Magnitude of Sexual Behaviours Among College Students In The Eighth Macro-Region of Iran By Self-Reported and Network Scale-Up

Background This study was designed to directly and indirectly estimate the prevalence of sexual behaviors among students of medical science universities in the eighth Macro- region of Iran. Methods This cross-sectional study was performed on 3900 students from Kerman and Sistan and Baluchestan provinces in 2019. The data were collected using direct (i.e., self-report of their own behaviors) and indirect (NSU: Network scale-up) methods. Results The mean (SD) age of students was 22.45 (3.25). The prevalence of heterosexual intercourse in return for money, extramarital heterosexual intercourse, masturbation, sexting, porn watching, homosexuality and abortion based on NSU method was 6.0%, 8.5%, 19.5%, 9.1%, 22.9%, 2.4% and 0.5% respectively. Corresponding figures of the direct method were 5.7%, 5.8% 18.6%, 9.7%, 23.1%, 2.1% and 0.9% respectively. Conclusion Sexual behaviors like porn watching, masturbation and sexting can harm the youth, family and society. The youth should be given training to correctly react to sexual situations.

Hypertension and Hirsutism in a Young Female: A Rare Form of Congenital Adrenal Hyperplasia?

Background: Rare forms of congenital adrenal hyperplasia (CAH) especially can be a diagnostic and management challenge. We present a case of hypertension and hirsutism with elevated mineralocorticoid and sex steroid precursors concerning for non-classic rare form of CAH. Clinical Case: A 22 y/o female was evaluated in our endocrinology clinic for primary hypertension and hirsutism (modified Ferriman-Gallwey score of 12) but without menstrual irregularity, clitoromegaly or deepening of voice. Family history was significant for hypertension and hirsutism in her mother. Renal and pelvic ultrasonographies were normal. CT abdomen showed thickened bilateral adrenal glands. Case detection testing was positive with PAC/PRA of 19.4/0.4 however intravenous saline suppression test suppressed aldosterone to 5 ng/dL, hence ruled out primary aldosteronism. Cortisol suppressed to 0.6 mcg/dL after 1 mg overnight Dexamethasone, hence ruled out Cushing’s syndrome; prolactin and TSH were normal, serum HCG was undetectable. This prompted work up for other endocrine causes of hypertension and hirsutism which revealed follicular phase elevated dehydroepiandrosterone-sulfate of 772 mcg/dL (35–430), pregnenolone of 603 ng/dL (15–132), 17-hydroxypregnenolone of 1516 ng/dL (<226), 11-deoxycortisol of 39.4 ng/dL (<32); but normal 17-hydroxyprogesterone of 36.8 ng/dL (15–70), androstenedione of 1.12 ng/mL (0.26–2.14) and free testosterone of 26 ng/dL (9–44). 250-mcg ACTH administration stimulated cortisol to 24.6 mcg/dL, pregnenolone to 1478 ng/dL, 17-hydroxypregnenolone to 1716, 11-deoxycortisol to 64.2 ng/dL but 17-hydroxyprogesterone only stimulated to 59.9 ng/dL. We initiated spironolactone at 12.5 mg increased to 25 mg daily, which normalized her blood pressure. She was counseled regarding its teratogenicity but is she declined birth control, as she was not engaging in heterosexual intercourse. Urinary steroid analysis and genetic testing were pending. Conclusions: Hypertension and hirsutism accompanied by elevated pregnenolone, 17-hydroxypregnenolone, 11-deoxycortisol and dehydroepiandrosterone-sulfate, however, normal baseline as well as stimulated 17-hydroxyprogesterone, raise concern for co-occurrence of partial 3-betahydroxysteroid dehydrogenase deficiency in addition to non-classic 11-betahydroxylase deficiency. Management with mineralocorticoid receptor antagonist helped control hypertension.

Streptococcus agalactiae and genital ulcers in a heterosexual male

Streptococcus agalactiae (S. agalactiae) is a microorganism that asymptomatically colonizes the female genital and gastrointestinal tracts of humans. It produces infections in extreme ages of life and in pregnant women. The case of an adult male is presented, with frequent heterosexual intercourse with different partners. He consulted for itching and burning in the penis' glans. His partner had marked vaginal dryness as a result of early ovarian failure. The patient had ulcerative, non-painful, erythematous lesions with raised edges and little yellow-green discharge. No Donovan bodies were found in the discharge smear and the culture was positive for S. agalactiae. His asymptomatic partner had negative microbiological tests. Both with negative serologies for Chlamydia, HIV and syphilis. No information was obtained from other sexual contacts. It cannot be ascertained that it was a venereal event, it is more likely that the injuries are related to repeated coital trauma.

