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(See Fall Archives)

January News Briefs and Links

UNITED KINGDOM:
"Sex Partner Acquisition While Overseas: Results from a British National Probability Survey"
Sexually Transmitted Infections Vol. 83; No. 7: P. 517-522, (12.01.2007) C.H. Mercer; K.A. Fenton; K. Wellings; A.J. Copas; B. Erens; A.M. Johnson
The number of overseas trips made by UK residents has increased dramatically over the past 20 years. While other studies have examined the frequency of partner acquisition abroad, they have used convenience samples and therefore are not generalizable to the British general population, said researchers in the current study. CDC Summary in Medical News.

"Teens Are More Talk, Less Action, Sexual Activity Survey Says"
Ottawa Citizen, (01.22.2007) Joanne Laucius
A survey of young Canadians and mothers of teens shows both groups misperceive the level of teen sexual activity, according to a new study. The online survey, conducted in October 2005, was completed by 1,171 respondents ages 14-17 and 1,139 mothers of teens ages 14-17. The mothers polled were unrelated to the teens surveyed. CDC Summary

5th Mexican Gay Youth March Aimed To Raise Awareness About HIV/AIDS
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=50076

Encouraging Teens To Receive HIV Test 'Much Easier' With Guarantee of Privacy, Editorial Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49851

"Traveling Young Injection Drug Users at High Risk for Acquisition and Transmission of Viral Infections"
Drug and Alcohol Dependence Vol. 93; No. 1-2: P. 43-50, (01.11.2008) Judith A. Hahn; Kimberly Page-Shafer; Jamye Ford; Alan Paciorek; Paula J. Lum
How does the documented high mobility of young injection drug users (IDUs) affect their risk of acquiring and transmitting viral infections? To find out, the researchers conducted a cross-sectional study of IDUs under age 30 in San Francisco between 2004 and 2006. CDC Summary

Recently Homeless Youth More Likely To Engage in Risky Sex, Increasing Risk of HIV, Other STIs, Study Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49721

"Study Links Drinking with Sex"
Washington Post, (12.25.2007) Laura Sessions Stepp
Studies have shown that young adults who drink heavily are more likely to have multiple sex partners compared to non-heavy drinkers. A team of researchers at Washington University School of Medicine in St. Louis set out to determine if the number of partners increases with the intensity of drinking and whether having a diagnosed conduct disorder affects that number. CDC Summary in Prevention Research.

See Fall Archives

Summaries

CANADA:
"Health Province to Launch Cervical Cancer Vaccination Program for Girls as Part of New Health Plan"
Telegraph-Journal (New Brunswick), (01.29.2008) Quentin Casey
New Brunswick Health Minister Mike Murphy today will announce a vaccination program to protect girls against human papillomavirus as part of his provincial health plan. The HPV vaccination program will begin in the 2008-09 school year.

The Gardasil vaccine has been shown to protect against HPV strains responsible for 70 percent of all cervical cancer cases. HPV is the most common STD in the country. According to the health ministry, there are around 40 new cervical cancer cases and 15 related deaths in New Brunswick every year.

In the first year, Gardasil will be administered to seventh- and eighth-grade girls. In the following years, it will be provided only to girls in seventh grade.

The vaccination program will be complemented by a cervical cancer screening program, in which women will be encouraged to have a Pap test done every three years, following two normal tests. Currently, no provincial program promotes cervical cancer screenings. New Brunswick will develop a database of women ages 18-69, the target population. The electronic system will prompt women to get tested, and it will log screening histories and diagnostic test results.

The new vaccination and screening initiative will cost the province $5.8 million (US $5.8 million) in 2008-09.

CANADA:
"Teens Are More Talk, Less Action, Sexual Activity Survey Says"
Ottawa Citizen, (01.22.2007) Joanne Laucius
A survey of young Canadians and mothers of teens shows both groups misperceive the level of teen sexual activity, according to a new study. The online survey, conducted in October 2005, was completed by 1,171 respondents ages 14-17 and 1,139 mothers of teens ages 14-17. The mothers polled were unrelated to the teens surveyed.

Together, the participants thought that 20 percent of teens ages 12-14 would have debuted sexually and that 40 percent of teens ages 15-16 would be sexually active. But just 17 percent and 23 percent of girls and boys, respectively, age 15 and younger reported sexual activity. Participants thought 66 percent of teens ages 17-18 would have had sex. In contrast, by age 17 just 42 percent of boys and 47 percent of girls reported having had sex. Sexually active girls reported an average of 2.4 sex partners and boys 2.7. The mothers endorsed an average of 17.6 years as the appropriate age for sexual debut.

