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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Family planning practitioners tend to be unaware of the reproductive health needs of disabled people. In many developing countries, disabled women are not taken for routine gynecologic examinations because it is assumed they will not have children. Even in developed countries, women with paralysis, impaired motor function, and other obvious physical disabilities are rarely offered counseling on sexuality or contraception. With proper education and counseling, disabled men and women may finally be in a position to make a truly informed decision about their reproductive lives. The selection of a contraceptive method for a disabled woman depends on consideration of factors such as the quality of circulation, abnormal clotting, the degree of physical sensation, manual dexterity, possible interactions with other medications, the effect of contraceptives on the disease process, problems with menstrual hygiene, and depression. For example, oral contraceptives are contraindicated in women with impaired circulation, a history of cerebrovascular accident, and immobility of the extremities. Methods than increase menstrual bleeding (e.g., copper IUDs) can cause hygiene problems for women with compromised manual dexterity. Although use of a barrier method may be difficult for women with poor coordination or upper-extremity disabilities, sexually transmitted disease (STD) prevention is especially important for women with pelvic sensory impairments that could allow STD symptoms to go unrecognized. Also in need of assessment in patients with physical disabilities are the impact of the disability on sexual expression and the possibility that sexual abuse is occurring.
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PMID:Disabled have many needs for contraception. 1229 57

To avoid social isolation, discrimination, or verbal or physical abuse, many men who have sex with men (MSM), especially young and minority MSM, do not disclose their sexual orientation. Young MSM who do not disclose their sexual orientation (nondisclosers) are thought to be at particularly high risk for human immunodeficiency virus (HIV) infection because of low self-esteem, depression, or lack of peer support and prevention services that are available to MSM who are more open about their sexuality (disclosers). However, the risks for HIV infection and other sexually transmitted diseases (STDs) are unknown for nondisclosers. To better understand the prevention needs of young MSM, CDC analyzed data from the Young Men's Survey (YMS) to compare HIV/STD risk differences between nondisclosers and disclosers. This report summarizes the results of that analysis, which indicate that 8% of 637 nondisclosers were infected with HIV compared with 11% of 4,952 disclosers. Among blacks, the prevalence of HJV infection was 14% among 199 nondisclosers compared with 24% among 910 disclosers.
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PMID:HlV/STD risks in young men who have sex with men who do not disclose their sexual orientation--six U.S. cities, 1994-2000. 1258 4

An increasing number of women with vulval problems and pain attend Olafiaklinikken, the centre for sexually transmitted infection (STI) in Oslo. The aim of the study was to investigate the prevalence of long-standing vulval problems and entry dyspareunia in a consecutive sample of STI-clinic visitors in Oslo. A self-administered questionnaire was distributed before and independent of the consultation. Response rate was 89.6% (502/560). Mean and median age were 25.9 and 24.0 years respectively, range 16-65 years. Vulval soreness, burning, dryness and fissures present for at least three months were reported by 23.1% (116/502), entry dyspareunia by 6.9% (34/494). Independent risk factors for dyspareunia were a history of >/=4 treatments for vulvovaginal candidiasis during the last year, reported by 34.6%, odds ratio (OR) 4.45, 95% confidence interval (CI) 1.81-11.0, and a history of bacterial vaginosis, reported by 42.4%, OR 2.34, 95% CI 1.11-4.92. Contraceptive methods, hygienic habits, a history of STIs, depression or sexual abuse were factors unrelated to longstanding symptoms. Investigation with regard to longstanding vulval problems and entry dyspareunia is required for a certain group of sexually transmitted disease-clinic visitors in Oslo, and referral to a special service for vulva patients would be beneficial for selected patients.
Int J STD AIDS 2003 Dec
PMID:Longstanding vulval problems and entry dyspareunia among STD-clinic visitors in Oslo-results from a cross-sectional study. 1467 85

