Summary on Recent Medical Researches on Prostitution in Thailand

Prostitution is an important social and medical problem in Thailand. Here, the author summarizes the recent medical researches on prostitution in Thailand. Female prostitution is a major factor relating to human immuno deficiency virus (HIV) infection and sexually transmitted diseases (STDs) among Thais. A number of sexually active Thai males have experience on getting contact with a female prostitute; therefore, health education for Thais since they are young is recommended. Apart from HIV and STDs, prostitution is also related to hepatitis and cervical cancer in Thailand.     

安乡县外出农民工艾滋病性病感染现况及相关因素研究

目的了解安乡县外出农民工人群艾滋病性病感染现况及相关因素,为制定当地艾滋病防治决策提供依据。方法利用外出农民返乡过年的时间,设计调查问卷对260名农民工进行调查,并采血检测艾滋病病毒(HIV)及性病感染情况。结果 260名农民工艾滋病防治知识知晓率为64.2%,艾滋病非歧视态度比例为35.8%,婚外性行为发生率为35.8%(93/260),婚外性行为每次均使用安全套比率为64.5%(60/93),艾滋病没有检出,性病发病率为45.2%(42/93)。性病患病与性别、文化程度、艾滋病防治知识、态度及安全套使用等有关。结论安乡县外出农民工是HIV感染的潜在高危人群,应加强健康教育,提高其艾滋病防治知识和自我保护意识,预防控制艾滋病。     

Italian public and non-governmental organisations related to HIV/AIDS infection and migrant populations

This work is the result of two surveys carried out to obtain an overview of the specific types of activities conducted by public institutions and non-governmental organisations (NGO) with regard to HIV infection and AIDS among migrant populations in Italy. The results reveal that the types of services offered to migrant populations differ when comparing public institutions to NGOs. Public institutions mainly provide services related to medical-health issues, whereas NGOs focus on social assistance and acceptance. Both types of organisations report problems in communicating to migrant populations information on HIV infection, sexually transmitted diseases, prevention, and therapy, which is a critical issue in the relationship between the psycho-social-health operator and the foreigner.     

生殖器支原体在HIV高危人群中的流行进展

生殖器支原体(Mg)是性传播疾病的病原之一,可引起男性非淋球菌性尿道炎、女性宫颈炎、子宫内膜炎及盆腔炎.近年来发现泌尿生殖道Mg感染在HIV阳性及高危人群中的流行呈上升趋势,并且Mg感染可能促进HIV的感染与传播,提示应对HIV高危人群的Mg感染给予充分的重视.此文就Mg在HIV阳性及高危人群中的流行情况及治疗的研究进展进行了综述.     

Intimate Partner Violence and HIV Risks: A Longitudinal Study of Men on Methadone

Whereas research has suggested that drug-involved men are at disproportionately high risk of engaging in transmission risk behaviors for HIV and of perpetrating intimate partner violence (IPV) against women, only a few cross-sectional studies have examined the relationship between IPV and HIV/sexually transmitted infection (STI) transmission risks among heterosexual, drug-involved men. This study builds on previous cross-sectional research by using a longitudinal design to examine the temporal relationships between perpetration of IPV and different HIV/STI transmission risks among a random sample of 356 men on methadone assessed at baseline (wave 1), 6 months (wave 2), and 12 months (wave 3). The findings indicate that (1) perpetration of IPV in the past 6 months at wave 1 was associated with having more than one intimate partner, buying sex, and sexual coercion at subsequent waves and that (2) noncondom use, injecting drugs, and sexual coercion at wave 1 were associated with subsequent IPV. The temporal relationships between perpetration of IPV and HIV risks found in this study underscore the need for HIV prevention interventions targeting men on methadone to consider IPV and HIV risks as cooccurring problems.     

