再次感染性病患者的相关高危行为因素分析

目的 :了解初次及再次感染性病患者 (既往有性病史 )的性病和艾滋病健康知识水平 ,分析再次感染性病的相关高危行为因素 ,探讨干预其相关高危行为而减少感染性病的健康教育模式。方法 :对在 2 0 0 1年 3月～ 9月性病门诊中确诊的新发病人 ,采取自填性病和艾滋病相关健康知识问卷 ,利用SPSS 1 0 1统计软件包进行卡方检验及相关分析。结果 :性病患者的性病及安全套相关知识偏少 ,而与非固定、固定性伴侣性行为时安全套始终使用率均偏低。再次感染性病的男女患者与非固定性伴侣性行为比率均高于初次感染性病 (既往无性病史 )的男女患者 (P >0 0 5 ) ,其中再次感染性病的男性患者与性工作者性行为比率明显高于初次感染性病的男性患者 ( χ2 =9 62 ,P <0 0 1 )。结论 :对性病门诊患者应加强性病艾滋病知识的健康教育 ,提倡在性行为时普及使用安全套 ,以减少其再次感染或传播性病艾滋病的机会     

蒙自市2008-2013年城区男性建筑工人HIV监测结果分析

目的通过对蒙自市城区男性建筑工人连续6年的HIV监测,了解该人群的HIV感染状况、变化趋势及行为干预效果。方法 (2008-2013)年每年监测期内随机抽取蒙自市城区(5-20)个建筑工地,对男性建筑工人采用统一问卷进行调查和HIV抗体检测,分析各年HIV感染、艾滋病知识知晓、高危行为改变等情况。结果艾滋病知识知晓率从40.44%上升到88.86%,不同年龄、文化程度、民族、在城区居住时间知晓率均有统计学意义(P0.01);HIV抗体阳性率平均为0.88%,梅毒抗体阳性率平均0.26%;调查对象中最近一年与女性性工作者发生性交易、与临时性伴发生性行为、与男性发生性行为的比例分别为9.45%、9.81%、0.24%,最近一次使用安全套的比例分别为70.82%、43.80%、16.67%。结论该地男性建筑工人大部分处在性活跃期,存在非婚性行为、安全套使用率低等高危性行为,接受干预服务、HIV咨询检测率低。应针对该人群的行业特点进行警示性健康教育,强化居住地安全套的推广使用,减少高危性行为,降低艾滋病在该人群中的传播与流行。     

上海市嘉定区性病门诊就诊者艾滋病高危行为特征及血清学监测结果分析

目的了解嘉定区性病门诊就诊者性病艾滋病知识、行为和态度,以及艾滋病/梅毒感染情况。方法对性病门诊就诊者进行问卷调查,同时采集血样进行HIV及梅毒血清学检测。结果共调查性病门诊就诊者437人,2例HIV抗体阳性,66例RPR初筛阳性,占15.1%。调查对象对性、血液、母婴三大传播途径的知晓率分别为89.5%,90.4%和87.4%。最近3个月内,35.9%发生过商业性行为,其中34.6%有1个以上商业性伴,商业性伴平均数(1.52±0.84)个。最近一次发生商业性行为时71.3%没有使用安全套。没有使用安全套的主要原因:51.8%为不愿使用,22.3%身边没有,11.6%忘记使用等。如果以后出现性病相关症状,92.0%会选择性病专科医院或综合性医院进行诊治。结论性病门诊就诊者性病艾滋病知识不足,高危行为的发生率高,安全套使用率低,梅毒检出率高,应加强健康教育,进一步推广安全套使用。     

上海地区男性性病患者口腔性行为现状分析

目的了解性病患者中口腔性行为的人群分布情况和特征。方法调查男性性病患者的性行为方式、社会人口学特征和患病情况。结果共490位男性性病患者中,有口腔性行为史者63．06％,其中年龄≥33岁、常住上海和受教育程度〈12年的已婚男士更容易发生口腔性行为。在有口腔性行为的患者中既往患淋病的比例是15．53％,显著高于无口腔性行为的患者。在口腔性行为和阴道性行为中,安全套使用率分别是1．94％和41．10％。结论上海地区男性性病患者中,年龄偏大、受教育程度较低的已婚上海常住男性更易发生口腔性行为,并且安全套的使用率显著低于在阴道性行为中的使用率。     

