Sexual behavior and sexually transmitted diseases among Swedish university students

Students at Uppsala University, Sweden, were interviewed about their sexual behavior, their knowledge of and attitudes to sexually transmitted diseases (STDs) and related issues. The purpose of the study was to ascertain trends in behavior and attitudes as an indication of the likely risk of the spread of STDs, in particular AIDS, among students. Results revealed that change of partner was commonplace. A significant number of students had suffered from an STD. Students' claims that their own sexual practices, and those of others, had changed as a result of the AIDS epidemic, proved to be unsubstantiated in their behavior. Although contraceptive use was high, condom use with change of partner was infrequent. Alcohol played a significant role in impairing judgement. Despite a reasonably sound knowledge of STDs, the students exhibited a high degree of risk-taking behavior. The study has highlighted the dichotomy between knowledge and practice in student sexual behavior. Notable was the lack of perception among university students of their own risk of contracting STDs.     

General sexually transmitted diseases

This review discusses current trends in sexually transmitted diseases. Topics include treatment and prevention of syphilis and gonorrhea, as well as the association of sexually transmitted diseases with sexual assault. Also discussed are the various organisms that cause vulvitis, including Trichomonas, Candida, and Gardnerella species, along with a discussion of vulvar lesions that are especially difficult to diagnose and treat. Diagnosis, sampling, pathogenesis, and treatment of Chlamydia trachomatis are also covered. A discussion of the various degrees of protection offered by different forms of contraception encourages use of barrier methods and oral contraceptives for teenagers as well as postponement of sexual activity. Detection, treatment, and vaccination against genital herpes are covered, along with diagnosing anogenital warts in children as either skin or genital wart virus types, and the relationship between human papillomavirus and cancer.     

Avoiding sexually transmitted diseases

As the spectrum of sexually transmitted diseases (STDs) has broadened to include many infections that are not readily cured, prevention of STDs has become more important than ever. Primary prevention methods include abstinence, careful selection of sexual partners, condoms, vaginal spermicides, and a vaccine for hepatitis B. Condoms will protect against STDs only if they are used consistently and correctly; vaginal spermicides may also reduce risk of certain STDs. Health care providers should routinely counsel women on methods to reduce risk of STDs.     

Epidemiology of sexually transmitted diseases

The epidemiology of STDs is a vast topic. It includes examining not only the frequency of disease but also those factors that influence the frequency. It requires taking into account not only the characteristics of the infected persons and their risk factors but also the characteristics of the causative organisms. There is a commonality between various STDs that results in people frequently harboring one or more agent. In view of this, efforts should be made to evaluate patients for inapparent disease. Another important aspect is recognizing that patients do not acquire their infection except through sexual contact, indicating that another person is involved. Therefore, for control purposes, treatment of all sexual contacts also must be addressed.     

Sexual experience, abortion and sexually transmitted diseases among young women at a contraceptive clinic.

All visitors who during one year visited a contraceptive clinic in the Solna district of Stockholm County and were below the age of 26 were asked to fill in a questionnaire and offered a test for C. trachomatis. Three hundred and six women (97%) participated. Ninety percent had at some time used oral contraceptives and 91% had experience of condom use. One-fifth of the whole group had undergone one or more legal abortions, and one fourth had experience of a sexually transmitted disease (STD). The most common STD experienced was chlamydia, followed by condyloma. The actual prevalence of chlamydia in the group was 6%. Sexual contacts were often made early in on-going steady relations. Forty-two percent admitted casual sex, but the number of life-time partners was five or less among the majority.     

Personal protection against sexually transmitted diseases

Primary prevention of sexually transmitted diseases has received little emphasis in control programs. To evaluate the effectiveness of prevention strategies, we reviewed the world's literature on this topic. Use of condoms and spermicides greatly reduces the risk of gonorrhea, and barrier methods are practical and acceptable. Certain systemic antibiotics are effective, but for practical reasons, their use cannot be recommended. Washing or urinating after sexual exposure does not appear to protect against infection. Although the effectiveness of modifying sexual behavior to reduce the risk of sexually transmitted diseases has not been evaluated, many people have changed or are willing to change their behavior. Even if preventive measures are used consistently by only a minority of persons at risk, rates of sexually transmitted diseases would decline rapidly. In this era of sexually transmitted diseases that are not readily cured by antibiotics, use of effective preventive measures should be strongly encouraged.     

Office diagnosis of sexually transmitted diseases

Treatment of sexually transmitted diseases begins with prompt and accurate diagnosis. Several new diagnostic techniques allow more rapid or easier testing, however sometimes at a cost. The vast array of diagnostic methodologies available to the office practitioners are discussed with special regard to their sensitivity, specificity, and ease of use.     

