Female circumcision: perceptions of clients and caregivers.

Abstract

Abstract Female circumcision is a custom which continues to be widespread in many parts of the word, yet very little is known about the practice by health care providers in the United States. Student health services in colleges and universities with large populations of international students need to be prepared to meet the health needs of this group of women. This paper discusses basic information about the practice of female circumcision. It summarizes data from a descriptive study conducted to identify specific needs and concerns of a group of 12 circumcised women who have used the western medical system while living in the United States. It also discusses the results of a follow-up study based on a questionnaire sent to 95 student health centers in the United States that had a foreign student population base of more than 500. Responses to the questionnaire identified the problems and concerns that student health providers encountered while caring for circumcised women. Suggestions for improved care are included from the perspective of both the client and the student health service personnel. “Screening Test for HTLV-III (AIDS Agent) Antibodies: Specificity, Sensitivity, and Applications,” STANLEY H. WEISS, et al. The third member of the human T-cell leukemia (lymphotropic) retrovirus family (HTLV-III) is a newly discovered retrovirus that has been closely associated with the acquired immunodeficiency syndrome (AIDS). In our application of an enzyme-linked immunosorbent assay (ELISA) for HTLV-III antibodies, 72 (82%) of 88 patients with AIDS were positive, 14 (16%) were borderline, and two (2%) were negative. In contrast, only 1% of the 297 volunteer blood donors were positive, 6% were borderline, and 93% were negative, demonstrating that this ELISA for HTLV-III antibodies is highly specific and sensitive for AIDS (excluding borderline results, 98.6% and 97.3%, respectively). Among persons at high risks for AIDS, 8% had borderline results, with positive and negative results readily distinguished as bimodal distributions that paralleled the temporal and geographic trends in AIDS. None of the 188 laboratory and health care employees working with patients with AIDS or their specimens were positive for HTLV-III antibodies, indicating that current precautions for health care workers appear adequate. This ELISA for HTLV-III antibodies will be a useful screening test among blood donors and populations at risk for AIDS, will aid in the diagnosis of suspected AIDS, and will help in defining the spectrum of diseases that are etiologically related to HTLV-III. (Journal of the American Medical Association 1985;253:221–225.) “Cimetidine, Cigarette Smoking, and Recurrence of Duodenal Ulcer,” Stephen Sontag, et al. Three hundred seventy patients with recently healed duodenal ulcer entered into a one-year, double-blind, randomized multicenter trial comparing placebo with three different dose schedules of cimetidine (200 mg twice a day, 300 mg twice a day, and 400 mg at bedtime) for the prevention of recurrent duodenal ulcer. By the end of one year, the cumulative symptomatic recurrence rate as demonstrated by endoscopy was similar for the patients receiving the three doses of cimetidine (19%, 15%, and 13%, respectively; not significant), whereas the placebo-treated group had a 34.7% symptomatic recurrence rate (P < 0.01 as compared with each cimetidine group). Cigarette smoking was found to be an important variable; among the placebo recipients ulcer recurrence was significantly more likely in smokers (72%) than in nonsmokers (21%, P < 0.001). The frequency of ulcer recurrence in smokers was significantly reduced by treatment with cimetidine (from 72% to 34%, P < 0.01). Smokers who received cimetidine were at least as likely to have a recurrence as were nonsmokers who received placebo (34% vs. 21%, not significant). Thus, smoking appears to be a major factor in recurrence of duodenal ulcer, and in smokers, giving up smoking may be more important in the prevention of ulcer recurrences than administration of cimetidine. (New England Journal of Medicine 1984;311:689–93.)