Cytomegalovirus infection in women of reproductive age with an at-risk obstetrical history

Studies aimed at the detection of cytomegalovirus infection (CMVI) in women of reproductive age with obstetric complications in their medical history were carried out. 230 women aged 17-44 years were examined with the use of virological and serological tests. As the result of complex examination, CMVI markers were detected in 159 (69%) of women. Three forms of CMVI were detected in the examined women: latent (30%), reactivated (14%) and persistent (25%). This investigation revealed that the most complete detection of CMVI and the evaluation of its activity in women with obstetric complications in their medical history requires the combined use of virological and serological tests.     

The relationship of HIV prevalence in pregnant women to that in women of reproductive age: a validated method for adjustment

OBJECTIVE: To devise and validate a method for adjusting HIV seroprevalences in pregnant women to estimate population prevalences among all women in their child-bearing years. DESIGN: Birth and termination rates from women with known HIV infection in the United Kingdom were calculated according to the likely route of HIV infection and whether HIV infection was diagnosed. METHODS: Birth and termination rates were weighted and combined to produce summary statistics. Comparisons were then made with population birth and termination rates to derive summary relative inclusion ratios (RIRs), the relative probabilities of including HIV-infected and uninfected women in seroprevalence surveys of pregnant women. RESULTS: The derived RIRs for women having live births were close to unity: 1.03 [95% confidence intervals (CI) 0.90-1.17] for London and 0.80 (Cl, 0.71-0.89) for elsewhere in England and Wales. This indicates that currently observed overall seroprevalences among pregnant women having live births in London would be similar to those among all women of the same age, while elsewhere it would be slightly underestimated. Sensitivity analysis indicated that RIRs could, however, vary three-fold (0.47-1.56) according to the proportion of diagnosed maternal infections and the mix of maternal HIV-exposure categories. The method was validated by using it to predict the ratio of unlinked seroprevalences between women having terminations and live births in London. It predicted a ratio of 1.74: 1, which is close to the observed ratio of 2.07 : 1. CONCLUSIONS: Application of HIV seroprevalences from pregnant women to whole populations may need adjustment for fertility rates among HIV-infected women. A general method for this has been derived and validated. Gathering fertility data for HIV-infected women is a useful adjunct to serosurveillance.     

HIV infection and HIV-1 clades among pregnant women in Harare, Zimbabwe

Official figures indicate that at least 1 million of Zimbabwe's 11 million population are infected with HIV, while the most recent survey results indicate that about 24% of apparently healthy women in the country are HIV seropositive. 60 (29.1%) of 206 pregnant women attending Edith Opperman and Budiriro clinics in Harare who were screened for infection with HIV were found to be HIV-1 seropositive. 66.6% of the HIV-1-infected women were infected with subtype C, 48.3% with subtype A, and 33.3% with subtype B. 45% of the infected were infected with subtypes A and C, 10% with A and D, 30% with B and C, and 6.6% with subtypes A, B, C, and D. 2 samples (3.3%) were nonreactive. The high prevalence rate of HIV-1 infection in this study population points to the urgent need to implement more aggressive approaches to controlling HIV/AIDS among women in Zimbabwe.     

HIV infection among pregnant women in Lindi, Tanzania, 1989-1993

One obstacle to contain the HIV-1 epidemic in the general population in Africa is a lack of knowledge about how it is spread in rural areas. We examined 683 pregnant women in 1989 and 484 in 1993 who attended antenatal clinics in Lindi district, Tanzania to determine changes in the prevalence of HIV-1 in a remote area in East Africa. The prevalence rose from 0.44% in 1989 to 8.7% in 1993. Women with more than 1 partner (17.25% vs 2.78%), STD patients (42.4% vs 6.2%), women from urban areas (10.2% vs 3.57%) and patients younger than 21 years were more likely to have HIV antibodies. By logistic regression analysis, 1993 as year of testing was associated with the greatest risk for HIV seropositivity (P < 0.00002) followed by clinical signs of STD (P < 0.00005) and urban residence (P = 0.0275). Teaching of all women attending antenatal care how to minimize their future risk of acquiring HIV is urgently needed as one tool to prevent a fast spread of HIV throughout the continent.     

