Sociological and serological profiles of some men with recurrent sexually transmitted infection in Western Jamaica - abstract

In early 1991, a sociological and serological study of a sample of 98 specially selected men was done at the Cornwall Regional Hospital (CRH) in Montego Bay. These men were all returning to the Sexually Transmitted Disease (STD) clinic for treatment of at least their second episode of infection. Low repeaters and high repeaters were compared. There was a tendency for men who were living either with a parent or with their steady female partner to have fewer repeat infections than men who lived alone or with other relatives or friends. The average number of sexual partners reported was relatively small. No one admitted to having homosexual contacts. Twenty-five men had never used condoms and most of the others used them sporadically. The prevalence of antibodies to syphilis was 25.5 percent, hepatitis B core antibodies 21.1 percent, hepatitis B surface antigen 3.3 percent and HIV antibodies 10 percent. HIV seropositivity correlated significantly with evidence of exposure to syphilis an with prostitute contact. Sixty-four per cent of the men used alcohol, 50 percent used ganja and 4 percent used ganja with crack or cocaine shortly before or during their last sexual contact. Everyone knew about HIV and AIDS, and 87 percent felt at some risk for catching HIV. This study shows a relatively high prevalence of syphilis and HIV infection in STD Clinic attenders in the Montego Bay area, and underlines the reality that knowledge about diseases and perception of risk do not always guarantee safe sexual behaviour. Men who get repeated episodes of STDs are important core transmitters of these diseases and should be targeted for special education. (AU)

The attitudes, experiences and needs of private practioners in the Kingston Metropolitan area in relation to HIV-infected patients - abstract

A questionnaire survey of 83 private practioners in the Kingston Metropolitan area (representing 20 percent of practioners in the area) showed that, in the past 5 years, 51(61 percent) had established 185 doctor-patient relationships with suspected and confirmed HIV/AIDS patients. Only 77 percent of the 108 confirmed cases were reported to the Ministry of Health, suggesting a need to better integrate the private practitioners into the notification system. There was a disparity between the number of practitioners who were willing to do HIV testing (50; 60 percent) and those willing to do the necessary counselling (30; 36 percent). Deep reservations were felt, such that only 24 percent were willing to maintain a therapeutic relationship with an HIV-infected patient. Three of the 4 reservations expressed could be partially alleviated by an educational programme aimed at the private practitioners and their support staff; 75 percent of the practitioners were desirous of a consistent referral system for further care. The establishment of an HIV/AIDS research/treatment centre may answer this need through a supporting role to co-ordinate an islandwide programme for the medical, social and legal management of HIV-infected patients. (AU)