Hepatitis B and Hepatitis C Infections among Female Inmates in a Prison in Jeddah, Saudi Arabia.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major health concerns worldwide. Recent data indicate a decline in prevalence in the Saudi population; however, there are no data on the prevalence in prisoners. This study is the first to investigate the prevalence of viral hepatitis in female inmates in Jeddah, Saudi Arabia. This study aimed to explore the prevalence of HBV and HCV infections and to assess the knowledge and attitudes related to these infections among inmates. METHODS: Inmates were interviewed using a pre-designed questionnaire, and their blood samples were tested for HBV and HCV infections using serology, PCR, and phylogenetic analysis. RESULTS: The overall prevalence of HBV infection in the study population was 4.4%. The age group > 25 years was predominantly affected; 11.1% of the infected cases were Saudi nationals, and 88.9% were non-Saudis. The prevalence of HCV infection was 2.4%. Among the studied variables, age and previous employment were significantly associated with positive HBV PCR, while conviction, knowledge about protection from sexually transmitted infections (STIs), knowledge about condom use for protection against STIs, and condom use for protection against STIs were significantly associated with HCV infection. CONCLUSIONS: This study shows higher HBV and HCV prevalence in the female prisoners in Briman prison compared to the general population. Uneducated prisoners, over 25 years old, and convicted of prostitution are more associated with both HBV and HCV infection. Future preventive plans should include screening new prisoners with these risk factors for HBV and HCV at the time of entry.

Sexual behavior and knowledge of human immunodeficiency virus/aids and sexually transmitted infections among women inmates of Briman Prison, Jeddah, Saudi Arabia.

BACKGROUND: To reduce the incidence of HIV and sexually transmitted infections (STIs), it is necessary to target high-risk populations such as prison inmates. This study aims to explore the range of knowledge on HIV and STIs, sexual behaviors, and adoption of preventive measures among women inmates. METHODS: This was a survey conducted between July 1, 2012 and July 29, 2012 among women inmates at Briman Prison, Jeddah, Saudi Arabia. The author gave an educational lecture on STIs in a conference room at the prison. Educational material was distributed to the attendees after the lecture, and the survey was conducted one week later. All the participants were asked to complete an anonymous 40-item self-administered questionnaire in the presence of a professional health assistant and a translator, for non-Arabic speakers. Data collected included the personal data of the respondent, her alleged criminal background, penal status, accumulative time in prison, history of smoking, alcohol or drug addiction, knowledge about the seven most common STIs, symptoms, modes of transmission, prevention, sexual activity, addiction, and means of protection. Descriptive analysis was performed using Microsoft Excel. RESULTS: We interviewed 204 women aged 16-60 years (mean, 33.3 years). Most of the respondents (n = 170; 83 · 0%) were not aware of STIs; 117 respondents (57 · 4%) did not undergo screening for STIs before marriage or intercourse, while only 59 (28 · 9%) did. Over half of the respondents (n = 107; 52.5%) thought they knew how to protect themselves from STIs. Nevertheless, 87 (42.6%) were uncertain about the role of condoms in protection from STIs and (n = 41; 20.1%) thought condoms provide 100% protection against STIs, while 72 respondents (35.3%) thought condoms did not confer 100% protection against STIs. Only 10 respondents (4.9%) used condoms to protect themselves from STIs. Saudi women (P = 0.033) and those with a higher level of education (P < 0.01) were significantly more likely to have better knowledge. CONCLUSION: Women inmates at Briman Prison have poor knowledge of STIs as well as risky sexual behaviors. Campaigns aimed at increasing awareness of STIs should also target prison inmates, who in general constitute high-risk populations.

Chlamydia trachomatis infection among female inmates at Briman prison in Saudi Arabia.

BACKGROUND: Chlamydia trachomatis infection is the most common sexually transmitted infection (STI) in the western countries; its prevalence in the conservative Muslim population of Saudi Arabia is not known, but it is generally believed to be low. This study is the first to investigate the prevalence of and risk factors for C. trachomatis infection in the high-risk group of female inmates at Briman Prison in Jeddah. METHODS: The inmates were interviewed using a pre-designed questionnaire, and their urine samples were tested for C. trachomatis infection by real-time PCR assay. RESULTS: The overall prevalence of C. trachomatis infection was 8.7% in the study population. The ≤25 age group was predominantly affected, with an average prevalence of 16.6%. Two out of five (2/5, 40%) Yamani, (4/33 12.1%) Indonesian, (3/33, 9.1%) Somalian and (2/26, 7.7%) Ethiopian inmates were positive for infection. None of the Saudi inmates (0/14) were positive for infection. Among the studied variables, only age was significantly associated with the infection rate. The other variables (marital status, nationality, religion, employment status, education level, nature of the offense committed, knowledge about protection from STIs, and knowledge about condom use and the purpose of condom use) did not show a significant correlation with Chlamydia infection. CONCLUSIONS: The overall prevalence of C. trachomatis infection was within the range published by other reports in similar prison settings in developed countries. The results indicate the need for a countrywide screening and treatment program for all inmates at the time of entry into prison.

