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Autoimmune thrombocytopenic purpura in homosexual men.

Since November 1980 we have diagnosed 11 cases of severe autoimmune thrombocytopenic purpura in homosexual men; their mean platelet count (+/- SE) was 16 000 +/- 3000/mm3. All patients have been sexually active with multiple partners and exposed to numerous viruses and drugs. During this period, we also have diagnosed 20 cases of classic autoimmune thrombocytopenic purpura in heterosexual persons, with a normal women to men ratio of 3:1. Eight of nine homosexual patients had elevated platelet IgG compared with normal values in eight of 10 homosexual control subjects having normal hemograms (p less than 0.01). All responded moderately or completely to steroids. The three patients who had splenectomy had excellent responses. Four of five patients had a decreased helper/suppressor T cell ratio compared to healthy controls (p less than 0.001). Circulating immune complexes and total gamma globulin levels were elevated and lymphocytes relatively decreased in homosexual patients compared with homosexual controls (p less than 0.05). Thus, some sexually-active homosexual men seem to have an increased incidence of an immune regulation disorder directed against platelets.

Adult↗

Attitudes toward homosexuality: an overview.

In the last decade it has become clear that impairment of the psychological well-being of homosexuals has its origin in a society that discriminates and stigmatizes homosexuality. The article provides some basic information on homosexuality and continues with an overview of current knowledge on attitudes toward homosexuality. It gives special attention to the situation of homosexuality in Israel. Limited knowledge on the situation in Israel suggests that although there is an increase in tolerance toward homosexuality, it is not universally accepted and prejudice is common.

Attitude↗

Brain differentiation and preferred partner characteristics in heterosexual and homosexual men and women.

OBJECTIVES: The current study examined and compared the preferred partner characteristics of heterosexual and homosexual men and women in relation to speculated patterns of brain differentiation underlying the preferences. Further, the study compared the preferences of butch versus femme homosexual women. METHODS: Two hundred twelve heterosexual and homosexual men and women completed questionnaires on which they rated themselves and their idealized sexual partners on various morphological and behavioral characteristics. RESULTS: Results of within-subjects multivariate analyses of variance (MANOVAs) showed that the pattern of preferred partner characteristics of heterosexual women is most consistent with the theorized brain differentiation underlying those preferences. There was varying support for the theory as it applies to the other three groups. Between-subjects MANOVAs provided evidence to support some of the predictions generated by theory on the differences in brain differentiation between heterosexual and homosexual men and women and between homosexual women categorized as butch and femme. CONCLUSION: The overall pattern of preferred partner characteristics among and between heterosexual and homosexual men and women does not support theory that holds that underlying brain differentiation between the groups is discrete and categorical. Rather, it supports theory that holds that differentiation manifests itself on a continuum leading to a variety of patterns of sexual orientation, and by extension, preferred partner characteristics.

Adolescent↗

[Investigation on emerging rate and prevalence of male homosexuality in Hangzhou City].

OBJECTIVE: To understand prevalence of male homosexuality in Hangzhou, Zhejiang Provicne of China. METHODS: To investigate emerging rate of male homosexuality and infer its prevalence in public gathering by observation at fixed points and questionnaire survey in gay men. RESULTS: There were 2 012.5 male homosexuals taking part in public gatherings, with 95% confidence interval of 1 899 - 2 129, in Hangzhou. Frequency of such activities they took part in was once every 3 - 15 days (11.3 +/- 2.7) days. Each gay man knew 1.51 +/- 0.33 (0 - 6) other male homosexuals who never exposed their sexual orientation. The emerging number of male homosexuals was 5 051.38. CONCLUSION: The emerging rate of male homosexuality was 0.58%, with its prevalence of about 1% - 2% in public gatherings in Hangzhou.

Adult↗

[Investigation of acquired immunodeficiency syndrome correlated with high risk sexual behavior and knowledge of male homosexuality in Hangzhou Province, China].

