This thesis presents data on incidence and risk factors for individual sexually transmissible infections (STIs) and STIs as risk factors for HIV acquisition in a community-based cohort of HIV negative homosexual men in Sydney. Nearly half of men aged under 25 years were seronegative to hepatitis A and B infection. The prevalence of hepatitis C (HCV) was 0.85%, which was close to that of the general population. HCV infection was strongly associated with injecting drug use (OR 60.43, 95% CI 6.70-544.79), and sexual transmission was not demonstrated in this cohort. There was a nearly 40 fold increase in syphilis notifications in inner Sydney between 1999 and 2004. The stable incidence of 0.6% per year in the HIM cohort suggests that it was disproportionately affecting HIV positive men. Oral sex was an important transmission route and about one third of cases were asymptomatic. The incidence of urethral and anal gonorrhoea was 3.78 and 3.19 per 100 person-years, and for urethral and anal chlamydia it was 7.98 and 5.20. In addition to unprotected anal intercourse (UAI), insertive oral sex was related to urethral infections and anal infections were associated with non-intercourse anal sexual practices. The prevalence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) was 75% and 23% respectively. Sexual contact not only with men, but with women, was significantly associated with both infections. Among those susceptible at baseline, the incidence for HSV-1 and HSV-2 was 5.58 and 1.45 per 100 person-years. Oral sex was associated with incident HSV-1 infection and certain non-intercourse anal sexual practices were significantly associated with incident HSV-2 infection. HIV incidence was 0.94 per 100 person-years. It was significantly associated with a higher number of episodes of receptive UAI with a partner of unknown HIV status (p trend&lt0.001) or a partner known to be HIV positive (p trend&lt0.001). After controlling for sexual behaviour, HIV seroconversion was significantly associated with anal gonorrhoea (HR 12.68, 95% CI 3.66-44.00). The association with anal warts and prevalent HSV-1 infection was of borderline significance. These data will inform intervention designs targeting STIs which aim to prevent HIV in homosexual men.

xv, 179 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of Medicine, 1974

Studies from developing countries disagree on whether mobility is a risk factor or a protective factor for HIV risk. The difference is often determined by gender. Few studies exist, however, examining the relationship among high risk populations in developed nations. This study seeks to examine that relationship in 10 high risk ZIP codes of Atlanta, Georgia using data gathered from the Geography Project by Rothenberg and colleagues. Logistic regression was used to examine the relationship between HIV risk and five independent variables of mobility. Results were stratified by gender. After controlling for demographic and behavioral variables, use of public transportation by men was significantly protective of HIV risk. Significant associations were also observed with ever injection drug use and recent condom use, indicating that high risk behaviors may be the real driver of the epidemic in these neighborhoods.

Syfte: Undersöka preventivmedelsanvändning, sexuellt riskbeteende gällande könssjukdomar och oönskade graviditeter samt skillnader i sexuellt riskbeteende mellan olika ursprung, självförtroende och ålder vid sexuell debut hos kvinnor i åldern 14-31 år. Metod: En enkätundersökning, konsekutivt urval, utförd på RFSU-kliniken under år 2011 inkluderade 419 kvinnor. Resultat: Kondom var det vanligaste preventivmedlet vid första samlaget och p-piller var vanligast vid senaste samlaget. Nästan hälften, 48,7 %, hade haft en könssjukdom, klamydia var vanligast. Över hälften, 60,2 %, hade riskerat att få en könssjukdom och 45,6 % hade riskerat att bli oönskat gravid under de senaste tolv månaderna. Den främsta anledningen till detta var på grund av att de struntade i kondom ”i stundens hetta”. Kvinnor som haft sin sexuella debut i yngre ålder angav oftare att de haft en könssjukdom och någon gång under de senaste tolv månaderna riskerat att bli oönskat gravid. Kvinnor som skattat sitt självförtroende som högt struntade oftare i att använda kondom ”i stundens hetta”. Slutsats: Över hälften hade ett sexuellt riskbeteende gällande könssjukdomar och oönskade graviditeter. Kvinnor som hade sin sexuella debut i yngre ålder samt kvinnor som skattade sitt självförtroende högt visade oftare på ett sexuellt riskbeteende. Det fanns ingen signifikant skillnad mellan svenskfödda och utlandsfödda gällande ett sexuellt risktagande. / Aim: Investigate contraceptive use, sexual risk behavior regarding sexually transmitted diseases (STD’s) and unwanted pregnancies and examine differences in sexual risk behavior regarding different backgrounds, self-confidence and age at first intercourse in women aged 14-31 years. Method: Consecutive sample including 419 women with a questionnaire, at a RFSU-clinic in Stockholm, 2011. Results: Condoms were most common at first intercourse and oral contraceptives most common at latest intercourse. Almost half had had an STD, Chlamydia the most common. Almost 60 % risked getting STD’s and 45,6 % risked unwanted pregnancies at sometime during the last twelve months. Main reason why participants risked this was because they ignored the condom in “the heat of the moment”. Women who had their first intercourse at a young age more often have had an STD and during the last twelve months risked an unwanted pregnancy. Women with a high self-confidence more often ignored using a condom in “the heat of the moment”. Conclusion: Over half of the participants had a sexual risk behavior regarding STD’s and unwanted pregnancies. Women who had their first intercourse at a young age and women with a high self-confidence showed signs of sexual risk-taking. There’s no significant difference between Swedish born and foreign born participants regarding sexual risk-taking.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Thesis (M. Med. Sc.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 35-42).

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Library wanting Figure 11 which is missing from manuscript. Typescript. Vita. Includes bibliographical references (leaves 102-120). Also available on the Internet.

Diss. Tromsø : Universitetet i Tromsø, 2006.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. Linköping : Linköpings universitet, 2008.