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Sexually Transmitted Diseases (sexually + transmitted_diseases)
Kinds of Sexually Transmitted Diseases Selected AbstractsCandida balanitis: risk factorsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 7 2010C Lisboa Abstract Background, The amount of available information on the prevalence and incidence of candida balanitis is still surprisingly scarce. Objectives, To determine the prevalence of candida colonization and candida balanitis in men attending a Sexually Transmitted Diseases (STD) clinic. To identify risk factors associated with candida balanitis. Methods, During a 36-month period, a cross-sectional study was carried out on consecutive men attendees of the STD clinic in Hospital S. João, Porto. Clinical and epidemiological data were recorded. Specimen collection from the glans penis and the coronal sulcus followed two procedures: a cotton tipped swab and the direct impression on the surface of CHROMagar Candida medium. Risk factors were considered singly and in combination through logistic regression models. Results, Among 478 men enrolled, the prevalence of candida colonization was 26.2% and the prevalence of candida balanitis was 18%. Candida colonization was strongly associated with an age above 60 years (OR = 3.375; 95% CI: 1.547,7.362) and with the presence of other cause of balanitis apart from Candida organisms (OR: 2.466; 95% CI: 1.491,4.078). An age above 40 years (OR: 2.27; 95% CI: 1.005,4.500), diabetes mellitus (OR: 19.390; 95% CI: 7.789,48.273) and more than ten candida colonies recovered by culture (OR: 9.586; 95% CI: 2.682,34.263) were risk factors for candida balanitis. Conclusions, This study highlights the impact of factors other than sexual behaviours upon the epidemiology of this infection. For both candida colonization and infection, age was an important risk factor. Diabetes mellitus was an independent risk factor for candida balanitis. More than ten colonies recovered from culture are associated with clinical signs and symptoms. [source] Sexually Transmitted Diseases Diagnosed Among Travelers Returning from the TropicsJOURNAL OF TRAVEL MEDICINE, Issue 2 2009Séverine Ansart MD Objectives Data are lacking on the spectrum of sexually transmitted diseases (STDs) diagnosed in returning travelers. Study Design All consecutive travelers consulting our tropical unit between November 1, 2002 and October 31, 2003 were included if they presented within 1 month after their return from the tropics, with mucocutaneous signs suggesting STDs. Results Forty-nine patients (12 women and 37 men; median age 36.4 y, 35 heterosexuals) were included. Four patients had traveled with their usual sexual partner and 45 patients had casual sex while abroad (31 with locals and 14 with other tourists). The main diagnoses were gonococcal urethritis (n = 18), herpes simplex virus 2 infection (n = 12), urethritis of undetermined origin (n = 9), Chlamydia trachomatis infection (n = 4), primary syphilis (n = 4), and primary human immunodeficiency virus infection (n = 2). Conclusions These results illustrate the broad spectrum of STDs contracted by travelers to the tropics. They suggest the need to also inform travelers of the risks of STD and to promote the use of condoms in case of casual sex while abroad. [source] Implications of Racial and Gender Differences In Patterns of Adolescent Risk Behavior for HIV And Other Sexually Transmitted DiseasesPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 6 2004Carolyn Tucker Halpern CONTEXT: Sexual and substance use behaviors covary in adolescence. Prevalence of HIV and other sexually transmitted diseases (STDs) differs according to race and gender, yet few studies have systematically investigated risk behavior patterns by subgroup, particularly with nationally representative data. METHODS: A priori considerations and K-means cluster analysis were used to group 13,998 non-Hispanic black and white participants in the National Longitudinal Study of Adolescent Health, Wave 1, according to self-reported substance use and sexual behavior. Multinomial logit analyses examined racial and gender differences by cluster. RESULTS: Among 16 clusters, the two defined by the lowest risk behaviors (sexual abstinence and little or no substance use) comprised 47% of adolescents; fewer than 1% in these groups reported ever having received an STD diagnosis. The next largest cluster,characterized by sexual activity (on average, with one lifetime partner) and infrequent substance use,contained 15% of participants but nearly one-third of adolescent with STDs. Blacks were more likely than whites to be in this group. Black males also were more likely than white males to be in three small clusters characterized by high-risk sexual behaviors (i.e., having had sex with a male or with at least 14 partners, or for drugs or money). Black females generally were the least likely to be in high-risk behavior clusters but the most likely to report STDs. CONCLUSIONS: Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed. [source] Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates, 2000PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2004Hillard Weinstock CONTEXT In the United States, young people aged 15,24 represent 25% of the sexually experienced population. However, the incidence and prevalence of sexually transmitted diseases (STDs) among this age-group are unknown. METHODS Data from a variety of sources were used to estimate the incidence and prevalence of STDs among 15,24-year-olds in the United States