Late results of surgery for abdominal aortic aneurysm

Little is known concerning sexually experienced and inexperienced adolescent girls' perceptions of the prevalence of condom use and sexually transmitted diseases (STDs). Girls (n = 174; 41% sexually experienced) rated the prevalence of condom use among friends and STDs among male and female friends and adolescents in general. Girls perceive the prevalence of STDs similarly across both gender and level of familiarity. For the most part, however, the girls perceived the prevalence among boys and girls more similarly than among friends and adolescents in general. No significant differences were found between sexually experienced and inexperienced girls in perceptions of condom use prevalence, but girls with a history of STD perceived condoms as used less frequently. Girls with an STD history perceived STDs as the most prevalent, followed by sexually inexperienced girls and then sexually experienced girls without a history of an STD. After an adolescent girl initiates sexual intercourse, STD experience could be a key variable in affecting her perceptions. Prevention programs can incorporate an understanding of patients' perceptions of condom use and STDs.     

Reproductive biology knowledge, and behaviour of teenagers in East, Central and Southern Africa: the Zimbabwe case study

Sexuality in the teenager is often complicated by unplanned/unwanted pregnancy, abortion and the risks of STDs including AIDS. There is therefore a need for improved understanding of factors affecting adolescent sexuality and the implementation of programmes designed to improve their knowledge, risk awareness and subsequent behavioural outcomes. A multicentre study of reproductive health knowledge and behaviour followed by a health education intervention was undertaken amongst teenagers in selected countries of East, Central and Southern Africa. Reported here are findings at baseline derived from the Zimbabwe component on reproductive biology knowledge and behavior. A self-administered questionnaire was used among 1 689 adolescent pupils drawn from rural, urban, co-education, single sex, boarding and day secondary schools in Zimbabwe. Correct knowledge on reproductive biology as measured by the meaning and interpretation of menstruation and wet dreams varied by school from 68 pc to 86 pc, with a significant trend (p < 0,01) based on level of education at baseline. The reported mean age at which menarche took place was 13,5 years +/- 1,3 (mean +/- SD). First coitus was reported to have taken place at the mean age of 12 years for boys and 13,6 years for girls. Seventeen pc of the adolescent pupils reported that they were sexually experienced and 33,2 had relationships. There were misconceptions reported on menstruation with 23 pc reporting that it was an illness. Peers, followed by magazines were the first sources of information on various aspects of reproductive biology, both of which might not provide the correct first information. Among pupils reporting that they were sexually experienced, the largest proportion (56 pc) had unprotected sex. The findings point to the need for targeting the adolescent pupils for information on reproductive biology and increased awareness on the risks of pregnancy, STDs and HIV.     

Sexually transmitted diseases among teenagers in England and Wales

A profile of sexually transmitted diseases (STDs) and HIV infections among teenagers in England and Wales was obtained from reports of newly diagnosed STDs among teenagers attending genitourinary medicine (GUM) clinics in 1995, laboratory reports of newly diagnosed HIV infections between 1985 when reporting began and the end of 1995, and the prevalence of HIV (unlinked anonymous programme) among teenagers attending genitourinary medicine clinics and antenatal clinics in 1994 and 1995. STD reports were analysed by sex, age group, and place of residence of patients--whether in the NHS Thames regions or elsewhere in England and Wales. High rates of STDs were reported in teenagers, particularly in girls. The incidences of gonorrhoea, chlamydia infection, and first attack genital wart infections were higher in teenage girls than in any other age group. Boys under 16 years of age had substantially higher rates of infection with all STDs in the Thames regions than elsewhere. Rates of gonorrhoea in teenagers of both sexes in the Thames regions were more than twice those in the rest of the country. Infection rates for genital herpes, and chlamydia in girls, were also higher in the Thames regions, although the geographical differences were less marked. The seroprevalence of HIV among heterosexual teenagers was very low. In contrast, 226 HIV infections among teenage boys had probably been acquired through sexual intercourse with other males. Unlinked anonymous testing revealed HIV antibody in 7.5% of routinely collected serology specimens taken from teenage homosexual or bisexual males attending GUM clinics in London. The high rates of STDs among teenage girls and all teenagers in the Thames regions make these groups a high priority for sexual health promotion, with special consideration given to homo/bisexual male teenagers. Detailed surveillance of risk factors for STDs, and further studies of teenage sexual behaviour will help to effectively target resources to improve the sexual health of teenagers in England and Wales.     

