Sexual Partners Of Women Research Articles

Genital microbiota of sexual partners of female patients with bacterial vaginosis is responsible for its recurrences

Aim. To evaluate the genital microbiota of sexual partners of women with bacterial vaginosis and its role in the development of its recurrences. Materials and Methods. We examined 59 consecutive patients with bacterial vaginosis. In the treatment group, sexual partners of the female patients were treated by local delivery of clindamycin; in the comparison group, sexual partners did not receive the drug. All women included in the study received the same therapy: metronidazole per os and local delivery of clindamycin at the stage 1 and local delivery of lactic acid at the stage 2. All patients were examined by microscopy, PCR test, and inoculation of the genital discharge. Monitoring of the female patients with bacterial vaginosis was continued for 6 months. Results. In male patients, genital microbiota was similar to their female partners. Gardnerella vaginalis was detected in 96% of females and 62% of males. Prevotella was identified in 93% of females and 41% of males while Atopobium vaginae was found in 79% of women and 48% of their sexual partners. The amount of bacterial species was similar in males and females of the treatment group. The most frequent microorganisms were Escherichia coli, Staphylococcus spp. and Enterococcus faecalis. Female patients of the treatment group had two-fold lower risk of recurrent bacterial vaginosis than those of the comparison group. Conclusion. Genital microbiota of sexual partners may be responsible for the recurrent bacterial vaginosis in females, and parallel treatment of sexual partners is required to minimize its risk.

An investigation of the relationship between physical fitness, self-concept, and sexual functioning.

BACKGROUND:Obesity and inactivity have led to an increasing number of individuals with sexual dysfunctions (43% of women; 31% of men). Small bouts of exercise can drastically improve sexual functioning. Thus, the present study is designed to examine the effects of physical fitness and self-concept on sexual functioning.MATERIALS AND METHODS:Fitness assessments and questionnaires were administered to 133 participants between the ages of 18 and 50 years. Physical fitness was assessed through body composition, cardiovascular endurance, muscular strength, and muscular endurance. Self-concept was presented as a total self-concept score and as six individual concepts of self. Sexual function was presented as both an aggregate score and five separate constructs of sexual functioning – fantasy/cognition, arousal, orgasm, behavior/experience, and drive/desire.RESULTS:The results indicated that sexual behavior/experience was predicted by body fat percentage. In men, fantasy was related to total self-concept; sexual behavior/experience was related to likeability. In women, arousal was predicted by cardiovascular endurance. Total self-concept was related to both orgasm and sex drive/desire. Power and muscular strength were significantly related to number of sexual partners in women but not men.CONCLUSIONS:The present study adds to the growing body of evidence indicating a positive relationship between physical fitness and sexual health. Individuals with sexual dysfunctions, particularly women, who are not persuaded by the currently publicized benefits of physical activity, may be inclined to exercise to improve sexual functioning.

263 HPV infection in male sexual partners of women diagnosed of high grade cervical lesions and concordance in couples

263 HPV infection in male sexual partners of women diagnosed of high grade cervical lesions and concordance in couples

Acetowhite Test for Detection of Papilloma Virus Infection in Men Sexual Partner of Women Diagnosed of High Grade Cervical Lesions