in 2000. The quality and reliability of the estimates were categorized as good, fair or poor, depending on the quality of the data source. RESULTS Approximately 18.9 million new cases of STD occurred in 2000, of which 9.1 million (48%) were among persons aged 15,24. Three STDs (human papillomavirus, trichomoniasis and chlamydia) accounted for 88% of all new cases of STD among 15,24-year-olds. CONCLUSIONS These estimates emphasize the toll that STDs have on American youth. More representative data are needed to help monitor efforts at lowering the burden of these infections. [source] SEXUALLY TRANSMITTED DISEASE AND THE EVOLUTION OF MATING SYSTEMSEVOLUTION, Issue 6 2002Hanna Kokko Abstract ., Sexually transmitted diseases (STDs) have been shown to increase the costs of multiple mating and therefore favor relatively monogamous mating strategies. We examine another way in which STDs can influence mating systems in species in which female choice is important. Because more popular males are more likely to become infected, STDs can counteract any selective pressure that generates strong mating skews. We build two models to investigate female mate choice when the sexual behavior of females determines the prevalence of infection in the population. The first model has no explicit social structure. The second model considers the spatial distribution of matings under social monogamy, when females mated to unattractive males seek extrapair fertilizations from attractive males. In both cases, the STD has the potential to drastically reduce the mating skew. However, this reduction does not always happen. If the per contact transmission probability is low, the disease dies out and is of no consequence. In contrast, if the transmission probability is very high, males are likely to be infected regardless of their attractiveness, and mating with the most attractive males imposes again no extra cost for the female. We also show that optimal female responses to the risk of STDs can buffer the prevalence of infection to remain constant, or even decrease, with increasing per contact transmission probabilities. In all cases considered, the feedback between mate choice strategies and STD prevalence creates frequency-dependent fitness benefits for the two alternative female phenotypes considered (choosy vs. randomly mating females or faithful vs. unfaithful females). This maintains mixed evolutionarily stable strategies or polymorphisms in female behavior. In this way, a sexually transmitted disease can stabilize the populationwide proportion of females that mate with the most attractive males or that seek extrapair copulations. [source] The Reproductive Health of Young people in Côte d'Ivoire: Issues and ProspectsINTERNATIONAL SOCIAL SCIENCE JOURNAL, Issue 164 2000Aminata Touré In Côte d'Ivoire, young people aged between 14 and 24 represent 25% of the population, and this is the age group that is particularly vulnerable to reproductive health problems. Sexually transmitted diseases and AIDS in the main affect 15 to 18-year-olds; the early pregnancy rate is high; and the widespread recourse to illegal abortion by women at an increasingly young age reflects the emergence of an unfilled need for family planning services among the young. To cope with this situation, the Côte d'Ivoire authorities have adopted several strategies, which include launching wide-ranging information campaigns and making condoms generally available. However, over and beyond such actions, which are beginning to bear fruit, it seems that particular attention needs to be focused on young people not at school and on girls, whose social status is low. The promotion of equality between the sexes and the legalisation of abortion could give added force to strategies to promote the reproductive health of young people. [source] Sexual Practices, Risk Perception and Knowledge Of Sexually Transmitted Disease Risk Among Lesbian and Bisexual WomenPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 1 2005Jeanne M. Marrazzo CONTEXT: Sexually transmitted diseases (STDs) can be spread between female sex partners, probably through the exchange of cervicovaginal fluid and direct mucosal contact. Additionally, lesbians have a high prevalence of bacterial vaginosis, which may represent an STD in this population. However, few data on sexual practices or perceived STD risk among lesbians are available to guide development of interventions aimed at reducing the risk. METHODS: To inform the development of a safer-sex intervention for women who have sex with women, focus group discussions were conducted with 23 lesbian and bisexual women aged 18,29. Topics included sexual practices, STD transmission and prevention, and knowledge about bacterial vaginosis. RESULTS: Although six participants had had bacterial vaginosis and three an STD, women reported little use of preventive measures with female partners (washing hands, using rubber gloves and cleaning sex toys). Participants said that vaginal penetrative practices using sex toys and fingers or hands are common, and that partners frequently share sex toys during a sexual encounter, generally without condoms. Knowledge of potential for STD transmission between women, and of bacterial vaginosis, was limited. Participants viewed use of barrier methods (gloves or condoms) as acceptable, provided that there is a reason (usually STD-focused) to use them and that they are promoted in the context of sexual health and pleasure. CONCLUSIONS: Safer-sex messages aimed at lesbian and bisexual women should emphasize the