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Effect of single session counselling on partner referral for sexually transmitted infections management in Bangladesh.
Alam N, Streatfield PK, Shahidullah M, Mitra D, Vermund SH, Kristensen S
(2011) Sex Transm Infect 87: 46-51
MeSH Terms: Adult, Bangladesh, Condoms, Counseling, Female, Health Education, Humans, Male, Marital Status, Middle Aged, Referral and Consultation, Sexual Behavior, Sexual Partners, Sexually Transmitted Diseases, Young Adult
Show Abstract · Added March 5, 2014
OBJECTIVES - This study evaluated the role of single session counselling on partner referral among index cases diagnosed as having sexually transmitted infections (STIs) in Bangladesh.
METHODS - A quasirandomised trial was conducted in 1339 index cases with symptomatic STIs in 3 public and 3 non-government organisation operated clinics.
RESULTS - Out of 1339 index cases, partner referral was achieved by 37% in the counselling group and 27% in the non-counselling group. Index cases in the counselling group and non-counselling group were similar in terms of condom use rates, STI symptoms and duration of disease. A quarter of the index cases reported having more than one sex partner in last 3 months, and 39% reported having commercial sex partners. Only 8% of the index cases reported using condoms during their last sex act. Partner referral rates were higher among index clients with higher age, higher income, those who attended NGO clinics, those who had only one partner and among those who had no commercial partners, but counselling had significantly positive impact in all of these subgroups. In multivariate analysis, the probability of partner referral was 1.3 times higher among index cases in the counselling group (prevalence ratio 1.3; 95% CI 1.1 to 1.6) as compared to index cases in the non-counselling group.
CONCLUSIONS - Patient-oriented single session counselling was found to have a modest but significant effect in increasing partner referral for STIs in Bangladesh, greater emphasis should be placed on examining further development and dissemination of partner referral counselling in STI care facilities.
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15 MeSH Terms
Association between intimate partner violence and irritable bowel syndrome: a population-based study in Nicaragua.
Becker-Dreps S, Morgan D, Peña R, Cortes L, Martin CF, Valladares E
(2010) Violence Against Women 16: 832-45
MeSH Terms: Adult, Cross-Sectional Studies, Female, Humans, Irritable Bowel Syndrome, Middle Aged, Nicaragua, Odds Ratio, Risk Factors, Sexual Partners, Spouse Abuse, Surveys and Questionnaires, Young Adult
Show Abstract · Added May 20, 2016
Irritable bowel syndrome (IBS) is a disabling functional gastrointestinal disorder, which serves as a model for abdominal pain syndromes. An association between intimate partner violence and IBS has been shown among White women in the industrialized world. To determine whether this relationship transcends cultural boundaries, we conducted a population-based, cross-sectional survey in Nicaragua using the innovative Health and Demographic Surveillance System in the León province. Women who had experienced physical intimate partner violence had significantly increased risk of IBS (odds ratio [OR] = 2.08; 95% confidence interval [CI] = 1.35, 3.21), as did those who had experienced sexual intimate partner violence (OR = 2.85; 95% CI = 1.45, 5.59). These findings argue for intimate partner violence screening among Latina women with IBS.
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13 MeSH Terms
Estimation of HIV-1 incidence among five focal populations in Dehong, Yunnan: a hard hit area along a major drug trafficking route.
Duan S, Shen S, Bulterys M, Jia Y, Yang Y, Xiang L, Tian F, Lu L, Xiao Y, Wang M, Jia M, Jiang H, Vermund SH, Jiang Y
(2010) BMC Public Health 10: 180
MeSH Terms: AIDS Serodiagnosis, Adult, Catchment Area, Health, China, Cross-Sectional Studies, Female, HIV Infections, HIV Seroprevalence, HIV-1, Humans, Incidence, Male, Marriage, Population Surveillance, Pregnancy, Prevalence, Sex Work, Sexual Partners, Spouses, Substance Abuse, Intravenous, Surveys and Questionnaires
Show Abstract · Added March 5, 2014
BACKGROUND - Since 1989 when the first 146 HIV positives in China were identified, Dehong Prefecture had been one of the areas hardest-hit by HIV in China. The local and national governments have put substantial financial resources into tackling the HIV epidemic in Dehong from 2004. The objective of this study was to track dynamic changes in HIV-1 prevalence and incidence among five focal populations in Dehong and to assess the impact of HIV prevention and control efforts.
METHODS - Consecutive cross-sectional surveys conducted in five focal populations between 2004 and 2008. Specimens seropositive for HIV were tested with the BED IgG capture enzyme immunoassay to identify recent seroconversions (median, 155 days) using normalized optical density of 0.8 and adjustments.