Interaction between Set1p and checkpoint protein Mec3p in DNA repair and telomere functions

OBJECTIVES: This article describes the implementation and impact of the first statewide condom social marketing intervention in the United States. METHODS: A statewide social marketing program made condoms freely available in 93 public health clinics, 39 community mental health centers, 29 substance abuse treatment sites, and more than 1000 businesses in neighborhoods with high rates of sexually transmitted diseases (STDs) and HIV. Surveys about condom use were conducted annually. RESULTS: Between 1994 and 1996, more than 33 million condoms were distributed without significant opposition. Over time, self-reported condom use at the last sexual encounter increased among African American women (from 28% in 1994 to 36% in 1996), particularly African American women with 2 or more sex partners (from 30% to 48%). Condom use at the last sexual encounter increased among African American men (from 40% in 1994 to an average of 54% in 1996). The number of reported sex partners did not increase. CONCLUSIONS: Condom social marketing can be successfully implemented in the United States. The widespread availability of free condoms is associated with increased condom use, particularly among persons at high risk for STDs and HIV.     

Changes in attitude, sexual behaviour and the risk of HIV/AIDS transmission in southwest Nigeria

This pilot study was carried out in southwest Nigeria to determine the current trends in sexual behaviours known to be associated with HIV transmission in Nigeria. Knowledge of AIDS in general and as an incurable disease was high (91.4% and 79.4% respectively). Knowledge of the means of AIDS transmission was also very high among both men and women. Overall, condom use was consistent at 25%, inconsistent at 55% and non-existent at 20% for all sexually active respondents. Over 60 per cent of sexually active respondents had two or more sexual partners, with significantly more males than females having this number of sexual partners (p < 0.01). Eighteen per cent of sexually active respondents had a history of sex with commercial sex workers while 25% had a history of at least one sexually transmitted disease. Using multiple logistic regression, the significant determinants of condom use among the sexually active group were: being in a stable sexual relationship, history of sex with commercial sex workers, self-perception of testing positive for HIV and self-perception of HIV/AIDS risk in Nigeria. Prevalence of condom use in this study was much higher than those reported in previous studies, suggesting a probable decline in high risk sexual behaviours among inhabitants of urban Southwest Nigeria since the advent of AIDS. Most sexually active respondents aged 19 years or below (adolescents) who perceived themselves at a high risk of testing positive for HIV had never used condoms. The non usage of condoms among this group of adolescents is disturbing, since they are at greatest risk of spreading the disease. Health education and promotion of safe sex practices need to be extensively targeted at adolescents.     

Problems in differentiating sexually from nonsexually abused adolescent psychiatric inpatients by self-reported anxiety, depression, internalization, and externalization

To ascertain whether self-reported psychopathology differentiated sexually and nonsexually abused adolescents, the Beck Depression Inventory, Beck Anxiety Inventory, and the Achenbach Youth Self-Report were administered to 111 psychiatric inpatients between 13 and 17 years of age who were diagnosed with various psychiatric disorders. Data about 14 background and clinical characteristics that were purported to be associated with sexual abuse were also collected. Forty (67%) of the 60 girls reported sexually abusive experiences, whereas six (12%) of the 51 boys reported such experiences. None of the scales were correlated with sexual abuse in either sex, and a history of physical abuse was the only characteristic that was significantly correlated with sexual abuse for both sexes. Furthermore, none of the scales was correlated with identity of sexual abuser, age of first abuse, age of last abuse, number of abuses, days of abuse, penile insertion, and the reporting of the abuse to the authorities in the sexually abused girls.     