不同性取向的男男性行为人群行为特征差异性分析

目的了解男男性行为(MSM)人群的社会人口学特征、性取向及行为差异性,为高危人群干预提供参考依据。方法通过VCT门诊、同伴推动、网络动员、外展干预等方式招募MSM人群,开展面对面问卷调查,并采集血样进行HIV抗体检测。结果 334例MSM人群中,HIV(+)39例(占11.68%)。自诉同性恋者159例(占47.60%),自诉双性恋者175例(占52.40%)。同性恋和双性恋已婚/再婚的比例分别为15.09%和50.29%。MSM人群过去5年性行为方式仅与男性、以男性为主、男女各半、以女性为主的比例分别为41.02%、26.65%、13.47%和18.86%,不同性取向MSM人群性行为对象差异有统计学意义。过去6个月内,MSM人群拥有女性性伴、固定男性伴、多次男性伴(与非固定男性性伴发生过多次性行为)、偶遇男性伴(与非固定男性性伴发生过一次性行为)、商业男性伴的比例分别为37.13%、43.11%、52.69%、56.29%和4.19%,不同性取向MSM人群拥有性伴的种类数,女性性伴、固定男性伴、多次男性伴比例差异有统计学意义;MSM人群与女性伴、固定男性伴、多次男性伴、偶遇男性伴发生无保护性行为(性行为时没有使用安全套)的比例分别为75.21%、65.97%、59.66%、48.40%,双性恋者与偶遇男性伴发生性行为时安全套使用率低。MSM人群中,12.28%曾患有性传播疾病,14.07%最近一年出现过性病相关症状,到正规医疗机构就诊的比例仅为40.43%。51.80%曾做过HIV抗体检测。结论 MSM人群性病艾滋病患病率较高,性伴种类多、高危性行为比例高,尤其是双性恋的MSM人群是重点关注群体。     

依托性病门诊开展男男性行为人群梅毒感染调查

目的:依托性病门诊在佛山地区开展男男同性性行为人群(men who have sex with men,MSM)梅毒感染状况的调查,为预防与控制梅毒的流行、向MSM提供相应的高危行为干预及高质量的公共卫生服务提供科学依据.方法:2010年7月~2011年12月,通过性病门诊共对161名MSM进行血清学检测和问卷调查.应用酶联免疫吸附方法检测血清中特异性梅毒螺旋体抗体和对HIV抗体初筛,用甲苯胺红不加热血清试验检测非特异性梅毒螺旋体抗体.用2 检验进行单因素分析;运用二分类logistic回归模型分析梅毒感染的相关因素.结果:调查对象的梅毒感染率为12.4%(20/161),与梅毒感染相关的高危因素有不与家人同住(OR=4.35)、性伴多于3人(OR=12.58)、最近一次性行为没有使用安全套(OR=5.19)以及HIV感染(OR=16.84)等原因.结论:多性伴、既往HIV感染、发生性行为时不使用安全套等是梅毒感染的高危因素,应在性病防治工作中开展有效干预,遏制梅毒传播.     

青岛市男男性行为人群艾滋病高危性行为调查

目的:了解男男性行为人群(MSM)的高危性行为,为制定预防控制策略提供依据。方法:采用同伴推动抽样法对MSM人群进行问卷调查。结果:累计调查1849人,年龄中位数26岁,与男性发生过肛交者占98.37%;最近3个月男性性伴在2人以上者占46.29%,有女性性伴者占11.14%;最近一次与男性肛交时安全套使用率为57.92%,最近3个月与男性肛交时每次都使用安全套的比例为35.37%。结论:MSM人群普遍存在多性伴、无保护的性行为,传播性病艾滋病的风险较大。     

性病门诊患者求医行为特征的研究

目的 为探讨性病患者求医行为特征并对性病服务质量提出较为客观的评价，方法 我们采用对性病门诊200例患者进行问卷调查和深入访谈的方法。结果显示，本组200例中52%的患者怀疑患者病时能及时求医；6.2%的患者在非婚性接触时坚持使用安全套；48%的性病患者在正规医院求医时担心遇见熟人，98%的男性患者希望增设夜诊；92%的患者认为性病防治机构诊疗可靠。结论 对性病患者及高危人群应加强咨询宣传教育，同时应针对患者的隐私问题，制订相应的保护措施，从而提高性病患者就诊率，完善性病诊治措施。     

