Sexual behavior, use of contraceptive methods and risk factors for HPV infections of students living in central Italy: implications for vaccination strategies.

The most frequent risk factors related to the infection/persistence of HPV in the population are an early start of sexual activity, the number of sexual partners, smoking, and the utilization of some contraceptive methods. In Italy, HPV vaccine is offered free of charge to all 12-year-old female adolescents, with a possible extension to other age groups according to Regional policies. In order to value the suitability of the current HPV vaccination strategies in Italy, an epidemiological study on sexual habits in adolescents and young adults was organized. An anonymous questionnaire on sexual behavior and risk factors for HPV infection was administered to 2300 students aged 13-24 years attending secondary schools and universities in Tuscany during 2008-09. About 12% of the sample declared to be foreign citizen. The results highlight the early start of sexual activity among young students. Particularly, more than half of the interviewed students declared to be already sexually active. The mean and the median age of the first sexual intercourse was 15.4 +/- 1.4 years and 15 years (25th and 75th percentiles = 14-16), respectively. More than 77% of students at age 16 years declared they already had the first sexual intercourse, compared with 0.3% of those <12 years. Generally, females aged 13-16-years, if sexually active, had sexual contacts with a single partner. Most students declared to know common contraceptive methods (male condom and contraceptive pill). However, only half of them declared a regular use of male condom. These data confirm the importance of vaccination against HPV for young females before their sexual debut. In addition, the current multi-cohort strategy of HPV vaccination in Tuscany (free of charge in the age range 12-16 years) allows also to catch up those girls that have not yet had their first sexual experiences before 16 years (21.5% according to our study) but also to those girls already sexually active, who very rarely are already infected by all vaccine types at 16 years. Our results also show the importance of sexual health education and of promotion of correct behaviours in schools.

Serum trace elements and risk of malnutrition in institutionalised elderly.

OBJECTIVE: The objective of this work is to evaluate the association between Selenium (Se)-, Copper (Cu)- and Zinc (Zn)-circulating concentrations and indicators of nutritional status. SUBJECTS/METHODS: This study enroled 428 institutionalised elderly. The diagnostic tools used are a form to collect data regarding gender, age, duration of stay in nursing home, number of prescribed drugs, chronic diseases, Mini Nutritional Assessment (MNA), anthropometric measurements, albumin, transferrin and serum concentrations of Se, Cu and Zn. The collected data were analysed with descriptive assessments of the differences χ(2), Student's t-test and analysis of variance. Multivariate linear regression were performed to evaluate the association between the concentrations of each trace elements and the other variables. RESULTS: The study population was represented by 327 women and 101 men, of whom 13.8% were 65-75 years old and 47.4% were older than 85 years. According to the MNA score, 58.4% were at risk of malnutrition and 21.3% were malnourished. The results show a significant reduction in the average concentrations of Se and Zn in women when the nutritional status gets worse. The same trend, although not statistically significant, is also observed in men. In both genders, the Cu concentration does not show a statistically significant association with nutritional status. Multivariate linear regression show some positive or negative associations. CONCLUSIONS: Our study seems to confirm the association between Se and nutritional status, as well as with some blood chemistry parameters. The length of institutionalisation seems to be an independent predictor of Se concentration.