Is the Risk for Sexually Transmissible Infections (STI) Lower among Women with Exclusively Female Sexual Partners Compared with Women with Male Partners? A Retrospective Study Based on Attendees at a Norwegian STI Clinic from 2004 to 2014

Background:

The prevalence of and the risk for sexually transmissible infections (STIs) for women engaging in same-sex sexual behaviour was investigated among women attending an STI clinic.

Methods:

Data from electronic medical records were reviewed and logistic regression used to estimate the odds ratio (OR) of STIs. Women reporting life-time exclusively female partners (WSW) and women reporting female and male partners (WSWM) were compared with women reporting exclusively male partners (WSM). Outcomes included: Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoea, HIV and syphilis.

Results:

The study population comprised 103 564 women (WSW 641, WSWM 12 010 and WSM 90 913). Overall prevalence of STIs was 8%. Crude OR of STIs for WSW: 0.56 (95% CI 0.39-0.81), for WSWM: 0.99 (95% CI 0.92-1.06) compared with WSM. Multivariate analysis revealed an interaction effect between same-sex sexual behaviour and smoking. Among non-smokers; WSW adjusted OR was 0.41 (95% CI 0.21-0.80), WSWM adjusted OR was 0.91 (95% CI 0.81-1.02) compared with WSM. Among smokers; WSW adjusted OR was 1.03 (95% CI 0.63-1.67) for WSWM adjusted OR was 1.00 (CI 95% 0.93-1.13), compared with WSM.

Conclusion:

This study, including the largest cohort of women reporting life-time exclusively female partners in an STI study, shows that WSW generally are at lower risk for acquiring STIs than WSM. Smoking WSW, however, had the same risk for acquiring bacterial STIs as WSM and WSWM. Our study suggests that all WSW should receive the same encouragement to test for STIs as WSM.

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By:  Sol-Britt Molin ^A B F, Birgitte Freiesleben De Blasio ^C D and Anne Olaug Olsen ^A B E 

^A Department of Rheumatology, Dermatology and Infectious Diseases, The Olafia Clinic p.o.b.4763, Oslo University Hospital, 0506 Oslo, Norway. 
^B Norwegian National Advisory Unit on Sexually Transmitted Infections, The Olafia Clinic p.o.b.4763, vv0506 Oslo, Norway. 
^C Oslo Centre for Biostatics and Epidemiology, Department of Biostatics, p.o.b1122 Blindern, Institute of Basic Medical Sciences, University of Oslo, 0317 Oslo, Norway. 
^D Department of Infectious Disease Epidemiology, Division of Infectious Disease Control, Norwegian Institute of Public Health, p.o.b.4404 Nydalen, 0403 Oslo, Norway. 
^E Institute of Clinical Medicine, University of Oslo, p.o.b.1171 Blindern, 0318 Oslo, Norway. 
^F Corresponding author. Email: solmol@ous-hf.no 

Sex Health. 2016 Apr 7. doi: 10.1071/SH15193. 

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Estimating the Magnitude of Female Genital Mutilation/Cutting in Norway: An Extrapolation Model

Background

With emphasis on policy implications, the main objective of this study was to estimate the numbers of two main groups affected by FGM/C in Norway: 1) those already subjected to FGM/C and therefore potentially in need for health care and 2) those at risk of FGM/C and consequently the target of preventive and protective measures. Special attention has been paid to type III as it is associated with more severe complications.

Methods

Register data from Statistics Norway (SSB) was combined with population-based survey data on FGM/C in the women/girls’ countries of origin.

Results

As of January 1^st 2013, there were 44,467 first and second-generation female immigrants residing in Norway whose country of origin is one of the 29 countries where FGM/C is well documented. About 40 pct. of these women and girls are estimated to have already been subjected to FGM/C prior to immigration to Norway. Type III is estimated in around 50 pct. of those already subjected to FGM/C. Further, a total of 15,500 girls are identified as potentially at risk, out of which an approximate number of girls ranging between 3000 and 7900 are estimated to be at risk of FGM/C.

Conclusion

Reliable estimates on FGM/C are important for evidence-based policies. The study findings indicate that about 17,300 women and girls in Norway can be in need of health care, in particular the 9100 who are estimated to have type III. Preventive and protective measures are also needed to protect girls at risk (3000 to 7900) from being subjected to FGM/C. Nevertheless, as there are no appropriate tools at the moment that can single these girls out of all who are potentially at risk, all girls in the potentially at risk group (15,500) should be targeted with preventive measures.