Background: Traditionally, men asked urologist for treatment of genital warts caused by low risk Papilloma virus (LR-HPV) but, recently, asymptomatic men also want to know if they are infected by high risk HPV (HR-HPV) and the benefits of HPV vaccine. The aims of this cross-sectional study were: (1) to evaluate acetowhite test usefulness for detection of asymptomatic and subclinical HRHPV infection in a high risk population of men and (2) to assess risk factors of HR-HPV infection in this population. Methods: Healthy men (n=137) sexual partners of women with preneoplastic cervical lesions were recruited. Acetowhite test was performed (5% acetic acid solution, colposcopic examination under 4-fold and 7-fold magnification). Genital samples were obtained for HR-HPV DNA detection from different penile areas. (Linear Array HPV Genotyping Test, Roche Diagnostics, Mannheim, Germany). SPSS 19.0 (IBM, Chicago, USA) was used for statistical analysis. Results: HR-HPV prevalence was 68/137 (49.6%). AW procedure was positive in 36/137 (26.3%) patients. Genital warts were present in 18/137 (13.1%) patients. Acetowhite test showed 25% sensitivity (95% CI: 13.9-36), 72.4% specificity (95% CI: 61.2-83.7), 47.2% predictive positive value (95% CI: 29.5-64.9) and 49.5% negative predictive value (95% CI: 39.2- 59.7) for the identification of HR-HPV infection. Subclinical lesions were detected in 16/68 (23.5%) infected males. Genital warts (p=0.010) were associated with an increased risk for HRHPV infection in men. Conclusion: In our experience, acetowhite procedure sensitivity was low for HR-HPV detection in asymptomatic/subclinical genital infection and it was not specific indicator of HR-HPV infection. Genital warts detection was associated with HR-HPV infection in men.

P10.19 Can hsv-2 seropositivity be used as a biological marker of sexual behaviour? findings from a seroprevalence survey in england

Introduction Reliable measures of sexual behaviour aid understanding of differences in sexually transmitted infections between groups or over time, but are often difficult or infeasible to collect. Antibody to herpes simplex virus type 2 (HSV-2) has been proposed as a marker of sexual behaviour. We investigated the seroepidemiology of HSV-2 in England to explore the use of HSV-2 as such a marker. Methods Anonymised sera from 16–44 year-old participants in the Health Survey for England (HSE) in 2010 and 2012, a series of nationally-representative household surveys, were tested for anti-HSV-2 antibodies using the HerpeSelect2 IgG ELISA. Factors associated with seropositivity were investigated using logistic regression Results HSV-2 seropositivity increased with age up to 15% (95% CI: 11%–19%) in women and 9% (6%–14%) in men aged 40–44 years. Seropositivity was higher in those with more sexual partners over the lifetime in women (1.4% in those with 0 vs. 14% in those with ≥10 lifetime sexual partners, p = 0.018) but not in men (5% vs. 7%, p = 0.683). There was no difference by number of partners in the last year or by recent condom use. Women of black or black British ethnicity had around 3-times higher odds of being seropositive than those of white ethnicity (24% vs. 10%, odds ratio [OR]:2.96, 95% CI: 1.16–7.54; p = 0.023). No difference by ethnicity was noted among men. Conclusion Our findings suggest antibodies to HSV-2 may be a useful marker for number of lifetime sexual partners in women but not in men. There was less evidence to support the use of HSV-2 as a marker for recent sexual risk behaviour. These data can be used to power future analyses using HSV-2 as a marker of sexual behaviour in women. Although detailed analyses by ethnicity were limited by sample size, the differential risk of seropositivity by ethnicity is of interest and warrants further investigation. Disclosure of interest statement The study was funded by the Health Protection Agency (now part of Public Health England). No pharmaceutical or diagnostic company grants were received in the development of this study.

Design and baseline findings of a large-scale rapid response to an HIV outbreak in people who inject drugs in Athens, Greece: the ARISTOTLE programme.

