Rates of asymptomatic nonurethral gonorrhea and Chlamydia in a population of university men who have sex with men

Abstract Objectives: The study determined prevalence of asymptomatic nonurethral gonorrhea and chlamydia in men who have sex with men (MSM) seen at the Columbia University Health Service for routine care. Participants: The study enrolled 200 participants from March 2007 to May 2010. Results: Specimens were tested using culture and nucleic acid amplification testing (NAAT): 3.5% (n = 7) tested positive for pharyngeal gonorrhea by NAAT, none were positive by culture; 3% (n = 6) tested positive for rectal chlamydia by NAAT and 0.5% (n = 1) by culture. Conclusions: The incidence of pharyngeal gonorrhea and rectal chlamydia in MSM who visited the Columbia Health Service was similar to rates of asymptomatic nonurethral gonorrhea and chlamydia in studies conducted in the MSM population in non-university settings. This suggests that, following the Centers for Disease Control and Prevention guidelines, (1) 3-site testing for MSM seen at the Columbia clinic is indicated. NAAT is more sensitive than culture for nonurethral gonorrhea and chlamydia.     

Nucleic acid amplification testing in suspected child sexual abuse

The American Academy of Pediatrics recommends that site-specific cultures be obtained, when indicated, for sexually victimized children. Nucleic acid amplification testing is a highly sensitive and specific methodology for identifying sexually transmitted infections. Nucleic acid amplification tests are also less invasive than culture, and this may provide an efficacious alternative for children suspected of being sexually abused.     

Risk factors for Chlamydia trachomatis infection in a California collegiate population

Chlamydia trachomatis infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening model to determine the presence of infection by testing urine for chlamydial DNA by polymerase chain reaction. Participants completed demographic and behavioral risk questionnaires and a chlamydia knowledge assessment. Overall, 3.4% of participants tested positive for infection. Screening of male and female students was evenly distributed and incidence rates for males (3.03%) and females (3.78%) were similar Variables associated with significantly increased risk were younger than 25 years, ethnicity other than White, more than one sexual partner in the preceding year or a new partner in the preceding 2 months, and current symptoms. Innovative outreach programs to screen a majority of at-risk college students should be developed.     

Female ejaculation: A case study

This case study provides objective evidence supporting the hypothesis that female ejaculation, a partial, infertile homologue of male ejaculation, exists. A karyotypically normal, multiparous woman suffered for a decade with urinary stress incontinence. During that time she had learned to inhibit an orgastic response which led to bedwetting. Although the liquid produced did not appear to be urine, she falsely concluded that her orgasmic expulsion was a manifestation of urinary incontinence. Using feedback from a Vaginal Myograph, she learned to do Kegel exercises properly, and the urinary stress incontinence soon disappeared. Around this time she became aware of the concept of female ejaculation and its possible association with an erotically sensitive area that could be stimulated through her anterior vaginal wall. Stimulation of this area, the “Grafenberg spot,” produced what she described as orgasm which felt “deeper” than orgasms in response to vulvar stimulation. Such an orgasm was often accompanied by expulsion of liquid from the urethra. Chemical analysis indicated that the expulsion was not urine. It contained prostatic acid phosphatase, an enzyme characteristically found in prostatic secretion.     

Positive confirmation in rational and irrational learning

A new experiment is reported which tests for positive confirmation bias when subjects learn about a rule. The experiment reveals strong evidence of positive confirmation bias and corresponding violations of expected utility. This evidence for positive confirmation not only covers the search for evidence but also the use of it in making decisions. These results are consistent with and expand on previous results on the subject.     

Risk Factors for Chlamydia Trachomatis Infection in a California Collegiate Population

Abstract

Chlamydia trachomatis infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening model to determine the presence of infection by testing urine for chlamydial DNA by polymerase chain reaction. Participants completed demographic and behavioral risk questionnaires and a chlamydia knowledge assessment. Overall, 3.4% of participants tested positive for infection. Screening of male and female students was evenly distributed and incidence rates for males (3.03%) and females (3.78%) were similar. Variables associated with significantly increased risk were younger than 25 years, ethnicity other than White, more than one sexual partner in the preceding year or a new partner in the preceding 2 months, and current symptoms. Innovative outreach programs to screen a majority of at-risk college students should be developed.     

What Is The Purpose of Neonatal Drug Testing?

Controversy over neonatal drug testing may be due to a lack of agreement on the purposes for such testing. This article examines six issues: (1) the purpose of neonatal testing; (2) the selection of infants for testing; (3) the requirement for parental consent; (4) the concept of prenatal harm; (5) the standard of conduct required of a pregnant woman; and (6) the practical application of such a standard in designing a testing policy. It is argued that maternal consent does not need to be required for testing provided that: (1) adequate drug treatment services are available for the mother and infant; and (2) test results are excluded from use in legal proceedings. If intervention, therapy and research (rather than punishment) guides a neonatal testing policy, the sporadic testing of an infant's urine for the presence of illicit substances clearly falls short of the desired goals.     