Electrocardiograms (ECG) from 35 dogs with subvalvular aortic stenosis (SAS) with a left ventricular outflow tract pressure gradient (PG) of > or =50 mm Hg were retrospectively evaluated for S-T segment depression (STD, > or =0.2 mV in lead II). Pressure gradient, age, heart rate (HR), and number of ventricular premature complexes (VPCs) on a 24-hour ambulatory ECG for dogs with STD were not significantly different from those for dogs without STD. The S-T segment deviation did not correlate significantly with PG, age, HR, or VPCs. The significance of STD in the dog with SAS remains uncertain. Long-term prospective studies are needed to fully understand this observation.
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PMID:The relationship of resting S-T segment depression to the severity of subvalvular aortic stenosis and the presence of ventricular premature complexes in the dog. 1473 1

The aim of this study is to evaluate the discriminative properties of the Multidimensional Quality of Life Questionnaire for HIV infection (MQoL-HIV) and to determine those factors contributing to the health-related quality of life (HRQoL) of HIV-1 infected persons living in Japan. The MQoL-HIV, the Nottingham Health Profile (NHP) as a generic instrument, and the Center for Epidemiologic Studies-Depression Scale (CES-D) as a psychological measure were administered in 375 patients as a multiple-centre study. The score distribution of the MQoL-HIV showed a unimodal distribution. The Cronbach's alpha coefficient scored more than 0.7 in seven out of 10 domains, but was low in both the physical functioning and sexual functioning domains. There was a strong correlation between the CES-D and MQoL-HIV index scores (R-0.73). Relatively high coefficient values were found between psychiatric and nervous symptoms and the index score (R=-0.60). In total, the MQoL-HIV may possess discriminative properties.
Int J STD AIDS 2004 Feb
PMID:A discriminative study of health-related quality of life assessment in HIV-1-infected persons living in Japan using the Multidimensional Quality of Life Questionnaire for persons with HIV/AIDS. 1500 73

We report clinical, radiological and virological data from nine consecutive HIV-infected patients with herpes simplex virus (HSV) infection of the central nervous system (CNS). Three patients presented with confusion, two with fever and headache, two with anxiety and depression, one with slow mentation and memory loss and one with expressive dysphasia. Five patients had previous AIDS-defining diagnoses: four of these five patients had previous cutaneous HSV infection. HSV DNA was detected by the polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) in seven patients. HSV infection was diagnosed by brain biopsy (after negative PCR on CSF) in one patient and at autopsy in one patient (after negative CSF PCR and brain biopsy). Seven patients received specific anti-viral therapy; two died of unrelated causes and the other five recovered. Two patients were not treated, in one the diagnosis was made at autopsy and the other recovered spontaneously. HIV-infected patients with CNS HSV infection have a varied presentation. Diagnosis by PCR on CSF identified the majority of cases. With specific treatment the outcome was good.
Int J STD AIDS 2004 Sep
PMID:Herpes simplex virus infection of the central nervous system in human immunodeficiency virus-type 1-infected patients. 1533 67

Our objective was to determine factors associated with sexual problems in a sample of HIV-seropositive gay male clinic patients. Using a cross-sectional survey design a volunteer sample of 78 outpatient HIV-seropositive gay male service users completed a self-report questionnaire. This examined sexual problems, their perceived causes and associated factors including demographics, health status, sexual behaviour, self-justifications for sexual risk-taking and mood state (Hospital Anxiety and Depression Scale). Fifty (69%) of 78 HIV-positive gay men reported one or more sexual problems. Erectile dysfunction (ED) was reported by 38% rising to 51% in the context of trying to use condoms. Loss of interest in sex was reported by 41% and 24% experienced delayed ejaculation. The presence of sexual problems affected condom use in that 33 (90%) of the 37 gay men who had ED associated with condom use were inconsistent condom users in insertive sex compared to 28% of those not having this type of ED (P < 0.001). The presence of ED did not reduce the frequency of anal intercourse but those with ED associated with condoms were significantly more likely to have had receptive anal sex in the past three months (62%) compared to men without ED with condoms (38%) (P = 0.05). Risk cognitions such as wanting to lose oneself in sex, leaving responsibility for condom use to the active partner and perceptions that condoms interfere with pleasure were significantly more likely to be endorsed by those who report ED with condoms. Other factors associated with sexual problems included low T-cell counts (i.e. < 200). Psychological explanations were the most frequently cited causes of sexual problems, whether alone or in interaction with HIV disease itself, and combination therapy. A high incidence of sexual problems was found amongst this sample of HIV-positive gay men. Untreated sexual dysfunctions may contribute to sexual risk-taking and therefore HIV clinics need to address both issues. Further research is required to better understand the role of psychological factors, HIV disease itself and combination therapy in the incidence and treatment of sexual problems.
Int J STD AIDS 2004 Nov
PMID:Factors associated with sexual problems in HIV-positive gay men. 1553 58