OBJECTIVE: To find out the acquired immunodeficiency syndrome (AIDS) correlated high risk sexual behavior and knowledge in male homosexuals in Hangzhou Province. METHODS: Using an self-designed anonymous questionnaire, 927 male homosexual were investigated anonymously in May 2003 to January 2004. RESULTS: Among the male homosexuals surveyed, the average age of this population was (29.8 +/- 9.9) years, the average number of sexual partners per person in past one year was 7.34 +/- 5.61. Among them, 199 (21.46%) had one sexual partner, 165 (17.79%) had 2 - 5 sexual partners, and 563 (60.73%) had more than 5 sexual partners, and 179 (19.30%) also had opposite-sex sexual partner the average number of opposite-sex sexual partner of this group was 1.16 +/- 0.21. According to sexual behavior, 40.66% of them used anal sexual behavior, 62.99% used oral sex, 74.11% used masturbation and 3.66% used oral-anal touch. Among 179 male homosexuals having opposite sexual partners, the percentage of using vagina sex, anal sex, oral sex and masturbation was respectively 59.77%, 36.87%, 40.22% and 26.25%. Although their understanding level about AIDS was high, the risk rate of sexual behavior among them was also very high. Only 11.11% of male homosexuals used condom when they had anal sex with same sex, most of them rarely used or never used protection measures. When having sex with female, almost none of them used protection. CONCLUSION: The risk rate of sexual behaviors in male homosexuals is very high that some appropriating and effective measures for prevention should be taken.

Acquired Immunodeficiency Syndrome↗

The alliance theory of homosexual behavior and the perception of social status and reproductive opportunities.

OBJECTIVES: The alliance theory holds that homosexual behavior in humans may have evolved because it reinforced same-sex alliances which contributed to survival and reproduction. The present study was designed to test this evolutionary hypothesis in view of the strongly negative perception of homosexual behavior. It was predicted that targets who engaged in homosexual behavior would be perceived as likely to achieve greater social status and reproductive opportunities when the behavior reinforced an alliance that led to increased social opportunities. METHODS: Three hundred sixteen men and women read scenarios in which a target engaged in homosexual behavior and then answered questions about the target's future social status and reproductive opportunities as measured by number of sexual partners. The data were analyzed in two 3 (social outcome: positive vs. neutral vs. negative) x 2 (gender of target) x 2 (gender of participant) analyses of variance. RESULTS: The results supported the predictions and demonstrated that targets were perceived as likely to have the greatest social status and reproductive opportunities in the positive outcome condition. CONCLUSION: The alliance theory of homosexual behavior may have heuristic value for the evolutionary study of homosexual behavior and its perception.

Adaptation, Psychological↗

[Phalloplethysmographic findings in homosexual pedophile offenders].

Using phalloplethysmographic tests comprising 20 coloured slides of four categories the authors examined 50 homosexual pedophil delinquents and a matched group of heterosexual men. The findings of the two compared groups differed significantly on exposure to three categories of erotic stimuli--adult heterosexual and homosexual objects and child homosexual objects. Only on projection of child heterosexual objects there were no statistically significant differences in the number and magnitude of positive vasomotor reactions recorded in the two groups. Men in the control group responded more frequently and more positively to adult heterosexual objects than homosexual pedophil delinquents. The latter responded more frequently positively to adult and child homosexual objects. In more than one quarter of the delinquents (13 men) a preference of child objects was found, i.e. a deviant pedophil orientation. In seven men the preference of child objects was without sexual differentiation, six men preferred homosexual child objects.

Adolescent↗

[Changes in sex behavior caused by fear of AIDS--an empirical study of male heterosexual and homosexual students].

UNLABELLED: This study examines changes in sexual behaviour in the context of the fear of being infected with the HI-Virus and, in particular, considers the influence of a relationship and of sexual orientation. The population studied included 72 homosexual and 54 heterosexual male students. RESULTS: (1) Only 7% of the heterosexuals, but 68% of the homosexuals report changes in their sexual behaviour pattern. (2) Among the homosexual group practice-oriented alterations (avoiding oral and anal sex or using condoms for these practices) and relationship-oriented alterations (reducing the number of sex partners) occur likewise. (3) Practice-oriented changes are less frequent among homosexuals with partners than those without. (4) Those homosexuals questioned who are in conflict with their homosexuality have less confidence in potential sex partners. They are more inclined to have "monogamous" relationships.

Acquired Immunodeficiency Syndrome↗

[HIV infection among homosexual and bisexual men in Denmark. Occurrence and transmission].

