Number Of Previous Sexual Partners Research Articles

Health-related quality of life and its associated factors among infertile women compared with fertile women in public hospital Addis Ababa, Ethiopia: a comparative cross-sectional study

BackgroundInfertility can have detrimental physical, psychological, and social effects that significantly impact health-related quality of life. Although the impact of infertility on quality of life is well established, there is a lack of research comparing the quality of life between fertile and infertile women in Ethiopia.MethodsA hospital-based comparative cross-sectional study was conducted among 287 infertile and 301 fertile women. Participants were selected using systematic random sampling. A structured, validated tool was used to collect data. An independent sample t-test was conducted to determine if there was a difference in the study participants' quality of life domains and the mean total quality of life score. Multiple linear regressions were used to correlate quality of life scores with significant predictor factors for the infertile group.ResultsInfertile women had a mean total Herbal of 66.54 ± 10.18, and fertile women (72.68 ± 7.57) were found to be statistically different between the groups. All domains except the physical domain were significantly different between the groups. Duration of marriage (β = -0.529), number of previous sexual partners (β = -0.410), total number of working hours per day (β = -0.345), types of infertility (β = -0.34), and history of the sexually transmitted disease (β = -0.277), in decreasing order of effect, were found to be associated with the quality of life of infertile women (R2 = 0.725).ConclusionsThe study found that infertile women had a lower mean HRQoL score compared to fertile women, with all domains except for the physical domain being significantly different between the two groups. This suggests that infertility can have a significant impact on various aspects of a woman's life, including her emotional well-being, social functioning, and psychological health. The factors associated with the quality of life of infertile women were the duration of marriage, the number of previous sexual partners, the total number of working hours per day, the types of infertility, and the history of sexually transmitted diseases, with duration of marriage having the strongest association. These findings highlight the need for healthcare providers to address the psychological and social aspects of infertility.

Romantic Attachment and Sexual Desire: The Role of Desire Target

ABSTRACT Attachment insecurities are characterized by distinct approaches to intimacy and sex, yet their roles in sexual desire remain largely unexamined. Drawing from theories of attachment and behavioral motivation, the current study investigated the role of attachment insecurities in sexual desire and how that role differs by desire target. The Sexual Desire Inventory provided both a general dyadic desire measure and a measure differentiating between partner-specific desire and desire for an attractive potential sexual partner (attractive other desire). In a sample of 321 young adults (51% men), two structural equation models (SEMs) were compared, each with attachment predicting desire: a Dyadic Combined model and a Partner Type model. Models accounted for gender, relationship status, sexual identity, racial/ethnic identity, number of previous sexual partners, and measurement error. Preliminary confirmatory factor analyses indicated adequate factor loadings (>.40) for both desire measures, yet superior fit for the partner type measure. In the SEMs, the Partner Type model outperformed the Dyadic Combined model across all indices. Attachment avoidance predicted lower partner-specific desire, yet higher attractive other desire. Attachment anxiety predicted higher partner-specific desire, yet was unrelated to attractive other desire. Findings suggest the discomfort with intimacy characterized by attachment avoidance deters interest in sex with romantic partners, yet may enhance sexual interest in nonattachment figures. Several discrepant associations across desire measures indicate that distinguishing between desire targets is critical for fully understanding individual differences in desire. Partner-specific sexual desire may be a unique experience that should not be conflated with other forms of sexual desire.

Long‐term effectiveness of HPV vaccination against HPV infection in young Japanese women: Real‐world data

