

Age of Minority Sexual Orientation Development and Risk of Childhood Maltreatment and Suicide Attempts in Women

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 4 2009
Heather L. Corliss MPH
Women with minority sexual orientations (e.g., lesbian, bisexual) are more likely than heterosexual women to report histories of childhood maltreatment and attempted suicide; however, the importance of the timing of minority sexual orientation development in contributing to this increased risk is uncertain. This study investigated relationships between self-reported ages of achieving minority sexual orientation development milestones (first awareness of same-gender attractions, disclosure of a minority sexual orientation to another person, and same-gender sexual contact), and childhood maltreatment and suicide attempt experiences in a sample of 2, 001 women recruited from multiple-community sources. Younger age of minority sexual orientation development milestones was positively linked to self-reported recall of childhood maltreatment experiences, and to a childhood suicide attempt. After adjusting for differences in maltreatment, the odds of suicide attempt attributable to younger age of sexual orientation development milestones was reduced by 50 to 65%, suggesting that maltreatment may account for about half of the elevated risk for childhood suicide attempts among women with early minority sexual orientation development. Implications for services, interventions, and further research to address maltreatment disparities for sexual minorities are discussed. [source]

Epidemiology of recurrent respiratory papillomatosis

APMIS, Issue 6-7 2010
DANIEL A. LARSON
Larson DA, Derkay CS. Epidemiology of recurrent respiratory papillomatosis. APMIS 2010; 118: 450,454. Recurrent respiratory papillomatosis (RRP) was first described in the 1800s, but it was not until the 1980s when it was convincingly attributed to human papilloma virus (HPV). RRP is categorized into juvenile onset and adult onset depending on presentation before or after the age of 12 years, respectively. The prevalence of this disease is likely variable depending on the age of presentation, country and socioeconomic status of the population being studied, but is generally accepted to be between 1 and 4 per 100 000. Despite the low prevalence, the economic burden of RRP is high given the multiple procedures required by patients. Multiple studies have shown that the most likely route of transmission of HPV in RRP is from mother to child during labor. Exceptions to this may include patients with congenital RRP who have been exposed in utero and adult patients who may have been exposed during sexual contact. Although cesarean section may prevent the exposure of children to the HPV virus during childbirth, its effectiveness in preventing RRP is debatable and the procedure itself carries an increased risk of complications. The quadrivalent HPV vaccine holds the most promise for the prevention of RRP by eliminating the maternal reservoir for HPV. [source]

Commentary on Intrapersonal, Interpersonal, and Contextual Factors in Extramarital Involvement

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 2 2005
K. Daniel O'Leary
Extramarital Involvements (EMIs) attract significant societal attention, as exemplified by the revelation of former President Clinton's EMI. Depression, anxiety, and divorce are important sequelae of EMIs, though it will be important to learn which couples successfully cope with EMIs. Allen et al. (this issue) provide an excellent overview of the prevalence of EMIs and the problems in trying to ascertain accurate estimates thereof. The impact of a very close relationship even without explicit sexual contact was noted, and Allen et al. present a useful framework for organizing theoretical positions and data on EMIs. It is an excellent review for a clinician or researcher addressing EMIs. [source]

Network of sexual contacts and sexually transmitted HIV infection in Burkina Faso

JOURNAL OF MEDICAL VIROLOGY, Issue 6 2006
Vito Latora
Abstract Two thirds of the people who have been infected by human immunodeficiency virus (HIV) in the world live in Sub-Saharan African countries. The results of a study measuring the degree distribution of the network of sexual contacts in Burkina Faso are described. Such a network is responsible for the spread of sexually transmitted diseases, and in particular of HIV. It has been found that the number of different sexual partners reported by males is a power law distribution with an exponent ,,=,2.9 (0.1). This is consistent with the degree distribution of scale-free networks. On the other hand, the females can be divided into two groups: the prostitutes with an average of 400 different partners per year, and females with a stable partner, having a rapidly decreasing degree distribution. Such a result may have important implications on the control of sexually transmitted diseases and in particular of HIV. Since scale-free networks have no epidemic threshold, a campaign based on prevention and anti-viral treatment of few highly connected nodes can be more successful than any policy based on enlarged but random distribution of the available anti-viral treatments. J. Med. Virol. 78:724,729, 2006. © 2006 Wiley-Liss, Inc. [source]