plausibility of STD transmission between women, personal responsibility and care for partners' well-being; should target common sexual practices; and should promote healthy sexuality. [source] Vulval disease in pre-pubertal girlsAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 4 2001Gayle O Fischer SUMMARY Children present with vulval complaints less frequently than do adults; although there are many similarities between paediatric and adult groups of patients with vulval disease, there are also important differences. In both groups, dermatitis, psoriasis and lichen sclerosus are the most frequently seen dermatoses. Birthmarks and congenital abnormalities presenting for the first time are more of an issue in children than in adults. Fusion of the labia and streptococcal vulvovaginitis are conditions seen only in the paediatric group. Sexually transmitted diseases such as genital warts and genital herpes are not common in this group and should always raise the possibility of child sexual abuse. Chronic vulvovaginal candidiasis, although a very common problem in adult patients, is not seen in the prepubertal group. [source] Sexually transmitted diseases of insects: distribution, evolution, ecology and host behaviourBIOLOGICAL REVIEWS, Issue 3 2004Robert J. Knell ABSTRACT Sexually transmitted diseases (STDs) of insects are known from the mites, nematodes, fungi, protists and viruses. In total 73 species of parasite and pathogen from approximately 182 species of host have been reported. Whereas nearly all vertebrate STDs are viruses or bacteria, the majority of insect STDs are multicellular ectoparasites, protistans or fungi. Insect STDs display a range of transmission modes, with, pure'sexual transmission only described from ectoparasites, all of which are mites, fungi or nematodes, whereas the microparasitic endo-parasites tend to show vertical as well as sexual transmission. The distribution of STDs within taxa of insect hosts appears to be related to the life histories of the hosts. In particular, STDs will not be able to persist if host adult generations do not overlap unless they are also transmitted by some alternative route. This explains the observation that the Coleoptera seem to suffer from more STDs than other insect orders, since they tend to diapause as adults and are therefore more likely to have overlapping generations of adults in temperate regions. STDs of insects are often highly pathogenic, and are frequently responsible for sterilizing their hosts, a feature which is also found in mammalian STDs. This, combined with high prevalences indicates that STDs can be important in the evolution and ecology of their hosts. Although attempts to demonstrate mate choice for unin-fected partners have so far failed it is likely that STDs have other effects on host mating behaviour, and there is evidence from a few systems that they might manipulate their hosts to cause them to mate more frequently. STDs may also play a part in sexual conflict, with males in some systems possibly gaining a selective advantage from transmitting certain STDs to females. STDs may well be important factors in host population dynamics, and some have the potential to be useful biological control agents, but empirical studies on these subjects are lacking. [source] Results of longterm hospital based cytological screening in asymptomatic womenDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2006Jata S. Misra Ph.D., M.I.A.C. Abstract Routine cytological screening has been carried out in 27,062 asymptomatic women attending Gynaec and Family Planning O.P.D. of Queen Mary's Hospital, Lucknow, India (April 1971,December 2004). Incidence of squamous intraepithelial lesion (SIL) was found to be 5.9% in the series, while cervical malignancy was seen in 0.6% of cases. The study highlighted the immense utility of cytological screening in minimizing the incidence of carcinoma cervix in the segment of the urban population screened, as the incidence dropped down to 0.5% in the second half from 1.1% noticed in the first half of the screening period. The study also emphasized the utility of clinically downstaging the cervical cancer as 7,316 women showing clinical lesions of cervix were found to harbor SIL in 15.3% and carcinoma cervix in 1.3% of cases as against the incidence of 2.5% for SIL and 0.6% for frank cancer in women with normal cervix. The investigation into different risk factors involved in cervical carcinogenesis revealed that the incidence of SIL and cancer cervix showed a rise with increasing age and parity and prolonged sexual period. The incidences of both cervical cytopathologies were also higher in women of low socio-economic status while religion was found to have no bearing on the occurrence of the disease. Among the four sexually transmitted diseases (STDs) diagnosed in the cervical smears, Trichomonas vaginalis was found to be more prevalent (2.6%), while human papillomavirus (HPV) and Herpes simplex was seen in 0.4 and 0.2% of cases, respectively Herpes simplex was found to have strong affinity with both SIL and carcinoma cervix, while only SIL incidence was high with HPV infection. The study emphasizes need of proper education to women of low socio-economic class for creating awareness regarding hazards and risk factors of cervical cancer as well as management and cure of the disease. Diagn. Cytopathol. 