In Denmark, AIDS has primarily affected men with homosexual behavior. In order to follow the occurrence and development in this group, the sero-epidemiological investigations which focus on the underlying HIV epidemic are reviewed. HIV was introduced in Denmark towards the end of the nineteen-seventies and spread rapidly in the beginning of the nineteen-eighties among promiscuous homosexual men in Copenhagen to a level in which 1/4-1/3 were found to be infected in small selected materials. From the middle of the nineteen-eighties, decreasing tendencies were observed in the numbers of homosexual and bisexual men in whom antibodies to HIV were demonstrated for the first time. Epidemiological evidence suggests that the rate of spread of HIV among homosexual men slowed down in the second half of the nineteen-eighties. In 1985, it was estimated that at least 6,000 homosexual men were infected with HIV. No investigations justify new increased estimates of the numbers of HIV-infected homo- and bisexual men in Denmark. Epidemiological data demonstrate clearly that unprotected receptive anal coitus is the main route of infection for homosexually transmitted HIV. The risk of infection appears to be much lower for the active partner in anal coitus with an HIV-infected man. No epidemiological investigations have demonstrated oral sex as the route of infection for HIV among men although this does not exclude the possibility of HIV-infection in occasional cases of oral sex.

Acquired Immunodeficiency Syndrome↗

Specificity of anti-lymphocyte antibodies in sera from patients with AIDS-related complex (ARC) and healthy homosexuals.

The presence and specificity of anti-lymphocyte antibodies (ALA) was investigated in sera from male homosexuals with AIDS-Related Complex (ARC) as well as healthy homosexuals. Individuals in the healthy homosexual group had no detectable antibodies to human immunodeficiency virus (HIV). Antibodies reactive with normal peripheral blood mononuclear cells were detected by Western blot analysis in sera from both groups of homosexuals. Of those individuals whose sera contained ALA, 71% of ARC patients and 83% of healthy homosexuals had antibodies recognizing a 73 kilodalton (kD) molecule. ALA present in ARC sera reacted with CD3+, CD4+ and CD8+ lymphocytes while little reactivity with B cells was observed. Our results indicate that ALA appear in homosexuals prior to HIV infection and are reactive primarily with T lymphocytes. A 73 kD structure associated with the T cell membrane is frequently the target for these antibodies.

AIDS-Related Complex↗

Plasma basal levels of FSH, LH and testosterone in homosexual men.

Plasma basal levels of FSH, LH and total as well as apparent free testosterone were determined in homosexual and heterosexual males. Significantly higher FSH concentrations (mean +/- SD = 6,89+/-5.00 mlU/ml; P less than 0.01) and LH concentrations (28.2+/-30.7 mlU/ml; P less than 0.002) were found in plasma of 50 homosexual males compared with those of 24 or 40 heterosexual males 4.17 +/- 2.34 mlU/ml and 12.6 +/- 7.6 mlU/ml, respectively). Significantly lower free plasma testosterone was observed in 35 homosexual males (10.7 +/- 3.3 ng/100 ml; P less than 0.01) than in 38 heterosexual males (13.3 +/- 4.5 ng/100 ml), whereas total testosterone in plasma of homosexual males (590 +/- 148 ng/100 ml) showed no significant difference in comparison with the heterosexual control group (562 +/- 126 ng/100 ml). The tendency to higher FSH and LH values as well as to lower free testosterone concentrations in plasma compared with the heterosexual control group was more evident for effeminized than for non-effeminized homosexual males. FSH and LH concentrations in plasma of 5 transsexual males were also significantly higher (11.74 +/- 5.06 and 18.3 +/- 3.4 mlU/ml, respectively; P less than 0.02) than those of the heterosexual control group. Our findings may be explained by the possible existence of a prenatal testicular androgen deficiency in homosexual males that is widely compensated by increased gonadotrophin secretion in adult life.

Follicle Stimulating Hormone↗

Male homosexuality in western culture: the dilemma of identity and subculture in historical research.

This article examines recent historical literature dealing with concepts of homosexual identity and subculture. It focuses on the current historiographical debate between the essentialists and the social constructionists. Historians are searching for the origins of the modern homosexual and for ways to explain the unique development of homosexual identities and subcultures in western societies. The distinction is drawn between macroanalysis and microanalysis. After critically examining their efforts, the article suggests the need to avoid focusing on global historical forces, which might account for the emergence of a homosexual identity (macroanalysis), and, instead, to analyze carefully particular homosexual subcultures (microanalysis). This latter approach can provide insights into the variety of homosexual social roles and identities that have existed in history.

