History Of Sexual Activity Research Articles

Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasia.

Experimental studies have provided strong evidence that human papillomavirus (HPV) is the long-sought venereal cause of cervical neoplasia, but the epidemiologic evidence has been inconsistent. Given improvements in HPV testing that have revealed a strong link between sexual activity history and cervical HPV infection, we conducted a large case-control study of HPV and cervical intraepithelial neoplasia (CIN) to evaluate whether sexual behavior and the other established risk factors for CIN influence risk primarily via HPV infection. We studied 500 women with CIN and 500 control subjects receiving cytologic screening at Kaiser Permanente, a large prepaid health plan, in Portland, Ore. The established epidemiologic risk factors for CIN were assessed by telephone interview. We performed HPV testing of cervicovaginal lavage specimens by gene amplification using polymerase chain reaction with a consensus primer to target the L1 gene region of HPV. Unconditional logistic regression analysis was used to estimate relative risk of CIN and to adjust the epidemiologic associations for HPV test results to demonstrate whether the associations were mediated by HPV. The case subjects demonstrated the typical epidemiologic profile of CIN: They had more sex partners, more cigarette smoking, earlier ages at first sexual intercourse, and lower socioeconomic status. Statistical adjustment for HPV infection substantially reduced the size of each of these case-control differences. Seventy-six percent of cases could be attributed to HPV infection; the results of cytologic review suggested that the true percentage was even higher. Once HPV infection was taken into account, an association of parity with risk of CIN was observed in both HPV-negative and HPV-positive women. The data show that the great majority of all grades of CIN can be attributed to HPV infection, particularly with the cancer-associated types of HPV. In light of this conclusion, the investigation of the natural history of HPV has preventive as well as etiologic importance.

Behavioral characteristics and laboratory parameters in homo- and bisexual men in West Berlin: An evaluation of five years of testing and counselling on AIDS

Sera of 1980 homo- and bisexual men who visited the Landesinstitut für Tropenmedizin Berlin (West) between April 1983 and December 1987 were tested for HIV antibodies; 24.3% were positive. Of HIV-antibody-positive men, 78.9% reported both active and passive anal intercourse, 58.8%, rectal enemas, and 53.3%, use of butyl nitrite. There was a sexual partner with known positive HIV-antibody status or AIDS in 33.9%, and in 32.4% there was a history of sexual activity in the USA. In the year before the test, 18.8% had had more than 50 partners. All these behavioral characteristics were found to be significantly correlated to HIV antibodies. We noted a substantial reduction of high-risk behavior from 1983 to 1987. The most important behavioral factor for HIV infection in 1983 and 1984 was sexual activity in the USA, and from 1984 to 1987, the numbers of lifetime partners. Persons infected with HIV were significantly more often carriers of antibodies against HAV, HBV, CMV, EBV, and syphilis. Prevalence of antibodies against HIV, HAV, HBV, and syphilis increased with age, duration of homosexual practice, and the number of partners. Overall crude prevalence rates of HIV antibodies, anti-HBc, anti-HAV, and antibodies to syphilis declined during the observation period. Clinical findings such as fever, oral lesions, and lymphadenopathy syndrome (LAS) were found to be highly indicative of HIV infection. Lower hemoglobin values, a reduced white cell count, and hyperimmunoglobulinemia were significantly more frequent in subjects with HIV antibodies.

Low prevalence of Chlamydia trachomatis in the oropharynx of adolescents.

This study determined the prevalence rates of Chlamydia trachomatis infection in the oropharynx of adolescents with and without pharyngitis. One hundred teenagers with and without symptoms of pharyngitis were cultured for C. trachomatis. Swabs were taken from the oropharynx and tonsillar areas for direct fluorescent antibody assay and cell culture. Of the 100 adolescents enrolled in the study 55% had a history of pharyngitis and 45% had no pharyngeal symptoms; 29% were male and 71% were female. The mean age was 15.5 years. Forty-two percent had a history of sexual intercourse, and 11.5% described a history of oral-genital sex. Only one 14-year-old female with a 2-week history of a sore throat had a positive culture. Her direct fluorescent antibody assay was inconclusive and the throat culture for Group A Streptococcus was negative. She had no history of sexual activity. The overall prevalence rate in the 100 adolescents was 1% with a 1.8% prevalence in the symptomatic group and 0 in the asymptomatic group. Of the symptomatic adolescents 39 had cultures for Group A Streptococcus and 8 (20.5%) were positive. The results of this study suggest that C. trachomatis is a rare inhabitant of the oropharynx in adolescents and is not a common cause of pharyngitis.

