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PubMed1987

Diabetes mellitus in Swedish middle-aged men. The study of men born in 1913 and 1923.

As part of a study of the epidemiology of diabetes mellitus in middle-aged Swedish men, the present paper reports the prevalence and incidence of diabetes and the prevalence of impaired glucose tolerance. Two cohorts of 50-year-old men, representative of the corresponding male population of Gothenburg, Sweden, were examined in 1963 and 1973, respectively, and then followed until 1980. In the cohort of men born in 1913 (n = 855) the diabetes prevalence (WHO criteria), based on a questionnaire and fasting blood glucose, increased from 1.5% at age 50 to 7.6% at age 67. In the cohort of men born in 1923 (n = 226) the prevalence was 3.7% at age 50 and 4.0% at age 57. The overall prevalence of diabetes and impaired glucose tolerance was 25% among men born in 1913 (age 67) and 18% among men born in 1923 (age 57). The cumulative risk of developing diabetes from age 50 to 67 was 7.8%. Variables associated with impaired glucose tolerance and newly found diabetes, when degree of obesity was considered, were systolic blood pressure and triglycerides, well known risk factors for both coronary heart disease and diabetes. Uric acid, fasting insulin and glutamic puruvic transaminase, recently discussed as possible risk factors, were also associated with impaired glucose tolerance and newly found diabetes. Thus, both impaired glucose tolerance and newly found diabetes were associated with a clustering of risk factors, not only for diabetes but also for coronary heart disease.

Blood Glucose↗

PubMed2006

Examining the role of partner status in an HIV prevention trial targeting HIV-positive gay and bisexual men: the seropositive urban men's intervention trial (SUMIT).

The goal of this analysis was to examine whether partner status impacted behavioral outcomes from the Seropositive Urban Men's Intervention Trial (SUMIT). We contrasted sample characteristics of HIV-positive gay and bisexual men with and without main partners and then examined differences in sexual behaviors among men participating in an enhanced HIV prevention intervention compared to those in a standard condition. Logistic regression analyses were performed to differentiate characteristics of men with and without main partners and mixed-model logistic regression analyses were performed to test for intervention effects. Men with main partners showed a greater likelihood of having unprotected anal sex with any partner, although the number of male sexual partners was higher for men without a main partner. SUMIT generally produced few differences in sexual risk behaviors and did not affect several potential mediator variables of the relationship between the intervention and sexual behaviors with main and nonmain partners.

Bisexuality↗

PubMed2006

Recruitment source and behavioral risk patterns of HIV-positive men who have sex with men.

To effectively target HIV prevention activities, community outreach workers need to know how to locate persons at greatest risk for acquiring or transmitting HIV. This study compared the behavioral characteristics of HIV-positive men who have sex with men recruited from different sources: AIDS service organizations, mainstream gay environments, public/private sex environments, and friend referrals. Men recruited from sex environments exhibited the riskiest behavior: more male partners, more likely to have casual sex, more likely to have had unprotected insertive sex with men of HIV-negative or unknown status, less likely to have disclosed serostatus to primary partners, less comfortable discussing serostatus with others, and less feeling of personal responsibility for disclosure. A distinctive group of men, the referral group, did not identify with the gay community and reported sex with men and women. Future efforts should continue to assess the types of people that are recruited from different sources so that program and research efforts can be appropriately targeted.

Adult↗

PubMed2005

A study on methods of estimating the population size of men who have sex with men in Southwest China.

OBJECTIVE: To ascertain practical methods of estimating the population size of men who have sex with men (MSM) by field application. METHODS: Nine public places were selected, where men who have sex with men (MSM) frequented. Capture-recapture method and multiplier method were used to count the number of men who have sex with men (MSM) in the assigned places in 10 days. RESULTS: The population size estimated using multiplier method counted 877. Three estimates produced by capture-recapture method were 1408 (95% CI: 1116-1908), 1207 (95% CI: 932-1712) and 949 (95% CI: 757-1272), respectively. CONCLUSIONS: Multiplier method was easy and smooth in practice and produced highly reliable results, which yet was expensive. The application of capture-recapture method cost less in both time and funds, and the three results produced could verify each other, which was fit for the estimation.

China↗

PubMed2005

Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study--a large observational study of the determinants of fracture in older men.