Caring for pregnant teens and their mothers, too

STUDY OBJECTIVE: To describe the sexual behavior and contraception use among a sample of high school and vocational school adolescents in Barcelona, Spain. DESIGN: Cross-sectional study. METHODS: A random sample of 3139 students, aged 14 to 19 years, living in the city of Barcelona, were surveyed by means of an anonymous, self-administered questionnaire. SPSS/PC+ was used for statistical analysis. Significance criterion was set at 0.01. MAIN RESULTS: 13% of the students had previously participated in sexual intercourse; percentages between the sexes was equal. Frequency increased with age. Boys had their first experience at a significantly earlier age, but girls participated in sexual intercourse more often. The majority of adolescents used condoms as their primary contraceptive method; seven (3.3%) of the sexually active girls had been pregnant, and two (1%) boys had caused their partners to become pregnant. CONCLUSIONS: The rate of sexual activity among adolescents in Barcelona is low compared with those in both European and American studies. However, a higher rate of condom use is observed.     

Sexual risk among African American girls: Psychopathology and mother–daughter relationships.

Objective: To examine the associations among mental health problems, maternal monitoring and permissiveness, mother–daughter communication and attachment, and sexual behaviors among African American girls receiving outpatient psychiatric care. Youths with mental health problems report higher rates of HIV-risk behavior than do their peers, and African American girls have higher rates of sexually transmitted infections than do girls of all other racial groups. Method: A sample of 12- to 16-year-old African American girls (N = 266, mean age = 14.46 years) and their female caregivers (73% biological mothers) completed computerized assessments of girls' mental health symptoms, maternal monitoring and permissiveness, and mother–daughter communication and attachment. Girls indicated their sexual risk behaviors (vaginal/anal sex, consistent condom use, number of partners). Results: African American girls who reported clinically significant externalizing problems, more permissive parenting, less open mother–daughter sexual communication, and more frequent mother–daughter communication were more likely to report having had vaginal and/or anal sex. Sexually active girls with greater maternal attachment were less likely to report inconsistent condom use. Conclusions: Findings revealed important risk and protective factors for African American girls in psychiatric care. HIV-prevention programs may be strengthened by improving mother–daughter relationships and communication and by reducing girls' mental health problems. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Report of ACMC annual meeting. Summary of proceedings: the second set report to plenary session, May 6, 1997

We assessed the sexual behavior patterns of 368 unmarried, sexually active adolescent boys (294 rural, 74 urban) and their knowledge of sexually transmitted diseases (STDs) and correct use of condoms. The mean knowledge score for STDs was low and significantly associated with educational level (p < .0001). The mean awareness score for correct use of condoms was 0.42 on a scale of 10 and significantly associated with employment status and age at first coitus (p < .001). There was a negative correlation (-0.17) between literacy and knowledge of correct use of condoms. Selection of the first sexual partner, usually a prostitute, was influenced by employment status, age at first coitus, and literacy level. These data suggest that sexually active adolescent boys in Gujarat, India are inadequately prepared to protect themselves against STDs and, therefore, that it is imperative to impart to them some knowledge of safe sex.     

Acculturation, sexual behavior, and alcohol use among Latinas

We explored the relationship of alcohol use to unsafe sex in Latinas. Telephone interviews were conducted with 523 currently sexually active Latinas aged 18-49 years. Only 7.5% of these women used alcohol half of the time or more prior to sex. "Regular" alcohol users had more sexual partners, but also had more experience with condom use, used condoms with primary partners as frequently as nonusers of alcohol, and used condoms more with secondary partners. While Latinas who use alcohol prior to sex more often have multiple sexual partners, alcohol use does not appear to interfere with condom use.     

Sexual behavior among U.S. high school students, 1990-1995

CONTEXT: High rates of unintended pregnancy and sexually transmitted diseases (STDs), including HIV infection, among adolescents are major public health concerns that have created interest in trends in teenage sexual activity. METHODS: Nationally representative data from Youth Risk Behavior Surveys conducted in 1990, 1991, 1993 and 1995 are used to examine levels of sexual experience, age at first intercourse, current sexual activity and condom use at last intercourse among students in grades 9-12. RESULTS: The proportion of students who reported being sexually experienced remained at 53-54% from 1990 through 1995, while the percentage of sexually active students who used condoms at last intercourse rose from 46% to 54% between 1991 and 1995. Black students were more likely than white students to report being sexually experienced, being currently sexually active and having had four or more lifetime sexual partners; black students also reported a significantly younger age at first intercourse. Gender differences in sexual behavior were found more frequently among black students than among white or Hispanic students. CONCLUSIONS: Although levels of sexual experience for high school students in the United States have not risen during the 1990s, a very high percentage of students continue to be at risk for unintended pregnancy and STDs, including HIV infection.     