To (i) describe an intervention implemented in response to the HIV-1 outbreak among people who inject drugs (PWIDs) in Greece (ARISTOTLE programme), (ii) assess its success in identifying and testing this population and (iii) describe socio-demographic characteristics, risk behaviours and access to treatment/prevention, estimate HIV prevalence and identify risk factors, as assessed at the first participation of PWIDs. A 'seek, test, treat, retain' intervention employing five rounds of respondent-driven sampling. Athens, Greece (2012-13). A total of 3320 individuals who had injected drugs in the past 12 months. ARISTOTLE is an intervention that involves reaching out to high-risk, hard-to-reach PWIDs ('seek'), engaging them in HIV testing and providing information and materials to prevent HIV ('test') and initiating and maintaining anti-retroviral and opioid substitution treatment for those testing positive ('treat' and 'retain'). Blood samples were collected for HIV testing and personal interviews were conducted. ARISTOTLE recruited 3320 PWIDs during the course of 13.5 months. More than half (54%) participated in multiple rounds, resulting in 7113 visits. HIV prevalence was 15.1%. At their first contact with the programme, 12.5% were on opioid substitution treatment programmes and the median number of free syringes they had received in the preceding month was 0. In the multivariable analysis, apart from injection-related variables, homelessness was a risk factor for HIV infection in male PWIDs [odds ratio (OR) yes versus no = 1.89, 95% confidence interval (CI) = 1.41, 2.52] while, in female PWIDS, the number of sexual partners (OR for > 5 versus one partner in the past year = 4.12, 95% CI = 1.93, 8.77) and history of imprisonment (OR yes versus no = 2.76, 95% CI = 1.43, 5.31) were associated with HIV. In Athens, Greece, the ARISTOTLE intervention for identifying HIV-positive people among people who inject drugs (PWID) facilitated rapid identification of a hidden population experiencing an outbreak and provided HIV testing, counselling and linkage to care. According to ARISTOTLE data, the 2011 HIV outbreak in Athens resulted in 15% HIV infection among PWID. Risk factors for HIV among PWID included homelessness in men and history of imprisonment and number of sexual partners in women.

Chronic vulvovaginal candidiasis: new look at old problem

The study on the effectiveness of fenticonazole treatment in 60 patients aged 18 to 45 years old with chronic recurrent vulvovaginal candidiasis was performed. Women were divided into two equal groups of 30 people. The main group received fenticonazole (drug Lomexin®) for 6 days (the sexual partners of women in the same period was recommended cream fenticonazole). The comparison group was administered ketoconazole for 10 days and treatment of sexual partners according to generally accepted recommendations.The results showed a high (96.67%) an anti-recurrence effect of Lomexin® local therapy of chronic vulvovaginal candidiasis compared with ketoconazole (80.0%). These results allow the authors to recommend the scheme of fenticonazole local therapy for chronic vulvovaginal candidiasis

Psoriasis and Sexual Behavior in U.S. Women: An Epidemiologic Analysis Using the National Health and Nutrition Examination Survey (NHANES)

Although sexual behavior is an integral part of most adults' overall well-being, this aspect of psoriasis patients' quality of life is rarely explored. The aim of this study is to assess the relationship between psoriasis and sexual behavior in U.S. women. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006. Our study focuses on responses to the dermatology and sexual behavior questionnaires of the NHANES. This study examines the association between psoriasis and sexual behavior in U.S. women with regard to sexual orientation, age of first sexual encounter, number of sexual partners, and frequency of unprotected sex. A total of 3,462 women provided responses to their psoriasis status: 2,753 (80%) women were heterosexual and 709 (20%) were nonheterosexual. Among them, 2.7% reported a physician-given diagnosis of psoriasis. On multivariate analyses, psoriasis was not associated with differences in sexual orientation (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.62-2.01). Among nonheterosexual women, multivariate analysis revealed a lower number of lifetime female sexual partners in women with psoriasis (rate ratio [RR] 0.11, 95% CI 0.04-0.33, P = 0.001). Among heterosexual women, no significant differences existed between those with and without psoriasis in age of first sexual encounter (weighted difference -0.54 years, 95% CI -1.27 to 0.19), number of lifetime male sexual partners (RR 1.19, 95% CI 0.69-2.06), or number of lifetime male oral sex partners (RR 0.72, 95% CI 0.40-1.29). Heterosexual women with psoriasis had 1.13 times more unprotected sex (RR 1.13, 95% CI 1.02-1.24, P = 0.03) compared with those without psoriasis. Psoriasis is associated with a significantly reduced number of sexual partners in nonheterosexual women. Psoriasis may differentially impact sexual behavior based on sexual orientation in women.

