Female Sexual Partners Of Men Research Articles

HIV Incidence and Associated Risk Factors in Female Spouses of Men Who Inject Drugs in Pakistan

Introduction: Female sexual partners of men who inject drugs (MWID) living with HIV are at risk of HIV transmission. HIV prevalence estimates among non-drug using female sex partners of MWID are scarce, with no studies documenting HIV incidence among this subpopulation. This study investigated HIV prevalence and incidence among female spouses of MWID who were registered at Nai Zindagi Trust (NZT), Pakistan, between 2012-2019. Methods: National NZT registration and service provision data for female spouses who participated in HIV testing and counselling were used to calculate HIV prevalence and HIV incidence using the person years (PY) method. Cox proportional hazards models identified factors associated with incident HIV infection. Results: Overall HIV prevalence among female spouses of MWID was 8·5% compared with 0.1% among the general population 15-49 years. Among 3,478 HIV negative female spouses, 109 incident infections were observed, yielding an incidence rate of 1·5/100PY (95% CI=1·2-1·8). Independent predictors of incident infection were registration in Punjab province and 1-5 years of education. Knowledge of HIV at registration was protective, along with having a MWID spouse who had initiated antiretroviral therapy (ART), while HIV incident infection was inversely associated with the number of children. Conclusions: Additional efforts are needed to reduce HIV transmission among female spouses of MWID, including provision of HIV education, access to HIV screening, and targeted programs for women who inject or receive injections from community providers. Interventions that target men who inject drugs are also required, including evidence-based drug treatment and access to ART, including support to maximise adherence. Finally, consideration should be given to making HIV pre-exposure prophylaxis available to female spouses at high risk of HIV transmission, particularly young women with fewer children and those whose husbands are not receiving, or have difficulty adhering to, ART. Funding Statement: Funding for this study was provided by Mainline Foundation, The Netherlands, through the Bridging the Gaps programme - Health and Rights for Key Populations. Declaration of Interests: None of the authors have any conflict of interest to declare. Ethics Approval Statement: The Institutional Review Board at NZT granted ethical approval for this study.

Estimations of Typical, Ideal, Premature Ejaculation, and Actual Latencies by Men and Female Sexual Partners of Men During Partnered Sex

BackgroundThe ejaculation latency (ELT) criterion for men with premature ejaculation (PE), including its 2 major subtypes of lifelong and acquired, relies heavily on expert opinion, yet such information represents only one source of data for this determination; furthermore, information regarding ELTs for PE within specific subgroups of men (eg, gay, bisexual) has been lacking. AimTo obtain data regarding men's lived experiences and expectations regarding typical ejaculation, ideal ejaculation, and PE and (for men) self-reported ejaculatory latencies during partnered sex across a variety a groups, including men vs women (ie, sexual partners of men), men with and without PE, and straight vs gay/bisexual men. MethodsWe recruited 1,065 men and sexual partners of men, asking them to estimate typical ejaculation, ideal ejaculation, and PE and (for men) self-latencies through an online survey posted on social media. Demographics, sexual identity, and sexual response data were also collected. ResultsTypical and self-reported ELTs were closely aligned with those reported in the literature, with ideal ELTs generally longer than typical ELTs. Median PE ELTs were consistently estimated around 1.5 min, with nearly all subgroups—men vs women; straight vs gay; PE and non-PE men—showing alignment on this criterion. Men with lifelong PE did not differ from men with acquired PE in either their PE ELT estimation or their self-reported ELT. Clinical ImplicationsThe data support the idea of extending the latency cutoff for establishing a PE diagnosis beyond the current 1-minute threshold. Strengths & LimitationsA large sample size drawn from a multinational population powered the study, whereas the use of social media for recruitment and lack of inclusion of lesbian and asexual individuals may have missed relevant data from some who have had sexual experience with men. ConclusionStraight and nonstraight men do not differ in their ELT estimations. In addition, the use of different ELT criteria for lifelong vs acquired PE may be unnecessary.Côté-Léger P, Rowland DL. Estimations of Typical, Ideal,Premature Ejaculation,and Actual Latencies by Men and Female Sexual Partners of Men During Partnered Sex. J Sex Med 2020;17:1448–1456.