Teens suspect their peers are more sexually active than they really are because their peers are talking about it, said lead author Dr. Jean-Yves Frappier, head of adolescent medicine at Montreal's Saint-Justine University Health Center. "They talk about sex," he said. "That doesn't mean they do it."

Parents may believe teens are sexually hyperactive based on what they see on television, movies, and in newspapers, Frappier said. "The idea is that sex is everywhere. You shouldn't consider your son or daughter as part of the pack, but as who they are."

While three-quarters of teen girls and 61 percent of boys considered abstinence a real option, that does not mean they would choose it or are practicing it, said Frappier. Moreover, almost all the teens did poorly on questions about their STD knowledge.

The full report, "Sex and Sexual Health: A Survey of Canadian Youth and Mothers," was published in Pediatrics and Child Health (2008;13(1):25-30).

CHINA:
"Hong Kong’s Majority Support Sex Education at Young Age: Survey"
Xinhua News Agency, (01.29.2008)
School-based sex education enjoys the support of a majority of Hong Kong residents polled in a recent telephone survey. Researchers interviewed 821 people; among their study's findings:
*84.6 percent believed it is very important for children and teens to receive sex education at school.
*67.9 percent supported compulsory sex education for primary and secondary students.
*96 percent favored teaching correct concepts and attitudes toward sex.
*60 percent said the lessons' content should include information on condoms and other methods of contraception.

Winnie Ho Sze Ki, program director of Hong Kong AIDS Concern, said the instruction should not be limited to knowledge about sex but should include values as well.

The Hong Kong Institute of Asia-Pacific Studies conducted the poll in November; it was commissioned by the Department of Social Work at the Chinese University of Hong Kong.

EUROPEAN UNION:
"Cervical Cancer Vaccine Cost-Effective: EU Agency"
Reuters, (01.22.2008) Michael Kahn
Vaccines against human papillomavirus (HPV) are cost-effective and should be given to adolescent girls before they are sexually active, the European Center for Disease Prevention and Control (ECDPC) said today. HPV vaccines are best for fighting cervical cancer, most cases of which are caused by HPV, when administered in conjunction with screening programs, the agency recommended.

"We are saying the vaccine is probably cost-effective and should be given to girls before they start their sexual life," said Johan Giesecke, ECDPC's chief scientist. Britain, France, Austria, Germany, and Italy already offer HPV vaccine through their national health plans, and most other EU members are considering doing so, he said.

Because HPV vaccines do not protect against all HPV strains, ECDPC recommends women continue cervical cancer screenings. "If you get infected before you get the vaccine, it [the vaccine] really doesn't help," Giesecke said. "We also don't know how long immunity lasts, because the vaccines are quite new."

The ECDPC's report, which was requested by the European Union, said the most cost-effective approach would be to vaccinate girls ages 12-15. It also called for extending catch-up programs to vaccinate slightly older girls.

VIRGINIA:
"House OKs Delay in Mandatory HPV Vaccinations for Schoolgirls"
Associated Press, (01.21.2008) Bob Lewis
On Monday, Virginia's House of Delegates approved a measure to delay by nearly two years the effective date of legislation mandating that schoolgirls be vaccinated against human papillomavirus (HPV). The bill, sponsored by Del. Robert G. Marshall (R-Prince William), would push back the start of the mandatory vaccinations to the fall of 2010.

The Republican-controlled House approved the bill by a 57-39 vote. The Senate, which has a slim Democratic majority, will take up the measure in February.

Opponents of delaying the requirement argued that the vaccination saves lives, since HPV is the main cause of cervical cancer. Because of the two-year delay, said Del. Vivian Watts (D-Fairfax), "We are telling those individuals that for the rest of your life, you are taking on a life-threatening possibility of cervical cancer that is unnecessary." In addition, she said, that burden would be borne disproportionately by low-income women.

Watts compared the HPV vaccination to the polio vaccines that came out 50 years ago. "Soon as they came out, everyone flocked to get them. The vaccine that is the subject of this bill… also targets a virus," she said.

Del. Kathy Byron (R-Campbell County), a supporter of the delaying measure, noted that HPV is sexually transmitted. "You don't contract HPV by sitting in a classroom," she said. "I truly believe parents have the inherent right to be the primary educator and decision-maker regarding their children's health."

Last year, Virginia became the only state to pass legislation compelling young girls to receive the vaccination. However, that law allows parents to opt their children out of participating.

