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PubMed2001

Gonorrhea in the HIV era: a reversal in trends among men who have sex with men.

OBJECTIVES: Gonorrhea cases among men who have sex with men (MSM) declined in the early years of the HIV epidemic. We evaluated more recent trends in gonorrhea among MSM through the Centers for Disease Control and Prevention's Gonococcal Isolate Surveillance Project. METHODS: Isolates and case information were collected from 29 US sexually transmitted disease (STD) clinics. Gonococcal urethritis cases among MSM were compared with those among heterosexual men, and cases among MSM in 1995 to 1999 were compared with earlier MSM cases. RESULTS: Of 34,942 cases, the proportion represented by MSM increased from 4.5% in 1992 to 13.2% in 1999 (P < .001). Compared with heterosexuals, MSM were older, more often White, and more often had had gonorrhea previously, although fewer had had gonorrhea in the past year. MSM with gonorrhea in 1995 to 1999 were slightly older than those with gonorrhea in 1992 to 1994, and a higher proportion had had gonorrhea in the past year. CONCLUSIONS: MSM account for an increasing proportion of gonococcal urethritis cases in STD clinics. Given recent evidence that gonorrhea may facilitate HIV transmission, these trends demand increased attention to safe sexual behaviors and reducing STDs among MSM.

Adult↗
PubMed2003

High-risk behaviors among men who have sex with men in 6 US cities: baseline data from the EXPLORE Study.

OBJECTIVES: We describe the prevalence of risk behaviors at baseline among men who have sex with men (MSM) who were enrolled in a randomized behavioral intervention trial conducted in 6 US cities. METHODS: Data analyses involved MSM who were negative for HIV antibodies and who reported having engaged in anal sex with 1 or more partners in the previous year. RESULTS: Among 4295 men, 48.0% and 54.9%, respectively, reported unprotected receptive and insertive anal sex in the previous 6 months. Unprotected sex was significantly more likely with 1 primary partner or multiple partners than with 1 nonprimary partner. Drug and alcohol use were significantly associated with unprotected anal sex. CONCLUSIONS: Our findings support the continued need for effective intervention strategies for MSM that address relationship status, serostatus of partners, and drug and alcohol use.

Adolescent↗
PubMedDate not supplied

The impact of T-ACASI interviewing on reported drug use among men who have sex with men.

Measurements of drug use and other illicit or stigmatized behaviors are subject to nontrivial underreporting biases. During in-person surveys, respondents are more likely to report such behaviors when interviewed using techniques that maximize interviewee privacy, e.g., use of paper SAQs and audio-CASI rather than questioning by human interviewers. Until recently, respondents in telephone surveys could not be offered similar privacy. A new technology, telephone audio computer-assisted self-interviewing (T-ACASI) overcomes this limitation of telephone surveys by allowing respondents to respond to a computer. A randomized experimental test of T-ACASI was embedded in the Urban Men's Health Study (UMHS). UMHS surveyed a probability sample of 2,881 men from four United States cities and who reported having sex with men. Respondents interviewed using T-ACASI reported a higher prevalence of drug use and drug-related behaviors than respondents interviewed by human interviewers. However, survey respondents were more likely to break off an interview when the interview was conducted by a T-ACASI computer rather than by a human interviewer.

Adolescent↗
PubMed2006

Men who have sex with men (MSM): how much to assume and what to ask?

In Australia, about 150,000 men aged 16-59 years identify as gay or bisexual, while a similar number identify as heterosexual but have some history of same-sex sexual contact. Pitts, Couch and Smith advise that the clinical implications for these men include more than sexual health concerns. They suggest several consultation skills that can help doctors to recognise these men and better meet their needs.

Australia↗
PubMedDate not supplied

Sexually transmitted diseases and sexual behavior in men attending an outpatients' clinic for gay men in Gothenburg, Sweden.

The prevalence of sexually transmitted diseases (STDs) diagnosed in men attending an outpatients' clinic for gay men from 1983 to 1997 and the results from a questionnaire survey concerning sexual behaviour conducted in 1994-96 are reported. The prevalence of gonorrhoea and chlamydia has decreased during the period, although in 1997 there was a micro-epidemic of gonorrhoea in gay men in Gothenburg. The results indicate that the reservoir of syphilis and hepatitis B in the gay population was eradicated during the early 1980s. Of altogether 1,808 HIV tests performed, 3.0% (n=55) were positive. In the questionnaire, the majority claimed they had sufficient knowledge on how HIV is transmitted, while 11.3% stated that they lacked that knowledge. Half of the patients stated that they had a steady sexual partner. Starting a new relationship was the most common reason (69%) for HIV screening. The use of condoms in anal and oral sex was 88% and 31%, respectively. Of those practising anal sex, 4% stated that they never used a condom. The prevalence of STDs has decreased in this period of time and safer sex is fairly well accepted, but the results also tell us that there is still a need for dedicated clinics like ours.