In Japan, public funding for HPV vaccination began in 2010 for girls aged 13–16 years (birth cohort years 1994–1997) and women born in 1994 who turned 25 in 2019. We aimed to verify the long‐term effectiveness of the bivalent HPV vaccine in women aged 25 years. Subjects were women aged 25–26 years who underwent cervical cancer screening and HPV testing in Niigata from 2019 to 2020 (birth cohort years 1993–1994). Information on vaccination status and sexual behavior was obtained from a questionnaire and municipal records. We compared the HPV infection rates of the vaccinated and unvaccinated groups. Of the 429 registrants, 150 (35.0%) and 279 (65.0%) were vaccinated and unvaccinated, respectively. The average period from HPV vaccination to HPV testing was 102.7 months (8.6 years), with a median of 103 months (range 92–109 months). The HPV high‐risk infection rate was 21.3% (32/150) in the vaccinated group and 23.7% (66/279) in the unvaccinated group (P = 0.63). The HPV16/18 infection rate was 0% (0/150) in the vaccinated group and 5.4% (15/279) in the unvaccinated group, showing a significant difference (P = 0.0018), and the vaccine effectiveness was 100%. The cross‐protective type HPV31/45/52 infection rate in the vaccinated group was significantly lower than that in the unvaccinated group (3.3% vs. 10.0%, P = 0.013). There was no significant difference in the mean age at sexual debut and the number of previous sexual partners between the two groups. We have demonstrated the long‐term 9‐year effectiveness of the bivalent vaccine against HPV infection for the first time in Japan.

P-02-63 Correlation Between Risk Factors, Clinical Features and Prevalence of Human Papilloma Virus (HPV) IN a Population of Young Men

Human Papilloma Virus (HPV) is among the most prevalent sexually transmitted infections. Disease progression, genotype-specificity, oncogenic risk and strategies for prevention and treatment are still unclear. Tetravalent vaccine, currently largely suggested to women only, is efficacious for prevention of precancerous and genital lesions. We aimed to estimate prevalence of different subtypes of HPV in a population of young men, assessing the association to risk factors and clinical manifestations. 150 men aged 18-20 years underwent coronal sulcus sampling via Cytobrush and Thin Prep. Samples were then testes via Test Linear Array (Roche Diagnostics) for genotyping. Clinical examination was performed and several risk factors were then assessed, including unprotected intercourse and number of previous sexual partners. Among the 150 patients included in the study, 47 samples could not be assessed; 31 patients tested positive for HPV (21%), whereas 72 resulted negative (48%). Oncogenic types (16 and 18) were identified in 6% and 13% of positive patients. Co-infections by different genotypes were found in most subjects: 13 patients had a single genotype (41%), 13 had two genotypes (41%), 2 had six genotypes (6%) and 3 (9%) had 3, 5 and 8 genotypes each. 95% of HPV-positive subjects had unprotected intercourse with several partners.

Associations Among Physical Activity, Sedentary Behavior, and Weight Status With Sexuality Outcomes: Analyses from National Health and Nutrition Examination Survey

IntroductionPhysical activity is likely to be associated with sexual activity. However, to date, there is no literature on the relationship between overweight/obesity and sexual activity outcomes. AimThus, the present study assessed the associations among physical activity, sedentary behavior, and weight status with sexual activity and number of previous sexual partners in a representative sample of U.S. adults. MethodsData on leisure time physical activity, total sitting time, weight status, sexual behavior outcomes, and other characteristics were extracted from the National Health and Nutrition Study cycle 2007 to 2016. Logistic regression models were used to evaluate associations among body mass index, leisure time physical activity, and total sitting time with past-year sexual activity and number of sexual partners. Main Outcome MeasureSelf reported frequency of past-year sexual activity and number of sex partners in the past year. ResultsIn a sample of 7,049 men (mean age: 38.3 ± 0.3 years) and 7,005 women (mean age: 38.7 ± 0.2 years) being overweight was associated with higher odds of frequent sexual activity (OR = 1.5; 95% CI = 1.2−1.7) among men, but lower odds among women (OR = 0.8; 95% CI = 0.6−0.9). Sufficient physical activity was associated with higher odds of frequent sexual activity among both men (OR = 1.3; 95% CI = 1.1−1.5) and women (OR = 1.2; 95% CI = 1.0−1.4). In those living alone, being obese was associated with lower odds of having at least 1 sexual partner for men (OR = 0.7; 95% CI = 0.5−0.9) and women (OR = 0.6; 95% CI = 0.4−0.8). Being sufficiently physically active was associated with higher odds of having at least 1 sexual partner only in men (OR = 1.6; 95% CI = 1.2−2.2). Clinical ImplicationsHealthcare professionals need to be made aware of these results, as they could be used to plan tailored interventions. Strengths & LimitationsStrengths include the large, representative sample of U.S. adults and objective measures of anthropometry. Limitations include the cross-sectional design of the study and that all variables on sexual history were self-reported. ConclusionThe present study identifies novel modifiable behavioral and biological antecedents of sexuality outcomes.Grabovac I, Cao C, Haider S, et al. Associations Between Physical Activity, Sedentary Behavior and Weight Status With Sexuality Outcomes: Analyses from National Health and Nutrition Examination Survey. J Sex Med 2020;17:60–68.

