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.     

Cytotoxicity of lindane and paraquat to human hepatoma cell lines

A serosurvey was conducted in a random sample of 259 women and 231 men in 12 rural communities in Mwanza Region, Tanzania, using a type-specific ELISA for Herpes simplex virus type 2 (HSV-2) infection. Seroprevalence rose steeply with age to approximately 75% in women >=25 years old and 60% in men >=30. After adjusting for age and residence, HSV-2 prevalence was higher in women who were married, in a polygamous marriage, Treponema pallidum hemagglutination assay (TPHA)-positive, had more lifetime sex partners, or who had not traveled. Prevalence was higher in men who were married, had lived elsewhere, had more lifetime partners, had used condoms, or were TPHA-positive. HSV-2 infection was significantly associated with recent history of genital ulcer. The association between HSV-2 infection and lifetime sex partners was strongest in those <25 years old in both sexes. This association supports the use of HSV-2 serology as a marker of risk behavior in this population, particularly among young people.     

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.     

Planned condom use among women undergoing tubal sterilization

BACKGROUND AND OBJECTIVES: Women who are undergoing tubal sterilization are at risk for various sexually transmitted diseases (STDs) if they do not use a barrier method of contraception. There is a paucity of data concerning dual use of condoms among sterilized women. GOAL: Planned use of condoms for protection against STDs was examined among 2,782 women undergoing surgical sterilization from 1991 to 1996. STUDY DESIGN: Cross-sectional survey. RESULTS: Planned condom use increased significantly over the 6-year study period. Of women who were using condoms before sterilization (n = 646), nearly half indicated no plans to do so after becoming sterilized. Thus, 11% of the total sample experienced an increased risk for exposure to human immunodeficiency virus or other STDs. Condom abandonment was significantly higher among Hispanic and married women. Multiple regression analysis was used to examine the association between condom use and various characteristics. Factors associated with future condom use were younger age, black ethnicity, being unmarried, previous STD, not having a steady partner, higher number of previous sexual partners, having used condoms for disease prevention in the past, and lack of partner involvement in the decision to undergo sterilization. CONCLUSIONS: Use of condoms among sterilized women appears to be on the rise, women at higher risk for disease are more likely than others to be using condoms, and only a small group of women experience an increased risk for exposure to disease as a result of selecting this permanent method of contraception.     

High HIV prevalence, low condom use and gender differences in sexual behaviour among patients with STD-related complaints at a Nairobi primary health care clinic

Of 22,274 patients > or = 12 years old attending a Nairobi primary health care (PHC) clinic, 1076 (4.8%) had STD-related complaints, of whom 980 underwent assessment of risk factors for human immunodeficiency virus (HIV) infection and infrequent condom use. Gonorrhoea, chancroid, syphilis seroactivity, trichomoniasis, or objective signs of STD were found in 78%, and HIV seropositivity in 15% of men and 19% of women. Most women were married, living with a spouse; while most men were single, or married, but living separated from a spouse. Among married men, last sex was with a female sex worker (FSW) or casual partner for 60% not living with a spouse and 26% living with a spouse (P<0.005). Two or more partners during the past year were reported by 82% of men and 25% of women (P <0.001), and 55% of men and 11% of women reported the last partner was high risk. HIV seropositivity among both genders was associated with numbers of partners, and among women, with being widowed or divorced. Only 3% reported use of a condom with the last partner. Among men whose last sex was with a FSW, 74% said the reason for not using a condom was not having one. Thus, infrequent condom use, low condom availability, and gender differences in behaviour necessitate modifying development policies that separate families; and better coordination between family planning, PHC, and AIDS/STD programmes, with improved supply, social marketing and community-based distribution of condoms in high-risk settings for STD/HIV prevention.     

Attitudes toward condoms and experience with their use among sex education teachers

BACKGROUND: The sex education is influenced by knowledge and attitudes. The aim of presented study was to evaluate the attitudes toward condom among sex education teachers and their personal experience with its use. METHODS AND RESULTS: Attitudes toward condoms were measured by 10-items anonymous questionnaires according to Zv?rina and Lippert. Personal experience was subjectively assumed in 5-point scale. The samples consists of 230 sex education teachers, among them 193 (84%) women. The average age was 40.5 +/- 9.7 years, in the range from 19 to 60 years. 37 teachers (16%) assigned themselves as religious. Condom was evaluated as a good protection against HIV and other STD in almost all answers. Three fifths of teachers considered condom to be an excellent contraception. 48% teachers did not know if the majority of women dislike condom. One tenth respondents rejected the opinion that the men dislike condoms. One tenth of teachers has never experienced condom personally. 12 percent stated to use it regularly, among them are more represented men. The opinions about quality of condom and decreased sensitivity by condom differ believers from atheists and users from non-users. CONCLUSIONS: Attitudes toward condom are predominantly liberal among Czech sex education teachers. The personal experience with use is common but not regular. The religion has small influence toward the attitudes and use.     