Very little information is available to direct the prevention or management of osteoporosis in men. The Osteoporotic Fractures in Men (MrOS) Study is a prospective cohort study designed to examine the extent to which fracture risk is related to bone mass, bone geometry, lifestyle, anthropometric and neuromuscular measures, and fall propensity, as well as to determine how fractures affect quality of life in men. The study is also designed to understand how osteoporosis is related to prostate disease. At baseline, participants completed questionnaires regarding medical history, medications, physical activity, diet, alcohol intake, and cigarette smoking. Objective measures of anthropometric, neuromuscular, vision, strength, and cognitive variables were obtained. Skeletal assessments included DEXA, calcaneal ultrasound, and vertebral radiographs. Vertebral and proximal femoral QCT was performed on a subset (65%). Serum, urine, and DNA specimens were collected. After the baseline assessments, a questionnaire is mailed to participants every 4 months to ascertain incident falls, fractures, prostate cancer, and deaths. After an average of 4.5 years, participants are scheduled to return for a second comprehensive visit. Men were eligible if > or =65 years. 5995 men enrolled with a mean (+/-SD) age of 73.7 (+/-5.9) years, 11% of which were minorities. Most rated their health as good/excellent. Few were current smokers, although 59% had smoked previously, and 35% reported no alcohol intake, while 47% consumed at least 2 drinks per week. The mean (range) body mass index was 26.9 kg/m2 (17-56). A non-traumatic fracture after age 50 was reported by 17% of the cohort. The MrOS cohort should provide valuable information concerning the determinants of fracture in men and should help set the stage for the development of effective methods to identify those at risk.

Aged↗

PubMed2000

A comparison of the morphology of testicular, epididymal, and ejaculated sperm from fertile men and men with obstructive azoospermia.

OBJECTIVE: To assess the morphology of testicular, epididymal, and ejaculated sperm. DESIGN: Morphology of the three types of sperm was assessed by using Tygerberg strict criteria. SETTING: The Regional Fertility Center, Royal Maternity Hospital, Belfast, Northern Ireland, United Kingdom. PATIENT(S): Thirty-two men with obstructive azoospermia and 10 fertile men. INTERVENTION(S): Trucut needle testicular biopsy and percutaneous epididymal sperm aspiration under local anesthetic. MAIN OUTCOME MEASURE(S): Percentages of normal sperm and sperm with head, midpiece, and tail defects for testicular, epididymal, and ejaculated sperm. Testicular sperm morphology in men with obstructive azoospermia was compared with that of fertile men. RESULT(S): The percentage of normal testicular sperm (4.3%) differed significantly from the percentages of normal epididymal (10. 8%) and ejaculated sperm (9.6%). Testicular sperm morphology in men with obstructive azoospermia did not differ from that in fertile men. CONCLUSION(S): Tygerberg strict criteria are not suitable for the assessment of testicular sperm morphology.

Ejaculation↗

PubMed2001

Does penile size in younger men cause problems in condom use? a prospective measurement of penile dimensions in 111 young and 32 older men.

OBJECTIVES: Young men often complain about problems with condom use, but very little information exists about the influence of men's age on penile dimensions and therefore on possible problems in the use of the most important means of contraception in the young. METHODS: We performed a prospective measurement of penile dimensions in 111 men,18 to 19 years old (group A), and in 32 men, 40 to 68 years old (group B). We measured penile length and width in the flaccid state and after visual and manual self-stimulation in group A and after intracavernous injection of prostaglandin E(1) in group B. RESULTS: The mean flaccid length in group A (8.60 cm) and group B (9.22 cm) was significantly different. The mean erect length in group A (14.48 cm) and group B (14.18 cm) was not significantly different. The mean flaccid width at the base was significantly different between group A (3.08 cm) and group B (2.87cm), but the mean flaccid width at the glans was not (group A, 3.02 cm; group B, 3.01 cm). The mean erect width at the base (group A, 3.95 cm; group B, 3.50 cm) and the erect width of the glans (group A, 3.49 cm; group B, 3.32 cm) were significantly different. CONCLUSIONS: Our assumption that the problems young men experience with condom use may be because of smaller penises could not be proved. To address the problems in condom use in younger men, a larger variety of condom sizes and better information about condom use may be useful.

Adult↗

PubMed1999

Decline of sexual function with age in Japanese men compared with American men--results of two community-based studies.

