Lifetime Sexual Partners Research Articles

Age at first sex and other determinants of multiple sexual partnerships among sexually active adolescent girls in Ghana: a regression analysis of the 2022 Ghana demographic and health survey

BackgroundEarly sexual debut is a widely recognized public health issue due to its influence on lifetime multiple sexual partners which can lead to complications such as teenage pregnancy, abortion, HIV/AIDS and other sexually transmitted infections. However, there is paucity of research evidence on sexual behaviour such as age at first sexual intercourse and the number of sexual partnerships among adolescent girls in Ghana. This study aims to examine the influence of age at first sexual intercourse and other determinants on multiple sexual partnerships among adolescent girls aged 15–19 years in Ghana.MethodsData for this study were obtained from the 2022 Ghana Demographic and Health Survey (GDHS) conducted between October 17, 2022 and January 14, 2023. A total weighted sample of 719 sexually active adolescent girls who reported having sexual partners was extracted from the women’s data file. Data were analyzed with SPSS version 27, employing multilevel logistics regression modelling. Statistical significance was set at p < 0.05.ResultsThe average age at sexual debut for adolescent girls aged 15–19 years in Ghana is 15.5 years. A little over half (51.6%) of adolescent girls reported having two or more lifetime sexual partners. Adolescent girls who initiated sex before reaching age 15 were more likely (aOR = 2.00; C.I 1.39–2.87) to have multiple partners compared to those who had their first sex before attaining age 20. After controlling for other factors, girls who had their sexual debut before age 15 had higher odds (aOR = 1.85; C.I:1.30–3.31) of engaging in multiple sexual partnerships. Girls living female headed households (aOR = 2.25; C.I:1.18–4.29] and consuming alcohol (aOR = 2.38; C.I 2.38–1.09–5.17) had higher odds of having multiple sexual partners.ConclusionThe study findings show that early sexual debut, living in female headed household, and consuming alcohol are strong predictors of multiple sexual partnerships among adolescent girls in Ghana. It suggests the need for policies promoting delayed sexual debut and empowering adolescents to make informed decisions to improve sexual health outcomes.

Seroprevalence of herpes simplex virus 2 infection among commercial sex workers in Colombo, Sri Lanka

Background: Herpes Simplex Virus Type 2 (HSV2) causes genital herpes, an incurable, lifelong sexually transmitted infection (STI). This study was conducted to describe the seroprevalence and associated factors of HSV2 infection in a cohort of Female Sex Workers (FSWs). Methods: A descriptive cross-sectional study was conducted on 136 FSWs who attended the central STD Clinic, in Colombo. They were assessed using an interviewer-administered questionnaire followed by serum sampling. Serum samples were tested for HSV2 IgG using an enzyme immunoassay specific for glycoprotein gG2 of HSV2. Results: HSV2 seroprevalence of FSW was 66.9% (91/136) of which only 14.3% (13/91) reported a history of genital infection. Age ≥35 years (OR 3.35, 95%CI 1.54-7.31, p=0.002), education ≥ grade 5 (OR 8.35, 95%CI 13.1- 64.7, p&lt;0.001), lifetime sexual partners ≥ 200 (OR 5.33, 95% CI 2.3-12.36), p&lt;0.001), duration of sex work ≥1 year (OR 4.5, 95% CI 2.09-9.65, p&lt;0.001) and history of STI (OR 4.52, 95% CI 1.9-10.78, p&lt;0.001) were statistically significant risk factors for high HSV2 prevalence. Consistent condom use by commercial partners in the last 3 months was not a significant protective factor in preventing HSV2 infection (OR 0.44, 95% CI 0.15-1.26, p = 0.12) in this cohort. Conclusions: The seroprevalence of HSV2 is high in this population and most of them did not report any genital infection. Multiple risk factors for higher prevalence were observed. Findings support the need for regular surveillance, monitoring of HSV-2 infection in high-risk populations, and expanding awareness of HSV-2 infection in the country.

Fitness consequences of depressive symptoms vary between generations: Evidence from a large cohort of women across the 20th century.