UNITED STATES:
"High HPV Rate Seen Even Among Girls Who Had Just One Sex Partner"
Canadian Press, (01.13.2008) Helen Branswell
A new study of 125 university students shows that nearly one-third of women who reported having just one male sexual partner were infected with human papillomavirus (HPV) within a year of starting that relationship.

Furthermore, three years later, nearly 50 percent of these women had been infected at least once, even though they still had only one sexual partner.

Lead author Dr. Rachel Winer, of the University of Washington-Seattle, said, "This paper shows that even just with one partner there's a high risk of infection."

She added, "It's unlike other STDs where… the virus or bacteria is in core [population] groups. HPV is different in that it's just very common among everyone who's having sex. So even just being exposed to one partner makes you susceptible to infection."

The authors suggested that some women in the study may have become newly infected after two or three years because of decreased condom use. Also, the infections may have resulted from male partners having sex with others; unreported sexual activity with other partners; or sexual activity other than intercourse.

Furthermore, the rate of infection was higher among women who thought their male friends had had more than two previous sexual partners, as opposed to those who thought their partner's experience was more limited.

According to Dr. Monika Naus, director of an immunization program in British Columbia, these findings underscore the wisdom of offering the HPV vaccine to girls before they have sex. In Canada, by age 16, 28.3 percent of males and 33.4 percent of females have had sexual intercourse. The US National Institute of Allergy and Infectious Diseases supported the study.

The full report, "Risk of Female Human Papillomavirus Acquisition Associated with First Male Sex Partner," is published in the Journal of Infectious Diseases (2008;197:279-282).

UNITED STATES:
"Traveling Young Injection Drug Users at High Risk for Acquisition and Transmission of Viral Infections"
Drug and Alcohol Dependence Vol. 93; No. 1-2: P. 43-50, (01.11.2008) Judith A. Hahn; Kimberly Page-Shafer; Jamye Ford; Alan Paciorek; Paula J. Lum
How does the documented high mobility of young injection drug users (IDUs) affect their risk of acquiring and transmitting viral infections? To find out, the researchers conducted a cross-sectional study of IDUs under age 30 in San Francisco between 2004 and 2006.

The study participants completed a semi-structured interview and underwent testing for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV.

The authors assessed whether travel was independently associated with drug, alcohol, sexual risk behaviors, and infection status after adjusting for demographic characteristics and years of drug injecting.

Travel outside of San Francisco in the previous three months was reported by 62 percent of participants (n=355). When compared to non-travelers, travelers were more likely to be under age 20, female, and planning to leave San Francisco in the coming months.

Travel was independently associated with heavy alcohol use, drinking alcohol until blackout, poly-substance use, more sex partners, more injecting partners, receptive needle sharing, sharing drug preparation equipment, backloading syringes, and pooling money to buy drugs. Younger travelers were more likely than younger non-travelers to be infected with HCV.

"Traveling young [IDUs] are at exceptionally high risk for acquiring and transmitting viral infections," the authors concluded, "while their mobility makes it challenging to effectively deliver interventions."

UNITED STATES:
"Predictors of Sexual Risk Behaviors Among Newly Homeless Youth: A Longitudinal Study"
Journal of Adolescent Health doi:10.1016/j.jadohealth.2007.09.023, (01..2008) M. Rosa Solorio, MD, MPH; Doreen Rosenthal, PhD; Norweeta G. Milburn, PhD; Robert E. Weiss, PhD; Philip J. Batterham, MPH; Marla Gandara, BA; Mary Jane Rotheram-Borus, PhD
In the current study, researchers sought to "longitudinally examine the association between newly homeless youth individual factors (sociodemographic characteristics, depression, substance use) and structural factors, such as living situation (family, institution, non-family), with sexual risk behaviors."

Newly homeless youth (N=261) ages 12-20 from Los Angeles County were interviewed at baseline, three, six, 12, 18 and 24 months. Each time, the youth were asked about symptoms of depression (using the Brief Symptom Inventory), substance use, living situation, and sexual risk behaviors (number of sex partners and condom use). Random effects models were employed to assess the effects of predictors on the number of sexual partners and on condom use over time, by gender.

Seventy-seven percent of the youths at baseline reported sexual activity, increasing to 85 percent at the 24-month follow-up. Among male youth, predictors of multiple sex partners included living in non-family settings and using drugs. Living situation was not predictive of multiple partners for female youth but drug use was. Among females, living in a non-family setting and drug use decreased the odds of always using condoms; for males, no factors were found to be predictive of condom use.

"Living with non-family members and drug use appear to be the most salient in explaining sexual risk among newly homeless youth," the researchers concluded. "Our findings indicate that interventions aimed at reducing sexual risk behaviors, and thereby reducing sexually transmitted diseases and HIV among newly homeless youth, need to help youth in finding housing associated with supervision and social support (family and institutional settings) as well as aim to reduce drug use."