Interrelationships Between Intimate Partner Violence, Coping Style, Depression, and Quality of Life Among the Regular Female Sexual Partners of Men Who Have Sex With Men.

The regular female sexual partners of men who have sex with men (MSM), namely, "Tongqi" in China, increasingly attract attention in the field of public health due to their high levels of depression and intimate partner violence (IPV), and their potential risk of HIV infection. Few studies have explored the relationships among IPV, coping style, depression, and quality of life (QOL) in this population. To examine these relationships, a cross-sectional online survey was conducted in China from February 2016 to March 2017. A questionnaire, including the Revised Conflict Tactics Scales, the Simplified Coping Style Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the World Health Organization Quality of Life Scale, was completed by a total of 194 Chinese Tongqi. Structural equation modeling (SEM) was used to test the relationships among IPV, coping style, depression, and QOL. IPV (β = -0.12, p = .002), depression (β = -0.79, p < .001), and active coping style directly (β = 0.17, p < .001) affected the QOL of this group of women; IPV also indirectly affected QOL through the mediating effect of passive coping style and depression, and the positive coping style indirectly affected QOL through the mediating effect of depression. The proposed model showed good fit of indices, χ2/d = 43.72/34 = 1.286 < 3, p = .123, root mean square error of approximation (RMSEA) = 0.038. Chinese Tongqi experienced high levels of IPV, which led to a poor QOL, partially through the mediating role of passive coping strategy and depression. Future studies or interventions should emphasize the IPV experienced by Chinese Tongqi and provide psychological support so as to improve the overall well-being of this vulnerable female population.

Critical evaluation of arguments opposing male circumcision: A systematic review.

ObjectiveTo systematically evaluate evidence against male circumcision (MC).MethodsWe searched PubMed, Google Scholar, EMBASE and Cochrane databases.ResultsDatabase searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high‐quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high‐quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk‐benefit analyses reported that benefits exceed risks by 100‐200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low‐risk, high‐benefit interventions such as MC for better health. Expert evaluations of case‐law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost‐saving to health systems.ConclusionsArguments opposing MC are supported mostly by low‐quality evidence and opinion, and are contradicted by strong scientific evidence.

Anejaculation: Relevance to Sexual Enjoyment in Men and Women

IntroductionEjaculation and orgasm are important components of sexual response in men. Our understanding of both phenomena is limited. Anejaculation can be a source of substantial distress, even when procreation (ostensibly the only purpose of ejaculation itself) is not a priority. AimTo present an opinion on male perceptions of ejaculation disorders (specifically anejaculation) based on a variety of data sources, including peer-reviewed literature. MethodsA non-systematic review of literature on anejaculation and other impairments of ejaculatory and orgasmic response was conducted. Relevant articles were critically analyzed and reported Main Outcome MeasureAn opinion is presented, based on existing data sources, on how and why ejaculation is deemed important to men and their sexual partners. ResultsThe peer-reviewed literature on disorders of ejaculation is scant; existing reports oftentimes do not adequately distinguish between orgasm and ejaculation in assessment. Men’s perceptions of ejaculation quality appear to be positively associated with satisfaction with sexual response, particularly regarding orgasm. Based on very limited data, female sexual partners of men appear to often (but not always) value the orgasmic experience of their partner; only a minority prioritize actual ejaculation. There is evidence that disorders of ejaculation may be particularly troublesome for men who have sex with men. Clinical ImplicationsThe influence of medical conditions and treatments on ejaculation should be considered in the clinical context. Psychological adaptations and interventions may be of value in some cases. Strengths & LimitationsData on the clinical relevance of anejaculation outside the context of concomitant orgasmic dysfunction are sparse. Men’s experience of orgasm is at least partially associated with ejaculation-specific variables; whether this association is mediated by psychological, physical, or a combination of factors remains unclear. ConclusionsEjaculation, orgasm, and sexual satisfaction are closely intertwined but distinct phenomena.Shindel AW. Anejaculation: Relevance to Sexual Enjoyment in Men and Women. J Sex Med 2019;16:1324–1327.