Depression has strong negative impacts on how individuals function, leading to the assumption that there is strong negative selection on this trait that should deplete genetic variation and decrease its prevalence in human populations. Yet, depressive symptoms remain common. While there has been a large body of work trying to resolve this paradox by mapping genetic variation of this complex trait, there have been few direct empirical tests of the core assumption that there is consistent negative selection on depression in human populations. Here, we use a unique long-term dataset from the National Health and Nutrition Examination Survey that spans four generational cohorts (Silent Generation: 1928-1945, Baby Boomers: 1946-1964, Generation X: 1965-1980, and Millenials: 1981-1996) to measure both depression scores and fitness components (lifetime sexual partners, pregnancies, and live births) of women from the United States born between 1938-1994. We not only assess fitness consequences of depression across multiple generations to determine whether the strength and direction of selection on depression has changed over time, but we also pair these fitness measurements with mixed models to assess how several important covariates, including age, body mass, education, race/ethnicity, and income might influence this relationship. We found that, overall, selection on depression was positive and the strength of selection changed over time-women reporting higher depression had relatively more sexual partners, pregnancies, and births except during the Silent Generation when selection coefficients neared zero. We also found that depression scores and fitness components differed among generations-Baby Boomers showed the highest severity of depression and the most sexual partners. These results were not changed by the inclusion of covariates in our models. A limitation of this study is that for the Millenials, reproduction has not completed and data for this generation is interrupted by right censoring. Most importantly, our results undermine the common belief that there is consistent negative selection on depression and demonstrate that the relationship between depression and fitness changes between generations, which may explain its maintenance in human populations.

Abstract A112: The seroprevalence of nine human papillomavirus types included in the nonavalent vaccine in unvaccinated women living in Puerto Rico

Abstract Introduction Human papillomavirus (HPV) surveillance is lacking in Puerto Rico (PR). We aim to estimate the seroprevalence of the HPV types included in the nonavalent vaccine (9vHPV) in women and explore associations. Methodology A population-based cross-sectional study of socio-demographic, clinical [including, sexually transmitted infections (STIs)], and behavioral characteristics of sexually active women (16-64 years) was conducted in PR from 2010-2013. Blood samples from 524/566 (92.6%) HPV unvaccinated women were included in this sub- analysis. Antibody responses to 9vHPV types (HPV-6/11/16/18/31/33/45/52/58) were analyzed using M9ELISA by the U.S. Centers for Disease Control and Prevention (CDC). A self-collected cervical and anal sample from all 524 women were also tested using L1 consensus primer (MY09/MY11) PCR followed by dot hybridization to detect 40 HPV types. Statistical analyses included Pearson’s chi-square and logistic regression models. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were reported. Results The mean age of participants was 42.4 years ± 0.6 standard deviations (SD), 52.5% were married/cohabited, and 9.7% were uninsured. About half (51.3%) had between 3-9 lifetime sexual partners, 15.9% had history of STIs, and 40.3% had a current anogenital HPV infection. Overall, 65.8% were seropositive to at least one of the 9vHPV types (1.0% to all 9vHPV types), 59.9% to any of the seven oncogenic types (HPV-16/18/31/33/45/52/58) and 49.1% to any of the quadrivalent vaccine (4vHPV) types. The seroprevalence for specific HPV types ranged between 10.7%-28.1% [HPV-33 (10.7%), 11 (11.6%), 45 (11.8%), 58 (15.8%), 18 (18.7%), 31 (25.0%), 6 (26.2%), 52 (26.9%), and 16 (28.1%)]. In bivariate analysis, significant associations between 9vHPV types were observed with marital status, age at sexual debut, lifetime sexual partners, anal sex, history of STIs and anogenital HPV infection (p&amp;lt;0.05). In the multivariate model, divorced/separated/widowed women (aOR: 2.2, 95%CI: 1.2-4.3) had higher odds of seropositivity to any of the 9vHPV types than single women. Women with 3-9 (aOR: 2.4, 95%CI, 1.5-3.8) and with &amp;gt;10 (aOR: 3.1, 95%CI, 1.6-5.8) lifetime sexual partners had higher odds of seropositivity than women with 1-2 partners. Women with a history of STIs (aOR: 2.1, 95%CI, 1.1-4.0) and with an anogenital HPV infection (aOR: 1.9, 95%CI, 1.2-2.9) had higher odds of HPV seropositivity than their counterparts. In this model, no differences were observed by age, education, healthcare coverage, age at sexual debut or anal sex. Conclusion Before implementation of the HPV nonavalent vaccine, the seroprevalence of at least one of the 9vHPV types among women in PR was high (65.8%). However, less than 1% of women were seropositive for all nine HPV types, indicating this population would benefit from HPV vaccine implementation. Acknowledgements Study funded by the National Institute of Allergy and Infectious Diseases Grant (Grant #1SC2AI090922-01) of the National Institutes of Health. Citation Format: Angeline Cruz, Jeslie M. Ramos-Cartagena, Gitika Panicker, Elizabeth Unger, Ana P Ortiz. The seroprevalence of nine human papillomavirus types included in the nonavalent vaccine in unvaccinated women living in Puerto Rico [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A112.