RESULTS - From 2004 to 2008, estimated annual HIV incidence among injecting drug users (IDUs) decreased significantly [from 15.0% (95% CI = 11.4%-18.5%) in 2004 to 4.3% (95% CI = 2.4%-6.2%) in 2008; trend test P < 0.0001]. The incidence among other focal populations, such as HIV discordant couples (varying from 5.5% to 4.7%), female sex workers (varying from 1.4% to 1.3%), pregnant women (0.1%), and pre-marital couples (0.2 to 0.1%) remained stable. Overall, the proportion of recent HIV-1 infections was higher among females than males (P < 0.0001).
CONCLUSIONS - The HIV epidemic in Dehong continued to expand during a five-year period but at a slowing rate among IDUs, and HIV incidence remains high among IDUs and discordant couples. Intensive prevention measures should target sub-groups at highest risk to further slow the epidemic and control the migration of HIV to other areas of China, and multivariate analysis is needed to explore which measures are more effective for different populations.
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21 MeSH Terms
Anal squamous intraepithelial lesions among HIV positive and HIV negative men who have sex with men in Thailand.
Li AH, Phanuphak N, Sahasrabuddhe VV, Chaithongwongwatthana S, Vermund SH, Jenkins CA, Shepherd BE, Teeratakulpisarn N, van der Lugt J, Avihingsanon A, Ruxrungtham K, Shikuma C, Phanuphak P, Ananworanich J
(2009) Sex Transm Infect 85: 503-7
MeSH Terms: Adult, Anus Neoplasms, Asia, Carcinoma in Situ, Carcinoma, Squamous Cell, Cross-Sectional Studies, HIV Seronegativity, HIV Seropositivity, Homosexuality, Male, Humans, Male, Prevalence, Risk Factors, Sexual Partners, Thailand
Show Abstract · Added March 5, 2014
OBJECTIVES - To evaluate the prevalence and risk factors of anal squamous intraepithelial lesions (ASIL), the putative anal cancer precursor, in Asian HIV positive and HIV negative men who have sex with men (MSM).
METHODS - Men who underwent anal Pap smear reported clinical, sociodemographic and behavioural information collected through questionnaire and interview between January 2007 and April 2008. Chi(2) and logistic regression were used to evaluate ASIL prevalence and risk factors among HIV positive and HIV negative MSM.
RESULTS - Of the 174 MSM (mean age 32.1 years), 118 (67.8%) were HIV positive. Overall, 27% had abnormal anal cytology: 13.2% had atypical squamous cells of undetermined significance (ASC-US), 11.5% had low-grade squamous intraepithelial lesion (LSIL) and 2.3% had high-grade squamous intraepithelial lesion (HSIL). Prevalence of ASIL was higher among HIV positive than HIV negative MSM (33.9% vs 12.5%; p = 0.003). Among HIV positive MSM, 16.1% had ASC-US, 14.4% had LSIL and 3.4% had HSIL and 7.1%, 5.4% and 0% in HIV negative MSM, respectively. Anal condyloma was detected in 22% of HIV positive and 16.1% (9/56) of HIV negative MSM (p = 0.5). In HIV positive MSM, anal condyloma (OR 3.42, 95% CI 1.29 to 9.04; p = 0.01) was a significant risk factor for ASIL. Highly active antiretroviral therapy use and CD4+ T cell count were not associated with ASIL.
CONCLUSIONS - One-third of HIV positive and 12.5% of HIV negative MSM had ASIL. Thus, as greater numbers of HIV positive MSM live longer due to increasing access to HAART worldwide, effective strategies to screen and manage anal precancerous lesions are needed.
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15 MeSH Terms
Clinical and psychosocial characteristics of men with erectile dysfunction: baseline data from ExCEED.
Latini DM, Penson DF, Wallace KL, Lubeck DP, Lue TF
(2006) J Sex Med 3: 1059-1067
MeSH Terms: Adult, Aged, Anxiety, Coitus, Depression, Erectile Dysfunction, Health Status, Humans, Interpersonal Relations, Life Style, Male, Middle Aged, North America, Psychometrics, Quality of Life, Registries, Reproducibility of Results, Self Concept, Severity of Illness Index, Sexual Partners, Stress, Psychological, Surveys and Questionnaires
Show Abstract · Added March 5, 2014
INTRODUCTION - Erectile dysfunction (ED) is associated with psychological impairment, and further research is required to understand their relationship.
AIM - We present descriptive baseline results from a longitudinal observational study of North American men seeking treatment for ED.