OBJECTIVES: To investigate the self-reported sexual function of Japanese men aged 40 to 79 years in a community-based study and compare the results to a similarly conducted study in Olmsted County, Minnesota. METHODS: Two hundred eighty-nine Japanese and 2115 American men from the community were queried about ability to have erections when stimulated, sexual drive, and satisfaction with sexual activity using a self-administered questionnaire. RESULTS: Both Japanese and American men showed an age-related decline in erectile function, sexual libido, and sexual satisfaction. In particular, 71% of Japanese men aged 70 to 79 years reported having erections only a little of the time or less when sexually stimulated, and 80% perceived sexual drive once per month or less during the past month. Although more Japanese than American men reported erectile dysfunction and decreased libido, there were no striking differences in self-reported sexual satisfaction between the studies. However, cultural and perceptual differences could play a role in these results, despite attempts to ensure linguistic equivalency in the questionnaires. CONCLUSIONS: Although erectile dysfunction and decreased libido were noted by a greater proportion of Japanese than American men, the self-reported degree of satisfaction was comparable between the studies. Perceptions of elderly male sexual function and its impact on health-related quality of life may differ among races, sites, and countries.

Adult↗

PubMedDate not supplied

Effects of a behavioural intervention to reduce acquisition of HIV infection among men who have sex with men: the EXPLORE randomised controlled study.

BACKGROUND: Effective interventions are needed to prevent acquisition of HIV infection in men who have sex with men. To date, no behavioural interventions specifically for this risk group have been tested with HIV infection as the primary outcome. METHODS: This multisite two-group randomised controlled phase IIb trial tested the efficacy of a behavioural intervention in preventing HIV infection among 4295 men who have sex with men. The experimental intervention consisted of ten one-on-one counselling sessions followed by maintenance sessions every 3 months. The standard condition was twice-yearly Project RESPECT individual counselling. Twice-yearly follow-up visits included testing for HIV antibody and assessment of behavioural outcomes. FINDINGS: The rate of acquisition of HIV infection was 18.2% (95% CI -4.7 to 36.0) lower in the intervention group than the standard group. Adjustment for baseline covariates attenuated the intervention effect to 15.7% (-8.4 to 34.4). The effect was more favourable in the first 12-18 months of follow-up. The occurrence of unprotected receptive anal intercourse with HIV-positive and unknown-status partners was 20.5% (10.9 to 29.0) lower in the intervention than in the standard group. INTERPRETATION: The results from the primary analyses allow us to rule out that the experimental intervention is associated with a 35% lower rate of HIV acquisition than in the standard group. The overall estimate of a difference of 18.2%, more favourable estimates of effect in the first 12-18 months, and similar effects on risk behaviours suggest that prevention of HIV infection among men who have sex with men by a behavioural intervention is feasible. Further work should be done to develop more effective interventions.

Adolescent↗

PubMed2001

Substance use and sexual transmission risk behavior of HIV-positive men who have sex with men.

We examined substance use in relationship to transmission risk behavior (unprotected insertive, UIAI, or receptive anal intercourse, URAI) between HIV-positive men who have sex with men (MSM) and their HIV-negative or unknown serostatus partners. Men who engaged in transmission risk behavior with casual partners were more likely than men who did not engage in such behavior to have used various substances. Users of certain drugs were specifically less likely to use condoms with HIV-negative or unknown status partners than users. Of men who drank alcohol, those who drank more frequently before or during sex engaged in significantly more UIAI with casual partners. Of men who used drugs, those who used more frequently before or during sex were more likely to engage in URAI with casual partners. In multivariate analyses, use of inhalants as well as drinking before or during sex predicted UIAI, while use of inhalants as well as noninjection drug use before or during sex predicted URAI. HIV prevention programs for HIV-positive MSM should focus on decreasing substance use and use specifically before or during sex. Developing prevention programs for substance-using MSM is critical to improve community health and decrease HIV transmissions.

Adult↗

PubMed2002

Gonorrhoea in Denmark: high incidence among HIV-infected men who have sex with men.

Diagnosis of gonorrhoea indicates that relatively recent unprotected sex has been practised and thus there is possibly a risk of HIV transmission. A retrospective analysis of gonorrhoea cases reported to the Danish national surveillance system was carried out for the period 1994-1999. The analysis included demographic pattern and mode of transmission of gonorrhoea in Denmark with the focus on trends and factors related to infection in men who have sex with men (MSM). We found that 646 (82.7%) reported cases of gonorrhoea were men, among whom 41.2% cases were due to sex with men, 52.9% were transmitted by heterosexual contact and 5.9% were due to unknown causes. The estimated mean annual reported incidence of gonorrhoea was more than 30 times greater among MSM than among heterosexual men and 6 times greater in MSM known to be HIV-positive, when gonorrhoea was diagnosed, than among other MSM (p < 0.001). No difference was found between the sites of infection among HIV-positive and HIV-negative MSM. A trend towards increase in the annual incidence of gonorrhoea has been seen since 1997, with an increase of 35% from 1997 to 1998 and a further increase of 41% from 1998 to 1999. The increase was mainly due to an increasing number and proportion of cases among MSM. The notified cases comprised 49% of patients with laboratory-confirmed gonorrhoea, which indicates a similar increasing trend. In conclusion, the rising trend of incident gonorrhoea, especially in MSM, may indicate a relapse to more unsafe sexual practices, which could lead to the spread of HIV infection. The higher incidence among HIV-positive MSM compared with other men underlines this concern.

