Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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Men who have sex with men (MSM) in gay male communities do not always use condoms when having anal sex. Reasons for such risky behavior include men's objections to the lack of spontaneity demanded from condom use, decreased sensation, and condom breakage. Reality, a polyurethane pouch designed to line the vagina, was developed mainly to provide women with a contraceptive and STD prevention option. A removable inner ring and fixed outer ring keep the device in place. Some MSM use Reality when having anal sex. 750 free Reality kits were distributed by the STOP AIDS Project in San Francisco at venues frequented by MSM. Kits included 2 female condoms, instructions, a self-administered questionnaire on the users' experiences with Reality, and a stamped return envelope. 108 surveys were returned, with 100 MSM reporting use of Reality during the past 6 months in 147 episodes of insertive and 187 episodes of receptive anal sex. 86 men reported that they would use Reality again, and 54 said they would rather use Reality than conventional male condoms. Generally most liked about Reality were its heightened sensitivity and spontaneity, while insertion difficulties and high cost were the factors least liked. Acceptability was higher among MSM who were HIV-positive, in nonmonogamous relationships, or who had serodiscordant sex partners. Negative experiences included difficulty inserting (33%), irritation (17%), bunching up (12%), unpleasant texture (10%), and noise (9%). Breakage was reported 3 times in 334 episodes of use. Reality appears to be a welcome alternative for some MSM who do not consistently use penile condoms. Although use of the method probably reduces HIV transmission compared to unprotected anal sex, more research is needed to definitively assess its effectiveness as a risk reduction method for MSM.
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PMID:Experiences of 100 men who have sex with men using the Reality condom for anal sex. 1007 May 90

The AIDS epidemic has an increasingly female face, and the need for women to use effective contraceptive and infection prevention methods has taken on a new urgency. Consistent, proper condom use is the most effective method of preventing sexually transmitted disease. Research shows that condom breakage most commonly results from latex deterioration or incorrect use. Spermicidal cream or gel containing nonoxynol 9 is effective in preventing sexually transmitted diseases that cause genital ulcers and cervicitis. Spermicides cause genital tract irritation in some people, however, increasing their risk of STD infection. Diaphragms can protect against pregnancy, but since the devices only protect the cervix and a small area of the vagina, HIV or STD transmission may still occur. Oral contraceptives do not protect against STDs, nor do injectable and implantable contraceptives.
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PMID:Building barriers to HIV. 1057 33

The purpose of this placebo-controlled, double-blind study was to determine the safety, tolerability and clinical efficacy of 5-fluorouracil (1%) in a vaginal hydrophilic gel (hydroxyethylcellulose, 1%) to cure intravaginal papillomas in women. Pre-selected, 60 women ranging between 18 and 50 years of age (mean 24.6), having 312 vaginal condylomas (mean 5.2) joined the study. The diagnosis of human papillomavirus (HPV) was established with clinical, histopathological and polymerase chain reaction (PCR) techniques. Subjects were randomized into 2 parallel groups. Each patient was allocated a pre-coded tube 15 g (active or placebo) with graduated vaginal applicators (disposable), and instructions how to insert 4 g of the trial medication deep into the vagina once at bedtime on every other day (1, 3 and 5) per week, to visit the clinic on day 7 for clinical evaluations and to receive the same pre-coded replacement to continue the regimen for another week. A maximum 12 applications were to be used in 4 weeks. Cure was defined as absence of clinical signs of infection, re-confirmed by PCR and Southern blot hybridization negative HPV DNA. By the end of the treatment 48.4% patients and 51.9% lesions were cured. Breaking the code revealed that 5-fluorouracil (1%) gel had cured 83.3% patients and 87% intravaginal warts. Placebo resolved 13.3% patients and 14% condylomas; (active gel versus placebo; P < 0.001). Twelve patients (20%) mostly in the active gel experienced mild erythema, erosion and oedema, with no drop-outs. Among cured patients 3 had a relapse after 16 months. In conclusion, the clinical results of the study demonstrate that 5-fluorouracil (1%) in a vaginal hydrophilic gel is safe, tolerable and significantly more effective than placebo to cure intravaginal warts in women.
Int J STD AIDS 2000 Jun
PMID:Management of intravaginal warts in women with 5-fluorouracil (1%) in vaginal hydrophilic gel: a placebo-controlled double-blind study. 1087 9