2006;34: 184,187. © 2006 Wiley-Liss, Inc. [source] Lifetime multiple substance use pattern among heroin users before entering methadone maintenance treatment clinic in Yunnan, ChinaDRUG AND ALCOHOL REVIEW, Issue 4 2010LEI LI Abstract Introduction and Aims. Multiple substance use leads to greater levels of psycho-behavioural problems, unsafe sex, and therefore a high risk of contracting sexually transmitted diseases, and is also more difficult to treat. This study aims to determine pattern of lifetime multiple substance use among Chinese heroin users before entering methadone maintenance treatment clinic. Design and Methods. A survey to obtain retrospective longitudinal data on lifetime multiple substance use was conducted among 203 heroin users in two of the biggest methadone maintenance clinics in Kunming City, Yunnan province. Results. All participants used more than one substance in their lifetime. Most of them used four or more substance groups (range two to seven groups). The most common substance patterns in lifetime use were alcohol, tobacco, opiates and depressants. Approximately 80% of them had a history of simultaneous substance use (co-use). The most common combination of co-use pattern was heroin with depressant. Common reasons for co-use were to get high, to experiment, to sleep and to increase the potency of other drugs. Determinants of co-use were education, marital status and family relationship. Discussion and Conclusions. Multiple substance use is highly prevalent among Chinese heroin users. Depressants are the most common substances used in combination with heroin.[Li L, Sangthong R, Chongsuvivatwong V, McNeil E, Li J. Lifetime multiple substance use pattern among heroin users before entering methadone maintenance treatment clinic in Yunnan, China. Drug Alcohol Rev 2010] [source] PROMISCUITY AND THE RATE OF MOLECULAR EVOLUTION AT PRIMATE IMMUNITY GENESEVOLUTION, Issue 8 2010Gabriela Wlasiuk Recently, a positive correlation between basal leukocyte counts and mating system across primates suggested that sexual promiscuity could be an important determinant of the evolution of the immune system. Motivated by this idea, we examined the patterns of molecular evolution of 15 immune defense genes in primates in relation to promiscuity and other variables expected to affect disease risk. We obtained maximum likelihood estimates of the rate of protein evolution for terminal branches of the primate phylogeny at these genes. Using phylogenetically independent contrasts, we found that immunity genes evolve faster in more promiscuous species, but only for a subset of genes that interact closely with pathogens. We also observed a significantly greater proportion of branches under positive selection in the more promiscuous species. Analyses of independent contrasts also showed a positive effect of group size. However, this effect was not restricted to genes that interact closely with pathogens, and no differences were observed in the proportion of branches under positive selection in species with small and large groups. Together, these results suggest that mating system has influenced the evolution of some immunity genes in primates, possibly due to increased risk of acquiring sexually transmitted diseases in species with higher levels of promiscuity. [source] Sexual activity as a risk factor for hepatitis CHEPATOLOGY, Issue S1 2002M.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] 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] Cigarette smoking, sexually transmitted diseases, and HIV/AIDSINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2000Ronni Wolf MD First page of article [source] Acute urethritis caused by Neisseria meningitidisINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2003NORIYUKI KANEMITSU Abstract A 48-year-old heterosexual Japanese man visited the outpatient clinic of Nagoya Urology Hospital, complaining of burning pain at voiding and pus discharge from the urethral orifice. These symptoms appeared the day following oral-genital contact (fellatio) with a commercial sex worker. On the basis of the presumptive clinical diagnosis of gonorrhea because of the microscopic detection of diplococci in the urethral discharge, he was treated with levofloxacin (300 mg per day) for 7 days. His symptoms responded quickly and urinalysis taken 7 days later was normal. Microbiological examinations isolated Neisseria meningitidis in the urethral discharge by culture with the use of enzymatic profiles. Further prevalence of sexually transmitted diseases (STD) through oral-genital contact would lead to an increase in meningococcal urethritis. [source] Risk and protective behaviours of bisexual minority women: a qualitative analysisINTERNATIONAL NURSING REVIEW, Issue 2 2005J. D. Champion phd Background, Public health messages urging women to seek health care services such as sexually transmitted diseases (STD) and cervical cancer screening or family planning services fail to address women who have sex with women (WSW). This negligence may have led to a false sense of security amongst WSW concerning sexual risk behaviour. Research has shown that WSW engaged in more high-risk sexual behaviours than heterosexual women. WSW has been identified as an important vector in the spread of STDs in all populations because of bisexuality. To prevent and reduce transmission of STDs amongst WSW, perceptions of risk for STD amongst WSW need to be understood so that effective interventions may be developed. Aim, To describe the relationship between sexual risk and protective behaviour and STD transmission amongst bisexual minority women with a history of STD. Methods, Life history methods were used to interview 23 African-American bisexual women with a