BACKGROUNDHeterosexual sex has become the dominant transmission route in China. Recently studies reported high heterogeneity in heterosexual transmission risk in resource-limited countries. The aim of this study was to summarize the risk of HIV transmission among Chinese serodiscordant couples.

METHODSA systematic review and meta-analysis of observational studies of heterosexual HIV transmission among serodiscordant couples in China was conducted. Two reviewers conducted a literature search using the China National Knowledge Infrastructure (CNKI), Chinese Medical Current Contents (CMCC), and Medline databases. Pooled transmission estimates per 100 person-years (PY) were calculated using a random-effects model. Meta-regression analysis and subgroup analysis stratified by study design, transmission direction and period of antiretroviral therapy (ART) availability were conducted to assess the factors associated with transmission.

RESULTSEleven eligible studies were identified reporting on 11 984 couples and 405 HIV transmission events. HIV transmission risk from HIV-positive individuals to heterosexual partners was 1.68 (95%CI 0.74 - 2.62) per 100 PY. Study design did not reach statistical significance in meta-regression analysis. The pooled female-to-male transmission estimate was 1.11 (95%CI 0.09 - 2.14) per 100 PY and male-to-female transmission estimate was 1.43 (95%CI 0.19 - 2.68) per 100 PY. The pooled estimate for those before the availability of the Chinese National Free Antiretroviral Therapy Program (2.13 (95%CI 0.00 - 4.63) per 100 PY) was higher than that for those after the implementation of this program (1.44 (95%CI 0.62 - 2.26) per 100 PY).

CONCLUSIONSTransmission estimates in China were lower than other developing countries, but higher than developed countries. Research that better defines HIV secondary transmission rates and the associated behavioral, treatment adherence, and health-related risk factors among heterosexual serodiscordant couples in China is needed.

We report two cases of unusual manifestations of secondary syphilis accompanied by human immunodefiency virus infection. The first case is a 57-year-old heterosexual man with human immunodeficiency virus (HIV) seropositivity and unusual manifestations of secondary syphilis. The second case is a 28-year-old man presented with unusual cutaneous lesions of secondary syphilis. The following laboratory tests showed that the patient was seropositive for HIV. Both patients' cutaneous lesions resembled those of a patient with Reiter's syndrome such as keratoderma blennorrhagicum and circinate balanitis. The VDRL test of the first case showed the prozone phenomenon (false-negative in undiluted specimen).
Adult ; Balanitis ; Heterosexuality ; HIV* ; Humans* ; Keratosis ; Male ; Middle Aged ; Syphilis*

A retrospective study of 152 heterosexual male patients with non-gonococcal urethritis (NGU) was carried out to find out the efficacious treatment of NGU. We obtained urethral swabs for analysis by Chlamydiazyme (Abbott, North Chicago, IL) and Gram's stain from all patients. We classified the patients into two groups: 72 patients with no history of treatment (group I), and 80 patients with recurrent or persistent NGU (group II). Doxycycline was initially administered to 130 patients about two weeks. Ciprofloxacin, erythromycin, or doxycycline as second-line antibiotics were used in the patients with recurrent or persistent NGU after treatment with doxycycline. C. trachomatis was detected in 50 (32.9%) of the 152 patients: a larger proportion (40.3%) of the group I than the group II (26.3%) was chlamydia-positive, but the difference between two groups was not significant (p>0.05). After treatment with doxycycline, a higher cure rate was observed in the chlamydia-positive men (72.5% ; 29 of 40 patients) than in the chlamydia- negative men (50.0% ; 45 of 90 patients): in 90 chlamydia-negative men, 27 (75.0%) of 36 patients of the group I and 18 (33.3%) of 64 patients of the group II was cured (p<0.05). Doxycycline was efficacious for the chlamydia-positive men. But the patients with recurrent or persistent chlamydia-negative NGU were tend to be resistant to doxycycline therapy.
Anti-Bacterial Agents ; Chlamydia trachomatis ; Ciprofloxacin ; Doxycycline* ; Erythromycin ; Heterosexuality ; Humans ; Male ; Retrospective Studies ; Urethritis*