Trichomoniasis, bacterial vaginosis (BV) and candidiasis are reproductive tract infections (RTIs) of the vagina. We conducted a cross-sectional study in 4 prenatal clinics in Kingston, Jamaica, to estimate the prevalence of these infections and the risk factors that may facilitate their transmission among pregnant women. Of the 269 women studied, 18.0% had culture-positive trichomoniasis, 44.1% had BV (Nugent score > or = 7) and 30.7% were positive for candidiasis by wet mount. A multiple logistic regression analysis showed that having a malodorous discharge was associated with trichomoniasis (odd ratios [OR]=3.9, confidence intervals [CI]=1.04-14.7) and BV (OR=3.4, CI=1.3-8.7). Women who took action to prevent HIV infection had lower BV prevalence (OR=0.34, CI=0.12-0.98). Women who were employed were less likely to have any of the infections (OR=0.61, CI=0.36-1.03). The strong association of a symptomatic presentation with trichomoniasis and BV suggests the merit of considering syndromic management of vaginitis in this population.
Int J STD AIDS 2000 Aug
PMID:Vaginal infections in pregnant women in Jamaica: prevalence and risk factors. 1099 Mar 36

All patients, who presented at the Sexually Transmitted Disease clinic of the University College Hospital, Ibadan, between the period of August 1996 and January 1998 were included in this study. They were examined for genital infections in order to determine the prevalence rate of Human papilloma virus genital infection (genital warts) among them. Out of the 1,373 patients seen in the clinic during the period, 861 (62.71%) had STD while the remaining 512 (37.29%) had other conditions. Out of these 861 cases, 69 (8.01%) had HPV genital infection, while the remaining 792 (91.9%) had other STDS. Of these 69 cases of genital warts, 35 (50.7%) were males while 34 (49.3%) were females. Their ages ranged between 17 and 74 years, with the peak incidence in the 20-29 years age group. 32 (46.4%) had concurrent genital infections with non-gonococcal urethritis and cervicitis 9(13%) constituting the most common type. The highest incidence (36.2%) of this condition was found among petty traders while the lowest was found among the business executives and applicants. In 67 (97%) of these patients, the nature of sexual intercourse was vaginal, while in 1 (1.5%) it was oral and another 1 (1.5%) both vaginal and oral. 26 (37.7%) of the patients had just one sexual partner, while 7 (8.1%) had 2 or more. Only 2 (2.9%) admitted to have had any sexual contact with commercial sex workers. The sites of warts in males include the shaft of the penis, the glans penis, perineum and intrameatum. In females, warts were found in the vulva, vagina, cervix, perineum and perianal regions. 42 (60.9%) of these patients were placed on 20% podophyllin on tincture of benzoin, 17 (24.6%) on cryotherapy and 1 (1.5%) on both. They all did well on the different treatment regimens except for 1 (1.5%) that had to change from podophyllin to cryotherapy when there was no reduction in size. 11 (15.9%) were however lost to follow up.
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PMID:Prevalence of human papilloma virus genital infections in sexually transmitted diseases clinic attendees in Ibadan. 1112 83

The clinical features of vulvovaginal candidiasis are the result of the inflammatory response of the vulva and vagina to Candida overgrowth. Topical treatments comprise intra-vaginal pessaries or cream used in combination with a similar azole-based cream for external application. In this audit Candida isolation rates from vulval and vaginal samples were strongly concordant confirming that combined topical treatments should be used for the recommended treatment time to ensure mycological cure.
Int J STD AIDS 2000 Dec
PMID:An audit of isolation rates of Candida species from vulval and vaginal sampling. 1113 20

