Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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The analysis of a representative survey of households (n = 968) in a San Francisco Bay Area county provides strong evidence for the role of problem drinking as a risk factor for sexually transmitted diseases independent of drinking patterns and drug use. Among women, age, race, early age at first intercourse, history of multiple partners, drinking patterns, as well as current symptoms of problem drinking were all associated with reported STD rates. Stepwise logistic regression analysis showed, however, that female problem drinkers are nearly four and a half times more likely (adjusted O.R. = 4.65, 95% C.I. = 1.30, 16.70) than other women to have had STDs independent of all these potential risk factors. Problem drinking puts women at a greater risk for STDs than a history of multiple sex partners (adjusted O.R. = 2.75, 95% C.I. = 0.98, 7.75). This finding is also observed among men, among whom STDs were associated with a history of multiple sex partners (adjusted O.R. = 4.12, 95% C.I. = 1.90, 8.94) and the lifetime prevalence of drinking problems (adjusted O.R. = 4.95, 95% C.I. = 2.13, 11.50). Frequent bar-going, drunkenness episodes, high volume drinking, feeling disinhibited while drinking and drug use increase the risk for STDs via their effects on the rate of sex partner change. Problem drinking determines STD rates independent of these factors. The implications of these findings for future research and health policy are discussed.
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PMID:Behavioral risk factors for sexually transmitted diseases in American households. 160 76

In Thailand a major HIV epidemic is spreading primarily through heterosexual contact and prostitutes. In the central region, 3 districts were chosen for interviews with 181 urban men (single and married blue-collar workers, single and married white-collar workers, and single college-level students) who had had sexual relations with at least 2 different women during the prior year. For further information, 50 women were interviewed: 24 service and entertainment workers, 18 students and unemployed teenagers, 6 wives of STD clients, and 2 village women who sometimes engaged in commercial sex. Only 1 out of the 181 male respondents had never patronized a commercial sex worker. 82% of the respondents indicated that they had drunk at their most recent episode and 74% said they had been drunk. 47% of the single men (excluding students) had noncommercial sexual relationships with more than 1 woman. Only 38% of the married men had no extramarital sex in the past year. Among married men, 38% engaged only in commercial extramarital sex, 22% had sex only with their wives and noncommercial partners, the remainder had sex with both commercial and noncommercial partners and also with their wives. 35% of the men reporting more than 20 commercial sex episodes in the past year usually used condoms. 58% of the men who had fewer than 5 episodes in the past year usually used condoms; 60% of the men who had 5-9 episodes did; and 65% of the men who had 10-19 episodes used them. 83% of the respondents mentioned fear of disease, while 35% cited HIV/AIDS as the reason for condom use in the last commercial sex event. More than 60% of the men showed very high- risk or high-risk behavior. The dominant pattern (64%) was a combination of commercial and noncommercial sex. The networking data revealed pathways for HIV/STD transmission and for intervention programs: 1) single men who have both commercial and noncommercial sex; 2) married men who have commercial, noncommercial, and marital sex; 3) married men who have noncommercial and marital sex.
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PMID:Sexual networking in provincial Thailand. 847 20

We aim to apply critical incident methodology to details of respondents' last sexual encounter to provide contextualized data on sexual behaviour and alleviate the problem of recall bias. In areas of Houston, Texas, registering high prevalence rates of syphilis, we elicited information from 400 men and women about the last time they had sex. Details of time, place, partner, activities, and situational circumstances were collected in street intercept interviews. Nearly 50% of men and 30% of women were drunk or high the last time they had sex, and more than one-quarter of last encounters occurred in hotel or motel rooms. Drug use was not related to condom use. Both men and women were more likely to use condoms with new than with more familiar sex partners; however, women were less likely than men to report condom use across all types of sexual activity, and particularly for anal sex. The findings are being used to design a syphilis prevention intervention in the study communities.
Int J STD AIDS 1997 Oct
PMID:The last sexual encounter: the contextualization of sexual risk behaviour. 931 Feb 25