MP76-18 “PARTNER PROSTHESIS PANIC”: MANAGEMENT OF FEMALE SEXUAL DYSFUNCTION IN PARTNERS OF MEN UNDERGOING PENILE PROSTHESIS IMPLANTATION

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I1 Apr 2016MP76-18 “PARTNER PROSTHESIS PANIC”: MANAGEMENT OF FEMALE SEXUAL DYSFUNCTION IN PARTNERS OF MEN UNDERGOING PENILE PROSTHESIS IMPLANTATION Sherita King, Rose Hartzell, and Irwin Goldstein Sherita KingSherita King More articles by this author , Rose HartzellRose Hartzell More articles by this author , and Irwin GoldsteinIrwin Goldstein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1869AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES About 30,000 penile implants are placed annually in the US. In our practice, several female partners in monogamous relationships with men with erectile dysfunction (ED) considering implant surgery have expressed significant concern over the re-introduction of an erect penis into their sexual lives. We define “Partner Prosthesis Panic” as the concerns of the female sexual partner who described issues such as: her low sexual desire, reduced arousal, muted orgasm, and bothersome pain during penetration. These conditions may negatively influence post-op outcome and frequency of implant use. We examined prevalence of “Partner Prosthesis Panic” and management strategies of distressed female sexual partners of men undergoing penile prosthesis implantation. METHODS In the last 50 consecutive penile implant surgeries in men in monogamous relationships, we identified 11 (22%) female sexual partners (mean age 57 +/- 11) who expressed “Partner Prosthesis Panic” and underwent management in our facility. RESULTS Contemporary management of women with sexual dysfunction is biopsychosocial including judicious use of FDA-approved and non-approved treatment options. 82% were menopausal, 18% were peri-menopausal. All had sexual dysfunction for >5 years prior to the implant. Female Sexual Function Index (mean 18 +/- 4) and Female Sexual Distress Scale (21 +/- 6) scores were abnormal in all. Psychologic interviews revealed findings consistent with a history of sexual trauma/abuse (27%) and mood issues: anxiety, depression, panic, use of mood-related medications (45%). Pelvic floor exams were abnormal in 73%. Vulvoscopy revealed abnormalities such as clitoral atrophy, resorption of labia minora, erythema/tenderness of minor vestibular glands, limited robust peri-urethral tissue, urethral prolapse, limited gavial rugae, abnormal vaginal pH in all patients. Hormonal assessments of sex steroids were abnormal in all patients. Following sex therapy, physical therapy, and biologic management, 8 of 11 experienced markedly improved sexual function that significantly facilitated couple satisfaction post-penile implantation. CONCLUSIONS Now that the FDA has approved treatments for women with sexual health concerns, management of women with sexual dysfunction, especially in monogamous relationships with men with ED considering penile implant surgery will become more commonplace. To maximize satisfaction following penile implant insertion, sexual medicine care to both individual members of the couple should be offered and provided. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1014 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Sherita King More articles by this author Rose Hartzell More articles by this author Irwin Goldstein More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Infection of Ureaplasma urealyticum in the group of full-term infants

There were 50 patients with acute epididymitis who were evaluated prospectively by history, examination and microbiologic studies, including cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. Escherichia coli was the predominant pathogen isolated from the urine of men more than 35 years old, while Chlamydia trachomatis and Neisseria gonorrhoeae were the predominant pathogens isolated from the urethra of men less than 35 years old. The etiologic role of Escherichia coli and Chlamydia trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine or urethral cultures for these agents. Chlamydia trachomatis epididymitis accounted for two-thirds of idiopathic epididymitis in young men and often was associated with oligospermia. Of 9 female sexual partners of men with Chlamydia trachomatis infection 6 had antibody to Chlamydia trachomatis, of whom 2 had positive cervical cultures for this organism and 2 others had non-gonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with Chlamydia trachomatis epididymitis and should be offered to the female sex partners