history of STD. Findings, Various themes unfolded during analysis of the patient interviews, including bisexual women's perceptions of STD risk, the context of sexual relationships with women and STD prevention, screening, and treatment practices. Conclusions, The contexts of sexual relationships including multiple or concurrent partner relationships with both men and women placed these women at high risk for STD. Regardless of the type of relationship or belief it is possible to get an STD, protection was often not used. These circumstances identify an extremely high-risk population of women with need for more extensive research to identify strategies for health care interventions. [source] Host reproduction and a sexually transmitted disease: causes and consequences of Coccipolipus hippodamiae distribution on coccinellid beetlesJOURNAL OF ANIMAL ECOLOGY, Issue 1 2004K. Mary Webberley Summary 1We know that sexually transmitted parasites and pathogens have extremely deleterious effects in human and domesticated animal populations, but know little of sexually transmitted diseases (STDs) in natural populations. 2One previously reported natural system is the sexually transmitted mite, Coccipolipus hippodamiae, on the eastern European coccinellid, Adalia bipunctata. Our aims were to determine how widespread this parasite is in terms of incidence and prevalence across host species, to identify the causes of the prevalence pattern and whether the parasite reduces fertility in all host species. 3Coccipolipus hippodamiae was present on four of 19 European species examined. The wide distribution and high prevalence of C. hippodamiae on A. bipunctata indicates that this is the major host. The mite was also present at substantial prevalence on Adalia decempunctata and at lower prevalence on Synharmonia (=Oenopia) conglobata and Calvia quatuordecimguttata. 4Laboratory studies on mite development time and transmission efficiency revealed that although physiological factors may affect incidence, they do not explain prevalence variation between hosts, but characteristics of host life history and reproductive behaviour are important in this context. Adalia bipunctata is more promiscuous than the less commonly infected A. decempunctata and S. conglobata. Diapause is needed before breeding will occur in C. quatuordecimguttata, leading to a lack of the consistent sexual activity between generations, which is needed for STD maintenance. Calvia quatuordecimguttata is probably periodically reinfected through hybrid matings with other host species. 5Coccipolipus hippodamiae infection has similar strong deleterious effects on female reproduction in A. decempunctata and S. conglobata as have previously been demonstrated in A. bipunctata. 6The results indicate that STDs may play a profound role in the ecology of promiscuous insect populations with overlapping generations. Here they may reach significant prevalence whilst exhibiting extreme virulence. [source] Blurring Emotional Safety With Physical Safety in AIDS and STD Risk Estimations: The Casual/Regular Partner Distinction,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 12 2000Lisa K. Comer Research on the sexual behavior of young adults has documented a casual/regular partner distinction in terms of condom use and perceived risk of contracting sexually transmitted diseases (STDs). How this population distinguishes between the 2 partner types has not been known, making it impossible to assess the rationality of this strategy. In the present study, college students' conceptions of casual vs. regular partners were explored and used to create 3 sexual partner scenarios: casual, regular with insufficient risk information (regular emotionally safe), and regular with sufficient risk information (regular objectively safe). Participants rated the target partner in terms of emotional safety, AIDS/STD risk, and likelihood of condom use. Results showed participants to be blurring emotional with physical safety; i. e., employing an emotionally based strategy in rating perceived risk. [source] HIV prevention for people with serious mental illness: a survey of mental health workers' attitudes, knowledge and practiceJOURNAL OF CLINICAL NURSING, Issue 4 2009Elizabeth Hughes Aim., The aim of this survey was to investigate the attitudes, knowledge and reported practice (capabilities) of mental health workers concerning humanimmunodeficiency virus (HIV) and other sexually transmitted diseases in people with serious mental illness. Background., People with serious mental illness are at increased risk of HIV and other sexually transmitted infections. Mental health workers have a key role to play in promoting sexual health in this population, but it is unclear how they perceive their role in this work and whether they have the capabilities to deliver sexual health promotion. Design., Cross sectional survey. Methods., A questionnaire was devised and distributed to 650 mental health workers working in a London (UK) NHS mental health service. Results., A response rate of 44% was achieved. Overall, workers reported positive attitudes to sexual health promotion and were knowledgeable about risk behaviours and risk factors for HIV infection. Adherence to glove wearing was good. However, participants' knowledge about HIV/AIDS in people with schizophrenia was poor and most reported they were not engaged in sexual health promotion activities with people with serious mental illness. Glove wearing was predicted by those who had drug and alcohol training and clinical experience and