Risky behaviour in Jamaican adolescent patients attending a sexually transmitted disease clinic

The prevalence of sexually transmitted diseases (STD) and risky behaviour patterns were studied in 165 adolescents attending a STD clinic in Jamaica. A standardised structured questionnaire, clinical algorithms for STD and serological tests for HIV and syphilitic infection were applied. High prevalences of risky behaviour including young age at onset of sexual activity, especially in boys, (mean age 12.5 +/- 2.5 years); unprotected sexual intercourse (only 4 used condoms consistently); multiple sexual partners (mean 3.8 +/- 2.4 and 1.8 +/- 1.2 for boys and girls, respectively) were found. Marijuana, used by 60 of the boys, was an independent risk factor for dysuria (adjusted Odds Ratio (OR), 2.0; 95 CI, 1.6-3.4). Repeated episodes of STD (33), coinfection with HIV (1.2), syphilis (1.2) and teenage pregnancy (13) were prominent findings. Educational strategies which promote behaviour intervention at an early age, frequent and consistent use of condoms, abstinence or delayed onset of sexual activity are essential to reducing the HIV/AIDS and STD risk in adolescents in Jamaica.

Drug use and syphilis. Co-factors for HIV transmission among commercial sex workers in Guyana

A cross-sectional survey was conducted among 124 street- and brothel-based female commercial sex workers (CSWs) in Georgetown in January and February 1997 to determine the seroprevalence of human immunodeficiency virus (HIV) infection and describe the sexual practices and drug use patterns. Their median age was 30 years (range 17 to 52 years). 119 (88) reported regular alcohol consumption while looking for clients, 27 (22) said they smoked cocaine and 51 (42) reported use of marijuana. Street-based CSWs were significantly more likely to report marijuana use (p = 0.033). 72reported that they never used condoms with regular sex partners and 35reported that they never used condoms with clients. Brothel-based women were significantly more likely to report consistent condom use with their clients (p = 0.05). 46(54/118) tested HIV positive and 28(33/118) had a positive serological test for syphilis. Factors that were significantly associated with HIV infection included a positive serological test for syphilis (OR = 7.56; 95CI = 2.7-21.97; p < 0.01) and a history of having received treatment for syphilis (OR = 2.93; 95CI = 1.12-7.8). Weak associations were also found between HIV infection and a history of cocaine use (OR = 2.57; 95CI = 0.95-7.11; p = 0.039); having more than four clients per night (OR = 5.14; 95CI = 1.65-16.74; p = 0.04); and a history of receiving treatment for salpingitis (OR = 2.31; 95CI = .93-5.75; p = 0.0035). No statistically significant association was found between HIV infection and marijuana use nor any sociodemographic variables (age, place of work, and duration of sex work). There is an urgent need for a community based behavioural intervention programme targetting this high risk population.