Treatment of sexually transmitted diseases in women

Guidelines for the treatment of patients with sexually transmitted infection are developed by the Centers for Disease Control and Prevention after consultation with a group of professionals knowledgeable in the field. This article briefly introduces various infections, reviews new diagnostic information, and presents the latest guidelines for therapy. All recommended and alternative regimens are drawn from the most recent treatment guidelines. Although this article focuses primarily on therapy, it also emphasizes the importance of counseling and prevention. Clinicians have the opportunity and obligation to provide education and counseling to patients. Prevention messages should be tailored to the individual patient with consideration given to her specific risk behaviors.     

Prevention of sexually transmitted diseases in women

Sexually transmitted diseases (STDs) are among the most common infections worldwide. Spread by sexual contact, various STDs directly cause much morbidity and mortality. General as well as specific aspects of STD prevention are discussed.     

Psychologic aspects of sexual abuse in adolescence.

This paper reviews psychologic aspects of sexual abuse in female adolescents. It documents that sexual abuse is widespread, occurring at an alarming rate at all socioeconomic levels of society. It is perpetrated principally by adult men in the victim's family. Often its effects are tragic. Adolescent female sexual abuse victims are at high risk for subsequent acting out behavior, sexual promiscuity, physical and sexual abuse, anxiety, depression, low self-esteem, alcohol and drug abuse or dependence, chronic sleep disturbance, dissociative disorders, eating disorders, emotional numbing, dissociation, guilt, shame, hyperalertness, suicidal ideation, and multiple associated psychiatric disorders. Although it may appear at a surface level that sexual abuse victims recover from such abuse, follow-up studies suggest that many remain disabled long after the abuse has ended. Health care professionals should be especially cognizant of the magnitude of the impact of sexual abuse on adolescent girls and recognize the need of these patients for psychologic and medical services.     

Sexually transmitted diseases in sexually abused girls and adolescents

PURPOSE OF REVIEW: The clinical evaluation for suspected child sexual abuse often includes sexually transmitted disease testing. In spite of the high prevalence of sexual abuse, however, most abused children will not have a sexually transmitted disease identified. The low prevalence of sexually transmitted diseases in this population requires special care by the clinician to exclude false-positive test results and to provide appropriate guidance to child protection workers. RECENT FINDINGS: The likelihood of sexual transmission varies for specific infectious agents and the transmission of infectious agents such as human papillomavirus is complex. Concern about the low positive predictive value of many tests for sexually transmitted diseases in this population is again being demonstrated and clinicians are asked to be cautious in interpreting test results. SUMMARY: Clinicians are mandated reporters of suspected child abuse. Treatment of sexually transmitted diseases may need to be delayed pending confirmatory testing of the initial results. HIV postexposure prophylaxis should be considered within hours of the exposure.     

Preventing fetal damage from sexually transmitted diseases

The STDs threaten the reproductive health of women in many ways, ranging from premature births through congenital infections and death. An understanding of the natural history of these diseases permits timely interventions which can mitigate the perinatal damage caused by these infections substantially. Ideally, primary prevention or safer sex will be adopted by sexually active women, thereby reducing the morbidity not only for their offspring but for themselves as well. Antiviral therapy is not yet available for minimizing any hazard of fetal exposure to HPV, HSV, HIV, and hepatitis B viral infections. Early antibiotic therapy should reduce the risk of congenital syphilis and any perinatal hazards associated with chlamydial and gonococcal infections.     

Sexually transmitted diseases and risk of HIV infection in men attending a sexually transmitted diseases clinic in Dakar, Senegal

This cross-sectional study was carried out among male outpatients with symptoms of STDs at the STD reference centre at the Institute of Social Hygiene (IHS), Dakar, Senegal, from March 1989 through May 1991. This study was used to determine the prevalence of STDs and HIV among male patients attending an STD clinic and to identify their socio-demographic characteristics and risk factors. A total of 975 patients were enrolled in the study. The most common syndromes were urethritis (76%) and genital ulcers (22%). Considering single infections, the major STD agents were Neisseria gonorrheae (N.gonorrheae, 30%), Chlamydia trachomatis (C.trachomatis, 15%), Treponema pallidum (T.pallidum, 12%), and Haemophilus ducreyi (H.ducreyi, 7%). HIV prevalence was 2.6 percent (25/975). After multivariate analysis, the risk factors associated with HIV infection were a history of sex with prostitutes (odds ratio [OR] = 8.6, 95% confidence interval [CI] = 2.0-37.8), unprotected sexual contact (OR = 5.6, 95% CI = 1.2-25.0), a history of urethritis (OR = 3.4, 95% CI = 1.3-8.9), current STDs due to H.ducreyi or T.pallidum (OR = 6.1, 95% CI = 2-18.8), and mixed STD infection (OR = 5.3, 95% CI = 1.3-21.8). HIV prevalence was quite low in this population compared to similar studies of STD patients from other sub-Saharan African countries. Neisseria gonorrheae and Chlamydia trachomatis were the leading causes of STDs. A history of risky sexual behaviour, previous STDs, current genital ulcers, and mixed STD infections were associated with HIV infection. Further studies are necessary to determine changes in the relationship of STDs and HIV infection in this population.