knowledge of risk factors was predicted by previous health promotion training. No other demographic factors predicted any of the other subscales. Conclusion., Mental health workers require training to provide skills for health promotion regarding sexual health and HIV in people with serious mental health problems. In addition, there needs to be more research on risk behaviours. Relevance to clinical practice., The development of effective interventions to reduce this behaviour. [source] Maximized virulence in a sterilizing pathogen: the anther-smut fungus and its co-evolved hostsJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 6 2008D. B. SLOAN Abstract Host sterilization is a common feature of sexually transmitted diseases (STDs). Because host reproductive failure may free up resources for pathogen reproduction and transmission, theory predicts that selection on sterilizing pathogens will favour maximum virulence (i.e. complete sterilization). We examined patterns of infection in sexually transmitted anther-smut fungi (Microbotryum) on four of their host species in the Caryophyllaceae. Using controlled fungal matings and experimental inoculations, we compared disease expression in inoculations ranging from host-specific pathogens to hybrids and cross-species treatments. Our data support the existence of host-specific sibling species within the genus Microbotryum based on a low infection rate from cross-inoculations and reduced fitness for hybrid pathogens. These patterns of host specificity and reproductive isolation, however, were not absolute. We did observe some successful cross-species and hybrid infections, but the expression of disease was frequently incomplete, including only partial host sterilization and the failed dehiscence of pathogen spores. The prevalence of these maladapted disease phenotypes may greatly inhibit the emergence of novel host pathogen combinations. Infections by hybrid pathogen genotypes were intermediate, in terms of both infection rate and the normality of disease symptoms, between host-specific and cross-inoculated pathogens. In addition, the frequency with which hybrid and cross-inoculated anther-smut pathogens were able to infect but not sterilize new hosts supports the prediction that sterilizing STDs are under selection to maximize virulence in natural populations. [source] Seroprevalence, risk factors, and hepatitis C virus genotypes in groups with high-risk sexual behavior in CroatiaJOURNAL OF MEDICAL VIROLOGY, Issue 8 2009Tatjana Vilibic Cavlek Abstract The seroprevalence, risk factors and genotypes of hepatitis C virus (HCV) in groups with high-risk sexual behavior (persons with multiple sexual partners, men who have sex with men, commercial sex workers and their clients and persons with sexually transmitted diseases) in seven Croatian cities were analyzed. A total of 821 participants without history of injecting drug use were included in the study. Anti-HCV prevalence among risk groups varied from 2.9% to 8.5% with an overall prevalence of 4.6% (95% CI,=,3.2,6.1) compared with 0.5% (95% CI,=,0.0,1.5) in controls (pregnant females; OR,=,9.66; 95% CI,=,1.32,70.7). HCV-RNA was detected in 73.1% anti-HCV positive patients. Three of the seronegative cases (2.1%) were also found to be HCV-RNA positive ("window period"). Genotype 1 was most commonly detected (55.6%). The most prevalent subtypes were 1a (38.9%) and 3a (38.9%). Sociodemographic characteristics (age, gender, marital status and level of education) were not associated with anti-HCV seropositivity. Among sexually transmitted disease markers, a higher seroprevalence of HCV infection was found in subjects with a history of HBV infection (10.5% vs. 3.8%, P,=,0.002) and gonorrhea (13.2% vs. 4.2%, P,=,0.011). No other factors reflecting risk sexual behavior such as sexual orientation, number of sexual partners and number of risk behaviors were associated with HCV seroprevalence. J. Med. Virol. 81:1348,1353, 2009. © 2009 Wiley-Liss, Inc. [source] Network of sexual contacts and sexually transmitted HIV infection in Burkina FasoJOURNAL OF MEDICAL VIROLOGY, Issue 6 2006Vito 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 Protective Strategies of Late Adolescent Females: More Than Just CondomsJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2001M. Katherine Hutchinson RN Objective: To identify the sexual protective strategies of late adolescent heterosexual women. Design: Open-ended questioning regarding sexual protective strategies was included in a larger cross-sectional survey on sexual risk. Participants' responses were recorded verbatim and analyzed using content analysis. Participants: 234 African American, Hispanic/Latina, and non-Hispanic white 19- to 21-year-old females were recruited from the driver's license records of a mid-Atlantic state. Main Outcome Measures: Participants re-1 to the on-ended question, "How or what do you do to reduce your risk for sexually transmitted diseases and HIV?" Results: Seven primary sexual protective strategies were identified from participants' responses: using condoms, abstaining or postponing sexual intercourse, getting tested for human immunodeficiency virus (HIV) and sexually transmitted diseases (SIDs), selecting safe partners, negotiating condom use, talking about sexual risk histories, and limiting the number of sexual partners. Conclusions: Some of the sexual protective strategies identified by study participants were less than effective and left young women vulnerable to infection with HIV and STDs. In addition, the use of these