50. THE MANAGEMENT OF MEN WITH ACUTE CHLAMYDIA-NEGATIVE NON-GONOCOCCAL URETHRITIS: A LACK OF CONSENSUS AMONG AUSTRALIAN SEXUAL HEALTH PHYSICIANS

Objective: In clinical practice, chlamydia-negative non-gonococcal urethritis (NGU) is a common but poorly understood condition. The purpose of this study was to determine how Australian sexual health physicians manage men with this condition. Methods: In July 2006, a survey was mailed to all members of the Australasian Chapter of Sexual Health Medicine. Results: Of 166 surveys mailed out, 111 (67%) were returned completed. The majority of sexual health physicians (73%, n�=�81) indicated that they believed that female partners of men with acute chlamydia-negative NGU were at risk of adverse reproductive health outcomes. However, only 19% (n�=�21) routinely tested men with acute NGU for pathogens other than Neisseria gonorrhoeae and Chlamydia trachomatis. Most commonly, this was for M. genitalium (n�=�16). While 68% of respondents believed that M. genitalium was a cause of acute NGU, only 27% had access to testing for this organism. Other pathogens that were sometimes tested for included herpes simplex virus, Trichomonas vaginalis and adenovirus. Over half of sexual health physicians indicated that they would usually initiate notification of female sexual partners of men presenting with acute NGU, even before confirmatory test results were available. Conclusion: There are substantial differences in how acute, chlamydia-negative NGU is managed by Australian sexual health physicians. In part, these may relate to differences in beliefs around which pathogens are responsible for this condition and the availability of testing for particular pathogens. Notification of female partners is commonplace, even though the underlying cause of urethritis in affected men appears to be poorly defined.

Prevalence of hepatitis G virus in patients with hemophilia and their steady female sexual partners.

Hepatitis G virus (HGV), also known as GB virus C, is a newly discovered Flavivirus that is transmissible by blood transfusion and other possible routes. To study the risk of sexual transmission of HGV in female sexual partners of men with hemophilia (n = 161 couples). Blood samples obtained from 11 medical centers were analyzed for (1) HGV RNA by polymerase chain reaction; (2) antibodies to HGV by enzyme immunoassay; and (3) other viruses and T-cell counts by routine laboratory tests. Subjects completed a questionnaire that assessed sexual intercourse frequency, number of sexual partners, condom usage, sexually transmitted diseases, illicit drug usage, and needlestick or broken-glass injuries. The HGV infection (RNA +/- antibody positive) prevalence was 48% among men and 21% among women. Prevalence of hepatitis C virus, hepatitis B virus, and HIV among men was 99%, 94%, and 86%, compared with 3%, 11%, and 12% among women, respectively. The odds ratio for HGV infection for women with an HGV-positive male sexual partner was 2.14 (P = 0.06) without adjustment, and 2.77 (P = 0.03) with adjustment for other variables, none of which were independently significant. These results suggest a low level of HGV sexual transmission.

Evaluation of the POCkit™ HSV2 serology test at point-of-care

There were 50 patients with acute epididymitis who were evaluated prospectively by history, examination and microbiologic studies, including cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. Escherichia coli was the predominant pathogen isolated from the urine of men more than 35 years old, while Chlamydia trachomatis and Neisseria gonorrhoeae were the predominant pathogens isolated from the urethra of men less than 35 years old. The etiologic role of Escherichia coli and Chlamydia trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine or urethral cultures for these agents. Chlamydia trachomatis epididymitis accounted for two-thirds of idiopathic epididymitis in young men and often was associated with oligospermia. Of 9 female sexual partners of men with Chlamydia trachomatis infection 6 had antibody to Chlamydia trachomatis, of whom 2 had positive cervical cultures for this organism and 2 others had non-gonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with Chlamydia trachomatis epididymitis and should be offered to the female sex partners

Heterosexual co-transmission of hepatitis C virus (HCV) and human immunodeficiency virus (HIV).