Adolescent↗
PubMed2000

HIV/AIDS among racial/ethnic minority men who have sex with men--United States, 1989-1998.

In the United States, racial/ethnic minority populations account for an increasing proportion of acquired immunodeficiency syndrome (AIDS) cases, including cases among men who have sex with men (MSM) (1). This report presents recent trends in AIDS incidence and deaths among MSM who belong to racial/ethnic minority populations, and compares data on human immunodeficiency virus (HIV) diagnoses with AIDS diagnoses during 1996-1998 among racial/ethnic minority MSM in the 25 states that have conducted confidential HIV surveillance and AIDS case surveillance since 1994. The findings indicate that among MSM, non-Hispanic black and Hispanic men accounted for an increasing proportion of AIDS cases and had smaller proportionate declines in AIDS incidence and deaths from 1996 to 1998. Of HIV and AIDS diagnoses among racial/ethnic minority MSM, the proportion who are young (aged 13-24 years) is higher than among white MSM.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs.

BACKGROUND: In Canada, inactivated hepatitis A vaccines are targeted selectively at those at increased risk for infection or its complications. In order to evaluate the need for routine hepatitis A vaccination programs in Vancouver for street youth, injection drug users (IDUs) and men who have sex with men (MSM), we determined the prevalence of antibodies against hepatitis A virus (HAV) and risk factors for HAV in these groups. METHODS: The frequency of past HAV infection was measured in a sample of Vancouver street youth, IDUs and MSM attending outreach and STD clinics and needle exchange facilities by testing their saliva for anti-HAV immunoglobulin G. A self-administered, structured questionnaire was used to gather sociodemographic data. Stepwise logistic regression was used to evaluate the association between presumed risk factors and groups and past HAV infection. RESULTS: Of 494 study participants, 235 self-reported injection drug use, 51 were self-identified as MSM and 111 met street youth criteria. Positive test results for anti-HAV were found in 6.3% of street youth (95% confidence interval [CI] 2.6%-12.6%), 42.6% (95% CI 36.2%-48.9%) of IDUs and 14.7% (95% CI 10.4%-19.1%) of individuals who denied injection drug use. Among men who denied injection drug use, the prevalence was 26.3% (10/38) for MSM and 12% (21/175) for heterosexuals. Logistic regression showed that past HAV infection was associated with increased age and birth in a country with high rates of hepatitis infection. Injection drug use among young adults (25-34 years old) was a significant risk factor for a positive anti-HAV test (p = 0.009). MSM were also at higher risk for past HAV infection, although this association was nominally significant (p = 0.07). INTERPRETATION: Low rates of past HAV infection among Vancouver street youth indicate a low rate of virus circulation in this population, which is vulnerable to hepatitis A outbreaks. An increased risk for HAV infection in IDUs and MSM supports the need to develop routine vaccination programs for these groups also.

Adolescent↗
PubMed2001

[Survey on the high risk behaviors related to acquired immunologic deficiency syndrome and sexually transmitted diseases among men who have sex with men in mainland China].

OBJECTIVE: To understand the high risk behaviors related to acquired immunologic deficiency syndrome (AIDS) and sexually transmitted diseases (STDs) among men who have sex with men (MSM) in mainland China. METHODS: A self-administrated anonymous mail survey was carried out in MSM throughout the mainland of China in 1999. RESULTS: One thousand eight hundred questionnaires were mailed out and 729 effective questionnaires were collected. The response rate was 40.5%. The average age of subjects was 31 years old. Their average age at first sexual intercourse with a man was 18.6 years old. Average number of male sexual partners were 39.2 out of which 75.7% reported having had anus-intercourse. In the latest year, 63.6% reported ever having sex with strange men, 39.8% reported ever having group sex, 9.3% reported having sold sex and 3.8% having bought sex. 50% of them reported ever having sex with women. One hundred thirty-three reported having been diagnosed STD. Sixty-two reported having tested for HIV antibody and 11 were positive. Two-thirds reported ever using a condom when having sex. CONCLUSION: High risk sexual behaviors were prevalent among MSM in mainland China with HIV infection rate already reaching a high level. Women having sex with MSM are at a greater risk of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Correlates of suicide attempts in an open cohort of young men who have sex with men.