Condom promotion remains the primary method of HIV prevention for sexually active couples. Measurement of condom use--essential for the evaluation of AIDS prevention programs--is impeded, however, by factors such as self-report bias, participation bias, test-retest reliability problems, social desirability responses, and memory error. Standardized methodology in studies where condom use is the dependent variable would allow for more accurate calculation of effect size and enable application of meta-analytical tools needed to avoid Type II errors. Recommended, to improve measurement of condom use, are the following: 1) separate measurement of condom use for receptive and insertive partners; 2) consideration of the multiple contingencies that exist for a participant to adopt long-term condom use for HIV prevention; 3) recognition that the person must be able to negotiate within the confines of competing threats to survival (e.g., violent reprisals); 4) use of intent to conceive a child as a covariate; 5) requirement that the person is motivated by the threat of HIV rather than by pregnancy prevention or prevention of the spread of an existing STD; 6) determination of the participation of the sex partners in the decision to use condoms for HIV prevention; 7) account for temporal factors such as depression or alcohol intoxication; 8) measurement of condom use data in the form of ratio rather than interval data; 9) quantification of acts of unprotected sex rather than proportion of condom use; and 10) where possible, use of a within-subject design for evaluation of the treatment effect.
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PMID:Condom use as a dependent variable: measurement issues relevant to HIV prevention programs. 988 89

The social and economic impact of AIDS add to those of a recent civil war in 1997. There were fratricidal confrontations before and after this period. Pointe-Noire, the second city of Congo and the economic Capital, was on the whole spared. We carried out a survey of 292 high-school students: 39% of girls and 61% of boys, from 14 old to 25 years old (average age of 19 years). They were from 5 general and technical schools, which are representative of the school recruitment of the city of Pointe-Noire. This study made in 1998 was the second part of a work achieved in France in 1997 with 1,859 high-school students: 70% of girls and 30% of boys, mean age 17.7 years, range 15-25 years. They came from 3 general, technical and professional schools of two departments of the region "Centre" ("Indre-et-Loire" and "Loir-et-Cher"). The material, corresponding to this study, is an anonymous self-questionnaire of 55 closed items presented in the form of assertions to which the student respond either yes or no. Items investigated: 1) pubertal maturation and subjective maturation; 2) different aspects of sexual experience in adolescence (components of sexual experience) [9] and 3) sexual behaviour (including sexual risk taking). All items have been formulated in the most accessible possible way for the youngsters. Previously, in 1996, we had made a pre-test with this material near sample of French people from 16 to 68 years old. The results of the study highlight that the Congolese youngsters present more risk than their French homologues. Although the pubertal status (the menarche and the spermarche) occurs slightly later, Congolese boys present a greater number of sexual partners and greater sexual precocity. Among 54% of Congolese pupils from the sample which had already had a sexual intercourse (68% of boys and 42% of girls) versus 52% of French pupils (58% of boys and 49% of girls), 88% of the Congolese boys have sexual intercourse at the age of 15, versus 72% of the girls at 16.5 versus 65% of the French boys in their 15.5 and 52% of the girls at 16. These differences are significant (p < 0.001) like all the following ones. Congolese students declare more sexual partners (4 during the last 12 months and 5 for all their life versus 3.2 and 4.4 for the French students); the boys more than the girls (6.5 sexual partners on the whole versus 3.7 for the girls in Congo and 5.7 versus 3.8 in France). Congolese girls generally have fewer sexual relations (over 12 months or during their entire life) than French high-school girls (respectively 5.9, 6.9 versus 8.7 and 9.3). We can see with French and Congolese students, a "traditional" dichotomy between boys and girls: that is to say girls tend to engage later in sexual relations and to favour the long and regular relations, while the boys have more short, and spaced sentimental relations. The relations of these last ones tend to evolve on a more preparatory mode, genital and intermittent, contrary to those girls who seem more sentimental and continuous. The use of the condom concerns 72% of the French pupils for the first sexual intercourse (74% of boys versus 72% of girls) - which is close to results of French reference surveys [1, 3]. On the other hand, they are only 39% to make use of it in Congo in this circumstance (36% of the boys and 34% of the girls). All Congolese young people present more STD (6% versus 4% for the French pupils) and more pregnancy (11% versus 3%). The other risky situations appear also more important in Congo: as the fact of having sexual intercourse after having drunk too much (6% of case where it arrives systematically versus 2% in France); to have sexual intercourse with a injecting drug user (4% versus 1%); paying or to have been paid (in a systematic way 7% versus 1%). The Congolese answers concerning the recourse to prostitution are more dissimilar and alarming concerning Congolese young people, especially if one takes into account all the situations where it occurred at least once (29% of the boys and 13% of the Congolese girls who declare to have had a sexual intercourse by paying (with money). Homosexual relations are more frequent in Congo (4 and 6% versus 2 and 3% for France). Homosexual experience concerned 13% of the Congolese pupils versus less than 5% of the French ones. The answers concerning a sexual partner who is "not sure" (20% in Congo versus 2% in France) can get clearer in the Congolese context with an elevated prevalence rate of infection by HIV. However, other cultural factors should not be neglected. The same applies for the answers relative to the sexual intercourse under duress (29% for Congo versus less than 7% in France). The answers relative to the fact of having a sexual intercourse with a much older partner (21% versus 13%) do not seem surprising for Congo. But it does not free risks. All these elements are not associated with a better estimate of the personal risk. (ABSTRACT TRUNCATED)
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PMID:[Survey on sexual behavior by Congolese and French high-school students in an AIDS context]. 1131 32