Response of religious groups to HIV/AIDS as a sexually transmitted infection in Trinidad

Background  

HIV/AIDS-related stigma and discrimination are significant determinants of HIV transmission in the Caribbean island nation of Trinidad and Tobago (T&T), where the adult HIV/AIDS prevalence is 2.5%. T&T is a spiritually-aware society and over 104 religious groups are represented. This religious diversity creates a complex social environment for the transmission of a sexually transmitted infection like HIV/AIDS. Religious leaders are esteemed in T&T's society and may use their position and frequent interactions with the public to promote HIV/AIDS awareness, fight stigma and discrimination, and exercise compassion for people living with HIV/AIDS (PWHA). Some religious groups have initiated HIV/AIDS education programs within their membership, but previous studies suggest that HIV/AIDS remains a stigmatized infection in many religious organizations. The present study investigates how the perception of HIV/AIDS as a sexually transmitted infection impacts religious representatives' incentives to respond to HIV/AIDS in their congregations and communities. In correlation, the study explores how the experiences of PWHA in religious gatherings impact healing and coping with HIV/AIDS.     

聊城市外来务工人员艾滋病防治知识态度行为及HIV感染状况

目的了解聊城市外来务工人员艾滋病知识态度行为及人类免疫缺陷病毒(HIV)感染状况,为制定该人群艾滋病防治策略及效果评价提供依据。方法采用随机抽样的方法,在聊城市几家大企业抽取外来务工人员406人,自行设计调查问卷,对艾滋病防治知识态度行为进行调查,同时进行相关血清学指标的检测。结果外来务工人员属于文化层次较低(初中以下学历占79.06%)的一个群体,对艾滋病一般知识的了解不高,对艾滋病是性病的正确回答率只有51.06%;对艾滋病3条主要传播途径知晓率较高,均在70%以上,而对非传播途径知晓率较低,与感染者握手、拥抱会感染艾滋病正确回答率仅为13.55%;对艾滋病预防知识知晓率较高,其中有87.78%的人认为只与一个性伴发生性行为可减少艾滋病传播;对非婚性行为者坚持使用安全套的比例仅为16.41%;对AIDS/HIV有歧视、偏见的占少数,仅有2.31%的认为不应得到任何帮助和支持;未有人检出抗-HIV和梅毒抗体阳性。结论外来务工人员艾滋病防治知识知晓率有待进一步提高,对非传播途径存在较多误解,今后,应采取多种渠道,加强部门联合,强化艾滋病防治知识的宣传教育,提高外来务工人员的艾滋病知识知晓率,并提供相关服务和行为干预。     

如皋市400名暗娼梅毒、HIV检测结果分析

目的:通过对暗娼性病感染情况的监测分析,为制定遏制艾滋病的发病对策提供科学依据。方法:对400名暗娼利用ELISA和TRUST试验进行梅毒抗体和艾滋病毒抗体的检测。结果:本次调查的400名娱乐场所女性从业人员中,共检出梅毒24例,梅毒检出率为6.0%,HIV未检出。结论:梅毒感染已经在暗娼这个群体中广泛存在,对这类人群进行相关知识的健康教育和监管防控措施,对预防和控制性病的传播具有要意义。     

Sexually transmitted infections. Current clinical and therapeutic data

A recent increase of syphilis and gonorrhea has been observed in France. More recently, the resurgence of very infrequent STDs, such as lymphogranuloma venerum, has been noticed in Western Europe. This data illustrates the emergence of high-risk behavior and the relative failure of prevention for sexually transmitted infection and HIV infection, especially in homosexual men. Since the onset of the AIDS epidemic, oral sex has been increasingly used both by heterosexual and homosexual partners. Even if the risk of HIV transmission with oral sex is very low, oral sex is a major mode of transmission for syphilis, gonorrhea, and genital herpes. Condoms are seldom used for oral sex. The transmission of STI by oral sex is less documented in heterosexual than in homosexual patients. The level of knowledge does not seem to reduce risky behavior in the most concerned population. An infection not normally considered as sexually transmitted (i.e. hepatitis C) may be transmitted by high risk sexual behavior increasing the risk of blood-blood contact, as recently reported among HIV-infected homosexual men. The emergence of high-risk sexual practices (traumatic practices, fisting) in a specific population required focused prevention measures to avoid blood-transmitted infections. The increased risk of HIV transmission by ST co-infection (syphilis, genital herpes, gonorrhea) and the potential morbidity of STI in HIV infected patients should also be emphasized.     