The Roles of Affective Lability, Boredom, and Mindfulness in Predicting Number of Sex Partners within Women

Affective lability, a trait related to borderline personality disorder, bipolar disorder, eating disorders, and post-traumatic stress disorder, is associated with a higher number of lifetime sex partners. Among individuals who are affectively labile, boredom proneness, which has been linked to impulsive and risky sexual behaviors, might increase the likelihood of having more sex partners. Conversely, mindfulness has been found to be associated with healthy emotion regulation and lower impulsivity, and may enable a greater tolerance of affective lability and boredom, and, in turn, lower the sense of urgency to engage in sex to cope. Thus, the present study investigated the links between affective lability, boredom proneness, mindfulness, and number of sex partners in the last year. We predicted that affective lability would be positively associated with number of sex partners, and that this association would be moderated by boredom proneness and mindfulness in a three-way interaction. Adult women (N = 469, Mage = 25.15 years) were recruited from online communities and completed measures of affective lability, boredom proneness, trait mindfulness, and number of sex partners in the last year. None of the preregistered three-way interactions were supported; however, exploratory analyses revealed that, among women who reported rapid changes between depression and elation, those who were less likely to observe thoughts and sensations had more sex partners in the last year. Clinicians and researchers should further investigate which facets of mindfulness may protect against a higher number of sex partners in affectively labile individuals.

Understanding the high-risk human papillomavirus prevalence and associated factors in the European country with a high incidence of cervical cancer.

High-risk human papillomavirus (HR-HPV) is a known cause of cervical cancer (CC). Latvia has a high incidence of CC compared with the average incidence in the European Union. This study aims to fill the data gap on the HR-HPV burden in Latvia, providing information on its prevalence and associated factors. The cross-sectional study was conducted from February 2021 to April 2022. Participants 25-70 years old visiting a general practitioner (general population) or those referred to a colposcopy clinic with changes in their cervical cytology (colposcopy population) collected vaginal self-sample and completed a paper-based questionnaire. Samples were analyzed with Cobas 6800 System (Roche) for HPV16, HPV18 and other HR-HPV (HPV31/33/35/39/45/51/52/56/58/59/66/68). Descriptive statistics for categorical variables were performed. The Chi-square test was used to determine for the statistical significance of differences in the proportions of the dependent variable between subgroups of the independent variable. Univariate and multivariate binary logistic regression were used to identify factors associated with positive HR-HPV status. Results were considered statistically significant at P < 0.05. A total of 1274 participants provided a valid sample. The prevalence of any HR-HPV infection was 66.8% in the colposcopy group and 11.0% in the general population. Factors associated with positive HR-HPV status were marital status single/divorced/widowed (vs. married/cohabiting) [adjusted OR (aOR) 2.6; P = 0.003], higher number of lifetime sex partners [aOR 5.1 (P < 0.001) and 4.0 (P = 0.001)] for six or more and three to five partners in the general population; in the colposcopy group, the statistical significance remained only for Latvian ethnicity (vs. other) (aOR 1.8; P = 0.008) and current smoking (vs. never) (aOR 1.9; P = 0.01). We documented a comparison to European Union HR-HPV infection burden in Latvia. Any HR-HPV positivity was significantly associated with sexual and other health behavior.

Chlamydia Trachomatis Infection among Pelvic Inflammatory Disease Patients Attending the Gynaecology Clinic of a Private Tertiary Hospital in Ogun State, Nigeria