Associations of marijuana use and sex-related marijuana expectancies with HIV/STD risk behavior in high-risk adolescents.

Multiple studies suggest an association of marijuana use with increased rates of sexual risk behavior and sexually transmitted diseases (STDs). Most studies have focused on global associations of marijuana use with sexual risk outcomes and few have examined relevant cognitive variables. Adolescents in the juvenile justice system are at elevated risk for HIV/STDs and preliminary evidence suggests that marijuana is a potentially important cofactor for sexual risk behavior in this population. This study evaluated global, situational and event-level associations of marijuana use and sex-related marijuana expectancies with sexual risk outcomes in a large, racially diverse sample of adjudicated youth (n = 656, 66% male, mean age = 16.7 years). Cross-sectional and prospective analyses identified associations of marijuana use and dependence symptoms with sexual risk outcomes, including lower frequency of condom use and higher STD incidence. Stronger sex-related marijuana expectancies predicted greater intentions for and frequency of marijuana use in sexual situations. In event-level analyses that controlled for alcohol, marijuana use predicted a significantly decreased likelihood of condom use; this association was moderated by sex-related marijuana expectancies. Mediation analyses suggested that behavioral intentions partly accounted for the prospective association of expectancies with marijuana use before sex. These results provide further evidence that marijuana use is a potentially important cofactor for HIV/STD transmission in high-risk adolescents and suggest that cognitive factors could be important for characterizing this association. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulation of the iron uptake genes in Pseudomonas fluorescens M114 by pseudobactin M114: the pbrA sigma factor gene does not mediate the siderophore regulatory response

OBJECTIVE: To review factors associated with adolescent condom use for the prevention of sexually transmitted diseases (STDs). DATA SOURCES: Thirty-six references on adolescent development, STDs, STD risk factors, and factors influencing condom use among heterosexual adolescents. STUDY SELECTION: Twenty-two research articles addressing issues influencing condom use by heterosexual adolescents. DATA SYNTHESIS: This review identifies unique risk factors related to adolescents and their risk for STDs, barriers to and facilitators of condom use, and suggestions for health care providers to increase condom use among adolescents. CONCLUSIONS: Although research on condom use among adolescents has inherent difficulties, current findings, along with reported high rates of STDs in this population, indicate infrequent and inconsistent condom use. Many factors contribute to the motivation for condom use and should be assessed individually. Using the Health Belief Model as a theoretical framework, health care providers can guide the adolescent to make realistic risk assessments and identify positive ways of incorporating condoms into their sexual lives. Further research then must be conducted to test the effectiveness of this approach.     

Prioritizing education about condom use among sexually active adolescent females

Many factors have been shown to influence condom use among adolescents, including negative experiences with prior use, risk-taking behaviors, perception of condom efficacy, and self-efficacy in obtaining and using condoms. In order to help prioritize topics for clinic-based education, this study attempted to determine which factors are most significantly associated with planned condom use. A 53-item questionnaire was administered to sexually active females presenting consecutively to an adolescent clinic. Two hundred ethnically and religiously diverse patients, with a median age of 17 years, participated. Median age at first sexual encounter was 15. Median number of lifetime partners was 2, with a median of 1 partner in the last year. Past condom use was reported by 88%, with 22% always, 38% usually, and 26% occasionally using condoms. Only 47% had used condoms during their most recent sexual encounter. Negative experiences with condom use were reported by 85%. Only 54% stated they would definitely use condoms during their next sexual encounter. Intent to use condoms in the future was significantly associated with both past use and fear of HIV infection. Intent was not significantly associated with most prior negative experiences, perception of condom efficacy in preventing STDs and pregnancy, or other perceived benefits of condom use. Thus, this novel approach to prioritizing topics revealed that health education among a clinic-based population should emphasize condom use from the onset of sexual activity, as well as its efficacy in preventing HIV infection.     