Effects of Genital Response Measurement Device and Stimulus Characteristics on Sexual Concordance in Women

Investigations of sexual concordance suggest that, on average, women exhibit a low, positive correlation between their subjective sexual arousal and genital response. However, this relationship appears to be stronger, on average, when genital response is measured via the external tissues of the vulva than within the vagina walls. Given the methodological variations, such as stimulus content and duration, in studies of vulvar and vaginal concordance, direct comparisons between individual studies are limited. In the current study, sexual concordance was examined using concurrent measures of vulvar blood flow (using laser Doppler imaging) and vaginal vasocongestion (using vaginal photoplethysmography) to investigate potential differences in vulvar and vaginal concordance. Twenty-five women viewed two erotic films that differed in sexual activity content (foreplay and intercourse) while their subjective sexual arousal and genital response was measured. In support of previous meta-analytic findings, results suggest that subjective sexual arousal is more strongly correlated with vulvar blood flow than with vaginal vasocongestion. Likewise, perceived genital response and actual vulvar blood flow are more strongly related than are vaginal vasocongestion and self-reported genital sensations. Practical implications for the study of women’s sexual concordance as well as broader implications for the understanding of female sexuality are considered.     

The Association Between Sexual Behavior and Affect: Moderating Factors in Young Women

Sexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women. Female first-year college students (N = 477) completed monthly assessments of their sexual behaviors and positive and negative affect. Participants reported more negative affect in months in which they engaged in sexual behavior compared to months in which they did not. This association was moderated by partner type, such that only sexual behavior with casual partners was associated with increased negative affect. Participants reported more positive affect during months with kissing/touching only compared to months without sexual behavior; however, this association did not differ significantly from the association between oral/vaginal sex and positive affect. Condom use did not moderate the association between vaginal sex and positive or negative affect. In this sample of young women transitioning to college, engaging in sexual behavior was generally associated with negative affect; however, changes in affect depended on partner type and sexual behaviors. Findings have implications for sexual health education.     

The relationship between urinary tract infections and the collegiate academic calendar

College students believe that they are more likely to be ill during examination periods than at other times in the academic year. We in the health service hypothesized that urinary tract infections are not affected by the demands of the academic calendar. During a 4-year study, the university health service obtained urine culture data prospectively from 456 patients who had a total of 508 episodes of urinary tract infections. Each year, the number of urinary tract infections decreased during both midterm and final examination periods, but rebounded to higher-than-average levels in the second week following the midterm examination period, as well as during the second week of the second (spring) semester, immediately after the mid-winter recess. Mean duration of symptoms was 34 hours (range, from 12 to 60). Urinary tract infections were less common during examination periods, when students were preoccupied with academic responsibilities, but such infections increased in frequency in the period immediately after examinations, when sexual intimacy was resumed or when sexual intercourse with a new partner began. Urinary tract infections in college women, the study indicated, are primarily related to sexual intercourse, and susceptibility is only indirectly affected by the demands of the academic calendar.     

A comparison of evolutionary and environmental theories of erotic response part II: Empirical arenas

Evidence from studies of ethnic differences in sexual conservativeness and Papanicolaou (Pap) testing behaviors suggests that there may be culture-linked differences in rates of participation in physically invasive sexuality studies, resulting in volunteer bias. The effects of ethnicity and acculturation on participation in female psychophysiological sexual arousal research were investigated in a sample of Euro-Canadian (n = 50) and East Asian (n = 58) women. Participants completed a battery of questionnaires and were given either course credits or $10 for their participation. Participants were then informed about the opportunity to participate in a second phase of the study, which involved psychophysiological sexual arousal testing and which was completely optional. Contrary to expectations, the results showed that the East Asian women were more likely to participate in Phase 2 than the Euro-Canadian women. Among the East Asian women, greater heritage acculturation and lower mainstream acculturation predicted a lower likelihood of Phase 2 participation. The findings suggest the need to be wary of overgeneralizing female psychophysiological sexual arousal research results and may have implications for improving Pap testing behaviors in East Asian women.     

Positive events and quality of life

Research evidence that might either support or deny the substantive contribution of positive life experiences on health and well-being would be of great value. Regrettably clinical research has been concerned primarily with the disruption in well-being and adjustment associated with stressful or otherwise aversive events. While positive events and their effects have not been ignored altogether, investigators traditionally have given them short shrift in developing and testing models of mental health and psychopathology. This paper evaluates some of these beginning efforts at testing the positive events on psychological functioning, and suggests some new directions for future work in this area.     