VulVoVaginitis and the treatment of asymptomatic partners: a systematic reView and metanalisis

Introduction: treating sexual partners of women with vaginal candidiasis and bacterial vaginosis is an issue in debate. Despite the present recommendations of the international guidelines to not to treat the asymptomatic sexual partners, this is a frequent practice between gynecologists. Objective: evaluate the influence of treating asymptomatic sexual partner of women with recurrent vulvovaginitis. Methods: databases searched: PubMed, Embase, Scielo and CINAHAL. Selection criteria: randomized clinical trials published from 1982 to 2012 were included. Studies involving pregnant women were excluded. Methodological quality was assessed using the Jadad scale. Data collection and analysis: Review Manager 5.1 was used for statistical analysis. Results: eight randomized clinical trials were included based on the chosen criteria: 1,088 women were enrolled. For bacterial vaginosis, the RR for cure was 1.00 (95%CI: 0.95–1.05) (p = 0.13), and for recurrence 0.84 (95%CI: 0.62–1.14) (p = 0.34). Vaginal candidiasis had a RR of 1.03 (95%CI: 0.94–1.14) (p = 0.48) for cure, and 1.02 (95%CI: 0.77–1.33 p = 0.91) for recurrence. Conclusion: treatment of asymptomatic sexual partners of women with vaginal candidiasis or bacterial vaginosis does not affect the cure or recurrence rates and may increase the risk of side effects and unnecessary financial costs.

The epidemiology of anal cancer

Anal cancer comprises malignancies of the anal canal principally of two morphologic variants: squamous cell carcinoma (SCC) and adenocarcinoma. In most settings, SCC compromises more than 70% of cases. In the general population, anal cancer is uncommon, with age-standardised incidence rates mostly between 1 and 2 per 100000 per year. However, incidence of anal SCC is increasing by 1-3% per year in developed country settings. High-risk human papillomavirus (HPV) types can be detected in 80-90% of all anal SCC cases, making it second only to cervical cancer in the closeness of its association with this virus. HPV-16 can be detected in ~90% of HPV-positive cases of anal SCC. Case-control studies have demonstrated that sexual risk factors (homosexuality in men and multiple sexual partners in women) are strongly associated with anal cancer risk. Other risk factors include immune deficiency and tobacco exposure. Anal cancer rates are highest in homosexual men, particularly in those who are HIV-positive, in whom anal cancer is among the most common of all cancers. Vaccination against HPV holds great promise for anal cancer prevention for those not already HPV-infected. For the current generation of adult high-risk populations, screening programs to allow early detection and treatment are under investigation.

Male urethral pap smears and peniscopy examination and polymerase chain reaction human papillomavirus correlation

The aims of this study were to determine HPV in a male population and its correlation with penile gross inspection and urethral pap smears. Fifty male volunteers were included in the study; all of them were sexual partners of women with evidence of HPV-related cervical diseases. Urethral Pap smear features and polymerase chain reaction (PCR; HPV detection) of urethral samples were correlated. Statistical analyses were conducted to identify variables associated with high and low-risk HPV types. Mean age of participants was 33.14 ± 1.52 (range, 23-50 years), and the mean age for those with high risk HPV was 32.12 ± 6.66 and 34.08 ± 6.58 for subjects with low-risk HPV (P = 0.820). Penile gross inspection revealed 19 (38%) cases with no lesions, papules in balanoprepusial furrol/sulcus in 23 (46%) cases, papilla in 23 (46%) cases, urethral lesions in 22 (44%) cases, penile body plaques in 22 (44%) cases, melanoses in 11 (22%) cases, sebaceous cysts on scrotum in 10 (20%) cases, and molting of the glands in 28 (56%) cases. Cytopathologic analysis revealed koilocytes in 24 (48%) cases. Dyskeratosis was observed in 24 (48%) cases. A bacterial background was found in 27 (54%) cases, and inflammatory cells were found in 27 (54%) cases. Twenty-six (52%) cases showed cytological features suggestive of Gardnerella Vaginalis. Twenty-four (48%) cases were high-risk HPV, and 26 (52%) were low-risk HPV (P = 0.037) as assessed by PCR-based detection. There was a statistically significant difference between koilocytes and bacterial background with high-risk human papillomavirus (P = 0.001). Abnormal colposcopy examination detected lesions were sampled for cytology by Pap smears.