Sexually Transmissible Infectious Agents in Sexually Active and Virginal Asymptomatic Adolescent Girls

Sixty-eight sexually active and 52 virginal adolescent girls were evaluated for six sexually transmissible infectious agents: Gardnerella vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Chlamydia trachomatis, Trichomonas vaginalis, and Neisseria gonorrhoeae. There were significant differences between sexually active and virginal girls with respect to the prevalence of isolation of U urealyticum (75% v 33%, P less than .005), M hominis (27% v 10%, P less than .05), and C trachomatis (19% v 2%, P less than .025) but not for G vaginalis (34% v 17%, P = .09). N gonorrhoeae and T vaginalis were isolated exclusively from sexually active girls, but their low prevalence (6% and 9%, respectively) made the difference statistically insignificant (P = .2 and .06, respectively). Race, current v previous sexual activity, multiple sexual partners, oral contraceptive use, and concurrent isolation of another organism did not identify those at increased risk for chlamydial isolation. Such girls were significantly more likely to have inflammatory Papanicolaou smears (36% v 10%, P less than .05) and excessive WBC in their vaginal secretions (50% v 19%, P = .05). The data support the contention that C trachomatis, N gonorrhoeae, and T vaginalis are organisms that are predominantly acquired via sexual routes. Significant nonsexual modes of transmission are supported by the data for the genital mycoplasmas and G vaginalis. Finally, a history of sexual activity in an adolescent female warrants specific diagnostic testing for Chlamydia.

Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations

Numerous previous studies of nonspecific vaginitis have yielded contradictory results regarding its cause and clinical manifestations, due to a lack of uniform case definition and laboratory methods. We studied 397 consecutive unselected female university students and applied sets of well defined criteria to distinguish nonspecific vaginitis from other forms of vaginitis and from normal findings. Using such criteria, we diagnosed nonspecific vaginitis in up to 25 percent of our study population; asymptomatic disease was recognized in more than 50 percent of those with nonspecific vaginitis. A clinical diagnosis of nonspecific vaginitis, based on simple office procedures, was correlated with both the presence and the concentration of Gardnerella vaginalis (Hemophilus vaginalis) in vaginal discharge, and with characteristic biochemical findings in vaginal discharge. Nonspecific vaginitis was also correlated with a history of sexual activity, a history of previous trichomoniasis, current use of non-barrier contraceptive methods, and, particularly, use of an intrauterine device. G. vaginalis was isolated from 51.3 percent of the total population using a highly selective medium that detected the organism in lower concentration in vaginal discharge than did previously used media. Practical diagnostic criteria for standard clinical use are proposed. Application of such criteria should assist in clinical management of nonspecific vaginitis and in further study of the microbiologic and biochemical correlates and the pathogenesis of this mild but quite prevalent disease.

Asymptomatic Bacteriuria in Adolescent Girls: I. Epidemiology

Because the incidence of bacteriuria in asymptomatic school girls is low (1% to 2%), we examined possible risk factors in adolescents, such as previous history of urinary tract infection (UTI) and sexual intercourse (previous and recent). Eight (1.6%) of 500 adolescent girls were detected with asymptomatic bacteriuria (ABU). Of 47 patients reporting a previous UTI, four (9%) were bacteriuric. Two other patients detected with bacteriuria had a history of enuresis; thus 6/8 adolescents with ABU had a history that suggests a need to screen for infection. A history of sexual activity was not helpful in case detection. Of the 500 girls, 133 had a routine pelvic examination at the time of the visit. The procedure was not associated with bacteriuria, as measured by a home nitrite test each day for three days following the clinic visit.

Preterm Prelabour Rupture of the Membrane & Feto-Maternal out come: an Observational Study

Objective: The aim of this study was to see the maternal and fetal outcome of preterm pre labor rupture membrane and to identify the risk factors for preterm pre labor rupture membrane. Methods and Material: This was a cross-sectional descriptive type study carried out in Dhaka Medical College Hospital, Dhaka, during April to September, 2005 (6months) in the Department of Obstetric and Gynecology. 50 pregnant women with preterm premature rupture of the membrane (gestational age 29-0 to 36-6 weeks) were included in this study. Results: The mean age of the women was 27.24±6.28years and 36% of them more than 30 years old. Sixty two percent women were multi gravid .Socio-economic condition, level of education and antenatal care of the women was low. Median gestational age of the patient was 35 weeks. Fifty six percent had previous history of PROM, preterm delivery, abortion, MR and dilatation and curettage. Sixty two percent women had history of sexual activity between 2 to 7days. Seventy two percent women had UTI, anaemia, and lower genital tract infection. Mean duration of the latent period was 18.87 ±16.17hours and time interval of rupture membrane and delivery was 27.60 ± 21.127 hours. Eighty four percent patient delivered by vaginal route and Fifty four percent delivered within 24 hours of ruptured membrane. Forty two percent newborn suffered from neonatal asphyxia, respiratory distress syndrome, neonatal jaundice and neonatal sepsis. Thirty two percent women suffered from chorioamnionitis, abruptio placent and endometritis.Conclusion: PPROM is malnutrition and poverty related disease. Antenatal care is an important tool to prevent PPROM by identifying the risk factors and its management. Steroid for fetal lung maturity, antibiotics to prevent fetal and maternal infection and induction and /or augmentation of labor will speeded delivery and reduce hospital stay and infection. Key words: Premature rupture of the membrane; maternal and neonatal outcome; risk factors. DOI: 10.3329/jbcps.v28i1.4639 J Bangladesh Coll Phys Surg 2010; 28: 17-23