Correlates of Tinder Use and Risky Sexual Behaviors in Young Adults.

Tinder is a frequently used geosocial networking application that allows users to meet sexual partners in their geographical vicinity. Research examining Tinder use and its association with behavioral outcomes is scarce. The objectives of this study were to explore the correlates of Tinder use and risky sexual behaviors in young adults. Participants aged 18-26 were invited to complete an anonymous online questionnaire between January and May 2016. Measures included sociodemographic characteristics, Tinder use, health related behaviors, risky sexual behaviors, and sexual attitudes. Associations among these variables were estimated using multivariate logistic regressions. The final sample consisted of 415 participants (n = 166 Tinder users; n = 249 nonusers). Greater likelihood of using Tinder was associated with a higher level of education (OR = 2.18) and greater reported need for sex (OR = 1.64), while decreased likelihood of using Tinder was associated with a higher level of academic achievement (OR = 0.63), lower sexual permissiveness (OR = 0.58), living with parents or relatives (OR = 0.38), and being in a serious relationship (OR = 0.24). Higher odds of reporting nonconsensual sex (OR = 3.22) and having five or more previous sexual partners (OR = 2.81) were found in Tinder users. Tinder use was not significantly associated with condom use. This study describes significant correlates of using Tinder and highlights a relationship between Tinder use with nonconsensual sex and number of previous sexual partners. These findings have salience for aiding public health interventions to effectively design interventions targeted at reducing risky sexual behaviors online.

The perceived threat of sexual communication, number of previous sexual partners and topic avoidance in romantic relationships

ABSTRACTPerceived threat of communicating about one’s sexual history (PTCSH) and sexual history topic avoidance (SHTA) were examined in this study. PTSCH references the anticipated possible consequences of discussing prior sexual activity, and SHTA refers to the phenomenon of avoiding the subject of prior sexual activity. Participants (n = 330) filled out measures designed to assess their PTCSH, SHTA, and were also asked to report their number of previous sexual partners. SPSS and the PROCESS macro were employed to probe relationships between these variables. As expected, PTCSH was significantly and positively associated with individuals’ number of previous sexual partners and SHTA. Further analyses confirmed a proposed mediational model, wherein PTSCH served as a mediator in the association between number of previous sexual partners and SHTA. Implications for how individuals’ number of previous sexual partners and social expectations for sexual behaviour may affect communication in close relationships are discussed.

Cervical intraepithelial neoplasia in pregnancy: Interference of pregnancy status with p16 and Ki-67 protein expression.