The aim of this study was to describe the needs of people living with HIV in the UK. A questionnaire addressing 17 areas of need was completed by 1821 people living with HIV in the UK. The core need indicator was a personal assessment of happiness with current state. A quarter of all respondents were happy with their current state across all needs. For each need, the following proportions were unhappy with their current state: sex, 40%; anxiety/depression, 33%; sleep, 32%; self-confidence, 32%; money, 28%; household chores and self-care, 18%; housing, 18%; appetite, eating and drinking, 17%; friendships, 17%; discrimination, 16%; mobility, 15%; dealing with health professionals, 15%; relationships, 14%; drugs and alcohol, 9%; taking treatments regularly, 5%; HIV treatment knowledge, 4%; looking after children, 2%. Although some people with HIV are coping well with minimal unmet need, the overall picture of need is dominated by personal, social and economic issues.
Int J STD AIDS 2004 Dec
PMID:The needs of people with HIV in the UK: findings from a national survey. 1560 84

The larval neuromuscular synapse of Drosophila serves as an important model for genetic and molecular analysis of synaptic development and function. Further functional characterization of this synapse, as well as adult neuromuscular synapses, will greatly enhance the impact of this model system on our understanding of synaptic transmission. Here we describe a form of short-term synaptic depression observed at larval, but not adult, neuromuscular synapses and explore the underlying mechanisms. Larval neuromuscular synapses exhibited a form of short-term depression that was strongly dependent on stimulation frequency over a narrow range of low frequencies (0.1-1 Hz). This form of synaptic depression, referred to here as low-frequency short-term depression (LF-STD), results from an activity-dependent reduction in neurotransmitter release. However, in contrast to the predictions of depletion models, the degree of depression was independent of the initial level of neurotransmitter release over a range of extracellular calcium concentrations. This conclusion was confirmed in two temperature-sensitive (TS) paralytic mutants, cacophony and shibire, which exhibit reduced neurotransmitter release resulting from conditional disruption of presynaptic calcium channels and dynamin, respectively. Higher stimulation frequencies (40 or 60 Hz) produced two components of depression that appeared to include LF-STD as well as a more conventional component of short-term depression. These findings reveal novel properties of short-term synaptic depression and suggest that complementary genetic analysis of larval and adult neuromuscular synapses will further define the in vivo mechanisms of neurotransmitter release and short-term synaptic plasticity.
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PMID:Properties of short-term synaptic depression at larval neuromuscular synapses in wild-type and temperature-sensitive paralytic mutants of Drosophila. 1584 98

One hundred and forty-one male patients who attended a District General Hospital's department of genitourinary medicine completed a questionnaire including demographic indices, history of sexual abuse/assault, anxiety and depression, and sexual concerns and attitudes. Of these, 52 (36.9%) reported past unwanted sexual experiences (USE). A significantly higher proportion of the USE group consisted of homosexual men than the non-USE majority. The prevalence rate for USE involving other men was 15.6%, which is comparable to previous studies. Hospital Anxiety and Depression scores were significantly greater for patients with a history of USE (t = -2.82, P = 0.006, for anxiety and t = -3.01, P = 0.003 for depression). Patients with a history of USE also scored significantly higher on a measure of sexual concerns. However, there were no significant differences between the USE and non-USE groups on two brief measures of alcohol and drug consumption. Clinicians in sexual health settings need to be sensitive to the fact that a significant proportion of male patients may have an undisclosed history of USE.
Int J STD AIDS 2005 Oct
PMID:The psychosexual and psychosocial profile of male genitourinary medicine patients with a history of sexual abuse/assault or unwanted sexual experiences. 1621 11


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