Predictors of short-term treatment outcomes among California's Proposition 36 participants

California's voter-initiated Proposition 36 offers non-violent drug offenders community-based treatment as an alternative to incarceration or probation without treatment. This article reports short-term treatment outcomes subsequent to this major shift in drug policy. Data are from 1104 individuals randomly selected from all Proposition 36 participants assessed for treatment in five California counties during 2004. The overall study sample was 30% female, 51% white, 18% Black, 24% Hispanic, and 7% other racial/ethnic groups. The mean+/-SD age was 37+/-10 years. Counties varied considerably in participant characteristics, treatment service intensity, treatment duration, urine testing, and employment and recidivism outcomes, but not in drug use at 3-month follow-up. Controlling for county, logistic regression analysis showed that drug abstinence was predicted by gender (female), employment at baseline (full or part-time), residential (vs. outpatient) stay, low psychiatric severity, frequent urine testing by treatment facility, and more days in treatment. Recidivism was predicted only by shorter treatment duration. Employment predictors included age (younger), gender (male), baseline employment, and lower psychiatric severity. The study findings support drug testing to monitor abstinence and highlight the need to address employment and psychiatric problems among Proposition 36 participants.     

Prevalence and Motivations of Vaginal Practices in Tete Province,Mozambique

ABSTRACT. Vaginal practices have been linked with an increase in risk for HIV transmission and other harms. In 2007, a household survey of 919 women was conducted in Tete province, Mozambique, as part of the World Health Organization Multicountry Study on Gender, Sexuality, and Vaginal Practices. Women aged 18 to 60 years old were interviewed to determine prevalence and motivations for vaginal practices. A large range of frequently used practices was identified. Nearly 80% of women reported three or more current practices, and virtually all had used at least three practices in their lifetime. Elongation of the vaginal labia minora was universal (99% of women), while a quarter stated they had made small vaginal cuts or incisions at least once. Ninety-two percent of women also reported ever use of intravaginal cleansing, and insertion of substances in the vagina was practiced by 72%. Around half (48%) reported ingestion of substances to affect the vagina, mostly to heat, tighten, or loosen the vagina. Application of substances on the genitalia (16%) and steaming (15%) were less popular. To prepare for sexual intercourse, women reported products were commonly applied, ingested, inserted, or steamed. Pregnancy, delivery, and postpartum were also associated with ingestion (26%), steaming (39%), and cutting (32%). Adoption of microbicides and condom use may be influenced by vaginal practices. HIV-prevention messages and interventions, including future microbicides, need to take into account the high prevalence of vaginal practices and motivations for their use. Further attention needs to be given to potentially harmful practices in HIV-prevention efforts in Mozambique.     

The Relationship Between Urinary Tract Infections and the Collegiate Academic Calendar

Abstract

College students believe that they are more likely to be ill during examination periods than at other times in the academic year. We in the health service hypothesized that urinary tract infections are not affected by the demands of the academic calendar.

During a 4-year study, the university health service obtained urine culture data prospectively from 456 patients who had a total of 508 episodes of urinary tract infections. Each year, the number of urinary tract infections decreased during both midterm and final examination periods, but rebounded to higher-than-average levels in the second week following the midterm examination period, as well as during the second week of the second (spring) semester, immediately after the mid-winter recess. Mean duration of symptoms was 34 hours (range, from 12 to 60).

Urinary tract infections were less common during examination periods, when students were preoccupied with academic responsibilities, but such infections increased in frequency in the period immediately after examinations, when sexual intimacy was resumed or when sexual intercourse with a new partner began. Urinary tract infections in college women, the study indicated, are primarily related to sexual intercourse, and susceptibility is only indirectly affected by the demands of the academic calendar.     

Prostitution and fellatio

Questionnaires gathered from men arrested while trying to hire female prostitutes in three Western cities indicate that the desire for fellatio is an important reason clients seek female prostitutes. Respondents were more likely to select fellatio than any other practice when asked which sexual practices they (a) had ever experienced with a prostitute (81% in comparison to 55% for vaginal sex; N = 995), (b) usually experienced with a prostitute (51% in comparison to 12% for vaginal sex, the second most common practice; N = 926), and (c) experienced during their most recent sexual encounter with a prostitute (68% in comparison to 43% for vaginal sex; N = 424). Though a majority of respondents (65%) found the practice of fellatio very appealing, an even greater proportion expressed that opinion about vaginal intercourse (76%; N = 55). These findings, when analyzed in the context of other research on sexual practices, suggest that the desire for fellatio may be one reason some men seek prostitutes.     

Price perception and confirmation bias in the context of a VAT increase

This paper examines a potential confirmation bias in price perception in consequence to a real-world event and different explanations for such a confirmation bias. In a panel design conducted 2 months before and after a raise in value-added tax (VAT), 303 participants had to estimate the current prices for four products affected and four products not affected by this raise in VAT and the anticipated or recalled prices of these products. Before the VAT increase, an undifferentiated belief in strong future price increases was prevalent. After the VAT increase, a confirmation bias was found: in retrospect, participants reported price increases that were significantly higher than the official price development and in line with an undifferentiated belief in marked price increases. Two theoretical explanations for confirmation bias, i.e., the biased use of price information and the selective distortion of memory, fit the data.     

Antibiotic resistance in urinary tract infections in college students

Abstract Objective: To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students. Participants: Symptomatic patients presenting to a student health service from September 2008 to December 2009. Methods: Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity. Results: Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%. Conclusions: In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.