The Correlation of Papanicolaou Smears and Clinical Features to Identify the Common Risk Factors for Cervical Cancer: a Retrospective and Descriptive Study From a Tertiary Care Hospital in Trinidad

Background: Cervical cancer, the fourth most frequent cancer in women, is associated with the human papilloma virus (HPV). This study focuses on identifying any risk factors and clinical findings for abnormal cervical cytology and histopathology in relation to the Trinidad and Tobago population. Some risk factors include early age of first coitus, high number of sexual partners, high parity, smoking, and use of certain medications such as oral contraception. This study is aimed to identify the significance of Papanicolaou (pap) smears and to identify the common risk factors that contribute to the development of premalignant and malignant cervical lesions. Method: A three-year retrospective, descriptive study of cervical cancer was conducted at the Eric Williams Medical Sciences Complex to assess the risk factors and clinical findings using cervical cytology and histopathology data of patients with premalignant lesions. The subject population included 215 female patients aged 18 years and older who had the following documented abnormal cervical cytology: (ASCUS), ASC-H, LSIL, HSIL, Atypical Glandular cells, HPV, Adenocarcinoma, Invasive Squamous Cell Carcinoma. Histopathology records were analysed for thirty-three of these patients. Patients’ information were recorded on data collection sheets adapted from the North Central Regional Health Authority’s cytology laboratory standardised reporting format request form (Appendix I). Results and findings: The data were analysed via Statistical Package for Social Sciences (SPSS) software edition 23 using frequency tables and descriptive analysis. The sample mean age of the population was 36.7 years, first age of coitus was 18.1 years, number of sexual partners was 3.8 and number of live births was 2. LSIL was the most popular abnormal finding, 32.6 %, followed by HSIL, 28.8% and ASCUS, 27.4%. Most histopathological reports resulted in CIN I and II.Conclusion: The major risk factors observed for cytology abnormalities and premalignant lesions were early age of coitus, high number of sexual partners, and no use of contraception.Patients mostly presented as asymptomatic despite obtaining abnormal cytology results. Hence, regular pap smear screening should continue to be highly encouraged.

Analysis of contraceptive behavior of female athletes of reproductive age

The article presents the materials of a large-scale study devoted to the study of the contraceptive behavior of female athletes of reproductive age, representing different sports. It has been established that the most commonly used types of contraception, in all age categories, are: interrupted intercourse, spermicides, barrier contraception (male condoms), hormonal patches. The most rarely used are hormonal contraception (single-phase and three-phase combined oral contraceptives) and intrauterine contraception. It has been established that the choice of a particular type of contraception among athletes is determined by such leading factors as sexual activity, frequency of sexual contacts, the number of sexual partners, the presence or absence of a family and marriage.

The Role of Objectification in College Women’s Substance Misuse and Sexual Risk

Sexism and objectification present major challenges for mental and physical health among women. Scholars have called for research to identify mechanisms that underlie these associations as well as to delineate factors to target in prevention and intervention efforts. This study aimed to build on central tenets of objectification theory through its examination of sexist experiences in relation to body surveillance, body shame, depressive symptoms, and the health risk behaviors of substance use (i.e., alcohol and drug misuse) and sexual risk (i.e., condom use and number of sexual partners) among a large sample of college student women. We also examined whether body surveillance, body shame, and depressive symptoms would mediate theorized pathways extended to substance use and sexual risk. A sample of 505 full-time college student women ages 18–26 completed an online survey that assessed their health and behaviors. We used structural equation modeling to test mediation hypotheses. Results largely supported hypotheses, extended objectification theory to sexual risk, and expanded upon past research on objectification in relation to substance use. Notably, results of this study provided a more nuanced knowledge of how objectification may lead to increases in sexual risk when assessed by number of sexual partners (but not condom use). Further research is warranted to understand potential explanatory pathways between sexism, objectification, and sexual risk. Findings can inform prevention and intervention efforts to target body surveillance, body shame, and depressive symptoms to attempt to reduce the burden of sexist experiences on women’s health.

Associated factors to the sexual behavior in Peruvian women among 15 and 25 years old

Background: The sexual behavior of women is associated with various protective or risk factors, which are important to assess. To determine the socioeconomic factors associated with the sexual behavior of Peruvian women within 15 and 25 years old. Method: A secondary analysis of the 2016 Demographic and Family Health Survey (ENDES) was conducted. Our sample was 7962 women from 15 to 25 years old, from all over the Peruvian territory. Associative analyzes were carried out on the age of sexual initiation, the number of sexual partners and the use of contraceptives, based on sociodemographic variables. Poisson regression with robust variance was also used. Results: It was found the factors, that are associated with the age of sexual initiation and the number of sexual partners, are the area of origin, marital status, educational level, employment status and socioeconomic level. While women who work and whose partners do not drink alcohol are the most likely to use contraceptives. Conclusions: It can be concluded that certain socioeconomic and work conditions act as protective factors of female sexual behavior, while having a partner who drinks alcohol is a risk factor.