Studies on the anaerobic (bacterial) vaginosis among the Bangladeshi women of reproductive age group

Vaginal swab from 190 patients aged between 15 to 45 years with the complaint of excessive and foul smelling vaginal discharge and 50 healthy controls of comparable age were studied. Different diagnostic techniques used for the detection of G.vaginalis were compared. Antibiogram of isolated G.vaginalis was also performed to determine the drug sensitivity pattern. G. vaginalis were isolated from 74 patients (38.9%) and from 6 controls (12%). The rate of isolation of G. vaginalis in the vaginal swabs of patients is significantly higher (p < 0.001) as compared to controls. Vaginal flora in 91% of G. vaginalis positive patients were Gardnerella morphotype and clue cells were found in vaginal discharge in 85% of these cases. In contrast, vaginal flora of 92% control group were Lactobacilli morphotype N and no clue cell was detected. No pus cell was observed in the vaginal discharge of 66 (89.2%) of 74 patients infected with G. vaginalis. Amine test was positive in 81% G. vaginalis positive patients. The test was negative in all the control cases. Significance of these findings were discussed in detail.     

Dual-method use among an ethnically diverse group of women at risk of HIV infection

CONTEXT: Few U.S. women protect themselves against both pregnancy and sexually transmitted diseases (STDs) by using an efficient contraceptive method and a condom. Understanding the factors that influence dual-method use could help improve interventions aimed at encouraging protective behaviors. METHODS: Interviews were conducted with 552 low-income women at risk of HIV who attended public health or economic assistance facilities in Miami in 1994 and 1995. Multinomial logit analyses were used to determine the influence of women's background characteristics, perceived vulnerability to pregnancy and AIDS, and relationship characteristics on the odds of dual-method use. RESULTS: Overall, 20% of the women used dual methods. Women who were not married, who worried about both pregnancy and AIDS, who had ever had an STD, who were confident they could refuse a sexual encounter in the absence of a condom and who made family planning decisions jointly with their partner were the most likely to use dual methods rather than a single method (odds ratios, 2.0-3.5); those who considered the condom only somewhat effective in preventing AIDS or who shared economic decision-making with their partner were the least likely to use dual methods rather than a single method (0.5-0.6). The results were generally similar in analyses examining the odds of dual-method use involving an efficient contraceptive, except that black and Hispanic women were significantly more likely than whites to use condoms in conjunction with efficient contraceptives (3.3-7.1). CONCLUSIONS: Both women's individual characteristics and the context of their sexual relationships influence whether they simultaneously protect themselves from pregnancy and HIV. The involvement of male partners in family planning decision-making and women's control over economic decision-making ensure greater protection against HIV infection.     

Pulsatile gonadotrophin secretion in hypothyroid women of reproductive age

With the emergence of chloroquine-resistant Plasmodium vivax (CRPV), new tests to detect P. vivax and predict response to therapy would be useful for clinical and research applications. We performed a 'blinded' evaluation of a non-isotopic (colourimetric) polymerase chain reaction (PCR) based assay (Digene SHARP Signal System) compared with microscopy and PCR/radiometric probe hybridization of ribosomal ribonucleic acid genes (RPH) for the detection of P. vivax malaria in 182 febrile travellers. Compared with PCR/RPH as the reference standard, the colourimetric assay had a sensitivity of 100% and specificity of 98%. Using microscopy as the reference standard, 84 of 87 patients with P. vivax infection had a positive colourimetric assay. The 3 patients with a negative assay were subsequently shown to be infected with P. ovale as determined by PCR/RPH. In a subset of patients followed longitudinally, the colourimetric assay was positive in 5 of 13 patients 6 or more days after initiation of therapy. Of these 5 patients, 4 were subsequently demonstrated to be infected with CRPV as determined by treatment failure in vivo and/or chloroquine blood levels. A positive assay result 6 or more days after initiation of therapy was associated with subsequent treatment failure (P < 0.01). This non-isotopic assay is a sensitive, specific, and rapid method for the detection of P. vivax PCR products and may prove useful in predicting treatment failure.     