To date, there are evidence-based guidelines available for cervical dysplasia diagnosed in pregnancy. Certain functional biomarkers have proven useful in the prediction of regressing and non-regressing cervical intraepithelial neoplasia (CIN) lesions in non-pregnant women. In the present study, Ki-67 and p16 immunostaining were evaluated in different grades of CIN lesions diagnosed in pregnant or non-pregnant women with the aim to identify any differences in order to better understand the behavior of CIN in pregnancy. The current retrospective case-control study included 17 pregnant patients that conceived naturally with first-time onset of CIN occurring at no later than 16 gestational weeks. The control group included 17 non-pregnant patients matched for age, parity and number of previous sexual partners. Exclusion criteria included previous cervical treatment, immunocompromised status, chronic hepatitis B and/or C and cigarette smoking. p16 and Ki-67 protein expression were respectively detected using the CINtec Histology kit and monoclonal antibodies against Ki-67. p16 and Ki-67 staining were analyzed using a classification system based on the distribution of positivity on a semi-quantitative three point-scale. p16 and Ki-67 immune reactivity correlated positively with the grade of epithelial dysplasia in the total cohort of pregnant and non-pregnant patients; expression increased linearly from CIN1 to CIN3. Furthermore, the association between p16 immunostaining and CIN grade was significant in non-pregnant patients but not in pregnant patients. In pregnant patients, positivity for Ki-67 was less intense than in non-pregnant patients. These results appear to suggest that pregnancy status interferes with the expression of cellular proteins involved in cell-cycle regulation and the carcinogenic process induced by high-risk human papilloma virus, exhibiting increased variability in their staining.

Glycodelin expression in pregnant patients with cervical intraepithelial neoplasia: a case–control study

We aimed to evaluate glycodelin immunostaining in pregnant women with a first diagnosis of cervical intraephitelial neoplasia (CIN) and to correlate the expression of CIN with Ki-67 and glycodelin immunostaining. A retrospective case–control study was performed including 20 patients with natural pregnancy and with first time onset of CIN occurring not later than 16 gestational weeks. The control group included 20 non-pregnant patients matched for age, parity, smoking status and number of previous sexual partners. Exclusion criteria included previous cervical treatment, immunocompromised status and chronic hepatitis B and/or C. Staining for Glycodelin and for Ki-67 was expressed using a classification based on the distribution of positivity on a semi-quantitative three-point scale. An inverse relationship was observed between glycodelin immunostaining and CIN grade in pregnant patients (p = 0.01), with a significantly higher expression in CIN1 than in CIN2 and CIN3, but not in non-pregnant patients (p = 0.81). Positivity for Ki-67 was less intense in pregnant than in non-pregnant patients. A significant inverse relationship was observed between glycodelin immunostaining and Ki-67 expression (p = 0.02). We suggest that the higher expression of glycodelin in pregnancy is related to a lower proliferative activity in CIN, which is probably associated to hormonal status of pregnancy. Further clinical studies are needed to support these findings.

Family intentions and personal considerations on postponing childbearing in childless cohabiting and single women aged 35-43 seeking fertility assessment and counselling.

What characterizes childless women aged 35 years and above seeking fertility assessment and counselling in relation to their reproduction and are there significant differences between single and cohabiting women? Despite the women's advanced age and knowledge of the age-related decline in fecundity, 70% of the single women sought fertility assessment and counselling to gain knowledge regarding the possibility of postponing pregnancy. Recent studies have indicated an increasing demand for ovarian reserve testing in women without any known fertility problem to obtain knowledge on their reproductive lifespan and pro-fertility advice. Women postpone their first pregnancy, and maternal age at first birth has increased in western societies over the past two to four decades. Postponed childbearing implies a higher rate of involuntary childlessness, smaller families than desired and declining fertility rates. Baseline data from a cross-sectional cohort study of 340 women aged 35-43 years examined at the Fertility Assessment and Counselling (FAC) Clinic at Copenhagen University Hospital from 2011 to 2014. The FAC Clinic was initiated to provide individual fertility assessment and counselling. Eligible women were childless and at least 35 years of age. All completed a web-based questionnaire before and after the consultation including socio-demographic, reproductive, medical, lifestyle and behavioural factors. Consultation by a fertility specialist included transvaginal ultrasound, full reproductive history and AMH measurement. The study comprised 140 cohabiting and 200 single women. The majority (82%) were well-educated and in employment. Their mean age was 37.4 years. Nonetheless, the main reasons for attending were to obtain knowledge regarding the possibility of postponing pregnancy (63%) and a concern about their fecundity (52%). The majority in both groups (60%) wished for two or more children. The women listed their ideal age at birth of first child and last child as 33 (±4.7) years and 39 (±3.5) years, respectively. Of the single women, 70% would accept use of sperm donation compared with 25% of the cohabiting women (P < 0.001). In general, 45% considered oocyte vitrification for social reasons, yet only 15% were positive towards oocyte donation. The two groups were comparable regarding lifestyle factors, number of previous sexual partners, pregnancies, and ovarian reserve parameters. The women in the present study were conscious of the risk of infertility with increasing age and attended the FAC Clinic due to a concern about their remaining reproductive lifespan, which in combination with their high educational level could impair the generalizability to the background population. The results indicate that in general women overestimate their own reproductive capacity and underestimate the risk of future childlessness with the continuous postponement of pregnancies.