Factors Associated with HIV Infection in Married or Cohabitating Couples in Kenya: Results from a Nationally Representative Study

BackgroundIn order to inform prevention programming, we analyzed HIV discordance and concordance within couples in the Kenya AIDS Indicator Survey (KAIS) 2007.MethodsKAIS was a nationally representative population-based sero-survey that examined demographic and behavioral indicators and serologic testing for HIV, HSV-2, syphilis, and CD4 cell counts in 15,853 consenting adults aged 15–64 years. We analyzed interview and blood testing data at the sexual partnership level from married or cohabitating couples. Multivariable regression models were used to identify factors independently associated with HIV discordant and concordant status.ResultsOf 3256 couples identified in the survey, 2748 (84.4%) had interview and blood testing data. Overall, 3.8% of couples were concordantly infected with HIV, and in 5.8% one partner was infected, translating to 338,000 discordant couples in Kenya. In 83.6% of HIV-infected Kenyans living in married or cohabitating couples neither partner knew their HIV status. Factors independently associated with HIV-discordance included young age in women (AOR 1.5, 95% CI: 1.2–1.8; p<0.0001), increasing number of lifetime sexual partners in women (AOR 1.5, 95% CI: 1.3–1.8; p<0.0001), HSV-2 infection in either or both partners (AOR 4.1, 95% CI: 2.3–7.2; p<0.0001), and lack of male circumcision (AOR 1.6, 95% CI: 1.0–2.5; p = 0.032). Independent factors for HIV-concordance included HSV-2 infection in both partners (AOR 6.5, 95% CI: 2.3–18.7; p = 0.001) and lack of male circumcision (AOR 1.8, 95% CI: 1.0–3.3; p = 0.043).ConclusionsCouple prevention interventions should begin early in relationships and include mutual knowledge of HIV status, reduction of outside sexual partners, and promotion of male circumcision among HIV-uninfected men. Mechanisms for effective prevention or suppression of HSV-2 infection are also needed.

Population-based study of asymptomatic infection with Chlamydia trachomatis among female and male students

There are few epidemiological studies of asymptomatic chlamydial infection among students in non-medical settings with minimal bias and improved accuracy; thus, useful data from screening among students are limited. We aimed to obtain accurate epidemiological information about asymptomatic chlamydial infection among students in non-medical settings. A population-based cross-sectional survey of 10,440 >or=18-year-old asymptomatic students who volunteered for a urine screening test for chlamydia was conducted. The prevalences of asymptomatic infection were 9.5% for women and 6.7% for men. Multivariate analysis revealed the risk factors to be a lifetime history of >or=4 sexual partners for women (odds ratio [OR] 3.17) and inconsistent condom use for men (OR 4.18). For both sexes, younger age at first intercourse was associated with a higher rate of inconsistent condom use. This study produced accurate epidemiological information on asymptomatic chlamydial infection. These results may contribute to the establishment of preventive countermeasures against such infection.

Association between Infection Aspects in Women with Squamous Intraepithelial Lesions and Peniscopic Findings in Their Male Sexual Partners

PURPOSE: To correlate colposcopy of women having squamous intraepithelial lesions (SIL) and peniscopic findings in their male sexual partners, to determine the prevalence of human papillomavirus (HPV) DNA in the male partners of women affected by SIL, and to assess the concordance of the viral group in the infected couple. PATIENTS AND METHODS: 27 females with different grade of SIL were examined by cytology, colposcopy and histology and their male sexual partners underwent clinical examination, peniscopy and biopsy. HPV testing was performed for all. RESULTS: 50 % of the sexual partners of women with low-grade squamous intraepithelial lesions (LSIL) were peniscopically negative. 36 % of the male partners of women with high-grade squamous intraepithelial lesions (HSIL) were peniscopically negative. Clinical lesions were observed in 50 and 9 % of the sexual partners of women with LSIL and HSIL, respectively, while subclinical lesions were found only in male partners of women with HSIL (45 %). Sexual partners of women with LSIL enrolled in our study were not HPV-positive. Male partners of patients with HSIL were HPV-positive in 63 % cases with 59 % being infected with high-risk viruses and 4 % with low-risk HPV viruses. The same genotypes were found in 19 % of couples, similarity in one genotype and difference in the other was found in 29.6 % of couples, while complete discordance was found in 48 % of couples. Highest concordance was achieved by high-risk types, especially type 16. CONCLUSION: Male sexual partners of women with SIL lesions have penile lesions determined by peniscopical examination that are mostly associated with the presence of high-risk HPV in women with HSIL. High-risk HPV prevalence is found among male partners with clinical and especially subclinical penile manifestations. Concordance of the viral group in infected pair needs to be more elucidated.