HIV knowledge, beliefs and sexual behavior of male heterosexual drug users and non-drug users attending an HIV testing clinic in Israel

The aim of the study was to compare HIV-related knowledge, beliefs in self-control and sexual behavior of non-drug using and drug using heterosexual men. All individuals attending an HIV testing site during a two-month period were asked to complete a questionnaire anonymously. Data for 49 drug users (DU), most of them non-injectors, were compared to that of 94 non-drug using (non-DU) men with similar education levels (high school or less). Sexual behavior items refer to previous six months. FINDINGS: HIV-related knowledge was reported correctly by the majority of men in both groups, but the DU showed significantly more misconceptions (p < 0.01). Consistent but statistically insignificant lower levels of self-control were reported by the DU. Type of sexual relations and the number of regular sexual partners were not different between the groups: 55% of the DU and 67% of the non-DU were not monogamous. DU had either none or many casual partners (three or more), significantly different from the non-DU. The proportion of DU who never used condoms (65%) was higher as compared to non-DU men (43%, p < 0.05). However, when controlling for type of partnership, this difference was sustained only among monogamous men (82% of DU vs. 42% of non-DU never used condoms, p < 0.05). Condom use was significantly associated with age, HIV knowledge and sexual partnership in the DU. The greater deficiencies in HIV-related knowledge, and the prevalence of risk behaviors among DU require intensive individual and group counselling, specifically adapted for the needs and the culture of drug users in Israel and incorporated with social-influence-orientated change processes.     

Sexual behaviour among London GUM clinic attenders: implications for HIV education

The aim of this study was to describe the sexual behaviour of a sample of genitourinary medicine (GUM) clinic attenders, 5 years after the launch of the UK government HIV media campaigns. A gender-specific and anonymous cross-sectional self-completion questionnaire was modified from the National Survey of Sexual Attitudes and Lifestyle and completed by 250 men and 250 women. The majority of the respondents were in their twenties, lived in London and were employed or students. Sixty-eight per cent of the men reported that one or more of their last 3 partners was not a regular partner. For those men whose last sexual encounter was with a new partner, 27% of heterosexuals and 33% of homosexuals reported using a condom. Fifty-one per cent of women reported one or more non-regular partners among their last 3 partners. For those women whose last sexual encounter was with a new partner, 43% of heterosexuals and 75% of bisexuals used a condom. Seventy-eight per cent of men and 75% of women had had a previous sexually transmitted disease (STD). These findings highlight the persistence of practices associated with the risk of contracting or transmitting HIV infection and which needs to be addressed in future educational campaigns. The GUM clinic population is an important population to monitor over time, either by longitudinal or serial cross-sectional studies. The results of this study provide a baseline against which to gauge the effects of future educational interventions.     

Gender differences in risk behaviors among HIV+ persons with an IDU history. The link between partner characteristics and women's higher drug-sex risks. The Manif 2000 Study Group

BACKGROUND AND OBJECTIVES: Risk-taking behaviors differ among women and men injection drug users (IDU). GOAL: To specify the nature of sexual and drug risk-taking among women IDU and ex-IDU and how it relates to partner characteristics. DESIGN: A cross-sectional analysis of 324 HIV+ subjects enrolled into a prospective cohort study in Marseille, France. RESULTS: Women, as compared with men, were considerably more likely to report nonuse of condoms with a main partner (31% versus 12%). They were more likely to shoot with a partner at last injection (39% versus 12%), but far less likely to sterilize used needles (4% versus 16%). Two thirds of both men and women reported consistent condom use with a seronegative partner, but only 47% of men and 23% of women reported the same with a seropositive partner. Among the women only, needle and syringe sharing was associated with consistent use of a condom. CONCLUSIONS: Women reported behaviors which protect their partners from STD infection more frequently than behaviors which protect themselves. Greater attention must be paid to sexual risk-taking among HIV+ women.     