广州市520名男男性行为者HIV感染情况及影响因素分析

目的:了解广州市男男性行为者(MSM)的艾滋病知识、高危行为以及艾滋病、梅毒感染情况及影响因素,为针对性开展MSM人群艾滋病防治工作提供依据。方法:面对面问卷调查520名MSM人群的艾滋病知识、行为情况,并进行艾滋病、梅毒血清学检测。结果:艾滋病知识知晓率为90.19%(469/520);HIV抗体阳性率为9.23%(48/520),梅毒阳性检出率为5.77%(30/520);最近六个月同性肛交性行为时每次均用安全套比例为53.81%(240/446);多因素logistic回归分析结果显示,感染了性病[OR=3.333,95%CI:(1.146~9.696)]、最近六个月与同性发生肛交性行为使用安全套的频率较少[OR=3.460,95%CI:(1.770~6.763)]是HIV感染的危险因素(P0.05)。结论:广州市MSM人群艾滋病知识知晓率高、安全套使用率低、知行分离严重,艾滋病、梅毒感染率高,应加强有效的干预检测和性病诊治。     

50岁以上人群HIV流行特征与相关危险因素的系统性分析

目的系统性分析了解中国≥50岁人群的HIV流行特征和相关危险因素。方法通过在中国生物医学文献数据库、中国期刊全文数据库及万方数据库中检索≥50岁人群艾滋病病毒感染者流行病学资料的相关文献,同时结合云南部分地区(1989~2012)年≥50岁艾滋病病毒感染者流行病学资料,进行系统性分析。结果疫情显示,近年≥50岁艾滋病病毒感染者占总报告数比重有增加趋势,部分地区已经超过50%;性别、职业、文化程度、婚姻状况、年龄等均呈现一定的地区差异。性途径感染HIV成为主要的流行方式(55.66%~91.74%),部分地区男男性接触感染高达17.10%;临床医疗机构检测、自愿咨询检测、阳性配偶或性伴检测成为发现≥50岁艾滋病病毒感染者的三种主要方式(近90%);感染者普遍存在非婚异性接触史(37.89%~79.00%),部分地区有男男性行为接触史12.73%。≥50岁男、女感染者感染HIV的因素不同,男性普遍因为有生理需求(63.35%)而发生嫖娼行为(80.37%),且基本未使用安全套(95.60%);女性更多的是因为与HIV阳性配偶(87.69%)发生未使用安全套的性行为(82.00%)而导致HIV感染。结论≥50岁人群艾滋病疫情逐年严峻,流行特征呈现一定的地区差异,HIV感染者高危性行为发生比例较高,且使用安全套意识薄弱。     

Association of adolescents' history of sexually transmitted disease (STD) and their current high-risk behavior and STD status: a case for intensifying clinic-based prevention efforts

BACKGROUND: Adolescents are at high risk of sexually transmitted disease (STD)/HIV infection, and one vulnerable subgroup is African American females. The association between adolescents' previous experience of STD and recent sexual risk behaviors has been ill-defined. GOAL: The goal was to examine the associations between adolescents' self-reported history of STD diagnosis and current sexual risk behaviors, prevention knowledge and attitudes, and STD infection status. STUDY DESIGN: This was a cross-sectional survey. Recruitment sites were in low-income neighborhoods of Birmingham, Alabama, characterized by high rates of unemployment, substance abuse, violence, and STDs. Participants were sexually active adolescent females (N = 522) 14 to 18 years of age. Information on STD history and current sexual behaviors (within the 30 days before assessment) was collected in face-to-face interviews. Less sensitive topics, such as STD prevention knowledge, attitudes about condom use, and perceived barriers to condom use, were addressed via self-administered survey. DNA amplification of vaginal swab specimens provided by the adolescents was performed to determine current STD status. Outcomes associated with past STD diagnosis were determined by means of logistic regression to calculate adjusted odds ratios (AORs) in the presence of observed covariates. RESULTS: Twenty-six percent of adolescents reported ever having an STD diagnosed. Although past STD diagnosis was associated with increased STD prevention knowledge, it was not associated with increased motivation to use condoms. Compared with adolescents who had never had an STD, adolescents with a history of diagnosed STD were more likely to report not using a condom at most recent intercourse (AOR = 2.54; 95% CI = 1.64-3.93; = 0.0001), recent unprotected vaginal intercourse (AOR = 1.79; 95% CI = 1.15-2.79; = 0.010), inconsistent condom use (AOR = 2.27; 95% CI = 1.46-3.51; < .0001), sexual intercourse while drinking alcohol (AOR = 2.09; 95% CI = 1.33-3.28; = 0.001), and unprotected intercourse with multiple partners (AOR = 3.29; 95% CI = 1.09-9.89; = 0.034). Past STD diagnosis was associated with increased risk for current biologically confirmed gonorrhea and trichomoniasis (AOR = 2.48; 95% CI = 1.09-5.23; = 0.030; and AOR = 2.05; 95% CI = 1.18-3.59; = 0.011, respectively). Past STD diagnosis was not significantly associated with increased risk of current biologically confirmed chlamydia (AOR = 0.78; 95% CI = 0.45-1.37; = 0.38). CONCLUSION: Among this sample of female adolescents, past STD diagnosis was an indicator of current high-risk sexual activity and increased risk for two common STDs: gonorrhea and trichomoniasis. Although adolescents may gain factual knowledge from the experience of having an STD diagnosed, they are not applying that knowledge to their current sexual behaviors. Thus, these adolescents remain at risk for subsequent STD infection. Therefore, the findings suggest that there is a need to intensify clinic-based prevention efforts directed toward adolescents with a history of STDs, as a strategy for reducing STD-associated risk behaviors and, consequently, the likelihood of new STD infections.     