Preferred Strategies of Men and Women for Managing Chlamydial Infection

Early identification and treatment of sexual partners of women with chalmydial infection is critical because of the high risk of reinfection primarily as a result of resumption of sex with an untreated partner. Management strategies used for identifying and testing sexual partners for possible infection include: (1) partner notification (patient referral) of the sexual partner to a clinic for testing and treatment; (2) patient-delivered partner medication (PDPM) which involves the delivery of antibiotics by the patient to sexual partners; and, (3) a postal testing kit which involves asking partners to mail a urine sample to a laboratory. To determine preference of patients and their sexual partners for one of these strategies, the investigators employed interviewer-conducted questionnaires in women and anonymous, self-administered questionnaires in men. The study subjects were women infected with chlamydia already participating in a study randomizing them to receive one of these strategies, and men attending genitourinary clinics, family planning clinics and hospital fracture clinics. The response rates for the women's questionnaire were 97% (174/180) at study entry and 81% (145/180) at 6-month follow up. For the men's questionnaire, the response rate was 81%. Over two-thirds of the women respondents (67%) preferred PDPM for their partner if given the choice; the majority (57%) also chose PDPM for themselves if a partner tested positive for Chlamydia. The most common reasons given by women for preference of PDPM were greater simplicity and convenience, and quicker treatment of partners. Ninety-three of 142 women (65%) reported that their partners were satisfied with whichever intervention they were randomized to receive. Of the 293 men who responded, 70% preferred patient referral for partners and 53% chose this intervention for themselves. PDPM was more likely to be the preference of men previously tested for Chlamydia (n = 22) compared to those never tested (n = 7) (P < 0.001). Less than 5% of women and 10% of men preferred postal testing kits for partners. The investigators conclude from these findings that PDPM appears to be more popular with women, and at least in theory, patient referral is more popular with men.

Independent Association of Hygiene, Socioeconomic Status, and Circumcision With Reduced Risk of HIV Infection Among Kenyan Men

Among Kenyan men recruited as sex partners of women with genital symptoms, 22 of 150 were HIV seropositive. Because male HIV infection and male hygiene were unexpectedly found to be associated with each other, we examined the relationship of 5 hygiene variables with HIV infection in the men in a principal components analysis, controlling for socioeconomic status and other potential confounders. By multivariate analyses, HIV infection in men was not only independently associated with previous illness (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.4-19.1) and inversely associated with being circumcised (OR, 0.12; 95% CI, 0.02-0.91), but also independently associated with a combined measure of hygiene (OR, 0.41; 95% CI, 0.19-0.90).

Genital human papillomavirus infection in the male sexual partners of women with isolated vulvar lesions

The purpose of this study was to detect human papillomavirus (HPV) positivity in the male sexual partners of women with isolated vulvar lesions. The male counterparts of the females were subjected to detailed physical and peniscopic evaluations. After the gross inspection, 5% acetic acid was applied and the whole genital organs were evaluated using a colposcope. Overall, 47 male sexual partners with isolated vulvar HPV lesions were included. None of the patients had condylomata acuminata. Twenty-six patients (55%) had papular or papillary lesions, and 21 (45%) had flat acetowhite lesions. Biopsies were taken from all these suspicious areas for histopathologic examination. Overall, 41 patients (87%) had the exact characteristics of HPV on biopsy specimens. Ninety-two percent of patients (24/26) having papular and/or papillary lesions on peniscopy had HPV on biopsy, while 81% of patients (17/21) who had acetowhite flat lesions had biopsy-confirmed HPV lesions. In conclusion, it is important to assess the male sexual partners of women with HPV-related lower genital tract disease. Peniscopy is valuable for detecting lesions, and histopathologic confirmation is mandatory.

