Changes in sexual behaviour focusing on condom use in STD clinic attenders in Göteborg, Sweden, from 1989 to 1994--a questionnaire survey.

During the 4 years from 1989/1990 to 1994 an increase in the use of condoms was registered. A high frequency of condom failures was reported and probably reflects inappropriate use. More efforts should be made to educate people how to use the condom. The impact of alcohol intake as a risk factor for unsafe sex seems to be significant and should also be stressed in educational safer sex programmes. STD patients are a well-motivated group for information about safer sex and condom use. Health workers in STD clinics have an important task in this context.

The risk of transmission of genital Chlamydia trachomatis infection is less than that of genital Neisseria gonorrhoeae infection.

A total of 211 men with 237 female sexual partners and a total of 155 women with 156 male consorts were examined for genital infection with Chlamydia trachomatis and Neisseria gonorrhoeae. The index patients had either single chlamydial or gonococcal infections or dual infections with both microorganisms. Analysis of recovery rates for groups of sexual consorts indicated that gonorrhea was contracted more frequently than chlamydial infection. Thus, when index patients had dual infections, 45% and 28% of their female and male consorts, respectively, had chlamydial infection, but 64% and 77%, respectively, had gonorrhea. When index patients had single infections with C. trachomatis or N. gonorrhoeae, chlamydial infections were observed in consorts of 45% (women) and 28% (men), but gonococcal infections were observed in 80% (women) and 81% (men). Moreover, a significantly larger proportion of consorts of patients with chlamydial infection eluded infection than did partners of patients with gonorrhea. Women who used an intrauterine contraceptive device had chlamydial and gonococcal infections more often than those who used other forms of contraception, or no contraceptive.

PIP: A total of 211 men with 237 female sexual partners and a total of 155 women with 156 male consorts were examined for genital infection with Chlamydia trachomatis and Neisseria gonorrhoeae. The index patients had either single chlamydial or gonococcal infections or dual infections with both microorganisms. Analysis of recovery rates for groups of sexual consorts indicated that gonorrhea was contracted more frequently than chlamydial infection. Thus, when index patients had dual infections, 45% and 28% of their female and male consorts, respectively, had chlamydial infection, but 64% and 77%, respectively, had gonorrhea. When index patients had single infections with C. trachomatis or N. gonorrhoeae, chlamydial infections were observed in consorts of 45% (women) and 28% (men), but gonococcal infections were observed in 80% (women) and 81% (men). Moreover, a significantly larger proportion of consorts of patients with chlamydial infection eluded infection than did partners of patients with gonorrhea. Women who used an IUD had chlamydial and gonococcal infections more often than those who used other forms of contraception or no contraception at all.

Contact tracing for human immunodeficiency virus (HIV) infection.

Contact tracing--or partner notification--is a generally accepted method for the control of sexually transmitted diseases (STDs), but its use as an epidemiological tool against the spread of acquired immunodeficiency syndrome (AIDS) has been questioned. The authors find contact tracing for infection with human immunodeficiency virus (HIV) quite feasible; it makes it possible for health care providers to reach people at high risk for infection in order to offer them counseling and testing. Contact tracing must be performed by someone directly engaged in caring for the HIV infected patient, as well as in giving support and aiding the patient through possible crisis reactions. Through this approach the authors were able to identify 188 contacts to 91 index patients. Thirty-eight of the contacts were seropositive for HIV infection, and 21 of these were previously unaware of their infection.

Serologic classification and contact-tracing in the control of microepidemics of beta-lactamase-producing Neisseria gonorrhoeae.

Serologic classification of isolated gonococcal strains and thorough contact-tracing were proved to be valuable in controlling an indigenous outbreak of infections caused by beta-lactamase-producing Neisseria gonorrhoeae (PPNG). Only 1-2% of gonococcal strains isolated in Sweden are PPNG, and before 1983 most of them were imported. During January-August 1983, 43 PPNG strains were isolated from 42 patients in Gothenburg. The PPNG strains were auxotyped and classified serologically. PPNG strains of serogroup WI, serovar (subgroup) Ae and of the prototrophic auxotype were isolated from 27 patients, including six prostitutes. Information obtained at interviews with these patients indicated that there had been a chain of infections. Quick and thorough contact-tracing stopped this microepidemic within three months. The serologic classification of the PPNG strains helped us to concentrate the epidemiologic efforts on those persons known to be infected with the epidemic strain, to trace this infection to other parts of Sweden, and to determine when the outbreak was finished.