Background: Pelvic inflammatory disease (PID) is one of the very serious complications arising from sexually transmitted infections (STIs) and Chlamydia trachomatis has been implicated as one of the commonest causes of STI. Considering the adverse sequelae of PID, there is a need for locally relevant data which will guide preventive and therapeutic efforts. Detection of a combination of immunoglobulin G (IgG) and immunoglobulin A (IgA) has been described as an indicator of an actively chronic infection Aims: The aim of this study was to determine the prevalence of Chlamydia trachomatis infection by the use of IgA and IgG and evaluate the associated risk factors among females that presented with Pelvic inflammatory disease at the gynaecology clinic of Babcock University Teaching Hospital. Ilishan-Remo, Ogun State, Nigeria. (BUTH) Materials and Methods: This was a hospital–based, case-controlled study involving 44 patients diagnosed with PID and 44 age-matched controls at the gynaecology clinic of BUTHI. Interviewer-administered questionnaires were used to obtain information on socio-demographic characteristics, and risk factors for PID, from consenting participants. Blood samples were collected from each participant and analysed, using the enzyme-linked immunosorbent assay, for Chlamydia trachomatis type‑specific for IgA and IgG. Analysis was done by SPSS, IBM version 23.0 Results: Both IgG and IgA were present in 15 cases (34.1%) as compared to none of the controls. The difference between Chlamydia IgG, IgA and (IgG+IgA) among the cases and the controls were statistically significant. Majority of the participants positive for the immunoglobulins were aged 25 years or younger (11, 73.3%), number of lifetime sex partners and age of first sexual intercourse being 18 years or younger were statistically associated with Chlamydia trachomatis causing PID. Conclusion: Chlamydia trachomatis remains an important causative pathogen of PID and more prevalent among the young people. Screening is advocated among the young in resource limited countries.

Trends in chlamydia prevalence in the United States, 2005–2016

In the United States (US), chlamydia is the most frequently reported sexually transmitted infection that is nationally notifiable. We examined trends in chlamydia prevalence in the US in 2011–2016 compared with 2005–2010. Cross-sectional, nationally representative surveys, National Health and Nutrition Examination Surveys (NHANES), were used to compare national chlamydia prevalence estimates from 2011 to 2016 with those from 2005 to 2010, and changes in prevalence since 1999–2004 were also reviewed. Persons aged 18–39 years were included in these analyses. Prevalence of chlamydia was based on results from urine specimens. Results were weighted to represent the U.S. civilian, noninstitutionalized population. The baseline characteristics of the study population were similar in gender, age and race/ethnicity between the two groups (P > 0.05). The overall chlamydia prevalence was 1.88% (95% confidence interval [CI] 1.55–2.22%) in 2011–2016 and 1.57% (95% CI 1.27–1.87%) in 2005–2010, a relative increase of 19.7% (95% CI 0.2–39.2%; P < 0.05) between the two surveys. Increases in chlamydia prevalence was especially concentrated in persons who were male, aged 18 to 29 years, had > high school educational level, never married, age at first sex < 18 years, had 2–5 sexual partners in lifetime and had no past sexually transmitted diagnosis between 2005 and 2016 (P < 0.05). Multivariable logistic regression analysis demonstrated that chlamydia was more prevalent in those aged 18–29 years, being non-Hispanic Blacks, had high school educational level, being widowed/divorced/separated and had > 5 sexual partners. The chlamydia prevalence had an increasing trend from 2005–2010 to 2011–2016. Those with high chlamydia prevalence such as sexually active young adults and Non-Hispanic Black should be screened annually so that infected persons can be diagnosed and they and their sex partners can be treated promptly.

Human papillomavirus 16 specific immunoglobulin g antibodies and its correlates among women attendees of selected hospitals in Southern Kaduna, Kaduna State, Nigeria

Human papillomavirus type 16 (HPV-16) is one of the high-risk viruses that cause cervical cancers. Persistent infection with the virus leads to development of precancerous lesions of the cervix in infected women, which without medical intervention can progress to invasive cervical cancer. This study assessed HPV16-specific immunoglobulin G (IgG) antibodies in the serum of women attendees of General Outpatient Department (GOPD) at General Hospital Kafanchan and Kagarko in Kaduna State. This was a cross-sectional study. Structured, self-administered questionnaire was used to collect information and blood samples were also collected for testing. This was in addition to information collected from the laboratory analyzed. Five milliliters (5mls) of blood were aseptically collected from each of the 200 women, who had no history of HPV vaccination at the time of the study for the determination of HPV16-specific IgG antibodies using enzyme-linked immunosorbent assay method. The sero-positivity for HPV 16-specific IgG antibodies among the women was 24.5%. The sero-positivity among women who had their first sexual intercourse at age 13-19 years was 37.6%, and it was significantly different from those who had their sexual debut at ≥20 years (14.8 %) (p=0.001). Sero-positivity also increased from 9.2 % in women with one lifetime sexual partner to 60.0% in those with multiple sexual partners(p=0.001). The finding showed that the women in this study have been exposed to the HPV-16 virus. Further study with a larger population of women in this locality to determine the level of susceptibility or immunity to HPV-16 is strongly advocated, among others.