PREVALENCE OF TRICHOMONAS VAGINALIS AMONG THE SEXUAL PARTNERS OF WOMEN WITH TRICHOMONIASIS IN IBADAN, NIGERIA

This study was conducted to determine the prevalence of Trichomonas vaginalis among the sexual partners of women with Trichomoniasis. While 103 female patients were found to have T. vaginalis using both direct wet mount microscopy and culture, only 44(42.7%) male contacts reported for screening. Trichomonas vaginalis was isolated from 20(45.5%) of the 44 male contact investigated, whilst there was no laboratory evidence of the agent in 13(29.6%) of the study group. Amongst the 60 control subjects, T. vaginalis was recovered from 7(11.7%) of them. The difference in the occurrence of T. vaginalis between the patients and the control group was highly statistically significant (p Key Words: Trichomonas vaginalis, Prevalence, Sexual Partners, Trichomoniasis, Ibadan. (Af J Clinical & Exp Microbiology: 2003 4(2): 107-115)

Women in contact with Sydney's gay and lesbian community: Sexual identity, practice and HIV risks

Total rates are low, but sex with a man remains the main risk for HIV transmission to women in Australia. In February 1998, 774 women in contact with gay, bisexual and lesbian communities completed a two-page questionnaire. Almost all respondents had some social contact with gay men. Two-thirds (503) thought of themselves as lesbian/dyke/homosexual/gay, 13% (100) as bisexual and 17% (133) as heterosexual/straight. In total, 212 women (27%) said they had ever had sex with a gay or bisexual man; 51 women (7%) had done so in the past six months. About 2% of the lesbians said they had recently had sex with a gay/bi man, as had 8% of the heterosexuals and 25% of the bisexuals; 25 women had recently had unprotected vaginal or anal intercourse with a male gay/bi partner. Forty-eight women (6%) had done sex work. Asked about drug use, 61 women (8%) said they had injected in the past six months. Twenty-three women had shared injecting equipment with someone, and five had shared with a gay/bi man. Compared with other women, these women have high rates of injecting drug use. If they have sex with men, these men are more likely to be gay or bisexual than are the male sexual partners of women moving in largely heterosexual milieux. For a case of so-called 'heterosexual' transmission of HIV to occur, neither person need be heterosexual.

Prevalence of anti-human papillomavirus type 16, 18, 31, and 58 virus-like particles in women in the general population and in prostitutes.

Genital human papillomavirus (HPV) infection is sexually transmitted. The aim of the study was to characterize serological responses to HPV types 16, 18, 31, and 58 by exploring type-specific virus-like particles (VLPs) in two groups of women with very distinct sexual behaviors. Anti-VLP antibodies for types 16, 18, 31, and 58 and HPV DNA in cervical cells were investigated with 177 prostitutes and 283 age-matched controls from the female general population in Spain. Anti-VLP positivity increased with number of lifetime sexual partners in women from the general population, and no seroresponse was found in virgins. However, in prostitutes HPV infection was characterized by higher multireactivity to three or four VLPs (25%) than the general population (3%) and by a more frequent antibody response to HPV-58 than in the general population. About 75% of the women seropositive for type 58 had been born in a Latin American country. Seroprevalence of HPV and cervical HPV DNA in prostitutes were 14 and 10 times higher than observed in women in the general population (prevalence odds ratio [POR] of HPV seropositivity, 14.04 [95%; CI = 8.4 to 23.6] and POR for HPV DNA, 10.4 [95% CI = 3.9 to 27.6). Our results indicate that prostitutes are at an increased risk of oncogenic HPV infections, and they confirm the validity of anti-VLPs as markers of present or past HPV infection, that the number of sexual partners is the major determinant in acquisition of oncogenic HPV, and that anti-VLPs could be used as a marker of repeated infection in prostitutes.