方便提供安全套对预防HIV经性传播的效果研究

目的 了解经性途径传播的HIV感染者不安全性行为特征及安全套使用情况,模拟方便提供安全套对预防人免疫缺陷病毒（human immunodeficiency virus,HIV）经性途径传播的效果。方法 采用问卷调查法,对新报告的经性途径感染的HIV阳性者感染告知前6个月内的相关情况进行调查,通过数学模型估计提供方便安全套对预防HIV经性途径传播的预期效果。结果 感染告知前6个月内调查对象安全套使用率为36.4%,其中63.6%的调查对象从未使用过安全套,14.8%有时使用,9.6%经常使用,12.0%坚持每次使用;未坚持使用安全套的原因受一种或多种因素影响,未坚持使用安全套的研究对象中,30.9%在发生不安全性行为时未及时获得安全套;方便提供安全套预期可避免13.79%的不安全性行为发生,减少10.92%经性途径传播造成的HIV新发感染。结论 公共娱乐场所等地提供方便可取的安全套可一定程度降低不安全性行为发生,对阻止HIV经性途经传播具有一定效果。     

Mortality related to sexually transmitted diseases in US women, 1973 through 1992.

OBJECTIVES: This study estimated the trends in mortality related to sexually transmitted diseases (STDs) and their sequelae in US women from 1973 through 1992. METHODS: The total number of deaths was obtained from US national mortality data and from AIDS surveillance data, and current literature was reviewed to estimate proportions of diseases attributable to sexual transmission. RESULTS: From 1973 through 1984, total STD-related deaths decreased 24%. However, from 1985 through 1992, STD-related deaths increased by 31%, primarily because of increasing numbers of deaths from sexually transmitted human immunodeficiency virus (HIV) infection. The most important changes during the 20-year period were the emergence of and continued increase in the number of deaths related to hetero-sexually transmitted HIV. CONCLUSIONS: The leading causes of STD-related mortality in women, viral STDs and their sequelae, are generally not recognized as being sexually transmitted. Increases in STD-related mortality are primarily due to sexually transmitted HIV, which will soon surpass cervical cancer as the leading cause.     

驻马店市新羁押劳教人员HIV感染率估计高危人群HIV综合感染率

目的了解驻马店市劳教人员艾滋病病毒(HIV)感染的相关行为信息,为类似人群开展艾滋病干预措施提供依据。探讨以此类人群艾滋病感染率替代各类高危人群综合艾滋病感染率的可行性。方法对2010年1月至9月间所有监狱3个月内新入监的劳动改造人员进行HIV检测和问卷调查。与我市高危哨点检测出的感染率进行比较。结果在1 226名新入监劳教人员中检测出HIV抗体阳性11例,感染率为0.89%,其中3例有献血史,3例有吸毒史和嫖娼史,2例吸毒,2例性乱,1例无吸毒、无性乱史。结论劳动改造人员成分比较复杂,卖淫嫖娼吸毒等高危行为比较常见,本次调查显示,新入监劳动改造人员0.89%的艾滋病感染率与我市高危人群(吸毒、暗娼、男男同性恋3类人群)综合的艾滋病感染率0.72%非常接近。提示我们以此类人群艾滋病感染率替代各类高危人群综合艾滋病感染率具有可行性。     