Knowledge and Behaviors toward Human Papillomavirus and Cervical Cancer in the Women of Reproductive Age in Thailand-Myanmar Border Areas.

Infectious disease is an important health problem in border areas as there is a possibility that the migrants may carry the disease into the area. The purpose of this study is to evaluate the knowledge and behaviors toward human papillomavirus (HPV) and cervical cancer in the women of reproductive age in the Thailand-Myanmar border area. A survey study in a population of 418 women of reproductive age in Mae Hong Son Province in the Thailand-Myanmar border area. Knowledge and risk behaviors of HPV and cervical cancer were described using descriptive statistics. Fifty percent of the participants had sexual debut at age less than 20 years, 27% had more than one lifetime sexual partner and only 3% had sex outside a monogamous relationship during the past 12 months. In term of knowledge, 62.5% knew about HPV. The proportion of correct answers about HPV and cervical cancer questions ranged from 14-95% and 52-94%, respectively. Among the cervical cancer screening target, 69.4% accessed the screening. The factors associated with better knowledge about HPV and cervical cancer were education level higher than high school and sexual debut. The women of reproductive age in the Thailand-Myanmar border areas showed relatively low sexually risk behaviors for HPV infection. More than one-third of the participants did not know about HPV. The percentage of correct answer to questions about cervical cancer were low. We encourage the Thai Ministry of Public Health to increase health promotion and health literacy on prevention of HPV and cervical cancer in the women of pre- and reproductive age in the Thailand-Myanmar border area.

Factors Influencing Cervical Cancer Screening Uptake among Reproductive-Aged Filipino Women: Findings from the 2022 Philippines National Demographic and Health Survey.

Cervical cancer (CC) is the fourth leading cause of death among cancer cases and women intimate partner violence (IPV) survivors are more likely to experience CC-related mortality. This study aims to evaluate the factors influencing CC screening uptake among reproductive-aged women, especially among IPV survivors in the Philippines. We used the 2022 Philippines' National Demographic and Health Survey. The outcome variable was undergoing CC screening. The independent variables were different types of IPV, sociodemographic characteristics (age groups, place of residency, education level, wealth quintile, marital status, religion, employment), and other important variables (number of sexual partners, number of children, and access to health care). Descriptive statistics and multivariable logistic regression analyses were performed to examine influencing factors of CC screening. The results revealed that approximately 10% (n = 1,648) of the women who participated in the survey had screened for CC. The results showed that women who experienced at least one type of IPV (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.08-1.62), aged 45-49 years (aOR = 6.42, 95% CI = 2.60-15.54), higher education (aOR = 14.26, 95% CI = 3.28-61.99), wealthier (aOR = 3.46, 95% CI = 2.54-4.72), having current employment (aOR = 1.30, 95% CI = 1.08-1.57), and having more than five lifetime sexual partners (aOR = 3.16, 95% CI =1.00-9.97), were more likely to undergo CC screening than their counterparts. Future CC screening initiatives should prioritize women with lower educational and socioeconomic backgrounds to effectively bridge the gaps in health disparities.

Prevalence of Human Papillomavirus (HPV) and HPV Type Distribution in Penile Samples in Young Men in Denmark: Results 10 Years After Implementation of a Girls-Only HPV Vaccination Program.

In Denmark, a girls-only human papillomavirus (HPV) vaccination program was initiated in 2008-2009. The study aim was to assess the HPV prevalence and type distribution in younger men prior to HPV vaccination in men. The study population was younger men who attended information days regarding military service. At random days (2019-2020), 280 men were included. We collected questionnaire data regarding risk factors for HPV infection and a penile swab for HPV testing. We compared results in this study with those from a previous study of young men (2006-2007). The majority of participants (94%) were 18-20 years old. The median number of lifetime sexual partners was 4. Altogether, 130 men (46.4%) were HPV positive. No infections with HPV types 6, 11, 16, 18, 31, and 45 were detected. The most frequent type was HPV-51 (detected in 11.1%). Comparison showed that the odds of high-risk HPV type infection were higher in 2019-2020 (prevalence odds ratio [POR], 1.7 [95% confidence interval {CI}, 1.1-2.7]) compared with 2006-2007. In contrast, the odds were lower (POR, 0.3 [95% CI, .1-.6]) for HPV types targeted by the 9-valent HPV vaccine. The multicohort girls-only vaccination program has to a large degree protected young men against the HPV types included in the licensed vaccines. This does not speak against gender-neutral vaccination as the HPV prevalence is still high, although consisting largely of less carcinogenic HPV types.