Multiple sexual partners among U.S. adolescents and young adults

CONTEXT: Because many teenagers and young adults fail to use condoms correctly and consistently, the number of sexual partners they have is an important risk factor for sexually transmitted diseases, including HIV. Identifying factors that are associated with having multiple partners can help in the design of disease interventions. METHODS: Data on 8,450 males and females aged 14-22 who participated in the 1992 Youth Risk Behavior Survey were used to examine the prevalence of and factors associated with young people's having multiple partners. RESULTS: In all, 63% of female respondents and 64% of males were sexually experienced. Among those who had had sex during the three months before the survey, 15% and 35%, respectively, had had two or more partners during that period. At each age, the majority of sexually experienced respondents had had more than one lifetime partner; between ages 14 and 21, the proportion who had had six or more rose from 8% to 31% among females and from 14% to 45% among males. In logistic regression analyses, alcohol use, illicit drug use and young age at first coitus were associated with increased odds that females had had two or more partners in the previous three months, and being married lowered the odds; black or Hispanic race or ethnicity, alcohol use and young age at first coitus increased the odds for males, and being married reduced the odds. As the number of reported alcohol-related behaviors increased, the adjusted proportion of respondents who had recently had multiple partners rose from 8% to 48% among females and from 23% to 61% among men. CONCLUSIONS: The strong association between alcohol use and having multiple sexual partners underscores the need to educate young people about the effects of alcohol on partner choice and the risk of infection with sexually transmitted diseases.     

Condom use in unmarried Latino men: A test of cultural constructs.

The effects of cultural factors on condom use were assessed in a random digit-dialing household survey of 1,600 unmarried Latino adults in 10 states with large Latino populations. Measures of traditional gender-role beliefs, sexual coercion, sexual comfort, and self-efficacy in using condoms were developed specifically for this population. A multisample structural equation model analysis included 594 men who reported one or more heterosexual partners in the 12 months before interview. As predicted, men with more traditional gender-role beliefs reported more sexual coercion and less sexual comfort. Men reporting more sexual coercion and less sexual comfort had lower condom self-efficacy. Men with more condom self-efficacy and stronger condom social norms reported more condom use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tobacco, marijuana, and sensation seeking: Comparisons across gay, lesbian, bisexual, and heterosexual groups.

This study examined patterns of smoked substances (cigarettes and marijuana) among heterosexuals, gays, lesbians, and bisexuals based on data from the 2000 National Alcohol Survey, a population-based telephone survey of adults in the United States. We also examined the effect of bar patronage and sensation seeking/impulsivity (SSImp) on tobacco and marijuana use. Sexual orientation was defined as lesbian or gay self-identified, bisexual self-identified, heterosexual self-identified with same-sex partners in the past 5 years, and exclusively heterosexual (heterosexual self-identified, reporting no same-sex partners). Findings indicate that bisexual women and heterosexual women reporting same-sex partners had higher rates of cigarette smoking than exclusively heterosexual women. Bisexual women, lesbians, and heterosexual women with same-sex partners also used marijuana at significantly higher rates than exclusively heterosexual women. Marijuana use was significantly greater and tobacco use was elevated among gay men compared with heterosexual men. SSImp was associated with greater use of both of these substances across nearly all groups. Bar patronage and SSImp did not buffer the relationship between sexual identity and smoking either cigarettes or marijuana. These findings suggest that marijuana and tobacco use differ by sexual identity, particularly among women, and underscore the importance of developing prevention and treatment services that are appropriate for sexual minorities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The UCLA Multidimensional Condom Attitudes Scale: Documenting the complex determinants of condom use in college students.

Describes the development and validation of the UCLA Multidimensional Condom Attitudes Scale (MCAS). The relationships between the MCAS and gender, sexual experience, intentions to use a condom, and past condom use were assessed. The MCAS has 5 distinct factors: (1) Reliability and Effectiveness of condoms, (2) the sexual Pleasure associated with condom use, (3) the stigma attached to persons who use condoms (Identity Stigma), (4) the Embarrassment About Negotiation and Use of condoms, and (5) the Embarrassment About the Purchase of condoms. Results strongly suggest that condom attitudes are multidimensional and thus cannot meaningfully be summed to a single global score. Results further indicate that men and women hold very different attitudes toward condoms. Implications of scale multidimensionality and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed obstetrical care