Factors associated with domestic violence: a cross-sectional survey among women in Jeddah, Saudi Arabia.

OBJECTIVE: This study aims to identify the factors associated with domestic violence (DV) among women in Jeddah. DESIGN: Cross-sectional survey. SETTING: Outpatient departments of three tertiary hospitals in Jeddah. PARTICIPANTS: Convenience sample of women, aged 15-70 years, at the outpatient and inpatient clinics. INTERVENTIONS: Between 15 December 2011 and 30 May 2012, a psychologist and a professional health assistant explained the purpose of the research to participants, who were then asked to fill a 50-item questionnaire. The questionnaire was created based on questions from three questionnaires: the NorVold Domestic Abuse Questionnaire, the Pregnancy Risk Assessment Monitoring System and the Kansas Marital Satisfaction Scale. The questionnaire was used to assess the association between DV and family status, male partner attitudes, age, educational attainment, employment, financial and socioeconomic status. RESULTS: A total of 2301 women participated in the survey (81% response rate). The mean±SD age of the participants was 34.4±10.9 years. The lifetime prevalence of DV was 34%. Abused women had more children than non-abused women (p=0.001), and their spouses were significantly older than those of non-abused women (p<0.0001). Financially dependent women and those with a high educational status were significantly more likely to report abuse (p=0.003 and p<0.001, respectively). Abused women were also likely to report that their spouse was a smoker (p<0.0001) and had completed at least primary or secondary education (p<0.0001). A significantly lower proportion of abused women reported that their male partners were alcohol users (p=0.001). The results of logistic regression showed that women who were financially dependent had about 1.5-fold odds of being physically abused by a spouse. CONCLUSIONS: Many factors are associated with DV against women, thereby highlighting the need to design effective DV prevention programmes.

Sexually transmitted infections among patients with herpes simplex virus at King Abdulaziz University Hospital.

BACKGROUND: Herpes simplex virus (HSV) infection is one of the commonest viral sexually transmitted infections (STIs). The aim of this study was to evaluate the prevalence of STIs among HSV positive patients at a tertiary hospital in Jeddah. Secondary objective of the study included the description of the demographic and clinical profile of patients with HSV and HIV co-infection. METHODS: A retrospective chart review of the medical records was performed for HSV positive women who presented to the emergency room and outpatient department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 1, 2003 and August 30, 2011. Data were collected from the medical records of all the patients and analyzed using the Statistical Package for the Social Sciences. RESULTS: Three hundred forty-three HSV positive patients were included in this study. Co-infection with HIV was documented in 45 patients (13.1%). Other STIs included chlamydia (n = 43, 12.5%), gonorrhea (n = 44, 12.8%), hepatitis B infection (n = 8, 2.3%), and cytomegalovirus infection (n = 37, 10.8%). Nineteen patients (5.5%) had a total of 47 term pregnancies and five abortions post HSV diagnosis. Genital ulcer disease was diagnosed in 11 (57.9%) of the cases during labor. One newborn developed neonatal herpes infection and subsequently showed delayed psychomotor development during follow up. Genital herpes was diagnosed in one patient's partner; however, there was no documentation of screening for STIs in the partners of the other patients. CONCLUSIONS: Sexually transmitted infections are relatively common among HSV positive patients at King Abdulaziz University Hospital. Amongst these, HIV is the most common, with a prevalence of 13.1%. Further studies are warranted to evaluate STIs in Saudi Arabia. Health policy makers should adopt a protocol to screen for STIs in the partners of persons who are positive for any STI as early detection and appropriate treatment can improve the outcome.

Different treatment modalities for refractory vaginismus in western Saudi Arabia.

INTRODUCTION: Although vaginismus is a common sexual dysfunction in Saudi Arabia, there are limited data concerning the treatment modalities associated with patients with symptoms of vaginismus. AIM: This study is aimed to evaluate the presentation and different modalities of management in patients with severe refractory vaginismus in western Saudi Arabia. MAIN OUTCOME MEASURES: Successful penetrative sexual intercourse suggesting that common elements of the therapies used were successful. METHODS: A retrospective study of patients presenting with severe refractory vaginismus treated in Jeddah, Saudi Arabia. The subjects were 15 women with third to fourth degree vaginismus who presented to King Abdulazziz University Hospital between January 1, 2008 and January 1, 2009. RESULTS: The mean age of the participants was 23 years. The mean duration of marriage before seeking medical advice was 12 months. Six patients had undergone conventional therapy successfully. The other six cases, four of which had a previous history of treatment failure, and two who were unresponsive to 4 months of conventional therapy were offered botulinum toxin type A. Five patients who received the Botox therapy had satisfactory intercourse on the same day of the treatment. One patient required a repeat injection after 2 months for recurrent vaginismus. Three of the 15 patients refused the treatment as they were already divorced and had only come in to exclude organic causes for their condition. CONCLUSIONS: Vaginismus is an overlooked topic in conservative societies such as Saudi Arabia. For most patients, not knowing who to confide in or where to turn to plays a major role in the under diagnosis of vaginismus. Conventional therapy proved effective in mild and moderate cases, while botulinum toxin has a more rapid effect and was thus more effective in severe cases.