Level of AIDS and HIV knowledge and sexual practices among sexually transmitted disease patients in China

BACKGROUND: Little is known about sex practices that increase the risk of contracting HIV infection or the level of HIV and AIDS knowledge among sexually transmitted disease (STD) patients in China. OBJECTIVE: To describe AIDS and HIV knowledge, sexual practices, and factors associated with never using condoms among patients at an STD clinic in Jinan, China. STUDY DESIGN: Clinic patients (n = 498) were randomly sampled to answer AIDS and HIV knowledge questions and to report sexual practices, including condom use. RESULTS: Patients had low levels of AIDS and HIV knowledge and engaged in high-risk sex behaviors. The majority of patients reported having had multiple sex partners. When having sex, few men and no women reported always using condoms. Gender, age, residence, AIDS and HIV knowledge, and having multiple sex partners were significantly associated with never using condoms. CONCLUSION: STD clinic patients report having engaged in high-risk sex behaviors. More research is needed to better understand the factors relevant to developing risk-reduction interventions for these patients in China.     

性病患者中输血传播病毒的检测及其传播途径

目的 探讨输血传播病毒(transfusion transmitted virus,TTV)在性病(STD)患者中的感染状况及经性传播的可能性。方法 调查性病患者的性行为相关因素及应用巢式聚合酶链反应(nested-PCR)检测237例STD患者和80例健康体检正常人的血清TTVDNA。结果 ①STD患者和正常人的血清TTVDNA阳性率分别为19.41%(46/237)和2.5%(2/80),前者TTVDNA的阳性率明显高于后者(P<0.005)。②STD患者男性与女性TTVDNA的阳性率分别为20.59%和17.82%,两者之间差异无显著性(P>0.05)。③不同STD病种患者中以梅毒、生殖器疱疹以及梅毒合并非淋球菌性尿道炎(NGU)和尖锐湿疣(CA)、生殖器疱疹合并NGU患者的TTVDNA的阳性率较高,分别为29.41%、30.43%、33.33%、42.86%、33.33%,而NGU患者的TTVDNA阳性率(10.87%)较低。④28对(56例)STD患者配偶TTVDNA阳性率为28.57%(16/56),11对(22例)正常人配偶TTVDNA的阳性率为4.55%(1/22),两者之间差异有显著性(P<0.05)。⑤TTVDNA阳性组和阴性组的STD患者嫖娼大于半年以上者的人数分别为21例和9例(P<0.005),性伴平均人数分别为17.12和7.86(P<0.001)。结论 STD患者中存在严重的TTV感染;嫖娼的时间越长,性伴数越多,感染TTV可能性越大,提示性传播可能是TTV感染途径之一。     

Baseline STD prevalence in a community intervention trial of the female condom in Kenya