alternative strategies may leave young women feeling less at risk and thus less likely to use other more effective strategies such as condoms. The implications for nursing practice and the assessment of the sexual protective strategies of young heterosexual women are discussed. [source] Risk factors for oral hairy leukoplakia in HIV-infected adults of BrazilJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 6 2006Mariela Dutra Gontijo Moura Background:, Oral hairy leukoplakia (OHL) may be an indicator of the progression of Human Immunodeficiency Virus (HIV)-induced immuno-depression, and the evaluation of risk factors leading to OHL is important in the management of these HIV-infected patients. However, there are few studies that analyze risk factors leading to OHL in the Brazilian population. The aim of this case,control study is to present data about prevalence rates and risk factors leading to OHL in a sample of HIV-infected adults in Brazil. Methods:, This case,control study included 111 HIV-infected patients treated at a clinic for sexually transmitted diseases and HIV. In the initial examinations with dentists, variables were collected from all patients. Diagnosis of OHL was performed in accordance with the International Classification System and cytological features. The Fisher and the chi-squared tests were used for statistical analysis. The proportional prevalence and odds ratio were estimated. Results:, Outcome presented a positive, statistically significant association among the presence of OHL and viral load of 3000 copies/,l or greater (P = 0.0001; odds ratio (OR) = 5.8), presence of oral candidiasis (P = 0.0000; OR = 11.1), previous use of fluconazole (P = 0.0000; OR = 24.6), and use of systemic acyclovir (P = 0.032; OR = 4.3). Antiretroviral medication presented a negative, statistically significant association with the presence of OHL (P = 0.002; OR = 8.4). Conclusions:, Prevalence of OHL was 28.8%. Viral load, oral candidiasis, previous use of fluconazole, and systemic acyclovir were determined to be risk factors for OHL. Antiretroviral medication proved to be protective against the development of OHL. [source] Oral candidiasis as a clinical marker related to viral load, CD4 lymphocyte count and CD4 lymphocyte percentage in HIV-infected patientsJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 1 2002J. Campo Abstract Background:, High viral load is currently considered to be one of the main indicators of the progression of HIV-induced immunodepression, but few studies have analysed its relationship to the presence of oral candidiasis (OC). The aim of this cross-sectional study is to analyse the relationship between viral load, total CD4 lymphocyte count, and percentage of CD4 lymphocytes to the occurrence of OC. Methods:, The present cross-sectional study included 156 HIV-infected patients seen at a clinic for sexually transmitted diseases and HIV. We assesed the presence or absence of OC, and microbiological samples were obtained from the palatine mucosa and dorsal tongue for a smear stained with KOH (potassium hydroxide) and culture on Sabouraud's dextrose agar in all patients. Viral load was determined by quantification of viral RNA in peripheral blood with a minimum detectable level of 500 RNA copies/ml. CD4+ counts/CD4+ percentage were categorized as <200/<14%, 200,499/14,28%, and >500/>29%, and HIV viral loads were categorized as <500, 500,10,000, >10,000 copies/ml. Results:, Thirty-eight percent (37.8%) of the patients had OC. Patients with CD4+ lymphocyte counts below 200×106/l and CD4+ percentages below 14% showed a significantly higher frequency of OC (57.9% and 48.0%, respectively). Patients with a viral load over 10,000 copies/ml also had OC more frequently (44.8%). In the multiple logistic regression analysis, OC showed a statistically significant association with high viral load [>10,000 vs <500, odds ratio (OR)=11.4], low percentage of CD4+ lymphocytes (<14% vs >28%, OR=5), and injection drug use (IDU vs heterosexual transmission, OR=10.2). In HIV-infected patients, high viral load was associated with more frequent OC, regardless of CD4+ lymphocyte level. Conclusions:, These findings suggest that oral candidiasis could be a useful clinical marker of patients with high viral load. In view of these results, emphasis should be placed on the importance of systematic examination of the oral cavity in all medical follow-up examinations of HIV-infected patients. [source] Youth Risk Behavior Surveillance , United States, 2001JOURNAL OF SCHOOL HEALTH, Issue 8 2002Jo Anne Grunbaum ABSTRACT: Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. This report covers data during February-December 2001. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority healthrisk behaviors among youth and young adults; these behaviors contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 34 state surveys, and 18 local surveys conducted among students in grades 9,12 during February-December 2001. In the United States, approximately three-fourths of all deaths among persons aged 10,24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 2001 national Youth Risk Behavior Survey demonstrated that numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 14.1% had rarely or never worn a seat belt during the 30 days preceding the survey; 30.7% had ridden with a driver who had been drinking alcohol; 17.4% had carried a weapon during the 30 days preceding the survey; 47.1% had drunk alcohol during the 30 days preceding the survey; 23.9% had used marijuana during the 30 days preceding the survey; and 8.