Mitchell Katz, Julie Gerberding, and Steve Boswell, experts involved in post-exposure prophylaxis of HIV infection, discuss using such measures to prevent possible sexual transmission of HIV infection. The risk of contracting HIV via sexual exposure is similar to the risk from an occupational needlestick injury; however, the type of sex, i.e., anal vs. vagina or insertive vs. receptive, dictates the degree of risk. Due to uncertainties in predicting the exact risk, the physicians recommend offering prophylaxis to people who have had sex with someone known to be HIV-infected or at high risk for being infected. Minimum program needs to provide effective post-sexual exposure prophylaxis are outlined, including the types of facilities best suited to treat patients. Emergency rooms are convenient; however, staff generally lack the expertise to properly treat these patients. If emergency rooms are used, follow-up should be received at other facilities, such as STD clinics. Persons seeking repeated post-sexual exposure prophylaxis should be dealt with on a case-by-case basis. The public health system or government should bear the treatment costs under the rubric of research.
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PMID:Post-sexual exposure prophylaxis: a roundtable discussion. 1136 78

'Microbicide' is the name for a number of new products currently under research which could become a new class of barrier method for use in the vagina and rectum for protection against HIV, prevention and/or treatment of other sexually transmitted diseases and/or act as a contraceptive. This is a summary report of this scientific conference, at which basic science, clinical trial efficacy and design, and ethical, behavioural and public health issues were on the agenda. There are many potential products but few have yet got beyond Phase I clinical trials. There is not likely to be an approved and available product for 5-10 years at best; finding a balance of low toxicity with high efficacy is the major challenge, given how rapidly HIV infection actually infects tissue. Phase III clinical trials of these products require new protocols and procedures. It was urged by many, and underscored by HIV positive women who were present that clinical trials must be treated as an opportunity to promote a total prevention package--STD treatment, voluntary HIV testing and counselling, condom use, practising safer sex--plus microbicides and contraception. Identifying effective products and making them available as soon as possible were obviously also a priority. How to do this--ethically and scientifically--were the main subject of the meeting.
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PMID:Microbicides 2000: report of an international conference, 13-16 March, Washington DC. 1142 60

The objective of this study was to identify the knowledge about sexuality (including STD/HIV/AIDS), the sexual practices more frequents and sexuality education sources in a group of students with visual impairments. A self administered questionnaire was utilized in 50 students with visual impairment. Descriptive statistics were utilized. Seventy six percent (76.0%) of the participants presented a high knowledge about sexuality and 22.0% presented moderated knowledge. The no penetrative sexual practice more frequent was corporal caress (82.0%) and the penetrative was penis-vagina (74.0%). The source of sexuality education most common was the conferences (83.9%). Although, in general, the knowledge about sexuality was high, there are "gaps" in them. There is the need to develop educational materials adapted to the needs of the studied population.
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PMID:[Knowledge about sexuality and sex behavior in university students with visual impairment: need of educational materials]. 1177 30

The aim of the study is to investigate knowledge and sexual practices with reference to correct use of condoms among first year South African University students. The sample consisted of 206 participants, 146 female and 60 male, the mean age was 20.9 years (SD = 3.4), with a range from 17 to 34 years. Results indicated that one third (29.2%) of the sample reported never using condoms, 35.4% always, 19.8% regularly and 8.5% irregularly in the past three months. About 90% levels of correct answers for condom use were found for the items of 'condoms as protection against STD and AIDS', 'expiry date of condoms', and 're-using condoms'. More than 15% were not aware that a condom should be put on before any contact with the vagina. The most common mistakes with respect to condom use were ignorance about the correct moment to put on a condom (56%), and when to take off a condom (55%). Male sex and especially increasing recent sexual encounters was associated with correct condom knowledge. The most common reasons for not using a condom were 'I do not have the AIDS virus' and 'I thought I was safe' seems to indicate a low perceived susceptibility. Findings are discussed in view of condom promotion programmes.
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PMID:Knowledge and practice of condom use among first year students at University of the North, South Africa. 1188 46


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