Visual Inspection with Acetic Acid Positivity in Screening and Early Detection of Cervical Dysplasia in Africa, 2023: A Meta-Analysis.

Visual Inspection with Acetic acid (VIA) is the best feasible method of screening and early detecting for cervical dysplasia for resource limited settings like Africa. There is no study that can represent Africa on VIA positivity. Therefore, this metaanalysis was planned to verify the best available articles to pool the visual inspection with acetic acid positivity in screening and early detection of cervical dysplasia in Africa. The Cochrane Library, Web of Science, PubMed, Scopus, free Google database search engines, Google Scholar, and Science Direct databases were used to conduct a true search of this research article. STATA version 14.0 was used to do the metaanalysis. This meta-analysis was registered in PROSPERO database under the identity pf CRD42023392197. This meta-analysis analyzed data from 21,066 women who had VIA examination to estimate the pooled VIA positivity in Africa. The overall pooled effect estimate of VIA positivity in Africa was 11.93 (95%CI: 11.48-12.37). Age <16 year during first intercourse 2.58(95%CI: 1.53-3.62), lifetime sexual partner ≥2 3.92(95%CI: 2.05-5.78) and HIV positivity 2.92(95%CI: 1.72-4.12) were the significant variables which influence VIA positivity. Overall pooled effect estimate of VIA positivity in Africa was high compared to other continents. The main factors that affect VIA positivity are age at first sexual contact being under 16 years old, the number of lifetime sexual partners being at least two, and HIV positivity. Therefore, the WHO's goal of creating Africa free of cervical cancer is still one that requires significant effort.

(046) Pattern of Sexual Activities among Pregnant Women Attending Antenatal Clinic

Abstract Introduction Sexuality is rarely discussed in many cultures even in clinical context. Sexual repression and abstinence are not uncommon among pregnant women due to several factors; some of which may be related to ignorance. The pattern of sexual activity in pregnancy with its associated changes and challenges remain poorly understood due to a complex interplay of bio-psycho-social factor. Objective This study demonstrates the pattern of sexual activities among pregnant women with associated changes resulting from pregnancy as well as perception and experiences of these women about sexual activities and function in pregnancy. Methods Pre-tested self-administered questionnaires were used to obtain data from women in second and third trimesters of uncomplicated pregnancies about their sexual activities before and during pregnancy as well as their perception about sexual activities in pregnancy. Results The study recruited 228 pregnant women aged 19 to 44years (Mean - 31.7years) with an average gestational age of 27.8weeks and most (93.8%) were singleton. Most of the respondents were married (97.4%) with tertiary level of education (87.9%). Majority (60.1%) were multiparous and most (96.5%) have commenced antenatal care. Majority (58.8%) reported only one lifetime sexual partner with mean age at coitarche of 23.6years. Only 1.3% have multiple sexual partners during the index pregnancy. Most (74.8%) had sexual activities at least once weekly prior pregnancy. During pregnancy however, only 48% had sexual activities at least once weekly, 25.3% had sexual activity less than once monthly, 5.8% had no sexual activity at all in pregnancy. Frequency of sexual activity in pregnancy was moderately associated with frequency before pregnancy (Pearson–0.428, p-0.000). Regarding changes in sexual activity and function associated with pregnancy; 53.5% reported a negative effect, 28.6% had improvement and 18% reported no change in frequency of sexual activities. Regarding sexual desire, 46.1% had reduction, 31.6% reported improvement and 22.3% reported no effect on their desire. For lubrication however, 39.5% had improvement, 31.2% reported reduction whereas 29.3% reported no change. Their overall satisfaction with their sexual function was reported as better in pregnancy m 43.7%, no change in 20.2% and reduction in 36.1%. Although 77.5% of respondents agreed that regular sexual activities can improve bonding with their partners, 64.3% of respondents were afraid of risk of injury to the baby, 58.8% were afraid of risk of infection, and 51.2% were afraid of bleeding in pregnancy and these fears were reported as reasons for their decision regarding sexual activities in pregnancy. Conclusions Marked reduction in frequency of sexual activities were reported in pregnancy; women who had infrequent intercourse prior pregnancy were more likely to have infrequent intercourse in pregnancy. Fear of injury to the baby, bleeding and infection were among the topmost reasons sexual activities were avoided in pregnancy. Education of pregnant women may reduce unnecessary abstinence and sexual repression in pregnancy and avoid its psychosocial consequences on these women and their partners. Disclosure No.