Adolescent↗

PubMed2004

Demographics, sexual behaviour and STD/HIV prevalence in two groups of men who have sex with men, in Rotterdam, The Netherlands.

This study was performed to investigate whether men who have sex with men visiting the sexually transmitted diseases clinic, and those participating in a gay cohort were different with regard to demographic characteristics, sexual behaviour and sexually transmitted diseases (STD)/human immunodeficiency (HIV) virus prevalence. Data from men who have sex with men presenting at the sexually transmitted diseases clinic (group I; n = 318) were compared with data from men participating in a cohort (group II; n = 286). All males underwent a routine venereological examination. Men in group II were more often older (p < 0.0005), of Dutch descent (p < 0.0005) and had more sex partners (p < 0.0005). New cases of HIV infection were detected far more often in group I (p = 0.04). Also, urethral gonococcal infection was significantly more prevalent in group I (p = 0.003). Multivariate analyses showed that males presenting at the STD clinic (group I) were at higher risk for urethral gonorrhoea. The higher prevalence of HIV infection in group I was associated with a higher prevalence of recent STD, more concomitant urethral gonorrhoea infections at the time of visit, over 10 sex partners in the previous 6 months, and non-Dutch descent.

Adolescent↗

PubMed2005

Experiencing release: sex environments and escapism for HIV-positive men who have sex with men.

There are nonsexual reasons that may motivate people to seek out sexual activity with others. Some men who have sex with men may seek out sex environments to engage in sexual behavior. Among the nonsexual reasons that exist for men who have sex with men is a desire to escape from distressing thoughts and feelings. The amplified sexuality and other unique characteristics of sex environments allow men to have more intense emotional experiences around sex. Using the cognitive escape model as a theoretical foundation, this analysis focuses on the emotional vulnerability that some of the men who visit these venues may be avoiding and how their experiences at these venues might act as releasing mechanisms to alleviate dissonant thoughts and feelings. Implications for public health services and future research are discussed.

Adult↗

PubMed1990

Married men and same sex activity: a field study on HIV risk among men who do not identify as gay or bisexual.

Interviews that took place at several sites where anonymous sex is practiced suggest that some married men engage in same sex activity without regard for the risk to HIV infection they impose upon themselves and their spouses. Much of the sexual activity is considered to be high risk by Centers for Disease Control standards, and the men who engaged in these behaviors were knowledgeable of those standards. A random sample of 94 individuals were interviewed from a possible population of 198 (47.9%). Of the men interviewed, 15% identified themselves as married or engaged to be married to a woman. Only 2 married men informed their female sex partner (regular partner) of their clandestine activity. By comparison, 29 of the gay or bisexual men had informed their partners of their unprotected and anonymous sex seeking. It is suggested that perhaps the focus on high risk groups instead of on high risk behavior has given a false sense of security to men who do not identify as gay or bisexual.

Adolescent↗

PubMed2005

Contexts for last occasions of unprotected anal intercourse among HIV-negative gay men in Sydney: the health in men cohort.

The objective of the paper was to compare encounters involving unprotected anal intercourse (UAI) and protected anal intercourse (PAI) among HIV-negative gay men in Sydney. Data were from those completing baseline face-to-face interviews to end June 2003 for the Health in Men open cohort of HIV-negative gay men in Sydney. The 1,148 participants ranged in age from 18 to 75 years (median = 36). Three hundred and fifty-two (30.7%) reported an occasion of UAI with a casual partner in the previous 6 months and 531 (46.3%) reported an occasion of UAI with a regular partner in that same time. The men's most recent sexual contact with a casual partner involving UAI was distinguished from those involving PAI by a greater likelihood for both partners to disclose HIV serostatus (p = 0.006) and by respondents being more inclined to restrict themselves to the insertive position or to practise withdrawal during occasions involving any UAI than when a condom was used (p = 0.003 and p = 0.001 respectively). Neither location nor recreational drug use differentiated men's most recent sexual contacts involving UAI from those involving PAI. The decision by HIV-negative gay men to use condoms during sexual encounters with either regular or casual partners is guided more by HIV serostatus and risk reduction strategies than by other factors.