BACKGROUND: Infertility is common in Africa, but virtually no data exist on HIV prevalence among infertile women. Mainly anthropological studies in Africa have shown that infertile women have higher risks of marital instability and possibly also have more sexual partners than fertile women. METHOD: This study was conducted in a hospital in northwest Tanzania during 1994 and 1995. Women presenting themselves with infertility problems to the outpatient clinic were interviewed, examined and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, were taken as a control group. The analysis was limited to women > or = 24 years. In total 154 infertile and 259 fertile women were included in the study. RESULTS: HIV prevalence was markedly higher among infertile women than among fertile women: 18.2% and 6.6% respectively (adjusted odds ratio [OR] for age, residence and occupation 2.7; 95%-confidence interval [CI]: 1.4-5.3). Data on past sexual behaviour showed that infertile women had more marital breakdowns, more lifetime sexual partners and a higher level of exposure to sexually transmitted diseases (STD). CONCLUSION: Women with fertility problems appear to have higher HIV prevalence, which justifies more attention for such women in the context of AIDS programmes. In addition, caution is needed when using sentinel surveillance data from antenatal clinics to monitor HIV prevalence.     

Current status of the female condom in Africa

The female condom was developed in the 1980s. It is a contraceptive device used by women that protects against both pregnancy and sexually-transmitted diseases (STDs) including HIV infection. Two studies have investigated the contraceptive effectiveness of the female condom, and it was found to be as effective as other barrier methods. It has been shown to be effective against STD and HIV transmission in vitro but there is only limited evidence of its efficacy in vivo. No serious local side effects or allergies have been reported and the female condom can be used with any type of lubricant, spermicidal cream or foam. The female condom is the only device other than the male condom that has been shown to prevent HIV transmission. The female condom has been marketed in 13 countries since the summer of 1996. Most of these countries are industrialized and the selling price in these countries is too high for developing countries. Sub-Saharan Africa has very high prevalence rates for HIV infection, at least 30% of the general population in Eastern and Central regions. The epidemic is also spreading fast in some parts of the Western region. In Ivory Coast for example, 12 to 15% of pregnant women are infected. African women are subordinate to men in many aspects of their lives, politically, educationally, socially and sexually. This sexual inequality makes them highly vulnerable to STDs, including HIV, and unwanted pregnancies. This paper reviews 10 of the 15 studies carried out in sub-Saharan African countries between 1990 and 1996 and compiled by the World Health Organization. Recruitment methods, education of subjects, methodology and assessment of acceptability differed between studies. Despite these limitations, most studies concluded that the women who participated in the trials generally found the female condom acceptable. Acceptability was established quicker among prostitutes than among other women and men found the female condom less acceptable than did women. However, the sample size is too small to draw any firm conclusions. Commercial sex workers in the studies reviewed were very interested in this new method because it gave them an additional method of safer protection during sex. However, they were occasionally faced with difficult negotiations with some clients, refusal to use the female condom and sexual violence. Reuse of the device was reported in four studies, but the term reuse is seldom defined. In cases where it was defined, the frequency of reuse, with washing of the device, accounted for no more than 1% of the total number of uses. The acceptability of the female condom among women other than prostitutes faces two obstacles, the reaction of the woman's regular partner and attitudes to the device itself (appearance, difficulties or uneasiness concerning its use). However, some women liked it because it provided dual protection against pregnancy and STDs and sexual pleasure. The moderate level of acceptability to male partners may be overestimated because women whose partners disliked the device would be more likely to discontinue its use. The studies of acceptability reviewed here show that use of the female condom in Africa is realistic and that it provides women with more independent protection. Initial negative perceptions of the device are often replaced with a more positive reaction after several uses. The experience gained with use reduces the technical problems. We need to overcome the stereotypes, simplifications and strong opinions that threaten to damage the acceptance of this new method and efforts to encourage women to adopt it. However, we still require further clinical data on the effectiveness of the female condom at preventing pregnancy and HIV transmission. Availability of the female condom is improving in Africa. Pilot marketing studies were launched in 1996 in Guinea, Zambia, South Africa, followed by Uganda and Tanzania. There are local initiatives in Ivory Coast and Zimbabwe. (ABSTRACT TRUNC     

