Showing papers by "Nancy Padian published in 1990"

The effect of number of exposures on the risk of heterosexual HIV transmission

Abstract: Several studies of the heterosexual transmission of human immunodeficiency virus have reported no association between transmission and number of exposures. In contrast, this study showed that for a susceptible sex partner, the number of exposures to an infected index case is indeed associated with transmission, but in a nonlinear fashion. Factors that can dilute an association between transmission and number of exposures include measurement error in calculating number of exposures, use of inappropriate statistical models, and failure to account for variations in transmission rates. For example, the practice of anal intercourse and the experience of bleeding during intercourse increase the likelihood of transmission. We also observed that transmission occurred with fewer exposures among couples who did not use condoms compared with couples who did. The number of exposures also affects the independent association between other risk factors and transmission and thus should be considered when analyzing other sources of risk.

Sexual histories of heterosexual couples with one HIV-infected partner.

Abstract: Ninety-eight heterosexual couples enrolled in a HIV transmission study, at least one of whom was HIV-infected, were interviewed about sexual behavior. Although males and females were interviewed separately, there was agreement between them on the number of sexual contacts, the practice or anal intercourse, and condom use. These findings of strong reliability are encouraging, but do not necessarily imply that the data are valid.

Report of the NIAID Study Group on Integrated Behavioral Research for Prevention and Control of Sexually Transmitted Diseases. Part I: Issues in defining behavioral risk factors and their distribution.

Abstract: This paper is a three-part report that addresses crucial research issues in 1) defining behavioral risk factors of sexually transmitted diseases (STDs) and their distribution; 2) designing behavioral interventions; and 3) evaluating those interventions with respect to the prevention and control of STDs. The report is a result of the two interdisciplinary conferences on Integrated Behavioral Research for Prevention and Control of STDs that was conducted by the National Institute of Allergy and Infectious Diseases. Part I is a summary of some of the risk factors and risk markers that may affect transmission of STDs or development of sequelae within the framework established for these risk factors. Part II defines categories of biomedical disease prevention and behavioral intervention. It also presents a theoretical framework for the design and execution of intervention and proposes a number of research needs that will be linked to research opportunities. In addition it provides specific recommendations for achieving and implementing an integrated approach to biomedical and behavioral intervention in the field of STDs. Part III discusses three categories in evaluating behavioral interventions; namely issues of measurement issues relevant to epidemiologic studies and issues relevant to intervention studies.

Risk of Chlamydial PID and Oral Contraceptives

Abstract: To the Editor.— Our colleagues Wolner-Hanssen et al 1 conclude that oral contraceptive use is associated with decreased risk of pelvic inflammatory disease (PID) among women infected with Chlamydia trachomatis but not among those infected with Neisseria gonorrhoeae . We have two questions about their methods and would like to caution against overinterpretation of their principal findings. First, why were all variables showing significant differences between the case and control groups 1(Table1) not considered in the multivariate analysis? The variables "ever pregnant" ( P P P =.002), and "mean number of lifetime sexual partners" ( P =.004) should also be included. Would inclusion of these variables affect the odds ratio and level of significance? Second, how is oralcontraceptive use measured? In particular, how is duration or intermittent use taken into account? The data on the overall relationship observed between oral contraceptive use and PID 1(Table3) do not demonstrate

Report of the NIAID Study Group on Integrated Behavioral Research for Prevention and Control of Sexually Transmitted Diseases.

Abstract: This paper is a three-part report that addresses crucial research issues in 1) defining behavioral risk factors of sexually transmitted diseases (STDs) and their distribution; 2) designing behavioral interventions; and 3) evaluating those interventions with respect to the prevention and control of STDs. The report is a result of the two interdisciplinary conferences on Integrated Behavioral Research for Prevention and Control of STDs that was conducted by the National Institute of Allergy and Infectious Diseases. Part I is a summary of some of the risk factors and risk markers that may affect transmission of STDs or development of sequelae within the framework established for these risk factors. Part II defines categories of biomedical disease prevention and behavioral intervention. It also presents a theoretical framework for the design and execution of intervention and proposes a number of research needs that will be linked to research opportunities. In addition it provides specific recommendations for achieving and implementing an integrated approach to biomedical and behavioral intervention in the field of STDs. Part III discusses three categories in evaluating behavioral interventions; namely issues of measurement issues relevant to epidemiologic studies and issues relevant to intervention studies.