OBJECTIVE: To investigate baseline correlates of attempted suicide in a large cohort of young gay and bisexual men. METHODS: Participants completed annual questionnaires asking demographic information, sexual behaviours, history of forced and paid sex, comfort with sexual orientation, use of illicit drugs, and validated measures of depression, social support, alcohol dependency, self-esteem and suicide ideation and attempts. Contingency table analysis and step-wise logistic regression were used to identify potential predictors of self-reported suicide attempts. RESULTS: Of 345 gay and bisexual men eligible for this cross-sectional analysis, 150 (43.5%) reported that they had ever considered suicide and 67 (19.4%) that they had attempted suicide at least once. After adjustment for multiple explanatory variables, the use of nitrite inhalants (poppers) (AOR = 2.37; 95% CI 1.30, 4.33), social support scores below the 75th percentile of all scores (AOR = 2.19; 95% CI 1.18, 4.09) and low or moderate self-esteem (AOR = 3.73; 95% CI 2.03, 6.86) were independently associated with elevated risk of attempted suicide. CONCLUSION: Our data indicate that men in this analysis who ideate or attempt suicide earlier in life are more likely to report lower social support and self-esteem, and high popper use.

Adult↗
PubMed2003

HlV/STD risks in young men who have sex with men who do not disclose their sexual orientation--six U.S. cities, 1994-2000.

To avoid social isolation, discrimination, or verbal or physical abuse, many men who have sex with men (MSM), especially young and minority MSM, do not disclose their sexual orientation. Young MSM who do not disclose their sexual orientation (nondisclosers) are thought to be at particularly high risk for human immunodeficiency virus (HIV) infection because of low self-esteem, depression, or lack of peer support and prevention services that are available to MSM who are more open about their sexuality (disclosers). However, the risks for HIV infection and other sexually transmitted diseases (STDs) are unknown for nondisclosers. To better understand the prevention needs of young MSM, CDC analyzed data from the Young Men's Survey (YMS) to compare HIV/STD risk differences between nondisclosers and disclosers. This report summarizes the results of that analysis, which indicate that 8% of 637 nondisclosers were infected with HIV compared with 11% of 4,952 disclosers. Among blacks, the prevalence of HJV infection was 14% among 199 nondisclosers compared with 24% among 910 disclosers.

Adolescent↗
PubMedDate not supplied

Anal dysplasia in men who have sex with men.

Risk factors for anal cancer include anal intercourse and infection with multiple strains of human papillomavirus, the causative agent of anal precancerous dysplasia. Several recent studies have shown that HIV-seropositive gay men are at greater risk for anal dysplastic lesions than seronegative gay men. Moreover, the risk for detection and progression of dysplastic lesions grows as the CD4+ cell count declines. A surgeon with a practice that includes gay men referred for anorectal disease presents data regarding the high prevalence of anal dysplasia in his patients.

Anus Neoplasms↗
PubMed2003

Results of an explorative empirical study on human mating in Germany: handsome men, not high-status men, succeed in courtship.

Recent research on human mating depicts men as searching for physical attractiveness (PA) and women as searching for status. To identify the mechanisms which lead to universal, biologically interpretable structures in social processes, we focused on the proximate causes for inter- and intrasexual differences in human mating preferences, attraction, and tactics. We collected data on 180 young singles (mean age 26.9 years) without a steady relationship. A questionnaire and a video sequence (20-30 seconds) of each subject was taken. Next, each video sequence was rated by approximately 20 individuals of the opposite sex, who also participated in this study. Surprisingly, the answers given by male and female subjects regarding sociosexual behaviour and mating preferences are predominantly congruent. Sex differences among preferences for good looking and high-status partners were small or even insignificant. Lower educated subjects had considerably higher status preferences than higher educated individuals. In both sexes, PA was much more preferred in a potential partner than status. For both sexes, physical appearance was decisive for the subject's dating attractiveness. Male, but not female dating attractiveness also correlates with a kind and charismatic appearance. Furthermore, there was a positive linear relationship between men's PA and their number of sexual partners within the last year. Men with more than four sexual partners were all above-average in PA, while the most attractive women had a medium number of sexual partners. However, in this respect, status had no influence. The results show that sex differences in mating are more complex than hitherto assumed.

Adult↗
PubMed2004

Trends in primary and secondary syphilis and HIV infections in men who have sex with men--San Francisco and Los Angeles, California, 1998-2002.