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2001, 45.6% of high school students had ever had sexual intercourse; 42.1% of sexually active students had not used a condom at last sexual intercourse; and 23% had ever injected an illegal drug. Two-thirds of all deaths among persons aged ,25 years result from only two causes: cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2001, 28.5% of high school students had smoked cigarettes during the 30 days preceding the survey; 78.6% had not eaten ,5 servings per day of fruits and vegetables during the 7 days preceding the survey; 105% were overweight; and 67.8% did not attend physical education class daily. Health and education officials at national, state, and local levels are using these YRBSS data to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators. [source] Primary care health issues among men who have sex with menJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2006Royal Gee MSN Abstract Purpose: The purpose of the article is to examine "appropriate" health care for men who have sex with men (MSM), which is not to suggest "special" health care. As a group, MSM are at increased risk for sexually transmitted infections, anal cancer, and mental health disorders. Focus areas in this article will address health issues that the primary care nurse practitioner (NP) may encounter in clinical practice: anal carcinoma, sexually transmitted diseases (STDs), high-risk sexual practices, depression, and substance abuse were topics chosen for inclusion in this article. These topics were among those highlighted in the Healthy People 2010 Companion Document for LGBT Health, which served to examine the healthcare disparities and lack of access to needed services related to sexual orientation. Data source: Extensive literature review of research articles, journals, clinical practice guidelines, books, and public health department Internet Web sites. Conclusions: There are unique health disparities that exist for MSM related to social, emotional, and mental health factors, in addition to physical issues such as STDs. There is an increasing need for primary care providers to be aware of these disparities, as well as the factors that influence these disparities, in order to provide multidimensional care and health counseling that is unique to NP practice. Implications for practice: Both the primary care NP and the patient should be aware of the unique healthcare issues among MSM that should be incorporated into the patient's routine health maintenance program. As primary care providers, it is within the standards of practice for NPs to provide culturally competent care, along with health promotion and disease prevention for MSM. [source] Mycoplasma genitalium: the aetiological agent of urethritis and other sexually transmitted diseasesJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2004Jørgen Skov Jensen ABSTRACT Mycoplasma genitalium was first isolated in 1980 from two of 13 men with non-gonococcal urethritis (NGU). It shares several features with M. pneumoniae, a recognized respiratory tract pathogen. It is extremely difficult to isolate by culture. The development of sensitive and specific polymerase chain reaction (PCR) assays in the early 1990s made clinical studies possible and a significant number of publications have shown a strong association between M. genitalium and NGU, independent of Chlamydia trachomatis. The purpose of this review is to evaluate the currently available information on the associations between M. genitalium and urogenital tract infections in men and women and assess their fulfilment of the Henle,Koch postulates. It is concluded that there is very strong evidence that M. genitalium is a cause of NGU in men and cervicitis in women. Evidence for upper genital tract infections in women has begun to accrue, but further studies are needed. The optimal treatment of M. genitalium infections remains to be determined, but antibiotics of the macrolide group appear to be more active than tetracyclines. [source] Personality dimensions of sexually transmitted disease repeaters assessed with the Millon Clinical Multiaxial InventoryJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2002M Bjekíc Abstract Objective To assess the personality characteristics of patients with repeated sexually transmitted diseases (STD). Method A case,control study comparing 101 STD repeaters (subjects with a lifetime history of three or more STDs) with 182 controls who had no history of STD. All subjects attended the City Department for Skin and Venereal Diseases in Belgrade (Yugoslavia) from June 1997 to April 1998. Personality characteristics was assessed by the Millon Clinical Multiaxial Inventory (MCMI). Results The analysis of MCMI test showed that STD repeaters had higher scores on narcissistic, antisocial and paranoid scales. The difference between STD repeaters and the controls was significant on antisocial, psychotic thinking and psychotic delusion scales, although scores on clinical syndromes were low for both cases and controls. Discriminant analysis showed that antisocial personality was predictive for STD repeaters. Conclusions This study support the hypothesis that STD repeaters are different from controls in terms of their psychological characteristics. The behaviour of STD repeaters is ego,syntonic, which makes the treatment of their personality difficult and emphasizes the importance of work on primary and secondary prevention of STD. 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