This study examined patterns of alcohol use and its association with unsafe sex and related sequelae among female sex workers in Mombasa, Kenya. A community-based cross-sectional study was conducted using snowball sampling. Binge drinkers (> or =5 alcoholic drinks on > or =1 occasion in the previous month) were compared with non-binge drinkers. Of 719 participants, 22.4% were lifetime-alcohol abstainers, 44.7% non-binge and 33.0% binge drinkers. Compared with non-binge drinkers, binge drinkers were more likely to report unprotected sex (adjusted odds ratio (AOR)=1.59, 95% confidence interval [CI]=1.00-2.53; P=0.047) and sexual violence (AOR=1.85, 95% CI=1.27-2.71; P=0.001) and to have either syphilis, Neisseria gonorrhoeae or Trichomonas vaginalis infection (AOR=1.56, 95% CI=1.00-2.41; P=0.048). HIV prevalence was higher among women having ever drunk (39.9%) than lifetime abstainers (23.2%; P<0.001), but was not associated with drinking patterns. Interventions are needed to assist female sex workers adopt safer drinking patterns. Investigation is needed for the effectiveness of such interventions in reducing unprotected sex, sexual violence and sexually transmitted infections.
Int J STD AIDS 2007 Nov
PMID:Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections. 1859 87

Associations between sexual risk and alcohol consumption may be self-evident but have eluded detailed examination in the UK. A cohort of 520 genitourinary (GU) medicine clinic attenders in the south of England were given a detailed questionnaire and compared with a matched cohort from the General Household Survey (GHS). Clinic attenders binged heavily--a median of 13 units on a usual night and 26 on a 'heavy' night, compared with six units in the GHS cohort. In all, 86% of clinic attenders exceeded the UK government 'binge drinking' level of six units, and 32% of subjects thought that alcohol played a role in their clinic attendance. A total of 77% had been drinking before sex with a new partner; of these, 65% were usually or occasionally very drunk. Binge drinking was increased in the 29% diagnosed with a bacterial sexually transmitted infection (P < 0.003). Of the women, 19% reported an unwanted pregnancy, with 28% drinking beforehand.
Int J STD AIDS 2007 Dec
PMID:Binge drinking, sexual behaviour and sexually transmitted infection in the UK. 1848 55