To determine the prevalence of antibodies to hepatitis C virus (HCV) in female sexual partners of multitransfused men with hemophilia and to compare the frequency of transmission of HCV and human immunodeficiency virus (HIV). Cross-sectional measurement of HCV and HIV antibodies. Ten hemophilia treatment centers. A total of 234 female sexual partners of 231 multitransfused men with hemophilia. The prevalence of antibodies to HCV (anti-HCV) among female sexual partners of HCV-positive men was 5 of 194 (2.6%). Anti-HIV prevalence among female sexual partners of HIV-positive men was 25 of 196 (12.8%). Five (3%) of the 164 female sexual partners of HIV-positive/HCV-positive men were infected with HCV compared with none of the 30 female sexual partners of HIV-negative/HCV-positive men. Twenty-one (13%) of the 164 female sexual partners of HIV-positive/HCV-positive men were infected with HIV compared with 4 (13%) of 32 female sexual partners of HIV-positive/HCV-indeterminate men. The co-infected men were five times more likely to transmit both viruses than would be expected by chance (P = 0.01). When a single virus was transmitted to a female sexual partner, it was more often HIV than HCV (18 of 164 compared with 2 of 164, P = 0.001; odds ratio, 8.5; 95% Cl, 2.2 to 33.1). The higher prevalence of HCV in female sexual partners of men with hemophilia than in blood donor and other low-risk groups suggests that there is a low level of sexual transmission. Male to female sexual transmission of HCV is less efficient than that of HIV. The frequency of HCV transmission to sexual partners is five times higher when HIV is also transmitted, suggesting that HIV may be a cofactor for the sexual transmission of HCV.

Transmission of HIV to heterosexual partners of infected men and women

Future heterosexual spread of HIV will in part depend on the efficiency of transmission from men to women and from women to men. We studied seventy-eight female sexual partners of men infected with HIV and 18 male sexual partners of infected women. Participants were interviewed concerning sexual practices, use of contraception and other risk factors for HIV infection. Fifteen out of 78 (19.2%) female partners and one out of eighteen (5.5%) male partners were seropositive for HIV antibody. All couples had practised vaginal intercourse. Seropositive female partners did not differ significantly from seronegative partners with regard to length of relationship, number of acts of vaginal intercourse, other sexual practices, stage of clinical disease in the index case, or numbers of other sexual partners in the last five years. In two women, seroconversion was documented after one act of unprotected sexual intercourse. The majority of infected female partners (eight out of 15) had sexual relationships with men who were asymptomatic and did not practice anal intercourse. Biological factors such as variability in infectivity of the index case and susceptibility of the contact, as well as behavioural variables may be important in determining transmission.

More heterosexual spread of HTLV-III virus seen

Welcoming participants to the recent International Conference on Acquired Immunodeficiency Syndrome (AIDS) in Atlanta, Department of Health and Human Services Secretary Margaret M. Heckler said: "For individuals in every country who fall within the risk categories, AIDS is an enormously serious disease. We must conquer it for their sake. We must conquer it as well before it affects the heterosexual population and threatens the health of our general population." Unfortunately, and perhaps despite all good intentions, not only was the secretary's phraseology offensive to many—but her timing also may have been off. Several speakers at the conference presented evidence that heterosexual transmission of AIDS is something to reckon with right now. While it has been accepted for some time that female sexual partners of men who are in the high-risk groups for AIDS—bisexuals, intravenous (IV) drug abusers, and persons with hemophilia—are at increased risk of contracting the disease, the epidemiologically