The Importance of Regulation in Natural Immunity to HIV

Worldwide, most Human Immunodeficiency Virus (HIV) infections are acquired through heterosexual intercourse, and in sub-Saharan Africa, 59% of new HIV infections affect women. Vaccines and microbicides hold promise for preventing the acquisition of HIV. To this end, the study of HIV highly exposed seronegative (HESN) female commercial sex workers (CSWs), who constitute a model of natural immunity to HIV, provides an exceptional opportunity to determine important clues for the development of preventive strategies. Studies using both female genital tract (FGT) and peripheral blood samples of HESN CSWs, have allowed identifying distinct features, notably low-inflammatory patterns associated with resistance to infection. How this seemingly regulated response is achieved at the initial site of HIV infection remains unknown. One hypothesis is that populations presenting regulatory profiles contribute to the orchestration of potent anti-viral and low-inflammatory responses at the initial site of HIV transmission. Here, we view to update our knowledge regarding this issue.

Nye seksualiteter, nye kjønn?

Fifty years ago, the concept “sexual script” was coined to describe sexual activities as social and learned interactions. Such scripts gradually change, however, and result in what we may label “generational sexualities”. Drawing on such theory and the Young in Oslo data set, we show that age of first heterosexual intercourse, perhaps contrary to expectations, has increased over the past two decades. We also show how debut age reflects sociodemographic and area-related characteristics in Oslo: Adolescents in the wealthy areas have a lower sexual debut age than those living in less affluent parts of the city. This pattern, however, varies with factors such as immigration, religion and the use of alcohol and social media. Further, we show that one in five no longer define themselves within the traditional homo-hetero dichotomy. We discuss whether gender identities have become more fluid, and we show that the term “queer”, with its connotations of exploration, openness and inclusion, has become popular, as opposed to older terms such as “lesbian”, “gay” or “bisexual”. Thus, strong social forces shape adolescent sexual behaviours, but sexual scripts, and sexual and gender identities, seem to allow for more variations than before.

Introduction

The introduction outlines the book’s main goal, which is to describe how, during the nineteenth, twentieth, and twenty-first centuries, physicians, psychologists, social workers, sexologists, and counselors came to advocate heterosexual intercourse as the norm for both men and women without overtly acknowledging the effects of that advocacy: the legitimation of male sexuality and male supremacy. The author argues that sex therapy has been, and continues to be, based on a series of pro-male, anti-female assumptions and sustained through practices that treat those assumptions as true. The introduction describes how the research began, how the book is organized, and the kinds of materials and methodologies used to support the observations and conclusions.

Temporal Trends in the Epidemiology of HIV in Turkey

Objective: The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016. Method: Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes. Results: A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p<0.001). The highest prevalence was among those aged 25-34 years followed by the 35-44 age bracket. The most common reason for HIV testing was illness (35%). While the frequency of sex among men who have sex with men increased from 16% to 30.6% (p<0.001) over the study period, heterosexual intercourse (53%) was found to be the most common transmission route. Overall, 29% of the cases presented with a CD4 count of >500 cells/mm3 while 46.7% presented with a CD4 T cell count of <350 cells/mm3. Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy. Conclusion: The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.

Behavior and experience of male homosexuals in Bangladesh

Homosexuality is defined as “the occurrence or existence of sexual attraction, interest and genitally intimate activity between an individual and other members of the same gender.” The objective of the study was to explore the behavior and experience of male homosexuals in Dhaka, Bangladesh. Due to hidden nature of this population, data were collected through a non-government organization working with them. This was a cross sectional study done during the period from March, 2009 to June, 2009. For this purpose, 102 male homosexuals were enrolled in the study by purposive sampling method and interviewed using a custom-built questionnaire. The results showed that all of the participants were biologically male with age ranged from 14-48 years and average age of first homosexual exposure for the participants was 11.75 years with a range from 4 to 27 years. The majority (56.9%) of the male homosexuals reported experiencing heterosexual intercourse. A high rate of sexual victimization history in childhood (64.7%) as well as in adulthood (49%) was reported. A sizable portion of the participants reported different discriminatory experiences including stigma and discrimination (48%), humiliation in public (49%), being cheated by male partner (60.8%), and exclusion from family (21.6%) because of their homosexual identity. Widespread childhood sexual abuse and discrimination clearly call for protective measures to be taken for safeguarding this vulnerable population. Bang J Psychiatry December 2016; 30(2): 41-44

Low seroprotection rate for meningococcus serogroup C in the adult HIV-1-infected population in Austria

Summary Current Advisory Committee on Immunization Practices (ACIP) guidelines recommend immunization of all human immunodeficiency virus (HIV)-infected patients against meningitis serotype ACWY due to recent outbreaks of meningitis C in homosexual men in the USA. Implementation of this recommendation in other countries, such as Austria is hindered by the scarce knowledge on the vaccine coverage. In this study the serostatus for meningococcus serogroup C was analyzed in 390 HIV-infected individuals residing in Austria. These individuals were representative for the Austrian HIV cohort regarding sex, age, transmission risk and HIV progression markers. Overall, 73% were on suppressive antiretroviral therapy, the mean CD4 cell count was 599 cells/μl and immunoglobulin G (IgG) seropositivity was 18% for meningococcus serogroup C. Migrants and patients who had acquired an infection via heterosexual intercourse had a higher chance for meningococcus serogroup C seropositivity. Importantly due to the well-preserved immune status of nearly all participants vaccination would be feasible in the majority of the seronegative patients. It is assumed that this measure would largely reduce the number of patients at risk for this vaccine-preventable disease.