Cost-effectiveness of improved treatment services for sexually transmitted diseases in preventing HIV-1 infection in Mwanza Region, Tanzania

Improved management of sexually transmitted diseases (STDs) is consistently advocated as an effective strategy for HIV prevention. The impact, cost, and cost-effectiveness of this approach were evaluated in a prospective, comparative study of six communities in Tanzania's Mwanza Region in which primary health care center workers were trained to provide improved STD treatment and six matched non-intervention communities. The baseline prevalence of HIV was 4% in both groups. During the 2-year study period, 11,632 cases of STDs were treated in the intervention health units. The HIV seroconversion rate was 1.16% in the intervention communities and 1.86% in the comparison communities--a difference in HIV incidence of 0.70 (95% confidence interval, 0.37-1.09) and a reduction of about 40%. The total annual cost of the intervention was US$59,060 ($0.39 per person served). The cost of STD treatment was $10.15 per case. An estimated 252 HIV-1 infections were averted each year. The incremental annual cost of the program was $54,839, equivalent to $217.62 per HIV infection averted and $10.33 per disability-adjusted-life-year (DALY) saved. The estimated cost-effectiveness compares favorably with that of childhood immunization programs ($12-17 per DALY saved) and could be further enhanced through implementation of the intervention on a wider scale. The intervention subsequently has been expanded to encompass 65 health units in Mwanza Region, with no increase in investment costs.     

Contraception for the under 16s: better safe than sorry

This study concerns the opinions of family planning clinic clients on the availability of contraception for adolescents under 16 years of age. The 1978 British statistics indicated that 1300 babies were born to girls under 16, while in France 3000 babies were born. A 1965 study by Schofield of sexual attitudes and behavior of 15-19 year olds in Britain found that experienced girls were as sexually active as experienced boys. He also found that 54% of sexually experienced boys never used a contraceptive and 65% of experienced girls did not insist on contraceptive use. Furthermore, sex education was found to be in heavy demand by adolescents, but that the demand was not being met. This and other studies suggest that adolescent children behave sexually although there is a marked reluctance to admit to it. The questionnaire study of opinions involved 60 British subjects ranging from 15-58 years of age. The mean age was 27, and age at marriage ranged from 16-36 years. The age at leaving home ranged from 13-32 years. Information was gathered on the onset of sexual activity, contraceptive habits, an evaluation of sexuality, and views on abortion, and premarital sexual intercourse. The results indicate that: 1) age at 1st intercourse ranged from 13-28 years with a mean age of 18, 2) age at 1st marriage was at a mean of 21 years, but at this age a drop in frequency of 1st intercourse occurred, 3) 14 of the 60 had not had premarital intercourse, 4) 60% of all subjects used contraception at the time of 1st intercourse, with 31.5% between 20-30 years of age using contraception, 5) the most careful contraceptive users were those who became sexually active over the age of 21, 6) 40.5% considered their sex life to be very important while 53.4% felt it was fairly important, 7) 48.9% considered their sex life to be completely fulfilling and 48.9% felt it to be satisfactory, 8) 49% favored premarital intercourse, 41.9% favored it if it was right for the girl, while 3% felt it was acceptible if the couple was engaged, and 5.4% were totally against it, 9) 62% felt abortion was the right of every woman and 31.1% felt it was acceptible if the physical or mental well being of the mother was at risk, 10) 40.9% agreed with the British Medical Association policy on teenage contraception which advises doctors to encourage under 16's to tell their parents, but if they refuse, the doctor can still prescribe the pill, 11) 22.7% wanted contraception unconditionally available, 18.2% felt it should be dependent on parental knowledge, and 17% said it should not be available, 12) there was a trend for opinions to become less liberal as age increased, and 13) young girls appear to be less conscientious in using contraception than older women.     