Below:  FGM/C Percentage of girls and women already subjected to FGM/C in Norway by country of origin

Below:  Numbers of girls and women subjected to FGM/C type III by most represented countries of origin

Full article at:   http://goo.gl/QFkFuS

By:  Mai M. Ziyada, Marthe Norberg-Schulz, and R. Elise B. Johansen

Norwegian Centre for Violence and Traumatic Stress Studies, P.b. 181 Nydalen, 0409 Oslo, Norway

Samfunnsøkonomisk analyse (Formerly DAMVAD Norge AS), Olavsvei 112, 1450 Nesoddtangen, Norway

Mai M. Ziyada, Email: on.stvkn@adayiz.m.m.

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Comparison of Drugs Used by Nightclub Patrons & Criminal Offenders in Oslo, Norway

The aim of this study was to investigate psychoactive drug use among nightclub patrons by analysing samples of oral fluid and compare with findings in blood samples from criminal suspects. 

We hypothesized that the profile of illicit drug use among nightclub patrons is different from what we observe in those forensic cases. Research stations were established outside nine popular nightclubs with different profiles and patron-characteristics in downtown Oslo. Data and sample collection was conducted on Fridays and Saturdays in March and May 2014. Individuals and groups who entered defined recruitment zones from 23:00 to 03:30 were invited to participate in this voluntary and anonymous study. Oral fluid was collected using the Intercept Oral Fluid Sampling Device. Methanol was added to increase the recovery of cannabinoids from the device. Sample preparation was performed using liquid-liquid extraction with ethyl acetate/heptane (4:1) after adding internal standards, ammonium carbonate buffer pH 9.3 and Triton X100. The first 80 samples were analysed for 122 substances, which included psychoactive medicinal drugs, classical illicit drugs and new psychoactive substances (NPS). Based on the findings and discussions with police and customs authorities, the remaining oral fluid samples were analysed for 46 substances. 

Among the 500 samples collected during the study period, we found illicit drugs in 25.4% and medicinal drugs in 4.2% of the samples. The most prevalent substances were: cocaine 14.6%, THC 12.4%, amphetamine/methamphetamine 2.8%, diazepam 1.2% and clonazepam 1.0%. Various NPS were found in 1.4% of the samples. 

The prevalence of drugs in blood samples from criminal suspects were for cocaine 3.4%, THC 34.7%, amphetamine/methamphetamine 37.0%, diazepam 12.0%, and clonazepam 29.3%. Multi-drug use was more common among criminal suspects (41.3%) than among club patrons (6.8%). 

The results showed that the drug use pattern among nightclub patrons was substantially different from the drug use pattern manifested by individuals apprehended by the police suspected for criminal conduct.

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By:  Gjerde H1, Nordfjærn T2, Bretteville-Jensen AL2, Edland-Gryt M2, Furuhaugen H3, Karinen R3, Øiestad EL3.

• 1Division of Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, NO-0403 Oslo, Norway. Electronic address: hallvard.gjerde@fhi.no.
• 2Norwegian Institute for Alcohol and Drug Research (SIRUS), PO Box 565, Sentrum, NO-0105 Oslo, Norway.
• 3Division of Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, NO-0403 Oslo, Norway. 
• Forensic Sci Int. 2015 Dec 30;265:1-5. doi: 10.1016/j.forsciint.2015.12.029

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The Hazard of Sharp Force Injuries: Factors Influencing Outcome

Highlights

• This study is original since sharp force injury is rather uncommon in Norway.
• The overall mortality rate of sharp force injury in this study was 29%.
• Penetrating chest injury was more deadly than penetrating abdominal injury.
• Isolated heart injury had a lethal outcome in 80% of the cases.
• Still the outcome of sharp force injury is often random and unpredictable.

Abstract

The risk of dying from sharp force injury is difficult to ascertain. To the best of our knowledge, no study has been performed in Norway regarding mortality due to sharp force injury or factors that impact survival. Thus, the objective of the present study was to investigate and assess mortality in subjects with sharp force injury. 

This retrospective study comprises data on 136 subjects (34 female, 102 male) with suspected severe sharp force injury (self-inflicted or inflicted by others) admitted to Haukeland University Hospital between 2001 and 2010. The majority of subjects were intoxicated, and the injury was most often inflicted by a knife. The incidence of sharp force injury in Western Norway is similar to the incidence in other European countries. Almost half of the subjects with self-inflicted injury died. In cases with injury inflicted by another individual, one in five died. Mortality rates were higher in those with penetrating chest injuries than those with penetrating abdominal injuries and higher in cases with cardiac injury compared to pleural or lung injury. Sharp force injury can be fatal, but the overall mortality rate in this study was 29%. 

Factors influencing mortality rate were the number of injuries, the topographic regions of the body injured, the anatomical organs/structures inflicted, and emergency measures performed.