Bacterial vaginosis among women at high risk for HIV in Uganda: high rate of recurrent diagnosis despite treatment

ObjectivesBacterial vaginosis (BV) is associated with increased risk for sexually transmitted infections (STIs) and HIV acquisition. This study describes the epidemiology of BV in a cohort of women at high...

Further understanding sexual communication

Individuals aged 15–24 years account for half of all new sexually transmitted infections. Such diseases are preventable, and communication lies at the center of this prevention. One safer sex behavior rooted in communication is the disclosure of one’s sexual history. Consistent with this perspective, and utilizing affection exchange theory (AET), this study focused on one aspect of sexual history discussions by examining the (dis)honesty of individuals’ disclosures of their number of previous sexual partners and associated safer sex behavior/communication. Results indicated that roughly two-thirds of participants correctly identified disclosure of the number of previous sexual partners as a safer sex practice. Yet about 60% of participants had, at some point, acted deceptively with their representation of their number of previous partners, and of those, nearly 20% never disclosed their number of previous partners. Deception about number of previous partners accounted for some differences in safer sex behaviors. Additionally, individuals who reported omitting their number of previous partners from all sexual partners also reported being the least comfortable with safer sex communication. Applied implications as well as implications for AET are discussed.

Differences in Personality Attributions Toward Tattooed and Nontattooed Virtual Human Characters

Individuals with body modifications, such as tattoos, have been shown to differ from nonmodified individuals in sensation-seeking personality characteristics and sociosexuality. This study examined possible differences in people’s attributions of those characteristics toward virtual human characters varying in body modification. Some 287 participants rated tattooed and nontattooed bodies of avatars on aspects of sensation seeking and number of previous sexual partners. Tattooed stimuli were rated as more experience, thrill, and adventure seeking as well as more likely to have a high number of previous sexual partners and as less inhibited when compared to nontattooed stimuli, and this was particularly true for male stimuli. It was concluded that people with body modifications, such as tattoos, are perceived differently compared to nontattooed individuals in terms of sensation seeking and previous sexual partner number, this being particularly true for men. Findings are discussed with reference to the evolutionary model of human sexual selection.

The role of the anterior cingulate cortex in women's sexual decision making

Women's sexual decision making is a complex process balancing the potential rewards of conception and pleasure against the risks of possible low paternal care or sexually transmitted infection. Although neural processes underlying social decision making are suggested to overlap with those involved in economic decision making, the neural systems associated with women's sexual decision making are unknown. Using fMRI, we measured the brain activation of 12 women while they viewed photos of men's faces. Face stimuli were accompanied by information regarding each man's potential risk as a sexual partner, indicated by a written description of the man's number of previous sexual partners and frequency of condom use. Participants were asked to evaluate how likely they would be to have sex with the man depicted. Women reported that they would be more likely to have sex with low compared to high risk men. Stimuli depicting low risk men also elicited stronger activation in the anterior cingulate cortex (ACC), midbrain, and intraparietal sulcus, possibly reflecting an influence of sexual risk on women's attraction, arousal, and attention during their sexual decision making. Activation in the ACC was positively correlated with women's subjective evaluations of sex likelihood and response times during their evaluations of high, but not low risk men. These findings provide evidence that neural systems involved in sexual decision making in women overlap with those described previously to underlie nonsexual decision making.