The presence of genital mycoplasmas in women of reproductive age

Although 5-HT1 and 5-HT2 receptor activity is known to influence copulation, the effects of 5-HT3 receptor-selective drugs on sexual activity have yet to be systematically studied. The following experiments investigated the effects of the 5-HT3-selective antagonists MDL 72222, ondansetron and ICS 205-930 on female sexual behaviour; male rats were studied using ondansetron and granisetron. These compounds influenced neither male nor female copulatory behaviours, suggesting that 5-HT3 receptors contribute little to the modulation of sexual activity. 5-HT3 receptor antagonists block certain opioid-induced behaviours and opioids selectively inhibit sexual behaviours; therefore, the ability of ondansetron and ICS 205-930 to modify morphine-attenuated copulatory activity was also tested. While morphine inhibited copulation, 5-HT3 antagonists failed to reverse the effects.     

Perceptions of AIDS susceptibility among minority and nonminority women at risk for HIV infection.

272 women sampled from mass transit waiting areas in an urban center completed anonymous surveys of AIDS-related risk behavior, perceptions of susceptibility, and knowledge. Variable patterns of HIV risk behaviors were identified, with 22% of women reporting high-risk behavior. Perceptions of susceptibility were associated with an interaction between ethnicity and level of risk; nonminority women at high risk reported greater concern about AIDS than did minority women at high risk, who did not differ from women at low risk. With an array of life problems and inaccurate information about HIV transmission, minority women were found to be at continued risk for AIDS-related behavior. Implications for culturally sensitive and relevant AIDS prevention efforts are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anonymous testing of HIV infection in pregnant women

To investigate the contribution of nigral degeneration to the development of parkinsonism in the early stages of corticobasal degeneration (CBD), we measured the cerebrospinal fluid (CSF) levels of homovanillic acid (HVA) in patients with early CBD (n = 5), and compared the levels with those in patients with early Parkinson's disease (n = 11) and in normal subjects (n = 13). The mean CSF HVA level in the early CBD group (33.1 +/- 6.0 ng/ml) did not differ significantly from that in the control group (37.1 +/- 12.7 ng/ml), whereas that in the early Parkinson's disease group (19.0 +/- 7.6 ng/ml) was reduced significantly (P < 0.001). This result suggests that neuronal cell loss in the substantia nigra and presynaptic nigrostriatal dopaminergic neuron dysfunction are mild in the early stages of CBD.     

Effectiveness of HIV interventions among women drug users

A prospective cohort study was conducted among chronic injecting and crack cocaine drug using women. The hypothesis tested was that participation in a standard-plus-innovative intervention was more likely to produce behavior change than participation in a standard intervention. Standardized intervention protocols and corresponding instruments were designed. Data were collected on drug and sex risk behaviors at baseline and six-month follow-up intervals. The level of behavioral change in two intervention arms--standard and a standard-plus-innovative intervention--was measured by composite sex risk and drug risk scores using the generalized estimating equation approach. The results show that on four risk measures the enhanced intervention was significantly associated with positive change in both drug use and sexual behavior: less frequent drug use, less drug use during sex, and more frequent condom use during particular frequencies for specific types of sexual activities. Public health interventions are effective when targeting specific risk behaviors through interventions tailored to prevent HIV and reduce risk behaviors among specific cultural and gender groups.     

Determinants of contraceptive use among women of reproductive age in Great Britain and Germany. II: Psychological factors

Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account. The attitude of respondents towards the various contraceptive methods was ambivalent and no method was seen as ideal. On medical methods (OCs, IUDs and sterilisation) many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently. Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant. Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on 'luck'. In the case of withdrawal and/or no method, underestimation of fertility played an additional role. Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.     