METHODS - Patients completed clinical and health-related quality-of-life information at baseline and three follow-up points over 12 months; 162 patients had usable baseline data, including clinical history and current status, sociodemographic information, and standard paper-and-pencil scales of psychosocial characteristics. Scores on the International Index of Erectile Functioning erectile functioning subscale were collapsed into mild (N = 27), moderate (N = 41), or severe (N = 94) categories. Using chi-square, anova, and logistic regression, we identified baseline characteristics associated with ED severity.
MAIN OUTCOME MEASURE - The main outcome measure was the degree of psychosocial impairment associated with mild, moderate, and severe ED.
RESULTS - Severe ED was significantly associated with not having a regular sex partner; a history of prostate cancer; and worse scores on measures of positive affect, belonging/loneliness, sexual self-efficacy-strength, psychological adjustment, marital happiness, anxiety at last intercourse, and depression. In a multivariate logistic regression model, poorer sexual self-efficacy was most closely associated with severe ED. The model rescaled R(2) was 0.63 (area-under-the-curve, 0.91).
CONCLUSIONS - Severe ED is related to impairment across a broad range of psychosocial domains, and clinicians should consider offering patients assistance in dealing with its psychosocial impact.
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22 MeSH Terms
Predicting adolescent risk behaviors based on an ecological framework and assets.
Reininger BM, Evans AE, Griffin SF, Sanderson M, Vincent ML, Valois RF, Parra-Medina D
(2005) Am J Health Behav 29: 150-61
MeSH Terms: Adolescent, Adolescent Behavior, Alcohol Drinking, Ethnic Groups, Female, Health Behavior, Health Surveys, Humans, Illegitimacy, Linear Models, Male, Models, Theoretical, Pregnancy, Pregnancy, Unwanted, Probability, Risk-Taking, Sex Education, Sexual Behavior, Sexual Partners, Smoking, Smoking Prevention, Social Values, Students, Surveys and Questionnaires
Show Abstract · Added March 11, 2014
OBJECTIVES - To examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years.
METHODS - Linear regression models for African American and white males and females predicted an aggregate risk score.
RESULTS - After adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive.
CONCLUSIONS - Taking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors.
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24 MeSH Terms
Personal risk perception, HIV knowledge and risk avoidance behavior, and their relationships to actual HIV serostatus in an urban African obstetric population.
Stringer EM, Sinkala M, Kumwenda R, Chapman V, Mwale A, Vermund SH, Goldenberg RL, Stringer JS
(2004) J Acquir Immune Defic Syndr 35: 60-6
MeSH Terms: Adult, Demography, Female, HIV Infections, HIV Seropositivity, Health Knowledge, Attitudes, Practice, Humans, Pregnancy, Pregnancy Complications, Infectious, Risk-Taking, Sexual Behavior, Sexual Partners, Social Perception, Urban Population, Zambia
Show Abstract · Added March 5, 2014
One quarter of pregnant women in Zambia are infected with HIV. Understanding how knowledge of HIV relates to personal risk perception and avoidance of risky behaviors is critical to devising effective HIV prevention strategies. In conjunction with a large clinical trial in Lusaka, Zambia, we surveyed postpartum women who had been tested for HIV but did not know their status before undergoing the questionnaire. Of 858 women for whom complete data were available, 248 (29%) were HIV infected. Women 22 years of age or older (adjusted odds ratio [AOR], 1.7; 95% confidence interval [CI], 1.1-2.5), women reporting > or =2 sexual partners in their lifetime (AOR, 1.8; 95% CI, 1.3-2.5), and women reporting a history of a sexually transmitted infection (AOR, 2.7; 95% CI, 1.7-4.3) were more likely to be HIV infected. Having had > or =2 lifetime sexual partners was a marker for perception of high personnel risk for HIV infection (AOR, 1.5; 95% CI, 1.1-2.1). However, there was no relationship between perceived risk of HIV infection and actual HIV status. In fact, 127 (52%) of 245 women who stated that they were at no or low risk for HIV infection were HIV infected. Living in an area of high HIV seroprevalence like Zambia seems to be the greatest risk factor for infection in unselected pregnant women. Before significant inroads can be made in decreasing the incidence of HIV infection among pregnant women, population-based strategies that involve men must be implemented.
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15 MeSH Terms
Patient-led partner referral in a district hospital based STD clinic.
Sahasrabuddhe VV, Gholap TA, Jethava YS, Joglekar NS, Brahme RG, Gaikwad BA, Wankhede AK, Mehendale SM
(2002) J Postgrad Med 48: 105-8
MeSH Terms: Adolescent, Adult, Aged, Analysis of Variance, Chi-Square Distribution, Cohort Studies, Female, Hospitals, District, Humans, India, Interpersonal Relations, Logistic Models, Male, Middle Aged, Multivariate Analysis, Outpatient Clinics, Hospital, Patient Acceptance of Health Care, Primary Prevention, Risk Assessment, Sexual Partners, Sexually Transmitted Diseases, Surveys and Questionnaires, Urban Health Services
Show Abstract · Added March 5, 2014
CONTEXT - Sexual communication and appropriate treatment of sexual partners is critical to the success of STD and HIV/AIDS prevention and control.