Women’s Knowledge, Attitudes, and Intentions Concerning Human Papillomavirus Vaccination: Findings of a Waiting Room Survey of Obstetrics-Gynaecology Outpatients

ObjectiveTo assess women’s knowledge, attitudes, and behaviours related to Human Papillomavirus (HPV) and HPV vaccination. MethodsA self-administered questionnaire was completed by 98 women (90.7% response rate) attending a hospital-based obstetrics and gynaecology outpatient clinic in a mid-size Ontario city. ResultsWomen had a moderate level of knowledge of general HPV-related issues, but lacked information about the ability of barrier contraception to prevent HPV and about characteristics of HPV vaccination. Women were strongly supportive of HPV vaccination for both male and female teenagers, but reported low levels of intention to receive vaccination themselves. Physician recommendation was the most influential factor in women intention to be vaccinated, and younger women were more likely to say they intended to be vaccinated. HPV-related knowledge, level of education, and number of previous sexual partners were unrelated to women’s intentions to receive HPV vaccination. ConclusionFindings indicate that women’s knowledge about HPV vaccination is inconsistent, that women are supportive of vaccinating both male and female teenagers, and that physician recommendation and younger age are associated with women’s interest in receiving the vaccine.

Diagnostic Loop Electrosurgical Excisional Procedure for Discrepancy

Although pathological discrepancy between Pap smear and biopsy is an accepted indication to perform a diagnostic loop electrosurgical excision procedure (LEEP), this procedure is not without complications. Our objective was to determine the incidence of cervical intraepithelial neoplasia (CIN) 2,3 and patient factors that increase the likelihood of detecting CIN 2,3. We performed a retrospective chart review of patients who underwent a diagnostic LEEP for pathological discrepancy at a university-based colposcopy clinic. Pathological discrepancy is defined as a high-grade Pap smear with a colposcopically directed biopsy of CIN 1 or less. Demographic, cytological, and histological information were collected using a computerized database. The patients were divided into 2 groups (CIN 2,3 and CIN 1 or less) based on the pathology from the LEEP specimen. Patient factors were compared with final pathological results using chi(2) test, Student t test, Wilcoxon rank sum test, and multivariate analysis as indicated. A total of 102 patients were identified. Seven patients had normal specimens, 3 had HPV changes, 25 had CIN 1, 29 had CIN 2, and 38 had CIN 3. Thirty-five patients (34%) had CIN 1 or less, whereas 67 patients (66%) had CIN 2,3. The 2 groups were comparable in terms of age (30.4 vs 28.1 years), parity (2.2 vs 1.9), and age of coitarche (16.3 vs 16.4 years). No statistical difference existed between the groups regarding race, smoking status, Pap smear, history of previous cytological abnormality, contraception method, number of previous sexual partners, and HIV status. The majority of patients (75%) had not undergone previous treatment of CIN. The CIN 2,3 group were more likely than the CIN 1 or less group to have had previous treatment or biopsy for CIN (66% vs 34%; p = .004). Univariate (p = .004) and multivariate (p < .001) analysis demonstrated previous treatment of CIN as the only significant factor predicting CIN 2,3. Two thirds of women undergoing a LEEP for pathological discrepancy between Pap smear and cervical biopsy will have CIN 2,3. Women that have had previous treatment of CIN are more likely to have CIN 2,3 detected on their LEEP specimen.

Contribution of sexually transmitted diseases and socioeconomic factors to perinatal mortality in rural Ghana.