Adolescent↗

PubMed2006

Circuit parties: sexual behaviors and HIV disclosure practices among men who have sex with men at the White Party, Palm Springs, California, 2003.

The syphilis epidemic among men who have sex with men (MSM) in major US cities and concomitant increases in high-risk sexual behavior, have raised concerns of increased HIV transmission in this population. Therefore, to provide information for health promotion and disease awareness efforts, we investigated sexual behaviors, partner selection preferences and HIV serostatus disclosure practices of MSM at the White Party in Palm Springs, California. Circuit party attendees reported engaging in unprotected anal sex, however, a high proportion reported disclosing their HIV status. These findings suggest that some gay men are serosorting as a risk reduction strategy or implementing sexual risk reduction strategies to protect themselves and their partners. In our study, HIV-negative men were nine times more likely to report a preference for a seroconcordant sexual partner. The self-protecting attitudes of HIV-negative men in our sample outweighed the partner-protecting attitudes of HIV-positive men. This suggests that prevention interventions focusing on HIV-positive persons are warranted.

Adult↗

PubMed2006

Prevalence of hepatitis C virus infection among men who have sex with men at a Boston community health center and its association with markers of high-risk behavior.

The present study sought to investigate the prevalence of hepatitis C virus (HCV) among men who have sex with men (MSM) seen at a community health center, and to examine risk factors associated with infection. The study population included 218 MSM who were screened for HCV infection during routine clinic visits from May through December, 2001. Eighty-four percent of those screened (n = 183) agreed to complete a self-report questionnaire assessing drug use, sexual practices, and medical history. Participants ranged in age from 22 to 54 years. The majority of participants (82%) self-identified as Caucasian and 35% were HIV-positive. Prevalence of HCV infection was 11.5%. Men infected with HCV were more likely than HCV uninfected men to be coinfected with HIV and hepatitis B, and to have a history of rectal or urethral gonorrhea. HCV-infected men were more likely to have seen blood on shared cocaine straws and to have used crack cocaine in the past 6 months. Overall, 12% of HCV-infected men reported no parenteral risk factors for HCV infection. HCV seropositivity was significantly associated with an aggregate score representing high-risk behavior in the past six months. HCV prevention and screening should target MSM engaging in high-risk sex. Conversely, HIV and sexually transmitted infection risk reduction interventions should be targeted at MSM with HCV.

Adult↗

PubMed2006

High risk of human immunodeficiency virus in men who have sex with men with herpes simplex virus type 2 in the EXPLORE study.

The relation between herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) acquisition was evaluated among 4,295 high-risk, HIV-negative men who have sex with men in an intensive behavioral intervention (colloquially referred to as "EXPLORE") study in the United States from 1999 to 2003. Sexual behavior data were obtained by computer-assisted self-interview, and sera were collected semiannually for HIV and HSV-2 serology. HSV-2 infection was classified as "recent incident" (at the first HSV-2 seropositive visit), "remote incident" (within 24 months of the first positive visit), and "prevalent" (for visits >24 months after the first HSV-2 positive visit). Baseline HSV-2 prevalence was 20.3%. HSV-2 incidence was 1.9 (95% confidence interval (CI): 1.6, 2.2) per 100 person-years; significant risk factors were African-American race, unprotected receptive anal intercourse, an HIV-positive male sex partner, and six or more male partners in the prior 6 months. The behavioral intervention did not reduce HSV-2 acquisition (adjusted hazard ratio (HR) = 1.2, 95% CI: 0.9, 1.6). Overall HIV incidence was 1.9 (95% CI: 1.7, 2.2) per 100 person-years. HIV risk was elevated among men who have sex with men with recent incident HSV-2 (adjusted HR = 3.6, 95% CI: 1.7, 7.8), remote incident HSV-2 (adjusted HR = 1.7, 95% CI: 0.8, 3.3), and prevalent HSV-2 (adjusted HR = 1.5, 95% CI: 1.1, 2.1) infection compared with HSV-2 seronegative participants. HIV intervention strategies targeting HSV-2 prevention and suppression among men who have sex with men should be evaluated.

Adolescent↗