AIMS - To understand factors influencing intention of STD patients to inform their regular sexual partners and identify predictors influencing actual return of the partners.
SETTINGS AND DESIGN - A non-randomised survey of patients attending STD clinic in a district hospital between May and November 2000.
METHODS AND MATERIAL - 182 patients were administered structured questionnaires to understand their intention to notify their regular sexual partners and encouraged to refer their regular sexual partners to the clinic for management. Factors related to intent to notify partners and actual partner referral were analysed.
STATISTICAL ANALYSIS USED - Chi square test and forward stepwise logistic regression.
RESULTS - Of the 182 STD patients 77.47% expressed their positive intention to notify their regular sexual partners. However, overall partner return rate was 40.65%. Patients from a better economic class (p=0.014), those who had sex since having the disease (p=0.001), those who felt it was easy to tell their partners (p=0.047) and perceived the necessity of investigating their partners (p<0.001) were more likely to have an intention to notify their partners. Independent predictors of actual return of sexual partners were patients' perception of partners' susceptibility (p=0.044), positive intention to notify partners (p=0.001), partners already informed before clinic visit (p=0.030) and presence of genital ulcerative diseases (p=0.033).
CONCLUSIONS - STD clinic counselling and education should focus on risk reduction, partner susceptibility, role of STDs in HIV transmission and improving spousal communication.
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23 MeSH Terms
Cervical ectopy in adolescent girls with and without human immunodeficiency virus infection.
Moscicki AB, Ma Y, Holland C, Vermund SH
(2001) J Infect Dis 183: 865-70
MeSH Terms: Adolescent, Adult, Cervix Uteri, Child, Cohort Studies, Contraception Behavior, Epithelium, Female, HIV Infections, Humans, Photography, Risk Factors, Sexual Behavior, Sexual Partners, Vaginosis, Bacterial
Show Abstract · Added March 5, 2014
The objective of this study was to examine factors, including human immunodeficiency virus (HIV) infection, associated with ectopy among adolescent girls aged 12-20 years who were participating in an ongoing study of HIV infection in adolescents. Samples for detection of bacterial vaginosis, Chlamydia trachomatis, and Neisseria gonorrhoeae and a high-resolution photograph of the cervix for ectopy measurement were collected. Ectopy data for 189 and 92 HIV-positive and -negative adolescents, respectively, were examined. Although univariate analysis found HIV infection and oral contraceptive use to be associated with the amount of ectopy, multivariate logistic regression analysis showed that only number of lifetime sex partners was a significant predictor, with more partners associated with less ectopy (odds ratio, 0.47; 95% confidence interval, 0.22-1.00; P=.05). In summary, adolescent girls with greater numbers of lifetime sex partners were more likely to have mature cervixes (less ectopy). HIV infection was not independently associated with ectopy.
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15 MeSH Terms
Behavioral and demographic risk factors for transmission of human immunodeficiency virus type 1 in heterosexual couples: report from the Heterosexual HIV Transmission Study.
Skurnick JH, Kennedy CA, Perez G, Abrams J, Vermund SH, Denny T, Wright T, Quinones MA, Louria DB
(1998) Clin Infect Dis 26: 855-64
MeSH Terms: Adult, Aged, Alcohol Drinking, Female, HIV Infections, HIV-1, Heterosexuality, Humans, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Risk Factors, Sexual Partners, Substance-Related Disorders
Show Abstract · Added March 5, 2014
We compared 224 heterosexual couples who were discordant for human immunodeficiency virus (HIV) type 1 infection (one partner HIV infected) with 78 HIV-concordant couples (both partners HIV infected) to identify demographic and behavioral risk factors for HIV transmission. Among the 229 couples whose male partner was first infected, HIV-concordant couples had engaged in anal sex more frequently before and after knowing that the male was infected than had HIV-discordant couples. Pap smears of grade 2 or higher (inflammation) were more prevalent among the second-infected female partners in HIV-concordant couples than among uninfected women in discordant couples (58% vs. 23%; P < .001). Anal sex and unprotected vaginal sex after knowledge of a male partner's infection were significant correlates of concordance in a multivariate logistic model, as were ethnicity, marital status, and antiviral therapy. Ethnicity strongly predicted concordance, even after controlling for sexual risk behaviors and stage of disease.
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15 MeSH Terms