Aquired immunodeficiency and related syndromes

In 1981, an unusual associationof pneumocystis carinii pneumonia, other opportunistic infections and Kaposi 's sarcoma was reported in previously healthy young men livingin the U.S.A. This syndomeappearedas an epidemic immuno-deficiency with predominant profound disturbances of cellular immune function. It was called the acquired immuno-deficiency (A.I.D.S.). The syndrome was first described in homosexual men havinga large number of partners and in intravenousdrug abusers. But other groups of patients with increased risk have since been recognized: female sexual partners of men with AIDS, Haitians living in the United States or in Haiti, people originatingfrom Zaire or the Congo, infants living in contact with drug abusers of patients with AIDS, transfusion recipients mainly in Haiti, and persons with hemophilia treated by Factor VIII concentrated perfusions ' II. The number of casesincreased exponentially and reachedapproximately 2500 in October 1983. The disease is not only found in the U.S.A.I, 10: at the present time, more than 250 cases are known in Europe. Cases have been described in every part of the world, and epidemiologic studies are beingperformedveryactively to have more precise data on the populations at risks. However, it is important to stress that nurses, laboratory workers or doctors cannot be contaminated while nursing patients or manipulating biological samples. The only way to be infectedis by sexual contact or by intravenousinjectiorr', The evolution of the disease is characterized by 2 phases. During the first stage, the patient appears to be healthy. In some case, fever with night sweats of thrornbopenic purpura can occur, but diffuse lymphadenopathies without hepatomegaly are found in most of the cases. The enlarged lymph nodes are mainly discovered in the cervical chains, predominantly the posterior, in the axilla and/or the groin. This first phase is sometimes called AIDS or lymphadenopathic syndrome AIDS-related. Lymph node biopsies disclose histopathological modifications resembling lymphoid stimulation of B dependant zones, with anomalous distribution of suppressor (increased) and helper (decreased) T lyrnphocytes. The duration of this prodromic phase remains unknown, sometimes 6 months, sometimes one year or more. In some cases, the evolution can be regressive.

An invitation to experience health.

Abstract “Immunodeficiency in Female Sexual Partners of Men with the Acquired Immunodeficiency Syndrome,” CAROL HARRIS, et al. Because the current outbreak of acquired immunodeficiency syndrome (AIDS) among previously healthy adults may be caused by a transmissible biologic agent, and because it may be preceded by immunologic abnormalities with or without a prodromal illness, we studied seven female sexual partners of male patients with the syndrome. The male patients were all drug abusers. One of the seven women was found to have the full-blown syndrome, a second had an illness consistent with the prodrome of AIDS (generalized lymphadenopathy, lymphopenia, and a decreased ratio of helper to suppressor T cells), and four others had generalized lymphadenopathy or lymphopenia, with or without a decreased ratio of helper to suppressor T cells. Only one woman had no abnormalities. These findings suggest that AIDS may be transmitted between heterosexual men and women. (New England Journal of Medicine 1983;308:1181–4.) “The Effect of Different Types of Intrauterine Devices on the Risk of Pelvic Inflammatory Disease,” DAVID W. KAUFMAN, et al. A case-control study of 155 women with pelvic inflammatory disease (PID) and 305 controls with other conditions was carried out. Compared with other methods of contraception, the age-adjusted relative risk estimate for use of any intrauterine device (IUD) within one month of admission was 8.6 (95% confidence limits, 5.3 and 13.8); for past use, the estimate was 1.6 (confidence limits, 0.6 and 4.0). The estimated risk was highest for users of the Dalkon Shield (11 cases and two controls), lowest for users of copper-containing devices (40 cases and 34 controls), and intermediate for users of other IUDs, principally the Lippes Loop (32 cases and 23 controls). Compared with copper-containing IUDs, the relative risk estimate for the Dalkon Shield was 6.5 (confidence limits, 1.5 and 27.5). When the Dalkon Shield and copper-containing IUDs were compared, in turn, with the Lippes Loop, the estimated risk was increased for the former and reduced for the latter, but the differences were not statistically significant. Nine of the 11 cases using the Dalkon Shield (82%) had severe PID (diagnosed at surgery or because of purulent cervical discharge), compared with 12 of 40 copper device users (30%) and nine of 32 Lippes Loop users (28%). The risk of PID did not seem to be related to duration of use of any of the three IUDs. This study confirms that IUD use increases the risk of PID. It also suggests that the Dalkon Shield is more harmful than other devices. (Journal of the American Medical Association 1983;250:759–762.)