The infant mortality rate is higher in sub-Saharan Africa than in other developing regions. The purpose of this study was to evaluate the association of sexually transmitted diseases (STDs) and socioeconomic and obstetric factors with perinatal mortality in rural Ghana. Perinatal mortality data were collected from 154 patient records of the outpatient and inpatient gynecology department of a rural Ghanaian setting in 1997. All women attended the antenatal care unit of the hospital at least once before delivery, where they were screened for common STDs, including syphilis, gonorrhea, and trichomoniasis. Patients' socioeconomic characteristics and previous obstetric complications were recorded. The rate of perinatal mortality at the Holy Family Hospital in the Berekum district of Ghana was 13.7% in 1997 (154 of 1123 documented births). Characteristics of mothers whose infants died in the perinatal period and who had attended antenatal care at least once were as follows: prior obstetric complications, 108 patients (70.1%); average age, 25 years (range: 16-42 years); average number of previous sexual partners, three; prevalence of STDs, including gonorrhea, trichomoniasis, or syphilis, 83 patients (53.8%); history of other chronic diseases, 13 patients (8.5%); and illiteracy, 66 patients (42.8%). The number of previous sexual partners and illiteracy were higher in the STD-positive women. Sexually transmitted diseases and previous obstetric complications seemed to contribute considerably to perinatal mortality in rural Ghana.

Influence of Health Beliefs, Attitudes and Concern About HIV/AIDS on Condom Use in College Women

ABSTRACT Acquired Immune Deficiency Syndrome (AIDS) represents a significant health risk for all sexually active adults. Women, in particular, may be at greater risk of HIV infection due to attitudes and beliefs which interfere with initiating and maintaining consistent condom usage. One hundred twenty-six college women completed a survey which measured the impact of sex role ascription, drug and alcohol use patterns, number of partners and sexual history in predicting condom usage. Additional factors explored include attitudes towards condoms, health beliefs, and present and future concern about contracting HIV/AIDS from a sexual partner. Findings indicate that intent to use condoms in the future was associated with greater present and future concern about contracting HIV/AIDS. In regression analyses, only number of previous sexual partners was significantly related to condom use.

Delivery of STD/HIV preventive services to adolescents by primary care physicians

To document the rates of STD/HIV preventive services delivered to adolescents by primary care physicians in California, and to identify variation owing to physician and practice-related factors. A stratified random sample of California internists, family physicians, obstetricians-gynecologists, and pediatricians was drawn from the AMA Masterfile and surveyed by mail about their practices with regard to STD/HIV prevention for 15-18-year-old adolescent patients. Sixty percent of eligible physicians responded; the final sample was 1217 physicians. Results showed that 40% of physicians reported screening all of their adolescent patients for sexual activity and 31% reported educating all of their adolescent patients about STD/HIV transmission. For their sexually active adolescent patients, 36% of physicians always provided STD/HIV education, 17% always screened for number of previous sexual partners; 12% always screened for sexual orientation; and 10% always screened for frequency of casual sex. Four percent of the physicians reported that they always provided condoms for their sexually active adolescent patients; 81% never provided condoms. Higher levels of preventive services delivery were associated with female physician gender, specialization in obstetrics-gynecology, and more recent date of medical school graduation. Physicians practicing in health maintenance organizations reported providing significantly higher rates of preventive services to sexually active adolescents than did physicians in private practice. Primary care physicians provide STD/HIV preventive services to adolescents at rates far below those recommended by current guidelines. Areas where additional research would be informative are highlighted.

The relationship of Chlamydia trachomatis infection and male infertility.

Infertility affects at least 2 million couples in the United States. One third of infertility is attributed to male causes, but the etiology of most male infertility remains obscure. This study was designed to investigate the relationship between Chlamydia trachomatis and unexplained infertility in men. Questionnaires and serum were collected prospectively from 52 case subjects (men from couples with explicitly defined idiopathic infertility) and 79 control subjects (first-time expectant fathers). Case subjects were significantly more likely than control subjects to be seropositive for antibody to C trachomatis at a titer of 1:64 or higher. By test of trend, higher titers were associated with higher odds ratios. Adjustment for age of either partner at initiation of pregnancy attempt, race, income, previous genitourinary symptoms or diagnoses, number of previous sexual partners, and barrier contraceptive use had no significant effect on the estimate of the odds ratio. One half of the men who were antibody positive had no history of genitourinary symptoms. Our results suggest an association between infection with C trachomatis in men and unexplained infertility and imply that infection is frequently asymptomatic.