OBJECTIVE: We present baseline sexually transmitted disease (STD) prevalence rates from an ongoing intervention trial at Kenyan agricultural sites. METHODS: After gaining the cooperation of management, we identified six matched pairs of tea, coffee, and flower plantations and enrolled approximately 160 women at each site. Six intervention sites received an information programme and distributed female and male condoms, while six control sites received male condoms only and similar information about them. At clinic visits, we tested participants for cervical gonorrhoea (GC) and Chlamydia trachomatis (CT) by ligase chain reaction on urine specimens, and Trichomonas vaginalis (TV) by culture. The study has 80% power to detect a 10% prevalence difference during follow up, assuming a combined STD prevalence of 20%, 25% loss to follow up and intracluster correlation coefficient (ICC) of 0.03. RESULTS: Participants at intervention and control sites (total 1929) were similar at baseline. Mean age was 33 years, the majority were married, more than half currently used family planning, 78% had never used male condoms, and 9% reported more than one sexual partner in the 3 months before the study. Prevalences of GC, CT, and TV were 2.6%, 3.2%, and 20.4% respectively (23.9% overall), and were similar at intervention and control sites. The ICC for STD prevalence was 0.0011. Baseline STD was associated with unmarried status, non-use of family planning, alcohol use, and more than one recent sexual partner, but the highest odds ratio was 1.5. CONCLUSIONS: Baseline results confirm a high prevalence of trichomoniasis and bacterial STD at these Kenyan rural sites. Improved STD management is urgently needed there. Our ongoing female condom intervention trial is feasible as designed.     

Condoms for men, not women. Results of brief promotion programs.

Three different brief intervention programs to promote condom use were tested among patients in inner-city sexually transmitted disease (STD) clinics. The first, "Condom Skills," focused on teaching mechanical aspects of how to use a condom. The second, "Social Influences," emphasized how to negotiate condom use with one's sexual partner. The third, "Distribution," provided patients with an unlimited number of free condoms, retrievable at local community businesses. Of the 903 subjects whose medical records were reviewed after exposure to the intervention programs, evidence of continued unsafe sexual behavior, documented by subsequent treatment for a new STD, was found for 12.6% of the women and 19.9% of the men. When compared with male control subjects, male study patients had fewer documented subsequent STD reinfections. The relative risk (RR) and 95% confidence interval (CI) values were 0.48 and 0.28, 0.81 for the condom skills group; 0.65 and 0.40, 1.04 for the social influences group; and 0.85 and 0.56, 1.29 for the distribution group. There was no decrease in the incidence of STDs among female patients compared with control subjects; indeed, there was a trend toward increased risk of STDs among women exposed to the Social Influences intervention program. This study demonstrates that brief condom promotion programs can be effective for male STD patients, and that caution must be exercised in promoting condoms to women with a high risk of acquiring STDs. Further research on programs promoting safer sex among these women is needed.     

Condom use in young blacks and Hispanics in public STD clinics.

BACKGROUND AND OBJECTIVES: Young blacks and Hispanics are an emerging risk group for contracting HIV. The goal of this study was to assess the most salient correlates of condom use for young Hispanics and blacks in Los Angeles county sexually transmitted diseases (STD) clinics as a first step toward designing a short clinic-based intervention. STUDY DESIGN: Face-to-face interviews were conducted with 376 patients younger than the age of 27 years at six STD clinics operated by the Los Angeles County Department of Health Services. Assessment included several attitudinal variables and AIDS risk behaviors. RESULTS: Condom use at last intercourse ranged from 40% among Hispanic females to 48% among black males. Among females, condom users were more likely to report high self-efficacy regarding condom use, peer norms supporting condom use, and more sexual communication than respondents who did not use a condom at last intercourse. Among males, no relationship was found between condom use at last intercourse and these attitudinal variables, except for sexual communication. The most important correlate of condom use among males and females was the frequency of carrying condoms. CONCLUSIONS: Our findings suggest that offering educational group sessions and attractive means for carrying condoms to patients in STD clinics may have the potential to increase condom use. The efficacy of these intervention strategies should be explored in future studies.     

珠海市皮肤性病专科门诊就诊人群7种性传播疾病感染分析

目的了解珠海市皮肤性病专科门诊就诊人群性传播疾病(STD)的感染情况,为临床性病的防治提供实验室依据。方法选取珠海市慢性病防治中心2015年至2017年皮肤科、性病科和妇科诊治患者,对沙眼衣原体(CT)、解脲支原体(UU)、人型支原体(MH)、梅毒(TP)、念珠菌(CA)、淋病奈瑟菌(NG)和人类免疫缺陷病毒(HIV)7种病原体(抗体)阳性率情况进行分析,统计分析剔除阳性复诊患者,同时统计分析混合感染和反复感染情况。结果3年共有6862人进行STD不同项目检查,7种病原体检测共有14828项,阳性1963项(13.2%),CT、NG、TP、HIV、UU、MH和CA病原体阳性率分别为14.2%、23.6%、11.1%、2.9%、31.9%、4.8%和17.3%,3年间STD病原体阳性率差异无统计学意义(P>0.05)。不同科室中,妇科送检病原体阳性率最高,为19.2%;不同性别中,女性患者的病原体总阳性率为19.3%,男性为9.8%,两者差异具有统计学意义(P<0.05),但男性CT、NG和HIV阳性率高于女性。患者混合感染率为2.5%,男性混合感染比女性高,但女性反复感染率高于男性。结论专科门诊就诊者7种病原体阳性率较高,女性病原体总阳性率高于男性,女性支原体、念珠菌反复感染现象较普遍,男性泌尿生殖道支原体和念珠菌感染应受到重视。加强对该类人群的性传播疾病的健康教育,引导就诊者进行STD联合筛查,对性传播疾病的防控具有重要意义。     