UNITED STATES:
"Young Athletes Warned: Injections Are Serious Subject"
USA Today, (01.11.2008) Sal Ruibal
In the wake of a spate of cases in which high-profile athletes are accused of taking injections of performance-enhancing drugs, a training association is warning youth athletes of the dangers of the practice.

"[Certified athletic trainers] are not licensed to give an injection," said Chuck Kimmel, president of the National Athletic Trainers' Association. "If a coach says your kid needs an injection, that should be a red flag," he said. "Parents need to consult with the right people: their child's physician and a certified athletic trainer."

In addition to the risks of the substances themselves, the possibility of blood-borne infections being transmitting by shared needles is high. Injecting substances into the human body is a serious matter, Kimmel said, and should only be done by qualified medical personnel.

Results of the latest Youth Risk Behavior Survey found that of about 14,000 US high school students polled, 4 percent reported using steroids.

UNITED STATES:
"Young Sisters Join Fight Against HIV/AIDS"
Voice of America News, (01.03.2008) Malcolm Brown
Two young sisters are starring in a new documentary titled "Please Talk to Kids About AIDS." The film follows seven-year-old Veneeta Hennessey and her five-year-old sister Sevilla around the 2006 International AIDS Conference in Toronto. In the movie, the girls ask experts and activists basic questions about the disease.

The frank responses the girls elicit from leading experts are drawing attention to the film. When prize-winning science writer Laurie Garrett is asked "How does AIDS get into your body?" she explains: "What's sneaky about the AIDS virus is that, guess what it infects, what kinds of cells it goes inside of? The immune cells. So, the army you have inside of you to protect you is exactly where this virus goes…."

The film is also being praised for the way it breaks taboos about discussing sex. One doctor explains what a sex worker is by saying, "A sex worker is someone who give sex services to another person in exchange for money…."

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, is one of the prominent experts featured in the film. "To have children, in their innocence, ask those questions and really force people to give a straight answer to this, I think really exemplifies why we need to talk straight about HIV," he said.

The girls, whose parents are both international public health advocates, are currently promoting the film, which has attracted interest from non-governmental and international organizations wanting to use it as an educational tool to fight HIV/AIDS.

UNITED STATES:
"Teen Voices of AIDS"
Washington Post, (01.08.2008) Susan Levine
Psychologist Maureen Lyon and physician Lawrence D'Angelo of Children's National Medical Center in Washington have compiled "Teenagers, HIV, and AIDS," possibly the first text to weave the experience of young patients with the knowledge of experts into plain-talk facts and advice. Available online and in stores, the book addresses medical treatment as well as support and disclosure issues. Beyond teens, it targets health care providers, school leaders, and parents.

HIV diagnoses are increasing among youths ages 13-19. According to the authors, a positive result must be followed by a compassionate and highly individualized conversation, since every aspect of HIV can be different in these cases, from the progression of HIV in a teen's body to the services available to them.

"Managing a life-threatening and socially stigmatizing illness is emotionally difficult and challenging for adults," noted one contributing author. "It is even more difficult for adolescents, who are more vulnerable and less prepared to deal with a health crisis of this magnitude, much less deal with it alone."

Lyon and D'Angelo have worked at Children's since Washington became an HIV epicenter in the 1980s. The book is dedicated to the more than 400 HIV-positive children for whom the staff there have cared. "They have served as teachers to us all," the longtime clinicians said.

Children's patients today reflect the current arc of the disease. Three-fifths were born to infected mothers; the remainder, both male and female, acquired HIV through sexual behavior. And the makeup of that group is shifting: Girls have gotten smarter, and safer, while HIV among young gay males is rising dramatically. "There's a whole new cohort that has to be educated," said Lyon.

EUROPE; NORTH AMERICA:
"Large Survey Reveals Sex Habits of Teens"
Reuters Health, (01.09.2008)
A large study of adolescents in 24 European and North American countries finds that while a "substantial minority" of 15-year-olds have had intercourse, only 13.2 percent reported no contraceptive during their most recent sexual encounter.