北京市流动人口艾滋病知识、行为及感染情况调查

目的了解北京市流动人口艾滋病知识知晓情况、行为特征、艾滋病/性病感染状况及影响因素。方法于2009年6—12月,对北京市外来建筑工人、企业员工和商贸经营人员进行匿名自填式问卷调查,采集血样检测艾滋病病毒(HIV)、梅毒及丙型肝炎病毒(HCV)。结果共调查4 187人,未检出HIV抗体阳性,梅毒检出率为0.4%(15/4 187),HCV检出率为0.6%(25/4 187);艾滋病知识知晓率为63.9%(2 677/4 187),75.9%(3 144/4 141)的调查对象有过性行为史,4.3%(177/4 141)最近1年有过非商业临时性行为,其中从未使用安全套者占27.1%(48/177),仅29.4%(52/177)每次均用;多因素logistic回归分析结果显示,年龄、婚姻状况、文化程度、在本地居住时间和职业类型是流动人口艾滋病知识知晓情况的影响因素;性别、婚姻状况和在本地居住时间是流动人口临时性行为发生的影响因素。结论北京市流动人口对艾滋病知识了解不够,且存在相当比例的非保护临时性行为,具有HIV传播流行的风险,应加强对其进行相关健康教育和行为干预。     

Survey on HIV risk perception and sexual behaviours among seafarers

Because the nature of their work seafarers spend long periods of time away from their families and therefore represent a group at risk for sexually transmitted diseases, including HIV infection. This paper reports the results of a survey to evaluate awareness and knowledge of the risk of HIV infection among seafarers. Risky behaviours for HIV transmission were also assessed. The survey was conducted using anonymous questionnaires on 197 workers of 9 vessels and 26 office employees of an Italian shipping company (FINAVAL S.p.A., Rome). The respondents considered HIV/AIDS as one of the diseases with a high risk of transmission. Most respondents had a good general knowledge of HIV/AIDS and on the ways of its transmission. However, there is still lack of knowledge on the basics of this disease. On the other hand, in spite of knowledge and awareness about the risks of the disease, only 56.35% of the interviewed crewmembers used protection in sexual intercourse with occasional partners. Compared to data available in literature, the percentage of self-protecting people is increasing, but the number of seafarers exposing themselves to risky behaviours is still high. As expected, condoms are used with regular partners with lower frequency compared to occasional intercourse. The results of this survey indicate that adequate prevention campaigns and major attention paid to seafarers health is useful for stimulating responsible conduct for the prevention of infectious diseases, including HIV infection. Nevertheless, it is still necessary to increase information about the risk of sexually transmitted diseases and how to reduce it.     

The influence of HIV infections on the demand for assistance in an outpatient clinic for venereal diseases

Educative campaigns on the danger of HIV infection have been quite successful. Within a decade the number of cases of gonorrhoea has sharply fallen. However, fear of AIDS does to some extent increase the demand for medical examination for sexually transmitted diseases. This explains why there is a discrepancy between the total number of consultations in the outpatient department and the actual number of cases of gonorrhoea diagnosed. From 1987 onward more time is being spent per consultation on counselling concerning HIV and prevention of HIV transmission by discouraging risk-bearing sexual practices. The numbers show that the target group has been reached successfully. In the University Hospital of Utrecht about half the patients with positive HIV serology were known before 1987 in the outpatient department for sexually transmitted diseases of that hospital. In the near future it will be mostly the venereal diseases clinics that will deal with the increasing demands concerning HIV.     

Prospective study of hormonal contraception and women's risk of HIV infection in South Africa

BACKGROUND: Many women using hormonal contraceptives are also at risk of sexually transmitted HIV infection, but data are mixed on whether hormonal contraception increases women's risk of HIV. We investigated associations between HIV incidence and use of combined oral contraceptives (COC), norethindrone enanthate (NET-EN) or depot medroxyprogesterone acetate (DMPA) in a cohort of South African women. METHODS: Participants were 4200 HIV-negative women aged 35-49 years enrolled into a cervical cancer screening trial. At enrollment, women were tested for sexually transmitted infections and reported on their sexual behaviour and contraceptive use. During the 24 months of follow-up, women reported on their sexual behaviours and contraceptive use and underwent repeat HIV testing. RESULTS: During the 5010 person-years of follow-up, 111 incident HIV infections were observed (HIV incidence, 2.2 infections/100 person-years). At enrollment, 21% of women reported using hormonal contraception, primarily DMPA (14% of all women) or NET-EN (5%). After adjusting for sexual risk behaviours and sexually transmitted infections, the incidence of HIV was similar among women using COC, NET-EN or DMPA compared with women not using any hormonal method [incidence rate ratios and 95% confidence intervals, 0.65, 0.16-2.66; 0.79, 0.31-2.02 and 0.96, 0.58-1.59, respectively]. There was also no association between increased duration of DMPA use and HIV incidence (P-value for trend, 0.51). CONCLUSIONS: These findings contribute to the evidence from general population cohorts of women that hormonal contraceptive use is not associated with increased risk of HIV acquisition. Nonetheless, family planning services are an important venue for HIV prevention activities.     

