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[社会病理行为与性病的反复感染]

[Sociopathologic behavior and repeated infection with venereal disease].

作者信息

Bjekić M, Vlajinac H, Marinković J

机构信息

Institute of Epidemiology, School of Medicine, Belgrade.

出版信息

Srp Arh Celok Lek. 1999 Jul-Aug;127(7-8):254-7.

Abstract

INTRODUCTION

The sexually transmitted diseases (STDs) comprise a large group of infections produced by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasme, protozoa, fungi, parasites, and viruses. A considerable number of sexually transmitted diseases patients are STD repeaters. As reported by Marjanovitsh and Laloshevitsh [2], in Belgrade, among patients who during the years 1985 and 1986 visited the City Department for Skin and Veneral Diseases, because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). In Richert et al. [6] study over 30% of all patients who in one year visited sexually transmitted diseases clinic in Dade County, Florida, returned with a new infection within 3 years of their index visit. The aim of this study was to test the hypothesis that there is a relationship between antisocial behaviour and repeated STD.

MATERIAL AND METHODS

Case-control study was performed in the population of Belgrade, from June 1997 to April 1998. Participants were recruited among patients attending the City Department for Skin and Venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The group comprised 101 patients who in their personal histories already had STD two or more times. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who in their personal histories have never had STD or had it only once (13% of controls). All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behaviour, as well as data on use of sedatives, smoking habit and sport activity, and data on antisocial behaviour (alcohol abuse, prostitution, drug abuse, prosecution for minor and criminal offences) were collected from all participants by an anonymous questionnaire. In the present paper only data on antisocial behaviour are presented. In the analysis of data chi 2 was used.

RESULTS

According to the results obtained, STD repeaters in comparison to their controls used more frequently alcohol (17.8%:0.9%) and drug 18.8%:3.8%), had more frequently sex for money (17.8%:2.8%), and were more frequently prosecuted for minor offences (58.4%:24.8%) and criminal offences (24.8%:4.3%). All these differences were statistically significant (p < 0.01).

DISCUSSION

In the present study STD repeaters consumed alcohol more frequently than their controls, especially hard liquors, and 55.5% of them had used alcohol at the time of STD infection. In the study of Myliueva et al. [4], 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle [5] found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has depressive effect on the central nervous system, reduces anxiety and increases libido. In this study STD repeaters in comparison with their controls were significantly more frequently drug users (the majority of them inhaled drugs). In several studies conducted in the USA [7, 8] the increase of gonorrhea and syphilis was related to drug use. Upchurch et al. [9] reported that individuals with repeated episodes of gonorrhea were frequently intravenous drug abusers. Drugs are most frequently used by young people, at ages of the highest sexual activity. While most of the subjects developed sexual disinterest and dysfunction with prolonged crack cocaine use, some of them become more sexually promiscuous and consequently contracted sexually transmitted diseases more often. Inciardi /10/ found that 1/3 of men who had exchanged sex for crack (or for money needed to by crack) had 100 or more sex partners during a 30-day period prior to study recruitment. Cleghorn et al. (ABSTRACT TRUNCAT

摘要

引言

性传播疾病(STD)是由不同微生物引起的一大类感染,包括螺旋体、细菌、衣原体、支原体、原生动物、真菌、寄生虫和病毒。相当一部分性传播疾病患者会复发。正如马尔亚诺维奇和拉洛舍维奇[2]所报道的,在贝尔格莱德,1985年至1986年间因梅毒或淋病前往市皮肤和性病科就诊的患者中,22.8%的人一生中患过这些疾病两次或更多次(男女比例为10:1)。在里希特等人[6]的研究中,在佛罗里达州戴德县性病诊所就诊的所有患者中,超过30%的人在首次就诊后的3年内再次感染。本研究的目的是检验反社会行为与复发性性传播疾病之间存在关联这一假设。

材料与方法

1997年6月至1998年4月在贝尔格莱德人群中进行了病例对照研究。研究对象是因性传播疾病(梅毒、淋病、非淋菌性尿道炎和尖锐湿疣)前往贝尔格莱德市皮肤和性病科就诊的患者。该组包括101名个人病史中已患过两次或更多次性传播疾病的患者。对照组由210名在同一机构接受治疗的霉菌性疾病患者组成,这些患者个人病史中从未患过性传播疾病或仅患过一次(对照组的13%)。所有参与者均为20至50岁的男性,均来自贝尔格莱德。通过匿名问卷收集了所有参与者的人口统计学特征、性病史和性行为数据,以及镇静剂使用情况、吸烟习惯和体育活动数据,还有反社会行为(酗酒、卖淫、吸毒、轻微犯罪和刑事犯罪起诉)数据。在本文中仅呈现反社会行为数据。数据分析采用卡方检验。

结果

根据所得结果,与对照组相比,性传播疾病复发者更频繁地酗酒(17.8%:0.9%)和吸毒(18.8%:3.8%),更频繁地从事性交易(17.8%:2.8%),并且更频繁地因轻微犯罪(58.4%:24.8%)和刑事犯罪(24.8%:4.3%)被起诉。所有这些差异均具有统计学意义(p < 0.01)。

讨论

在本研究中,性传播疾病复发者比对照组更频繁地饮酒尤其是烈性酒,其中55.5%的人在感染性传播疾病时饮酒。在米柳耶娃等人[4]的研究中,50%的性病患者偶尔饮酒,10%的患者频繁饮酒。谢伊特和温德尔[5]发现,60%的酗酒者因性伴侣数量多、避孕套使用率低以及为毒品或金钱而进行性行为而至少患过一种性传播疾病。酒精对中枢神经系统有抑制作用,可减轻焦虑并增强性欲。在本研究中,与对照组相比,性传播疾病复发者明显更频繁地吸毒(大多数人吸食毒品)。在美国进行的几项研究[7, 8]中,淋病和梅毒的增加与吸毒有关。厄普丘奇等人[9]报告说,淋病反复发作的个体经常是静脉注射吸毒者。年轻人在性活动最频繁的年龄段最常吸毒。虽然大多数受试者长期使用快克可卡因后会出现性兴趣和性功能减退,但其中一些人变得更加滥交,因此更频繁地感染性传播疾病。因恰尔迪[10]发现,1/3用性交易换取快克可卡因(或换取购买快克可卡因所需金钱)的男性在研究招募前的30天内有100个或更多性伴侣。克莱格霍恩等人(摘要截断

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