Prevention indicators for evaluating the progress of national AIDS programmes

Major interventions to reduce HIV transmission involve increasing knowledge about preventing HIV transmission for sustained behavioral changes; and enhancing the control of sexually transmitted diseases (STD), which increase the probability of HIV transmission. Activities have also been developed to prevent the transmission of HIV by blood, donor selection, and more rational use of transfusions. Behavioral changes among injecting drug users have also been promoted. Recommendations are made for the evaluation of AIDS programs, focusing on prevention of sexual transmission of HIV, and outlining the approach developed by the Global Program on AIDS (GPA; Geneva, Switzerland) for use by national programs. Based on the feasibility, accuracy, reliability and validity of the quantitative assessment of programs, 10 indicators of progress and outcomes of prevention activities have been developed by GPA. These include indicators of population knowledge regarding preventive practices, reported sexual behavior and use of condoms in the general population, STD service evaluation, and indicators of program impact. The latter are measured through the reported STD incidence in the general male population, and syphilis and HIV prevalence in women. The four methods are proposed for measuring the 10 core prevention indicators (PI). Five PIs are measured during a population survey: reported knowledge of preventive practices (PI-1), condom availability at peripheral level (PI-3), reported frequency of nonregular sexual partners (PI-4), reported condom use during nonregular sexual encounters (PI-5), and reported STD incidence among men (PI-9). Condom availability at central level (PI-2) is assessed through key-informant interviews with major distributors. Structured health facility surveys allow assessment of the appropriateness of STD case management (PI-6 and PI-7). A serosurvey among antenatal clinic attenders aged 15-24 years allows the measurement of HIV and syphilis seroprevalence in that population (PI-8 and PI-10). GPA recommends that such surveys be repeated after a period of 1 to several years.     

Safe sex?

The author has a Master of Arts degree in religion from the International School of Theology and he has lectured to thousands of students and professors at universities on six continents. He argues that condom use does not guarantee 100% protection against the transmission of HIV and that the only truly safe sex occurs in a faithful mutually monogamous relationship between two HIV-seronegative individuals. It is the author's belief that young people should wait until marriage before having sexual intercourse. It is known that condoms can slip, break, and leak during in vivo use. Condoms have a 15% failure rate in protecting against unplanned pregnancy. A sperm cell, however, is much larger than the human immunodeficiency virus. This failure rate therefore indicates that if sperm cells can penetrate/bypass the condom when having sex, the far smaller HIV can most certainly do the same thing. HIV can easily pass through many of the tiny pores in latex condoms. The author further argues that while premarital sex is physically risky, one can also be hurt emotionally and relationally. Sex can breed insecurity and generate performance fears which impede sexual response. Waiting until marriage helps both partners to have the confidence, security, trust, and self-respect which a solid, intimate relationship needs. In closing, the author acknowledges the physical and emotional difficulty of delaying the initiation of sexual intercourse.     

Sexual issues and condom use among injecting drug users

Recent surveys of injecting drug users reveal that their injecting behaviours have changed in the light of HIV, but their sexual behaviours have not and, in particular, they remain reluctant to use condoms to reduce the risks of sexual transmission. In an attempt to explore this issue further the present study assessed the behaviours and attitudes of injecting drug users to sexual issues, including condom use. Condom use was low. Obstacles to their use included for some a desire to conceive, for many a belief in their infertility, a perceived invulnerability to HIV infection through their sexual behaviour patterns, a dislike of condoms and difficulty in negotiating condom use with partners. The lifestyle of drug users may also have an influence on condom use. Many drug users funded their habit through illegal activities including prostitution, theft and fraud. The association between these and other factors and condom use are explored.     

Molecular mechanism of limb muscle patterning

A national household survey of a representative sample of 9,984 individuals aged 15 years or over, carried out in 1996 using a combination of face-to-face interviews and self-completion questionnaires, was analyzed in order to describe the frequency of HIV sexual risk behaviours and condom use in Spain. Of a total of 8,101 persons (81%) who completed the questionnaire, 37% reported no sexual partner during the previous 12 months, 57% reported one partner and 6% reported more than one partner. Three per cent reported engaging in HIV sexual risk behaviour (i.e. more than one partner and failure to use a condom systematically), a pattern of behaviour which showed independent positive association with the male sex, an age of 20-59 years and being unmarried. Among those who had casual sexual partners during the preceding 12 months, 38% had always used condoms. In the multivariate analysis, failure to use a condom systematically with casual partners was associated with a higher age and being married. Of those who had regular partners during the previous 12 months, 26% had always used condoms, a finding associated with a lower age, higher educational level, unmarried status and non-cohabitation with the sexual partner. This survey has furnished some useful indicators for prevention purposes. Periodic repetition of this survey would enable possible changes in sexual risk behaviours to be detected.