Precancerous cervical lesions and associated factors among women on antiretroviral therapy at Dukem Health Center, Central Ethiopia: A cross-sectional study.

Cervical cancer is a global public health problem and the second most common cancer which leads to morbidity and mortality among women in developing countries like Ethiopia. In Ethiopia, annually 6294 new cervical cancer cases and 4884 deaths are estimated in 2018 alone. This study aimed to assess the prevalence and associated factors of precancerous cervical lesions among women on antiretroviral therapy(ART) at Dukem Health Center, Central Ethiopia. An institution-based cross-sectional study was carried out among randomly selected 257 women receiving ART at Dukem Health Center. Data were collected using a pretested structured questionnaire, medical record review, and visual inspection with acetic acid. Collected data were entered into Epi-info 7.4 and exported to SPSS version 26 for analysis. The prevalence of precancerous cervical lesions and the characteristics of study participants were identified. Utilizing both binary and multivariable logistic regression models, the existence and degree of association with precancerous cervical lesions were determined with a pvalue < 0.05 and a 95% confidence interval. The prevalence of precancerous cervical lesions was 16% (95% CI: 11.7-20.6). Significant association was found between precancerous cervical lesions and a history of STIs (AOR = 4.30, 95% CI: 1.48-12.49), oral contraceptive use (AOR = 6.56, 95% CI: 2.10-20.50), having multiple lifetime sexual partners (AOR = 2.53: 95% CI: 1.05-6.10), and a recent CD4 count of less than 200 cells/mm3 (AOR:11.33, 95% CI: 2.88-24.58). In the study area, the prevalence of precancerous cervical lesions was relatively high. Therefore, concerned bodies are recommended to increase awareness of the prevention of sexually transmitted diseases and limit sexual partners.

Prevalence of sexually risky behaviors among Mexican medical students.

University students are at high risk of sexually transmitted infections due to the lack of adequate sexual education, as well as multiple associated factors, which lead to risky sexual practices. It is important to update data about sexual behaviors to identify the main factors associated with sexually risky behaviors. The present study aimed to evaluate the current prevalence of sexually risky practices in medical students. A cross-sectional study was conducted among medical students through an anonymous self-administered online questionnaire including demographic characteristics and sexual behaviors. We used descriptive statistics and multivariable regression to analyze the data collected. A total of 1520 undergraduate medical students aged between 18 and 28 years old were included in the study. Sixty percent of the students were sexually active with a higher proportion in men (70%), likewise, they had an earlier sexual debut (16.5 vs 16.9 years old), and a greater number of lifetime sexual partners than women (3.8 vs 2.2). The main sexual activity in both groups was vaginal sex with high use of condoms (75%), however, most of them (67%) reported having unprotected oral sex. Logistic regression analysis showed that condomless sex was associated with having oral sex, anal sex, and being female. The findings of this study showed that medical university students are involved in risky sexual behaviors, the major risk factor was unprotected oral sex. Based on these results, we recommended designing interventions to improve sexual education and preventive approaches from early stages such as in middle school students to mitigate sexually transmitted infections among medical university students.

Self-Rated Masculinity and Femininity and Reported Number of Lifetime Sexual Partners Among Cisgender Heterosexual and LGBQ Men and Women.

Prior research has quantitatively examined why heterosexual men and women report different numbers of lifetime different-sex sexual partners, whereas qualitative work has analyzed how men's masculinity-and to a lesser extent, women's femininity-is tied to gender norms about sexual activity. Less research, however, has quantitatively examined the associations between self-rated masculinity and femininity and reported number of lifetime sexual partners. This brief report uses a large sample of Canadians (n = 2117) to examine how self-rated masculinity and femininity relate to reported numbers of sexual partners among four groups of cisgender people: (1) heterosexual men (n = 972), (2) heterosexual women (n = 979), (3) gay and bisexual/pansexual men (n = 99), and (4) lesbian and bisexual/pansexual women (n = 67). Results demonstrate that self-rated femininity was negatively, and masculinity positively, associated with reported numbers of lifetime different-sex sexual partners among heterosexual women. No significant associations emerged for other groups. The lack of significant associations among heterosexual men may be attributable to the fact that most rated themselves as very masculine and not very feminine, whereas there was more variation among heterosexual women. In contrast, the non-significance among LGBQ women and men could reflect that subcultural norms and practices more strongly shape the number of sexual partners individuals report having in these communities. These results demonstrate that it would be beneficial for researchers to measure self-rated masculinity and femininity in future studies about sexual partnering practices, especially among heterosexual cisgender women.

