Early childhood maltreatment experience and later sexual behavior in Brazilian adults undergoing treatment for substance dependence

Objective: To investigate the prevalence of early childhood maltreatment and associations with later sexual behavior among adult substance users. Methods: A cross-sectional study enrolled 134 substance dependents who sought outpatient care in São Paulo, Brazil. Childhood trauma prevalence was assessed using the Childhood Trauma Questionnaire (CTQ). The Sexual Addiction Screening Test (SAST), drug of choice (DOC), and sexual behavior were also investigated. Results: The sample was composed predominantly of single adult males (76.1%), with alcohol as the DOC (73.9%). Experiences of emotional neglect (88.1%), emotional abuse (80.6%), physical neglect (78.4%), physical abuse (64.2%), and sexual abuse (31.3%) were prevalent. Women were more likely to have been sexually abused (OR 2.9, 95%CI 1.15-7.61) and physically abused (OR 3.7, 95%CI 1.31-10.6) in childhood. Those who were sexually abused in adulthood were more likely to have suffered physical abuse in childhood (OR 6.9, 95%CI 1.45-11.8). The odds of having been sexually abused in childhood were higher among subjects who reported to have exchanged sexual favors for drugs (OR 5.7, 95%CI 1.35-9.64) and to have been sexually abused in adulthood (OR 6.1, 95%CI 5.2-12.36). Conclusion: Physical and sexual abuse in childhood are highly prevalent in substance-dependent adults, and are associated with sexual revictimization and high-risk sexual behavior in adulthood.

Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil

Objective: There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls. Methods: We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors. Results: Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%). Conclusion: The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.

Social and immunological differences among uninfected Brazilians exposed or unexposed to human immunodeficiency virus-infected partners

Understanding the social conditions and immunological characteristics that allow some human immunodeficiency virus (HIV)-exposed patients to remain uninfected represents an on-going challenge. In this study, the socio-demographic and sexual behaviour characteristics and immune activation profiles of uninfected individuals exposed to HIV-infected partners were investigated. A confidential and detailed questionnaire was administered and venous blood was tested using HIV-1/enzyme immunoassays, plasma HIV-1 RNA levels/bDNA and immunophenotyping/flow cytometry to determine the frequencies of CD4 and CD8 T cells expressing activation markers. The data analysis showed significant differences (p < 0.05) for immune parameters in individuals who were uninfected, albeit exposed to HIV-infected partners, compared with unexposed individuals. In particular, the exposed, uninfected individuals had a higher frequency (median, minimum-maximum) of CD4+HLA-DR+ (4.2, 1.8-6.1), CD8+HLA-DR+ (4.6, 0.9-13.7), CD4+CD45RO+ (27.5, 14.2-46.6), CD4+CD45RO+CD62L+ (46.7, 33.9-67.1), CD8+CD45RA+HLA-DR+ (12.1, 3.4-35.8) and CD8+CD45RO+HLA-DR+ (9.0, 3.2-14.8) cells, a decreased percentage of CD8+CD28+ cells (11.7, 4.5-24.0) and a lower cell-surface expression of Fcγ-R/CD16 on monocytes (56.5, 22.0-130.0). The plasma HIV-1 RNA levels demonstrated detectable RNA virus loads in 57% of the HIV-1+ female partners. These findings demonstrate an activation profile in both CD4 and CD8 peripheral T cells from HIV-1 exposed seronegative individuals of serodiscordant couples from a referral centre in Belo Horizonte, state of Minas Gerais.

Aspectos relevantes das doenças sexualmente transmissiveis em mulheres atendidas em ambulatório de ginecologia preventiva / Considerable aspects of sexually transmitted diseases in women assisted in gynecological preventive ambulatory

Os autores estudaram os aspectos epidemiológicos relacionados as doenças sexualmente transmissiveis em pacientes atendidas em Ambulatório de Ginecologia Preventiva. Foram atendidas 10.000 mulheres submetidas a entrevista, exame clinico ginecológico e coleta de colpocitologia oncotica. Säo apresentados e discutidos os resultados relacionados a comportamento sexual, uso de drogas, conhecimento de doenças sexualmente transmissíveis e meios de prevençäo, principalmente relacionados a Sindrome da Imunodeficiência Adquirida