Cultural Characteristics↗

Homosexual identity formation as a developmental process.

Homosexual identity is conceptualized as a life-spanning developmental process that eventually leads to personal acceptance of a positive gay self-image and a coherent personal identity. Habermas' theory of ego development is utilized to provide a synthesis and understanding of the literature on the construction and maintenance of the homosexual identity. It is concluded that the homosexual identity generally emerges in a three-stage process in which the person progresses from: (1) an egocentric interpretation of homoerotic feelings to (2) an internalization of the normative, conventional assumptions about homosexuality to (3) a post-conventional phase in which societal norms are critically evaluated and the positive gay identity is achieved and managed. Developmental tasks associated with each stage are outlined in terms of their ego-integrative functions. Although the stages in the process of homosexual identity formation are theoretically the same for females and males, because of the paucity of research on the homosexual identity in females, this paper deals chiefly with males.

Adolescent↗

[Steady homosexual relationship and HIV infection].

In order to study the relative impact of a steady homosexual relationship on the presence of HIV antibodies, a cross-sectional study was undertaken of 719 homosexual men in Oslo during the period of 1983-1987. 74/719 (10%) were HIV positive. 37/74 (50%) of the HIV positives and 185/645 (29%) of the HIV negatives were having a steady homosexual relationship that had lasted six months or more (chi-square test, p < 0.05). In a multivariate logistic regression analysis the adjusted odds ratio of being HIV positive was 2.3 (1.3-4.3, 95% confidence interval (CI)) for homosexual relationship lasting 1/2-4 years and 3.1 (1.5-6.6, 95% CI) for homosexual relationship lasting 5 years or more as compared with not being in a homosexual relationship. The number of male partners and frequent anal intercourse were also significantly associated with presence of HIV antibodies. The results suggest that situational variables associated with a steady partnership may be barriers to HIV-preventive measures.

Adult↗

Direct comparison of the relationship between clinical outcome and change in CD4+ lymphocytes in human immunodeficiency virus-positive homosexual men and injecting drug users.

BACKGROUND AND METHODS: To compare rates of decline of CD4+ lymphocytes among human immunodeficiency virus-positive homosexual men and injecting drug users, we followed up prevalent human immunodeficiency virus-positive homosexual men and current or former injecting drug users from February 1988 through August 1991. Subjects were free of acquired immunodeficiency syndrome at study entry and had semiannual clinical and laboratory evaluation, including measurement of T-cell subsets, under common protocols. Initial levels and rates of change of CD4+ lymphocyte counts were compared according to cohort membership and clinical progression, defined by the development of thrush or an acquired immunodeficiency syndrome--defining illness. Median follow-up was 30 months for both cohorts. RESULTS: At study entry, homosexual men had lower absolute numbers of circulating CD4+ lymphocytes than did injecting drug users (459/microL [0.46 x 10(9)/L] vs 509/microL, respectively). During follow-up, homosexual men exhibited a faster decline in CD4+ lymphocyte counts as well as more frequent development of HIV-related symptoms (thrush or acquired immunodeficiency syndrome). In both cohorts, initial levels of CD4+ lymphocytes and rates of decline in these cells were strongly associated with progression of disease, defined as remaining asymptomatic, onset of thrush, or onset of acquired immunodeficiency syndrome. Once homosexual men and injecting drug users were stratified by disease progression, their initial levels and rates of decline of CD4+ lymphocyte counts were similar. Thus, crude differences between the two study groups largely resulted from differences in development of clinical symptoms. CONCLUSIONS: In these cohorts of homosexual men and injecting drug users, clinical outcome was much more important than risk group membership in determining changes in CD4+ lymphocyte numbers. The close similarity between the groups also suggests that drug use, ethnicity, and socioeconomic status play a minor role in the progression of human immunodeficiency virus infection.

Adult↗

Perceptions of general practice among homosexual men.