Below:  Ethanol and/or drugs in subjects with sharp force injury

Below:  Number of sharp force injuries, related to outcome

Below:  Distribution of sharp force injury in surviving and deceased subjects, related to anatomical regions (both penetrating and non-penetrating injuries)

Below:  Number of surviving and deceased subjects with penetrating sharp force injury

Full article at:   http://goo.gl/q2OIUT

By:  Kristoffersen S1, Normann SA2, Morild I3, Lilleng PK3, Heltne JK4.

• 1Department of Pathology, The Gade Institute, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Medicine, Gade Laboratory of Pathology, University of Bergen and Haukeland University Hospital, 5021 Bergen, Norway. Electronic address: stine.kristoffersen@helse-bergen.no.
• 2Cand.Med.-Degree Programme, Faculty of Medicine and Dentistry, University of Bergen, Norway.
• 3Department of Pathology, The Gade Institute, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Medicine, Gade Laboratory of Pathology, University of Bergen and Haukeland University Hospital, 5021 Bergen, Norway.
• 4Department of Anaesthesia and Intensive Care, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway. 

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Sexual Behavior of Gender-Dysphoric Individuals Before Gender-Confirming Interventions: A European Multicenter Study

A transsexual course of development that starts before puberty (early onset) or during or after puberty, respectively (late onset), may lead to diverse challenges in coping with sexual activity. 

The authors explored the sexual behavior of 380 adult male-to-female and female-to-male individuals diagnosed according to DSM-IV-TR criteria who had not yet undergone gender-confirming interventions. Data originated from the European Network for the Investigation of Gender Incongruence Initiative, conducted in Belgium, Germany, The Netherlands, and Norway. Information on outcome variables was collected using self-administered questionnaires at first clinical presentation. 

Compared with late-onset male-to-females, early-onset individuals tended to show sexual attraction toward males more frequently (50.5%), involve genitals less frequently in partner-related sexual activity, and consider penile sensations and orgasm as more negative. Early-onset female-to-males predominantly reported sexual attraction toward females (84.0%), whereas those with a late-onset more frequently showed other sexual attractions (41.7%). 

The study (a) shows that early- and late-onset male-to-females differ considerably with regard to coping strategies involving their body during sexual relations and (b) reveals initial insights into developmental pathways of late-onset female-to-males.

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By:  Susanne Cerwenka^a, Timo O. Nieder^a, Peggy Cohen-Kettenis^b,Griet De Cuypere^c, Ira R. Hebold Haraldsen^d, Baudewijntje P. C. Kreukels^e & Hertha Richter-Appelt^a*

^a University Medical Center Hamburg-Eppendorf, Department of Sex Research and Forensic Psychiatry, Hamburg, Germany

^b VU University Medical Center, Amsterdam, The Netherlands

^c Ghent University Hospital, Department of Sexology and Gender Problems, Ghent, Belgium

^d Rikshospitalet Oslo, Department of Neuropsychiatry and Psychosomatic Medicine, Oslo, Norway

^e VU University Medical Center, Department of Medical Psychology, Amsterdam, The Netherlands

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Past & Recent Abuse Is Associated with Early Cessation of Breast Feeding: Results from a Large Prospective Cohort in Norway

OBJECTIVE:

Breast feeding provides a wide range of health benefits for both infants and mothers. Few studies have examined the impact of past and recent abuse of women on breastfeeding behaviour. The aims of our study were to examine whether exposure to past and recent emotional, sexual or physical abuse was associated with early breastfeeding cessation, and to assess whether a potential association differed for known and unknown perpetrators.

PARTICIPANTS:

53 934 mothers participated in the Norwegian Mother and Child Cohort Study. We included mothers with singleton pregnancy who had responded to three questionnaires (weeks 18 and 30 in pregnancy, and 6 months postpartum) and had answered minimum one of the abuse questions in week 30.

MAIN OUTCOME MEASURE:

ORs were estimated by binary logistic regression with cessation of any (all) breast feeding before 4 months as the outcome, and abuse including subcategories of abuse, as the exposure.

RESULTS:

Nearly all women initiated breast feeding, but 12.1% ceased any breast feeding before 4 months and 38.9% ceased full breast feeding before 4 months, but continued partial breast feeding. Overall, 19% of the women reported any adult abuse and 18% reported any child abuse. The highest risk of any breast feeding cessation before 4 months was seen in women exposed to three types of adult abuse (emotional, sexual or physical), with adjusted OR being 1.47 (95% CI 1.23 to 1.76) compared with no abuse. Recent abuse and exposure from known perpetrator resulted in nearly 40% and 30% increased risk, respectively. The OR of any breast feeding cessation for women exposed to any child abuse was 1.41 (95% CI 1.32 to 1.50) compared with no abuse in childhood.

CONCLUSIONS:

Past and recent abuse of women is strongly associated with early cessation of breast feeding. Abused mothers comprise a key group to target for extra support and breastfeeding assistance.