Exploring the epidemiological trend of HIV/AIDS is required for making the national AIDS policy. In this study, the trend of HIV/AIDS incidence, rout of transmission and some characteristics of AIDS for the past 11 years in Korea using the reported cases from the national STD screening scheme were reviewed. Based on the results, the trend of main route of transmission according to the year was established by stage and the HIV/AIDS cases in this year was estimated and that to the year 2000 was projected by 'Epimodel' programme. The results were as follows. 1. Of the total infected persons, 76% were in their twenties and thirties, socioeconomically and sexually active age groups while the transmission by sexual contact overseas was decreasing, the infection through domestic heterosexual and homosexual contact was increasing. 2. In the middle of the 1980's, the infected persons were mainly prostitutes infected through heterosexual contact with the HIV positive foreigner in this county(stage l). And in the late of the 1980's the main source of infection was the sexual contact overseas and the domestic heterosexual contact(stage 2). Since the early of the 1990's, the infection through the heterosexual contact with non-regular sexual partner in this country has increased rapidly(stage 3), which was the evidence of the possibility of HIV epidemics. After that, it was expected that the infection through the homosexual contacts, the heterosexual contacts with commercial sex workers outside and the non-regular sexual contact inside of this county would increase continuously. In the result, the occurrence of neonatal infection by vertical transmission was expected(stage 4). 3. The number of HIV/AIDS was estimated at 572 to 2,313 and the projected number of HIV/AlDS to the year 2000 was around 5,800 including 627 AlDS patients. For the further study on the estimation and projection of HIV/AIDS, it was suggested that the sampling survey on the HIV infection rate in the high risk groups and the sentinel hospital surveillance system should be conducted.
Emigrants and Immigrants ; Heterosexuality ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Incidence ; Korea* ; Mass Screening ; Sex Workers ; Sexual Partners

PURPOSES: This study examined the relationship between risk behaviors and sexual knowledge, sexual attitudes, and sexual experiences of male high school students. METHOD: A cross-sectional, descriptive study was conducted. Data were collected from 2 male high schools in metropolitan Gwangju. Five hundred forty-eight boys were enrolled in this study. Descriptive statistics, factor analysis, t-test or ANOVA, and Pearson's correlation were used for data analysis. RESULTS: The mean sexual knowledge and sexual experience scores were relatively low, 0.60 out of 1 point, and 0.75 out of 4 points, respectively. Three attitude types of the students were identified: permissible, conservative and pleasure seeking attitude. The score of the permissible type was affected by the subjects' exposure to pornographic material. The score of the conservative type was affected by alcohol consumption and acquaintances with a heterosexual friend. The score of the pleasure seeking type was affected by their exposure to pornographic material, alcohol consumption, smoking, going to a video-room, and acquaintances with a heterosexual friend. There was a negative correlation between the permissible type and sexual knowledge, and a positive correlation between the conservative and pleasure seeking types and sexual experience. CONCLUSION: Male high school students who have been exposed to risk behaviors have a higher likelihood of indulging in sexual activity, and the pleasure seeking type appears to be related to sexual experience. An educational program may be needed to prevent risky behaviors and sexual experiences in male high school students considering their sexual attitude type.
Alcohol Drinking ; Friends ; Gwangju ; Heterosexuality ; Humans ; Male* ; Pleasure ; Risk-Taking* ; Sexual Behavior ; Smoke ; Smoking ; Statistics as Topic

OBJECTIVE: Many studies have showed that excess or lack of sexual hormones, such as prolactin and testosterone, induced the sexual dysfunction in humans. Little, however, is known about the role of sexual hormones showing normal range in, especially, the basal state unexposed to any sexual stimulation. We hypothesized sexual hormones in the basal state may affect sexual behavior. METHODS: We investigated the association of the sexual hormones level in the basal hormonal state before visual sexual stimulation with the sexual response-related brain activity during the stimulation. Twelve heterosexual men were recorded the functional MRI signals of their brain activation elicited by passive viewing erotic (ERO), happy-faced (HA) couple, food and nature pictures. Both plasma prolacitn and testosterone concentrations were measured before functional MR scanning. A voxel wise regression analyses were performed to investigate the relationship between the concentration of sexual hormones in basal state and brain activity elicited by ERO minus HA, not food minus nature, contrast. RESULTS: The plasma concentration of prolactin in basal state showed positive association with the activity of the brain involving cognitive component of sexual behavior including the left middle frontal gyrus, paracingulate/superior frontal/anterior cingulate gyri, bilateral parietal lobule, right angular, bilateral precuneus and right cerebellum. Testosterone in basal state was positively associated with the brain activity of the bilateral supplementary motor area which related with motivational component of sexual behavior. CONCLUSION: Our results suggested sexual hormones in basal state may have their specific target regions or network associated with sexual response.
Brain ; Cerebellum ; Dopamine ; Heterosexuality ; Humans ; Magnetic Resonance Imaging ; Male ; Plasma ; Prolactin ; Reference Values ; Sexual Behavior ; Testosterone