A meta-analysis of condom effectiveness in reducing sexually transmitted HIV

Before condoms can be considered as a prophylaxis for sexually transmitted human immunodeficiency virus (HIV), their efficacy must be considered. This paper reviews evidence on condom effectiveness in reducing the risk of heterosexually transmitted human HIV. A meta-analysis conducted on data from in vivo studies of HIV discordant sexual partners is used to estimate the protective effect of condoms. Although contraceptive research indicates that condoms are 87% effective in preventing pregnancy, results of HIV transmission studies indicate that condoms may reduce risk of HIV infection by approximately 69%. Thus, efficacy may be much lower than commonly assumed, although results should be viewed tentatively due to design limitations in the original studies.     

Outbreak of syphilis among men who have sex with men--Southern California, 2000

Syphilis is a sexually transmitted disease (STD) caused by infection with the spirochete Treponema pallidum, and like other genital ulcer diseases, syphilis enhances the transmission of human immunodeficiency virus (HIV). During the 1990s, syphilis occurred predominantly among heterosexual blacks in the South and in large cities. However, recent outbreaks of syphilis have occurred among men who have sex with men (MSM). A large syphilis outbreak occurred among MSM during January-July 2000 in southern California. During the outbreak period, the proportion of primary and secondary (P&S) syphilis cases among MSM increased to 51% from 26% for the same period in 1999. This report summarizes the findings of an investigation of this syphilis outbreak, which indicate a substantial increase in the number of syphilis cases among MSM, many of whom are HIV-positive. These data suggest that concern about HIV infection may be declining among MSM and emphasize the importance of strengthening efforts to prevent HIV infection in this population in the United States.     

Trichomonas vaginalis, HIV, and African-Americans.

Trichomonas vaginalis may be emerging as one of the most important cofactors in amplifying HIV transmission, particularly in African-American communities of the United States. In a person co-infected with HIV, the pathology induced by T. vaginalis infection can increase HIV shedding. Trichomonas infection may also act to expand the portal of entry for HIV in an HIV-negative person. Studies from Africa have suggested that T. vaginalis infection may increase the rate of HIV transmission by approximately twofold. Available data indicate that T. vaginalis is highly prevalent among African-Americans in major urban centers of the United States and is often the most common sexually transmitted infection in black women. Even if T. vaginalis increases the risk of HIV transmission by a small amount, this could translate into an important amplifying effect since Trichomonas is so common. Substantial HIV transmission may be attributable to T. vaginalis in African-American communities of the United States.     

The social constructions of sexuality: marital infidelity and sexually transmitted disease-HIV risk in a Mexican migrant community

OBJECTIVES: This article explores the social context of the migration-related HIV epidemic in western Mexico. METHODS: Data collection involved life histories and participant observation with migrant women in Atlanta and their sisters or sisters-in-law in Mexico. RESULTS: Both younger and older women acknowledged that migrant men's sexual behavior may expose them to HIV and other sexually transmitted diseases.Younger Mexican women in both communities expressed a marital ideal characterized by mutual intimacy, communication, joint decisionmaking, and sexual pleasure, but not by willingness to use condoms as an HIV prevention strategy. CONCLUSIONS: Migrant Mexican women's commitment to an illusion of fidelity will hinder HIV prevention initiatives targeted toward them. Furthermore, the changing meanings of marital sex may make it harder to convince young couples to use condoms as an HIV prevention strategy. If the chain of heterosexual marital HIV transmission is to be interrupted in this community, prevention programs must target men.