Sexual Risk Behavior of Travelers who Consulted a Pretravel Clinic

Intrafamilial transmission of hepatitis C virus: a systematic review

JOURNAL OF VIRAL HEPATITIS, Issue 2 2000
Ackerman
To examine the risk of hepatitis C virus (HCV) transmission between patients infected with HCV and their household members (siblings, offspring and parents), as well as their stable heterosexual partners, a systematic search of the MEDLINE database was undertaken for all relevant articles published up to June 1997. English language publications or those supplemented with an English abstract that reported studies concerning hepatitis C, and household, intrafamilial, sexual and intraspousal transmission of HCV, were reviewed. Data from uncontrolled and controlled studies were collected and analysed separately. Studies reporting the exclusive use of first-generation anti-HCV antibodies without supplemental tests were excluded. Pre- or postnatal mother-to-child transmission of HCV and homosexual and heterosexual transmission of HCV among non-permanent couples were not included. Unweighted data from individual studies were pooled for each category of family member. Data were also analysed separately for Japanese and non-Japanese studies because there is evidence that intrafamilial transmission may differ, based on endemicity of the viral infection. Comparisons were drawn only from controlled studies that reported the prevalence of HCV in family members of both HCV-positive and HCV-negative controls. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for each family category. In uncontrolled studies, the pooled prevalence of anti-HCV among 4250 stable sexual contacts of patients with HCV-related chronic liver disease (CLD) was 13.48%, while the pooled prevalence of anti-HCV among 580 stable sexual contacts of patients who contracted HCV as a result of multiple transfusions was 2.41%. In controlled studies, the pooled prevalence of anti-HCV among 175 siblings and household contacts of patients with CLD was 4.0% compared with 0% among 109 contacts of anti-HCV-negative controls (OR 9.75, 95% CI 0.91 ad infinitum). The pooled prevalence of anti-HCV among offspring of Japanese HCV-infected CLD patients was 17% compared with 10.4% among offspring of HCV-negative Japanese controls (OR 1.77, 95% CI 1.21,2.58, P=0.002). The pooled prevalence of anti-HCV among spouses of non-Japanese HCV-infected CLD patients was 15.2% compared with 0.9% in the spouses of non-Japanese HCV-negative controls (OR 20.57, 95% CI 6.05,84.08, P=0.0001). The prevalence of anti-HCV among non-Japanese offspring and Japanese spouses of HCV-infected patients was not increased compared with controls. HCV genotype homology and mutant analysis studies in pairs of HCV-infected patients and their HCV-infected contacts showed that concordant genotype homology was found in 66% of non-sexual contacts and in 74% of sexual contacts. Sequence homology of greater than 92% was found in 19 out of 35 pairs. Hence, evidence exists that familial, non-sexual and sexual transmission of HCV does occur. In Japanese patients, transmission probably occurs in younger family members while, in non-Japanese patients, transmission probably occurs at an older age, after contact with an HCV-infected spouse. [source]

The Fourteenth-Century Verse Novella Dis ist von dem Heselin: Eroticism, Social Discourse, and Ethical Criticism

ORBIS LITERARUM, Issue 4 2005
Albrecht Classen
Late-medieval German literature offers many highly intriguing examples of erotic narratives structured and motivated in the manner of the fabliaux and novelle. One of these maeren, Dis ist von dem Heselin, composed sometime around 1300, presents an account of a tryst between a naive peasant maid and a young knight who barters a hare for her love. The narrative lives from the charming contrast between this young woman's ignorance of the true meaning of the word minne, or ,courtly love,' and the moral decline of the nobility. Whereas she freely and openly grants her love to the knight and later tells everything to her mother, who severely punishes her for her seeming stupidity, the knight's noble fiancée proves to be highly cynical and morally untrustworthy. Mocking the peasant maid during the wedding celebration and emphasizing her own intelligent behavior in hiding her numerous sexual contacts with the family's chaplain, she deeply shocks her fiancé, who then quickly changes the marriage arrangements and takes the peasant maid as his wife. The maid triumphs over the noble lady because of her simplicity, trustworthiness, and true love for the knight. Her moral infraction is easily forgiven because of her ignorance and naiveté, whereas her highly respected competitor for the knight's hand loses because she knows nothing of true love and morality. [source]