Immune Deficiency Syndrome in Children-Reply

In Reply.— Rosner and Giron take issue with our suggestion that infants and children living in high-risk households may be in jeopardy of experiencing AIDS. They seem to believe in an exclusively perinatal or in utero mode of acquisition. We used household exposure in the broadest context to contrast with routine congenital immunodeficiency or infection and included a statement on so-called vertical transmission. Indeed, we have previously written on the latter possibility but believe that the monolithic position they take on pathogenesis is unwarranted. 1 We are aware of the data quoted on immunodeficiency in female sexual partners of men with AIDS. The mothers of the two infants in our report fathered by men with AIDS remain asymptomatic but have now experienced T-cell dysfunction themselves. Nevertheless, we are receptive to suggestions of other possible methods of spread. Analogies between the epidemiology of hepatitis B virus (HBV) and AIDS have been

Immunodeficiency in female sexual partners of men with the acquired immunodeficiency syndrome.

Because the current outbreak of acquired immunodeficiency syndrome (AIDS) among previously healthy adults may be caused by a transmissible biologic agent, and because it may be preceded by immunologic abnormalities with or without a prodromal illness, we studied seven female sexual partners of male patients with the syndrome. The male patients were all drug abusers. One of the seven women was found to have the full-blown syndrome, a second had an illness consistent with the prodrome of AIDS (generalized lymphadenopathy, lymphopenia, and a decreased ratio of helper to suppressor T cells), and four others had generalized lymphadenopathy or lymphopenia, with or without a decreased ratio of helper to suppressor T cells. Only one woman had no abnormalities. These findings suggest that AIDS may be transmitted between heterosexual men and women.

Etiology, Manifestations and Therapy of Acute Epididymitis: Prospective Study of 50 Cases

There were 50 patients with acute epididymitis who were evaluated prospectively by history, examination and microbiologic studies, including cultures for aerobes, anaerobes, Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma urealyticum. Escherichia coli was the predominant pathogen isolated from the urine of men more than 35 years old, while Chlamydia trachomatis and Neisseria gonorrhoeae were the predominant pathogens isolated from the urethra of men less than 35 years old. The etiologic role of Escherichia coli and Chlamydia trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine or urethral cultures for these agents. Chlamydia trachomatis epididymitis accounted for two-thirds of idiopathic epididymitis in young men and often was associated with oligospermia. Of 9 female sexual partners of men with Chlamydia trachomatis infection 6 had antibody to Chlamydia trachomatis, of whom 2 had positive cervical cultures for this organism and 2 others had non-gonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with Chlamydia trachomatis epididymitis and should be offered to the female sex partners

Acute epididymitis: etiology and therapy.

Fifty patients with acute epididymitis were evaluated prospectively by history, examination, and microbiologic studies, including cultures for aerobes, anaerobes, N. gonorrhoeae, Chlamydia trachomatis, and Ureaplasma urealyticum. E. Coli was the predominant pathogen isolated from the urine of men over 35 years old and C. trachomatis and N. gonnorrheae were the predominant pathogens isolated from the urethra of men under 35. The etiologic role of E. Coli and C. trachomatis was confirmed by isolation from epididymal aspirates from a high proportion of men with positive urine of urethral cultures for these agents. C. trachomatis epididymitis accounted for two thirds of "idiopathic epididymitis" in men, and was often associated with oligozoospermia. Of nine female sexual partners of men with C. trachomatis infection, six had antibody to C. trachomatis, of whom two had positive cervical cultures for this organism, and the others had nongonococcal pelvic inflammatory disease. Antibiotic therapy with tetracycline was effective for the treatment of men with C. trachomatis epididymitis, and should be offered to their female sex partner.