Full article at:   http://goo.gl/B3Hqah

By:   Sørbø MF1, Lukasse M2, Brantsæter AL3, Grimstad H4.

• 1Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Physical Medicine and Rehabilitation, Aalesund Hospital, More and Romsdal Health Trust, Aalesund, Norway.
• 2Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Faculty of Health Sciences, Department of Health, Nutrition and Management, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
• 3Department of Exposure and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway.
• 4Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. 

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The Norwegian Offender Mental Health & Addiction Study - Design & Implementation of a National Survey & Prospective Cohort Study

The Norwegian prison inmates are burdened by problems before they enter prison. Few studies have managed to assess this burden and relate it to what occurs for the inmates once they leave the prison. The Norwegian Offender Mental Health and Addiction (NorMA) study is a large-scale longitudinal cohort study that combines national survey and registry data in order to understand mental health, substance use, and criminal activity before, during, and after custody among prisoners in Norway. The main goal of the study is to describe the criminal and health-related trajectories based on both survey and registry linkage information. Data were collected from 1,499 inmates in Norwegian prison facilities during 2013-2014. Of these, 741 inmates provided a valid personal identification number and constitute a cohort that will be examined retrospectively and prospectively, along with data from nationwide Norwegian registries. This study describes the design, procedures, and implementation of the ongoing NorMA study and provides an outline of the initial data.

Below:  Baseline questionnaire information about prisoners’ experiences at different phases: childhood/early life, before and during custody.

Below:  Overview of risk factors and outcomes, and the national registers were information is retrieved

Table 1

Background and prisoning characteristics (n = 1499).

	TOTAL (n = 1499)		VALID PIN (n = 741)		NON-VALID PIN (n = 758)
	n	%	n	%	n	%
Gender (men)*	1396	93.1%	690	93.1%	706	93.1%
Age (mean)*	34.6		35.5		33.6
Country of birth*
Norway	1006	67.1%	604	81.5%	402	53.0%
Nordic Countries, outside Norway	40	2.7%	10	1.3%	30	4.0%
Western Europe outside Scandinavia	53	3.5%	9	1.2%	44	5.8%
Eastern Europe	126	8.4%	27	3.6%	99	13.1%
Africa	109	7.3%	23	3.1%	86	11.3%
South or Central America	20	1.3%	7	0.9%	13	1.7%
North America	10	0.7%	1	0.1%	9	1.2%
Asia	85	5.7%	42	5.7%	43	5.7%
Oceania	1	0.1%			1	0.1%
Norwegian citizenship*	1134	75.7%	662	89.3%	472	62.3%
Status of imprisonment*a
Sentence	1131	75.5%	579	78.1%	552	72.8%
Remand	269	17.9%	144	19.4%	125	16.5%
Protective custody	73	4.9%	17	2.3%	56	7.4%

Notes:

*Missing values: Gender (n = 7, 0.5%), Age (n = 131, 8.7%), Country of birth (n = 49, 3.3%), Norwegian citizenship (n = 35, 2.3%), Status of imprisonment (n = 41, 2.7%).

a15 respondents reported both Sentence and Remand.

Full article at:   http://goo.gl/vn3gCZ

By:   Anne Bukten,1,2,3 Ingunn Olea Lund,4 Eline Borger Rognli,1,2,5 Marianne Riksheim Stavseth,1 Philipp Lobmaier,1,2Svetlana Skurtveit,1,6 Thomas Clausen,1,7 and Nikolaj Kunøe1

¹Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

2Oslo University Hospital, Division for Mental Health and Addiction, Oslo, Norway.

3The Correctional Service of Norway, Staff Academy, Oslo, Norway.

4Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.

5Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway.

6Norwegian Institute of Public Health, Department of Pharmacoepidemiology, Oslo, Norway.

7

2Oslo University Hospital, Division for Mental Health and Addiction, Oslo, Norway.

3The Correctional Service of Norway, Staff Academy, Oslo, Norway.

4Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.

5Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway.

6Norwegian Institute of Public Health, Department of Pharmacoepidemiology, Oslo, Norway.

7

2Oslo University Hospital, Division for Mental Health and Addiction, Oslo, Norway.

3The Correctional Service of Norway, Staff Academy, Oslo, Norway.

4Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.

5Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway.

6Norwegian Institute of Public Health, Department of Pharmacoepidemiology, Oslo, Norway.

7

²Oslo University Hospital, Division for Mental Health and Addiction, Oslo, Norway.

³The Correctional Service of Norway, Staff Academy, Oslo, Norway.

⁴Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.

⁵Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway.

⁶Norwegian Institute of Public Health, Department of Pharmacoepidemiology, Oslo, Norway.

⁷Alcohol Research Group, Emeryville, CA, USA.

1Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

1Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

1Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

  

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