Partner number and use of COVID-19 risk reduction strategies during initial phases of the pandemic in British Columbia, Canada: a survey of sexual health service clients

Objectives Initial public health guidance related to sex and COVID-19 infection focused on reducing partner number. We characterized individuals having a higher partner number during the initial phases of the pandemic. Methods In British Columbia, the initial wave of COVID-19 cases was from March 14 to May 19, 2020, followed by gradual lifting of public health restrictions. We conducted an e-mail survey of existing sexual health service clients during the period of July 23 to August 4, 2020. We used bivariate logistic regression to examine the association between the reported number of sexual partners since the start of the pandemic and key variables (level of significance p < 0.01). Results Of the 1196 clients in our final sample, 42% reported 2+ partners since the start of the pandemic, with higher odds among participants who were men who have sex with men, and single or in open relationships prior to the pandemic. This group was more likely to perceive stigma associated with having sex during the pandemic, and had the highest use of strategies to reduce risk of COVID-19 infection during sexual encounters (mainly focused on reducing/avoiding partners, such as masturbation, limiting sex to a “bubble”, and not having sex). Conclusion Sexual health service clients in BC with 2+ partners during the initial phases of BC’s pandemic used strategies to reduce their risk of COVID-19 infection during sex. Our study provides support for a harm reduction approach to guidance on COVID-19 risk during sex, and highlights the need for further research on stigma related to having sex during the COVID-19 pandemic.

872. Number of Sexual Partners and Patient-Reported Outcomes among Older Adults Living With HIV

Background Many older (age 50+) adults living with HIV (OALWH) are sexually active. However, little is known about the relationship between number of sexual partners and mental health outcomes among OALWH. Methods Data were utilized from the Aging with Dignity, Health, Optimism and Community (ADHOC) cohort, an observational study of OALWH from ten US clinics. To measure sexual activity, participants were asked “How many sexual partners have you had in the last year?” with response options ranging from zero to “greater than five.” Loneliness was measured using the Three-item Loneliness Scale, and depression was measured using the Patient Health Questionnaire-2. Significance was determined by Kruskal-Wallis tests followed by unadjusted pairwise comparisons. Results Of 1,027 participants, the mean (SD) age was 58.9 (6.1) and 876 (85%) were male. 312 (30%) had zero sexual partners in the past year, 308 (30%) had one partner, 197 (19%) had 2-5 partners, and 210 (20%) had &gt;5 partners. Of the participants with one partner, 230 (75%) were married, coupled or partnered, and 78 (25%) were single, widowed, separated, or divorced (Single). Figure 1 shows that people with one partner were significantly less lonely than any other group (p&lt; 0.01 for pairwise comparisons), and all other groups were statistically similar to each other. This pattern was also seen with depression (p&lt; 0.01 for pairwise comparisons, Figure 2). Among subgroup of people with one sexual partner, those who were married, coupled or partnered were less lonely (4.41 vs. 5.67, p&lt; 0.01) and less depressed (0.95 vs 1.38, p=0.02) than those who were single, widowed, separated, or divorced. Conclusion Among OALWH, people with one sexual partner were less lonely and depressed than people with zero or with ≥2 partners. Furthermore, people with one sexual partner who were married or in a committed relationship were less lonely and depressed than people with one sexual partner who were not. Disclosures Peter Mazonson, MD, MBA, ViiV Healthcare (Grant/Research Support) Jeff Berko, MPH, BS, ViiV Healthcare (Scientific Research Study Investigator) Theoren Loo, MPH, ViiV Healthcare (Grant/Research Support) Giselle D. Coelho, MD. MPHTM, Lilly (Research Grant or Support)Medscape, Clinical Care Options (Independent Contractor)Viiv, Gilead, Janssen (Advisor or Review Panel member, Research Grant or Support) Erik Lowman, MD, Gilead (Grant/Research Support)Janssen (Grant/Research Support)ViiV (Grant/Research Support) Peter Shalit, MD, PhD, Abbvie (Grant/Research Support)Gilead Sciences (Consultant, Grant/Research Support, Speaker’s Bureau)Glaxo Smithkline (Consultant, Grant/Research Support)Janssen (Consultant, Grant/Research Support, Speaker’s Bureau)Merck (Grant/Research Support, Speaker’s Bureau)Thera (Speaker’s Bureau)ViiV Healthcare (Speaker’s Bureau) Frank Spinelli, MD, ViiV Healthcare (Employee)

A Multi-Scale Model for the Spread of HIV in a Population Considering the Immune Status of People