To identify strategies to prevent sexual problems in teenage girls, respondents in this study answered two open-ended questions: "What are strategies for teenage school girls to prevent unwanted coitus?" and "What are strategies for teenage girls to prevent pregnancy?" The respondents were 12,733 girls from an accessible population of 19,000, a multi-stage cluster sample from a population of 1,988,902 girls attending 4,684 schools in the seven largest cities and nine provinces in Korea. Data were collected by mail between October 2 and October 28, 2000. The response rate was 68.9%. The total number of responses for the first question was 10,345, and for the second, 9,624. Data were analyzed by content analysis. The results of this study are: 1. According to priority, frequent strategies to prevent unwanted coitus were, self assertiveness (35.7%), heterosexual interaction training (24.6%), sex education (21.2%), and innovations in the system of social culture (4.7%). The order of priority was the same whether the respondents had experienced coitus or not. 2. According to priority, frequent strategies to prevent pregnancy were, heterosexual interaction training (27.4%), sex education (26.2%), contraceptive use and induced abortion (21.4%), and innovations in the system of social culture (3.2%). The first priority for the respondents who had not experienced coitus was heterosexual interaction training (27.7%) but contraceptive use (35.5%) was the first priority for the group who had experienced coitus. In sex education, a focus on contraceptive use for teenage girls who have experienced coitus and on heterosexual interaction training for those who have not, would strengthen preventive strategies for these two sexual problems. Assertiveness training as part of sex education would further strengthen prevention strategies.
Abortion, Induced ; Assertiveness ; Coitus ; Surveys and Questionnaires ; Female* ; Heterosexuality ; Humans ; Korea* ; Postal Service ; Pregnancy ; Sex Education

We report a case of HIV, infection associated with syphilis. A 40-year-old heterosexual man presented with headache, malaise, and a cutaneous lesion consisting of a whitish patch and petechiae on the hard palate. The serum VDRL titer wss positive at 1:64 and the cerebrospinal fluid VDRL titer was negative. Anti-HIV antibodies were detected in the patient sera by particle agglutination test and confirmed by Western blot test.
Adult ; Agglutination Tests ; Antibodies ; Blotting, Western ; Cerebrospinal Fluid ; Headache ; Heterosexuality ; HIV* ; Humans* ; Palate, Hard ; Purpura ; Syphilis*

OBJECTIVE: To understand the associated factors on human immunodeficiency virus (HIV) transmission via heterosexual contact and to provide evidence for decision-maker for prevention of HIV.
 METHODS: Questionnaire survey was conducted in 250 HIV-positive persons to understand their socio-demographic characteristics and sexual behavior. Meanwhile, 431 persons who had heterosexual contact with the HIV carriers were traced to their HIV infection status. The factors associated with continued HIV transmission were reviewed by case-control analysis.
 RESULTS: Among the 432 persons, 59 were HIV-positive because of heterosexual contact. The secondary attack rate and the growth rate was 13.7% (59/431) and 0.236 (59/250), respectively. The factors associated with the spread of HIV included: the degree of knowledge on HIV/AIDS, psychological reflection after infection, the condition for condom usage among spouses, and regular sexual partners or non regular sexual partners.
 CONCLUSION The secondary attack rate and the growth rate of HIV transmission by heterosexual contact are high. Improvement of the knowledge about HIV/AIDS prevention and control, enhancement of psychological education and promotion of condom usage can reduce the risk for continued HIV transmission.
HIV Infections ; transmission ; Heterosexuality ; Humans ; Incidence ; Risk Factors ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

BACKGROUND: This study was performed to characterize the epidemiologic and clinical features of outbreak of syphilis among HIV sero-positive patients in Korea. MATERIALS AND METHODS: A retrospective case review of patients diagnosed with primary and secondary syphilis from July 1999 to September 2003 was carried out at Seoul National University Hospital in Korea. To estimate the incidence, person-years (PYs) of all HIV sero-positive patients, who visited the hospital in the same period, were calculated every 6 months. RESULTS: In a 51 month period, 465 HIV-positive patients were followed up at Seoul National University Hospital. 38 cases of primary and secondary syphilis were diagnosed. The incidence of primary and secondary syphilis was 4.1 per 100 PYs during the study period. There was no case from July 1999 to December 2001, and then the incidence rose until September 2003 from 5.5 per 100 PYs in 1999 to 18.8 per 100 PYs in 2003. The rate of primary and secondary syphilis was 4.3 times higher among homosexual and bisexual men than heterosexual men (95% CI 1.87 to 11.17), and 10.9 times higher among patients who did not receive HAART than patients who were receiving HAART (95% CI 5.47 to 21.79). CONCLUSION: The outbreak of primary and secondary syphilis among HIV-positive patients started in 2002 and has been escalating, especially among homosexual/bisexual men and in patients who did not receive HAART.
Antiretroviral Therapy, Highly Active ; Bisexuality ; Heterosexuality ; HIV* ; Homosexuality ; Humans ; Incidence ; Korea* ; Male ; Retrospective Studies ; Seoul ; Syphilis*