From May 1989 through April 1990, 1,001 adult homosexual and bisexual men attending sexually transmitted disease clinics were interviewed regarding potentially abusive sexual contacts during childhood and adolescence. Thirty-seven percent of participants reported they had been encouraged or forced to have sexual contact before age 19 with an older or more powerful partner; 94% occurred with men. Median age of the participant at first contact was 10; median age difference between partners was 11 years. Fifty-one percent involved use of force; 33% involved anal sex. Black and Hispanic men were more likely than white men to report such sexual contact. Using developmentally-based criteria to define sexual abuse, 93% of participants reporting sexual contact with an older or more powerful partner were classified as sexually abused. Our data suggest the risk of sexual abuse may be high among some male youth and increased attention should be devoted to prevention as well as early identification and treatment.

Adolescent↗

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Homosexual men who engage in high-risk sexual behavior. A multicenter comparison.

To describe homosexual men who continue to engage in unprotected oral and anal sex, 601 men who attended three urban STD clinics and who had engaged in these behaviors with a male partner in the previous 4 months were interviewed regarding their sexual and drug-use behaviors. Although approximately one fourth of participants had engaged in 1 to 2 episodes of unprotected anal sex, more than 20% reported engaging in greater than 23 episodes. Higher frequency of anal sex was associated with lower condom use rates. Although 50% had primary relationships, less than 22% had sex with just one partner, and less than 10% were in relationships concordant for HIV-antibody status. Multiple regression analyses showed that number of drugs used each month, sex in a steady relationship, and Hispanic ethnicity were the most consistent predictors of risk behavior across sites. Careful evaluation of the diverse nature and characteristics of these men is essential to target risk-reduction programs for this population.

Adult↗

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Phonocardiographic criteria in the diagnosis of atrial and ventricular septal defects. An experimental and clinical study.

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Animals↗

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Failure to disclose HIV risk among gay and bisexual men attending sexually transmitted disease clinics.

We analyzed data from a multisite study of 1,063 gay or bisexual men attending sexually transmitted disease clinics to evaluate factors predicting failure to disclose human immunodeficiency virus (HIV) risk behaviors to clinic staff and the extent of such failure. We compared data from a brief screening assessment on unprotected anal and oral sex with data on the same behaviors from a subsequent detailed interview. We also compared behavioral data from screening and the interview with data on diagnoses of rectal gonorrhea abstracted from medical charts. Of 523 men reporting unprotected anal sex at interview, 29% failed to report this behavior at screening. Men failing to disclose unprotected anal sex were also less likely to disclose engaging in unprotected oral sex. Among men reporting no unprotected anal sex, either at screening or interview, 1.6% were diagnosed with rectal gonorrhea. Logistic regression analyses comparing men who did and did not disclose at screening having engaged in unprotected anal sex showed that men who failed to disclose reported greater involvement in gay organizations, greater perceived peer support for condoms, fewer episodes of unprotected anal sex in the last four months, and lower rates of substance abuse treatment. Our data suggest that men who failed to disclose may have lower risk levels, and may be more integrated into the gay community. Brief interviews, as opposed to detailed ones, also may underestimate incidence of unsafe sex. Where feasible, HIV risk assessment and counseling and laboratory screening should be routinely provided to all clinic attendees, regardless of self-reports.

Adolescent↗