HIV risk correlates among non-injection cocaine dependent men in treatment

Guided by the AIDS Risk Reduction Model (ARRM), psychosocial correlates of HIV risk behavior were examined among noninjection cocaine dependent, heterosexual men (NI-CD-HM) in treatment. Subjects (N = 111) completed a structured interview to measure ARRM mediating variables and HIV risk behaviors. The results indicated that greater perceived susceptibility to contracting HIV, lower sexual self-efficacy, higher lifetime incidence of sexually transmitted diseases, and being under the influence of alcohol or other drugs during sex predicted having more sexual partners in the month prior to admission. Despite adequate knowledge of safer sex guidelines, subjects remained misinformed regarding certain aspects of HIV transmission. Men who perceived that their partners viewed condoms more positively and who exchanged drugs for sex were more likely to use condoms, yet condom use skills were typically inadequate to ensure effective prevention. These results suggest that HIV prevention interventions among NI-CD-HM should focus on improving knowledge, enhancing beliefs in the capacity to enact safer sex behaviors for preventing HIV and other STDs, building relevant skills (e.g., condom use, open sexual communication between partners), and emphasizing psychoactive substance abstinence. Couple interventions, in which partners actually rehearse safer sex negotiations, may be particularly effective in this regard.     

Sexual lifestyle of long distance lorry drivers in India: questionnaire survey

This article presents a study on the sexual lifestyle of long distance lorry drivers in India. Using a questionnaire survey method, a total of 5709 consecutive long distance lorry drivers were interviewed by three trained investigators between March 1994 and August 1994. Results showed that 87% (4949 men) of subjects were sexually promiscuous, of whom only 11% (563) used condoms during commercial sex. The percentage using condoms decreased with increasing age. In the 21-30 age group (n = 1766), 78% of unmarried sexually promiscuous men (331/425) reported having 31-60 sexual partners during the past 12 months. In addition, a significantly higher proportion of men over age 40, compared with men under age 21, were sexually promiscuous and abused alcohol and a lower proportion had AIDS knowledge (P 0.001). In the context of infection of sexually transmitted diseases (STDs), responses of long distance lorry drivers suggest that they are highly vulnerable and are crucial in spreading STDs and HIV infection throughout the country in a short time. Thus, research is urgently needed to find effective strategies to persuade lorry drivers to change their risky sexual behavior.     

Misperceived risk among female adolescents: Social and psychological factors associated with sexual risk accuracy.

This study of 411 urban female adolescents had 3 objectives: (a) assess the relationship between perceived risk and sexual risk behavior (condom use, number of partners, partner risk, presence of STDs, and aggregate sexual risk), (b) assess the accuracy of risk perceptions, and (c) identify variables related to inaccurate sexual risk perceptions. Participants were classified as accurate or inaccurate risk perceivers on the basis of actual sexual behavior and perceived risk. Accurate versus inaccurate risk perceivers were compared on psychological maintenance variables (self-esteem, distress, and coping), relationship context variables (partnership duration and pressure to have unprotected sex), and risk knowledge at different levels of sexual risk. Approximately half of the participants underestimated the risk of their sexual behavior. Accurate and inaccurate risk perceivers differed on risk knowledge, partnership duration, and pressure to have unprotected sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

African-American adolescents' knowledge, health-related attitudes, sexual behavior, and contraceptive decisions: Implications for the prevention of adolescent HIV infection.

195 African-American adolescents completed measures of knowledge related to AIDS, attitudes toward condoms, health locus of control, vulnerability to HIV infection, peer sexual norms, personal sexual behavior for the past 6 mo, and contraceptive preferences. Hotelling's T–2 tests revealed that girls were more knowledgeable about AIDS, reported fewer sexual partners, held more positive attitudes toward precautionary sexual behavior, and perceived themselves to have greater control than boys. Five variables accounted for 44% of the variance in condom use: condom use from the 1st intercourse occasion, earlier grade in school, lower belief in an external locus of control, and higher scores on the Effect on Sexual Experience and Self-Control subscales of the Condom Attitude Scale. Implications for the content, format, and timing of HIV prevention with African-American adolescents are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)