BACKGROUND: Primary care has an important role to play in the prevention and management of the human immunodeficiency virus (HIV). It has been suggested that homosexual men experience a variety of problems in relation to primary care. AIM: As part of a larger study, it was decided to examine the extent to which a sample of homosexually active men experienced difficulties in general practice and whether they consulted their general practitioner for problems related to HIV or the acquired immune deficiency syndrome (AIDS). METHOD: Homosexual men were recruited for interview in 1991-92 from a variety of sources including genitourinary clinics and homosexual organizations. RESULTS: Of 623 men registered with a general practitioner 44% had not informed their general practitioner of their sexual orientation and 44% of the 77 men who were HIV antibody positive, as confirmed by the study, had not informed their general practitioner of this fact. Men who viewed their practice as unsympathetic towards homosexual men were less likely to have informed their general practitioner of their sexual orientation or HIV status. The majority of men (87%) nevertheless viewed primary care as an appropriate source of HIV/AIDS advice. CONCLUSION: There is considerable scope for improvement in the acceptability of general practice to homosexual men.

Acquired Immunodeficiency Syndrome↗

Kaposi's-sarcoma-associated herpesvirus is detected in peripheral blood mononuclear cells of HIV-infected homosexuals more often than in heterosexuals.

PURPOSE: The Kaposi's-sarcoma-associated herpesvirus is thought likely to play an important part in the pathogenesis of Kaposi's sarcoma, which is the most common tumor in AIDS patients. To determine whether peripheral blood is also infected by the virus, we prospectively tested mononuclear cells from HIV-infected individuals, both with and without Kaposi's sarcoma. PATIENTS AND METHODS: Thirty-three patients with AIDS were studied. Twenty-three were homosexuals, and 10 of these patients had Kaposi's sarcoma. All 10 nonhomosexual patients were free of Kaposi's sarcoma. PCR amplification of peripheral blood mononuclear cells was performed for a 233-base-pair segment of Kaposi's-sarcoma-associated herpesvirus on all patients. Fisher's exact test was used to compare the patient groups. RESULTS: Kaposi's-sarcoma-associated herpesvirus sequences were detected in the peripheral blood mononuclear cells of homosexual men both with (7/10) and without (5/13) Kaposi's sarcoma. However, none of the nonhomosexual patients (0/10) had detectable virus. Therefore, those with Kaposi's sarcoma are at greater risk for Kaposi's-sarcoma-associated herpesvirus infection than patients without Kaposi's sarcoma, and among HIV-positive patients without Kaposi's sarcoma, homosexuals are more likely to have detectable Kaposi's-sarcoma-associated herpesvirus than are nonhomosexuals. In the homosexual patients, the presence of virus was unrelated to total CD4+ cell counts. A comparative dilutional analysis showed that the nonhomosexual patients had a low viral load in their peripheral blood mononuclear cells relative to most homosexuals with Kaposi's sarcoma. Sequential studies on two patients revealed clearing of the virus while on therapy; one patient was treated for HIV with the protease inhibitor indinavir, and the other patient was treated for Kaposi's sarcoma with liposomal doxorubicin. CONCLUSIONS: These results indicate that Kaposi's-sarcoma-associated herpesvirus is harbored in peripheral blood mononuclear cells of HIV-infected patients, and that the rates of infection are significantly higher in homosexual men compared with their nonhomosexual counterparts. The significance of viral clearing in response to therapy is unknown but warrants further study, as prophylactic treatment for this virus might alter the occurrence of Kaposi's sarcoma in this susceptible patient population.

AIDS-Related Opportunistic Infections↗

Birth order and male homosexuality: extension of Slater's index.

Homosexual men tend to be later-born children. Slater's index, the ratio of older sibs to all sibs, is consistently higher for male homosexuals than for comparable heterosexuals. According to some explanations of this tendency, homosexual men are later born with respect to their brothers and later born with respect to their sisters only secondarily and less strongly. We show that if sisters have no direct bearing on a brother's sexual orientation and brothers do, then [formula: see text] On the other hand, if sisters have the same bearing on a brother's sexual orientation as male sibs do, then [formula: see text] These ratios are calculated and compared in nine samples of homosexual men and nine corresponding samples of control heterosexuals. The first equation holds for homosexual men, and the second equation holds for heterosexual men. The late birth order of homosexual men is sex specific. What matters is a boy's birth order relative to his brothers only. This effect may have its origins in an immune reaction or in behavioral contagion.

Analysis of Variance↗