Dr. Emmanuelle Godeau, of Service Medical du Rectorat de Toulouse, France, and colleagues examined survey responses from 33,943 15-year-olds. Among their findings:
*The proportion of the youths who had had intercourse ranged from 14.1 percent in Croatia to 37.6 percent in England.
*Boys were more likely than girls to report intercourse.
*82.3 percent of sexually active teens reported using condoms and/or birth control pills at last intercourse.
*Condoms were the most commonly used form of birth control. Condom use ranged from 53 percent in Sweden to 89 percent in Greece.
*Use of contraceptive pills ranged from 3 percent in Croatia to 48 percent in Flemish Belgium and the Netherlands.
*Use of condoms and contraceptive pills together ranged from 2.6 percent in Croatia to 28.8 percent in Canada.
*Effective contraceptive use was more common in Western Europe than in Eastern or Central Europe.

"Condoms, even if not the best method to prevent pregnancy with a first-year failure rate of 14.5 percent for those younger than 18 years when used alone, have the advantage of also protecting against [STDs]," the authors wrote.

In an accompanying editorial, Dr. John Santelli and colleagues at Columbia University, New York, noted that contraception use is high and pregnancy rates are low in nations that are "strongly accepting of teenage contraceptive use and are insuring adolescent access to contraception and sex education. Such examples challenge the notion that teenage sexual activity always has serious short-term and long-term health-compromising consequences."

The study, "Contraceptive Use by 15-Year-Old Students at Their Last Sexual Intercourse," and the editorial, "Transnational Comparisons of Adolescent Contraceptive Use," were published in the Archives Pediatric and Adolescent Medicine (2008;162(1):66-73 and 92-94).

UNITED STATES:
"Study Pinpoints Factors for Early Sex"
USA Today, (11.13.2007) Marilyn Elias
Not feeling close to parents, low self-esteem, and lots of TV-watching combined raise the odds a teen will begin having sex before age 15, according to recent research. Janet Shibley Hyde of the University of Wisconsin-Madison and co-author Myeshia Price presented the results of their two-year study of 273 children in November in Indianapolis at a conference of the Society for the Scientific Study of Sexuality.

"It isn't any one thing," Hyde said. "It's cumulative, and the more risks there are, the greater the chances that they'll begin sex early."

The students were in a larger database study that gave information about their families. Using anonymous surveys, the researchers asked about sexual activity at age 13 and again two years later. They found that by 15, one out of five boys had participated in oral sex, and roughly one in 10 said they had had intercourse. The numbers were somewhat lower for girls. Because the teens were mostly middle-class and white, they had lower rates of sexual experience than the US average.

Each risk factor raised the odds of sexual activity by 44 percent. Boys with more advanced puberty development started sex early. Teens with low self-esteem, Price speculated, may start sex to boost their self-image or gain popularity. The study found that defiant teens with attention-deficit hyperactivity disorder, those whose parents had little education, and those who regularly watched certain types of TV also tried sex sooner.

Researchers asked about viewing six kinds of TV: MTV, BET, music videos, wrestling, daytime soap operas, and sports. Price said the more TV watched, the greater the likelihood of starting sex between ages 13-15.

Vickie Rideout, vice president of the Kaiser Family Foundation, said kids ages 13-15 see about three hours of TV a day, "And there's a lot of sex on TV." Rideout said TV alone is not entirely to blame, since heavy viewers may often be left unsupervised by their parents.

"You have to remain close to your kids," Hyde said. Warmth from parents and clear, firm guidelines can make a big difference to kids this age."

ASIA:
"Preventing AIDS Through Animation"
Palo Alto Weekly (Calif.), (01.01.2008) Arden Pennell
A doctoral student worked with her advisors at Stanford University's School of Education and with overseas physicians to create an animated tutorial to teach young Asians about HIV/AIDS. Offered in separate versions targeting youths in India and in the rest of Asia, the program uses the occasion of a student's visit to the doctor to give the facts about the disease.

"This is a way you can teach about AIDS education without being so sexually explicit, so it fits abstinence-only curriculum," said Piya Sorcar, who began working on the project in summer 2006. On a visit to India, she found that while students were exposed to many prevention messages, the facts were not getting through. For instance, having learned that fluids can transmit HIV, "students were scared of all fluids. So they were scared of water, and they were scared of saliva," Sorcar said.

Sorcar examined the latest research on how people learn to change their behavior. Acting on a suggestion by a Korean business person, she sought and received support from the South Korean Ministry of Science and Technology, which put her in touch with local doctors and animators.

The curriculum is now part of Sorcar's doctoral work, and she continues to refine it with input from focus groups. More than 90 percent of 423 Indian students who viewed it said they learned more from it than from AIDS instruction in school or on TV.

Sorcar next wants to encourage students to share the tutorials through social networking Web sites, and she hopes to make them available via cell phones - a critical step, since many people in the developing world lack access to computers.

To view the materials, visit www.interactiveteachingaids.org .

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