Epigenetic age acceleration and reproductive outcomes in women

Life history theory applied to human development stipulates that humans have evolved to detect and encode information from the early developmental environment that entrain coordinated development pathways. One possible mechanism is epigenetic age acceleration but few studies have prospectively examined associations between epigenetic aging and life-history related phenotypes. The purpose of this study was to examine the relations between epigenetic age acceleration when children were age 7 years and indices of reproductive development during adolescence using a sample of N = 512 youth from the Avon Longitudinal Study of Parents and Children (ALSPAC). A path model was used to test direct and indirect associations between epigenetic age acceleration and age at menarche (AAM), age at first sex, and lifetime and past year sexual partner number. Results showed epigenetic age acceleration was directly associated with earlier age at first sex and increased sexual partner number. There were further indirect associations with sexual partner number via age at first sex. Epigenetic age acceleration was not associated with AAM. Follow-up analyses to determine if aspects of the early developmental environment were associated with age acceleration were null. Implications for life history theory and the need for additional research are discussed.

Risk Factors for the Anal and Oral Human Papillomavirus (HPV) Infections among Women with Severe Cervical Lesions: A Prospective Case-Control Study.

The carcinogenicity of HPV infection in the anogenital and oropharyngeal regions is broadly accepted. The aim of the study was to define risk factors for anal and oral HPV infections in high-risk patients with biopsy-proven severe cervical lesions (CIN2+). Altogether immunocompetent 473 females with CIN2+ were categorized into the study group and another 245 women into the control group. The strongest risk factor for anal HPV infection was the presence of cervical HPV infection (p < 0.001). Furthermore, ten or more lifetime sexual partners (p = 0.013), a sexual non-coital contact with the anal area (p < 0.001), and actively practicing anal-penetrative intercourse (p < 0.001) were significantly associated with anal HPV. A history of genital warts in the woman (p = 0.010) and the presence of genital warts in the male partner (p = 0.029) were found statistically significant for the risk of oral HPV infection. Our data suggest that the presence of HPV infection, especially high-risk genotypes, in one anatomical site poses the greatest risk for HPV infection in another anatomical site. The cervix is the main reservoir of infection, but the risk factors for anal and oral HPV infections are dissimilar according to different anatomical distances and more complex routes of transmission.

Factors and presenting symptoms associated with intestinal spirochaetosis in men who have sex with men: A systematic review.

The transmission dynamics and presenting symptoms of intestinal spirochaetosis (Brachyspira pilosicoli, Brachyspira aalborgi) are poorly understood but is seen more frequently in men who have sex with men (MSM) where sexual transmission may occur. We aimed to systemically review the literature to define the factors and presenting symptoms associated with intestinal spirochaetosis in MSM. We systematically searched three bibliographical databases (MEDLINE, EMBASE and Scopus) for manuscripts written in English up to November 2022. The primary author conducted an initial screen and three authors conducted independent reviews to determine the final eligible manuscripts. We only included manuscripts where there were specific data on factors and presenting symptoms associated with intestinal spirochaetosis in MSM. Fifteen manuscripts published between 1981 and 2022 met the inclusion criteria that included 188 MSM. Sexually transmitted intestinal spirochaetosis in MSM was associated with-living with HIV (including having a low CD4 count <200 mm3), having a concomitant sexually transmitted infection, a history of a sexually transmitted infection, co-infection with intestinal parasites; and sexual behaviour including oro-anal sexual contact, oro-genital contact, fisting, condom-less anal sex, receptive anal sex, multiple non-regular sexual partners and increased number of lifetime sexual partners. The presenting symptoms of MSM with intestinal spirochaetosis were diarrhoea, abdominal pain, constitutional symptoms and proctitis, including rectal pain, rectal bleeding rectal discharge, flatulence and tenesmus. We have highlighted some biological and behavioural factors and presenting symptoms associated with intestinal spirochaetosis in MSM which provide insight for clinicians, guidelines and future public health control strategies.