The aim of the study was to determine whether international students have greater risk-taking behaviours that could lead to importing novel and resistant strains of sexually transmitted infections (STIs). We conducted a cross-sectional web-based survey of university students' sexual behaviour, alcohol and drug use, and self-reported diagnosis of STIs and compared these between British and international students. In all, 827 students completed the survey, of whom 123 (15%) were international students. International students were less likely to have ever drunk alcohol (95.4% versus 87.8%, P = 0.002) and used drugs (56.4% versus 41.5%, P = 0.002). International students were on average almost two years older at first intercourse (18.7 versus 17 years; P < 0.001). There were no differences in the number of sexual partners between national and international students. On a discriminant analysis model, international students were characterized by being older and from a non-white background, less likely to use cocaine, they drank alcohol less frequently and were more likely to have had unprotected intercourse with two or more partners in the previous year. In conclusion, international students tend to drink more moderately and use fewer recreational drugs than British students. However, they exhibit higher sexual risk behaviours that could lead to importing novel and resistant strains of STIs.
Int J STD AIDS 2009 Sep
PMID:Sexual behaviour, drugs and alcohol use of international students at a British university: a cross-sectional survey. 1971 Mar 34

We investigated whether inebriation was associated with having non-main partners and unprotected sex with non-main partners and whether drinking motivations were associated with sexual risk behaviors among patients attending an STD clinic in St Petersburg, Russia. A cross-sectional behavior survey was applied to 362 participants between 2008 and 2009. Multivariate logistic regression was used for analysis. At-risk drinking per Alcohol Use Disorders Identification Test (AUDIT-C) criteria (OR 2.5, 95% CI 1.4-4.4) was independently associated with having non-main sexual partners. Inebriation (OR 3.2, 95% CI 1.3-8.1) but not at-risk drinking or drinking prior to sex was associated with unprotected sex with non-main partners. Among drinkers, the consumption of alcohol to facilitate sexual encounters (OR 2.7, 95% CI 1.6-4.5) was associated with having non-main sexual partners. HIV prevention programs in Russia must address inebriation in addition to conventional patterns of problem drinking such as those measured by AUDIT-C and consider individuals' motivations to drink that lead to sexual risk taking.
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PMID:Inebriation, drinking motivations and sexual risk taking among sexually transmitted disease clinic patients in St. Petersburg, Russia. 2213 16

Our research aims were to: (1) assess the prevalence of two condom use problems: breakage or slippage and partial use (delayed application or early removal) among men who have sex with men (MSM) seeking services in urban US STD clinics; and (2) examine the association between these condom use problems and participant, partner and partnership characteristics. Analysis was restricted to HIV-negative MSM who reported having anal sex at least once in the preceding 3 months and who completed both the baseline and 3 month follow-up assessments. Two models were fitted using the generalized estimating equations (GEE) approach. A total of 263 MSM (median age=32 years) reported 990 partnerships. Partnerships with no condom use 422 (42.6%) were excluded. Thus, 207 MSM and 568 partnerships were included. Among condom users, 100% use was reported within 454 partnerships (79.9%) and <100% within 114 (20.1%), and 21(3.7%) reported both condom use problems, 25 (4.4%) reported only breakage, 67 (11.8%) reported only partial use, and 455 (80.1%) reported no errors. The breakage or slippage and partial use rates per condom used were 3.4% and 11.2%, respectively. A significantly higher rate of breakage or slippage occurred among non-main partnerships. Characteristics associated with increased odds for condom breakage or slippage were: lower education level (OR=2.78; CI: 1.1-7.5), non-main partner status (OR=4.1; CI: 1.5-11.7), and drunk or high during sex (OR=2.0; CI: 1.1-3.8), and for partial use: lower education level (OR=2.6; CI: 1.0-6.6), perceived partner sexually transmitted infections (STI) risk (OR=2.4; CI: 1.3-4.2), and inconsistent condom use (OR=3.7; CI: 2.0-6.6). A high percentage of MSM partnerships reported no condom use and among condom users, a sizable proportion did not use them consistently or correctly. MSM may benefit from interventions designed to increase proficiency for condom use with a particular focus on the behaviors of inconsistent and partial condom use.
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PMID:Condom use problems during anal sex among men who have sex with men (MSM): findings from the Safe in the City study. 2251 80


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