Prevention of HIV infection in women: overcoming barriers

The proportion of total reported cases of acquired immune deficiency syndrome (AIDS) in US women increased annually between 1988 and 1994 from 10% to 18%, indicating an urgent need for prevention measures. Interventions designed to reduce unsafe sex and drug-using behaviors in women have been limited. Barriers to human immunodeficiency virus (HIV) prevention for women include a disproportionately low investment of resources, inadequacy and inaccessibility of substance abuse treatment programs, the crack/cocaine epidemic and resulting unsafe sex behaviors, lack of a woman-controlled method to prevent sexual transmission of HIV, and unique social and cultural factors that limit women's power in sexual decision making. Some interventions have been successful in reducing women's risk behaviors. Expanding prevention efforts targeted to women is necessary in order to stem the rising rate of HIV infection.     

Change in sexual behaviour and decline in HIV infection among young pregnant women in urban Uganda

OBJECTIVE: To describe sexual behaviour that may partly explain a decline in HIV seroprevalence in pregnant women in urban settings in Uganda, East Africa. SETTINGS: Two major urban districts in Uganda. METHODS: Repeated population-based behavioural surveys in 1989 and 1995, and repeated HIV serological surveys in consecutive pregnant women attending antenatal clinics from 1989 to 1995. RESULTS: During the study period, a 2-year delay in the onset of sexual intercourse among youths aged 15-24 years and a 9% decrease in casual sex in the past year in male youths aged 15-24 years were reported. Men and women reported a 40% and 30% increase in experience of condom use, respectively. In the same study area, over the same period, there was an overall 40% decline in the rates of HIV seroprevalence among pregnant women attending antenatal clinics. It can be hypothesized that the observed declining trends in HIV correspond to a change in sexual behaviour and condom use, especially among youths. CONCLUSIONS: This is the first report of a change over a period of 6 years in male and female sexual behaviour, assessed at the population level, that may partly explain the observed decline in HIV seroprevalence in young pregnant women in urban Uganda. This result should encourage AIDS control programmes to pursue their prevention activities.     

The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania

Animal caps isolated from Xenopus laevis embryos at the blastula stage were treated sequentially with NH4Cl, a known cement gland inducer, and with 12-O-tetradecanoyl phorbol-13-acetate (TPA), a known neural inducer. The two artificial inducers were also used in reverse order to see if they can mimic the natural inducers acting during the progressive determination of the ectodermal organ. Immunofluorescence and whole-mount in situ hybridization were used to study the expression of tubulin, taken to indicate an early step on the pathway of cell elongation, and neural cell adhesion molecule (N-CAM) taken to indicate an early step in the determination of the nervous system. The expression of XCG-1, a marker of early specification of the cement gland, was also studied. The results showed that the two artificial inducers can mimic the effects of the natural inducers in animal cap explants. The TPA behaves like a neural inducer, reducing the number and the extension of the cement gland when added to the medium in addition to NH4Cl, before or after NH4Cl treatment. In the process of cement gland/neural induction, it is possible to redirect the ectoderm already specified as cement gland to neural tissue, but it does not seem possible to respecify the neural tissue as cement gland. Moreover, the animal caps were also cut into dorsal and ventral parts and the two halves were treated separately. The results were similar to those obtained with treatment of the entire animal cap, suggesting that a dorsal-ventral pattern is not yet established before the gastrula stage, and that in normal embryos there are boundaries between the effects of different inducers.     

Wife abuse among women of childbearing age in Nicaragua

Cytosolic low molecular weight phosphotyrosine-phosphatase shows dephosphorylating activity of the band 3 protein. Increased phosphorylation of this protein increases membrane rigidity and resistance to invasion of red blood cells by malarial parasites. This observation may explain the negative association previously reported by our group between the high activity *C allele of cytosolic low molecular weight phosphotyrosine-phosphatase and past malarial morbidity.