A multi-scale mathematical model is proposed, seeking to describe the propagation of Human Immunodeficiency Virus (HIV) in a group of young people between 15 and 24 years of age, through unprotected sexual contact. The uses of antiretroviral therapy (ART) and therapeutic failure are considered to show how the rate of propagation and prevalence are affected. The model consists of a complex network modeling the interactions on the population scale, coupled with the immunological dynamics of each individual, which is modeled by a system of differential equations. The immunological model allows to observe some known facts from the literature, such as to control HIV infection in the immune system, it is necessary to reduce the probability of healthy CD4 T cells becoming infected or increase the probability at which cells of the specific cell response against HIV eliminate infected CD4 T cells. At the population level, it is shown that, to have a high prevalence, it is not necessary for the virus to spread rapidly at the beginning of the simulation time. Additionally, it is observed that a greater number of sexual partners induces higher HIV prevalence. Using ART in the immune system reduces the number of infected CD4 T cells and, consequently, helps to reduce the spread of infection at the population scale. An important result observed in simulations is that the average number of HIV carriers who abandon ART is greater than those who access it. The study adds to the available literature an original simulation model that describes the dynamics of HIV propagation in a population, considering the immune state of people within that population, and serves as a basis for future research involving more detailed aspects aiming for a model closest to reality.

Environmental harshness and unpredictability: Do they affect the same parents and children?

Differential susceptibility theory stipulates that individuals vary in their susceptibility to environmental effects, often implying that the same individuals differ in the same way in their susceptibility to different environmental exposures. The latter point is addressed herein by evaluating the extent to which early-life harshness and unpredictability affect mother's psychological well-being and parenting, as well as their adolescent's life-history strategy, as reflected in number of sexual partners by age 15 years, drawing on data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Results indicated that mothers whose well-being and parenting proved more susceptible to harshness also proved somewhat more susceptible to environmental unpredictability, with the same being true of adolescent sexual behavior. Nevertheless, findings caution against overgeneralizing sample-level findings to all individuals.

Clinical Efficacy of Carbon Dioxide Laser Combined with ALA Photodynamics in the Treatment of Condyloma Acuminatum

’Purpose. To observe the clinical efficacy and safety of carbon dioxide laser combined with ALA photodynamics in the treatment of condyloma acuminatum. Method. A total of 211 patients with condyloma acuminatum admitted to our hospital from April 2018 to June 2021 were selected as the observation object. They were divided into the intervention group (CO2 laser combined with ALA photodynamic therapy, 125 cases) and conventional group (CO2 laser treatment, 86 cases), and the efficacy and incidence of adverse reactions between the two groups were compared. Result. The total effective rate of the intervention group (96.00%) was significantly higher than that of the conventional group (84.88%) ( P < 0.05 ). The total incidence of adverse reactions in the intervention group (8.00%) was lower than that in the conventional group (32.56%) ( P < 0.05 ). Univariate analysis showed that the patient’s smoking history, drinking history, course of disease, wart area, and number of sexual partners were related to the short-term prognosis ( P < 0.05 ). Multivariate logistic regression analysis showed that the patient’s course of disease, the area of the wart body, and the number of sexual partners were independent factors affecting the prognosis of patients with condyloma acuminatum ( P < 0.05 ). Conclusion. Carbon dioxide laser combined with ALA dynamics treatment of condyloma acuminatum significantly improves the clinical efficacy, does not increase the incidence of adverse reactions, and has important clinical therapeutic value. The course of the disease, the area of the wart, and the number of sexual partners are independent factors affecting the prognosis of patients with condyloma acuminatum.

Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic

Australia introduced a national lockdown on 22 March 2020 in response to the COVID-19 pandemic. Melbourne, but not Sydney, had a second COVID-19 lockdown between July and October 2020. We compared the number of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, and new HIV diagnoses during these lockdown periods. The three outcomes in 2020 were compared to 2019 using incidence rate ratio. There was a 37% and 46% reduction in PEP prescriptions in Melbourne and Sydney, respectively, with a larger reduction during lockdown (68% and 57% reductions in Melbourne’s first and second lockdown, 60% reduction in Sydney’s lockdown). There was a 41% and 32% reduction in HIV tests in Melbourne and Sydney, respectively, with a larger reduction during lockdown (57% and 61% reductions in Melbourne’s first and second lockdowns, 58% reduction in Sydney’s lockdown). There was a 44% and 47% reduction in new HIV diagnoses in Melbourne and Sydney, respectively, but no significant reductions during lockdown. The reduction in PEP prescriptions, HIV tests, and new HIV diagnoses during the lockdown periods could be due to the reduction in the number of sexual partners during that period. It could also result in more HIV transmission due to substantial reductions in HIV prevention measures during COVID-19 lockdowns.