Intimate partner violence and high-risk sexual behaviors among female patients with sexually transmitted diseases

BACKGROUND: Victimization by intimate partner violence (IPV) may play an important role in sexual decision-making, increasing the risk for sexually transmitted diseases (STDs) and HIV. GOAL: To explore the relationship between IPV and high-risk sexual behaviors, substance abuse, partners who had sex outside the relationship, and history of STD among women attending an STD clinic. STUDY DESIGN: A self-administered survey of patients attending a public STD clinic in San Francisco was conducted from October 1996 to March 1997. Topics included STD history, sexual risk behaviors, partner violence history, partner characteristics, and demographics. Logistic regression analysis was used to assess the independent effect of IPV on STD risk factors. RESULTS: Overall, 2115 patients participated, for a response rate of 96%. Data were analyzed for a subgroup of 409 female patients who reported recent male sexual partners. Among these women, 11% reported IPV in the past 12 months; lifetime history of IPV was 24%. A history of IPV was associated with a self-reported history of STD (adjusted odds ratio [OR], 2.15; 95% CI, 1.23-3.77). IPV in the past 12 months was associated with alcohol or drug use before sex (adjusted OR, 2.36; 95% CI, 1.17-4.77) and main partners who had sex outside the relationship (adjusted OR, 3.75; 95% CI, 1.94-7.26). CONCLUSIONS: IPV is common among female STD patients and is associated with risk behaviors and partner factors that increase patients' risk of contracting STD and HIV. Screening and referral for IPV should be routinely conducted for female patients attending STD clinics.     

Predictors of condom use among patients with sexually transmitted diseases in Uganda.

BACKGROUND AND OBJECTIVE: Patients with sexually transmitted diseases (STDs) are at an increased risk of HIV infection and they must be targeted for increased condom use. GOAL: To identify predictors of condom use among patients with STDs. STUDY DESIGN: In a cross-sectional survey, an interview-administered questionnaire was administered to 138 patients at the STD clinic, Mulago, and the outpatients department, Mbarara Hospital, in Uganda. Data were collected on socio-demographic situations, STD symptoms, type of sexual partners, and use of condoms. Multivariate logistic regression models were used to identify independent predictors of condom use. RESULTS: Of the 138 patients, 87 (66%) knew how to use condoms, 81 (59%) ever used a condom, 34 (25%) used a condom at least once in the previous 3 months, 20 (15%) used a condom during the last sexual intercourse, and 80 (58%) accepted a free supply of condoms. Reasons for not using condoms among the 57 who had never were: having a regular partner or spouse (28, 49%), partner does not approve (17, 30%), reduced sexual pleasure (5, 9%), and no answer (7, 12%). The independent predictors of condom use were: being a man, not having a regular partner, having had sex with a casual partner, being able to read English, having at least secondary education, and using electricity for lighting. CONCLUSION: Providing health promotion messages in local languages may improve condom use in this population. There is a need for complementary HIV prevention strategies for women and for regular sexual partnerships.     

Sexual abuse history, risk behavior, and sexually transmitted diseases: the impact of age at abuse

OBJECTIVE: The objective of this study was to examine the relationship between age at onset of sexual abuse, risk behaviors, and a diagnosis of sexually transmitted disease (STD) in a clinic-attending adolescent population. METHODS: Bivariate analyses were used to test association among age at onset of sexual abuse, risk behaviors, and STD diagnosis (n = 2175). Relationship between sexual abuse and STD acquisition was assessed by regression analysis. RESULTS: More females than males reported sexual abuse, 26.75% and 5.4%, respectively. Abuse at or before 10 years of age was associated with more lifetime and recent partners. History of abuse was associated with higher rates of STD tests. In regression analysis, for males and females, the odds of having an STD were 2.5 times greater if abuse occurred at 10 years or younger. CONCLUSION: Sexual abuse at a younger age is associated with more sexual risk behaviors and is a risk factor for STDs.