Because syphilis infection facilitates acquisition and transmission of human immunodeficiency virus (HIV), recent outbreaks of syphilis among men who have sex with men (MSM) in major U.S. cities, including San Francisco and Los Angeles, and reported increases in sexual risk behavior have raised concerns about potential increases in HIV transmission. In 2002, MSM accounted for the majority of primary and secondary (P&S) syphilis cases in men reported in San Francisco (93%) and Los Angeles (81%). To investigate a potential change in HIV incidence associated with the syphilis outbreaks in the two cities, local, state, and federal health officials analyzed data from HIV counseling and testing centers and a municipal sexually transmitted disease (STD) clinic. This report describes the results of that investigation, which indicated that, as of 2002, the outbreaks of syphilis had not had a substantial impact on HIV incidence among MSM in these two cities. However, the continued increase in syphilis cases in MSM underscores the need for integrated HIV- and STD-prevention strategies to control syphilis outbreaks and prevent potential increases in HIV infections (6,7) and for further systematic studies of HIV incidence among MSM infected with syphilis.

Adult↗
PubMed1991

Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men.

To investigate the gonadal dysfunction and changes in sex hormones in male patients with postnecrotic cirrhosis, and to compare them with those in alcoholic cirrhotic men, three age-matched groups of men (hepatitis B virus-related postnecrotic cirrhosis 27, alcoholic cirrhosis 21, normal controls 30) were studied. Twelve of the 21 (57%) alcoholic cirrhotics and 16 of the 27 (59%) postnecrotic cirrhotics had a history of impotence. Both alcoholic and postnecrotic cirrhotic patients had significantly lower basal testosterone, but higher estradiol and prolactin levels than the control group (p less than 0.05). However, no differences were noted between the two cirrhotic groups. The degree of reduced testosterone and increased prolactin levels correlated with the severity of the cirrhosis. Despite the low testosterone concentration, basal levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were not increased in the cirrhotic patients. All the three groups studied had normal FSH and LH responses to the stimulation of exogenous gonadotropin releasing hormone. On the basis of these results, we conclude that: (1) impotence and low testosterone level are not infrequent findings in men with hepatitis B virus-related postnecrotic cirrhosis, especially in those with decompensated liver function. (2) The liver disease per se is important for the development of male sexual dysfunction. (3) The derangement of hypothalamic-pituitary function may play a role in the sexual dysfunction and changes in sex hormones in male patients with cirrhosis.

Age Factors↗
PubMedDate not supplied

[The function of the hypophysis-gonadal system in men with diabetes and in men with thyroid diseases].

A study was made of indices of the hypophyseogonadal system in men with diabetes mellitus, in men with autoimmune thyroiditis and hypothyroidism, and in men with Basedow's disease. Sexual dysfunction was detected in 51% of patients with diabetes mellitus and in 78.5% patients with hypothyroidism. A high level of serum prolactin in these patients resulted in a decrease in the sensitivity of testicles to LH, causing a decrease in testicular androgenic function. It was confirmed by a low blood level of T and a decreased response of the gonads to CG administration. Patients with hypothyroidism demonstrated a decrease in the blood level of LH and TSH causing testicular dysfunction. An increased level of LH and T was found in patients with Basedow's disease. The absence of an adequate rise of the blood concentration of T in response to CG administration in this group of patients can be attributed to the fact that in Basedow's disease the hypophyseogonadal system functions under great strain.

Adolescent↗
PubMed1990

[Analysis of mortality among the population of productive age in Poland. I. Mortality among men and women and the higher mortality rate among men of productive age in Poland 1951-1985].

The paper presents the results of this study on mortality rate during the period of 1951-1985 for men and women aged 20-64. Moreover, the differences between male and female mortalities were analysed with a view of investigating the problem of excessive mortality ratio of men. In the period under study the descending and then ascending tendency of the mortality rate could be observed both in the male and female populations. Up to 1965 male mortality decreased gradually (by 35%) whereas the following years witnessed considerable rise of the level of male mortality (by 30% to 1985), which referred especially to males at the age range between 40 and 49, years. As regards the female population the mortality rate was decreasing till 1975. For the last 10 years increased female mortality has been observed, however, their dynamics is much more lower than that for the female group (by 6.2% less than for 1975). During the whole period examined i.e. 1951-1985 the excessive mortality ratio in men was found to be higher by 60.4%. High dynamics of the ratio concerned male population at lower age ranges.

Adult↗
PubMed1993

Predictors of sexual behavior change among men requesting their HIV-1 antibody status: the Chicago MACS/CCS cohort of homosexual/bisexual men, 1985-1986.

It has been proposed that human immunodeficiency virus (HIV) antibody testing and counseling are effective means of altering sexual behavior among individuals at risk of HIV infection and transmission. However, the evidence supporting this hypothesis is inconclusive. This study examines the factors associated with sexual behavior change among a group of participants in the Chicago MACS/Coping and Change Study (CMACS/CCS) who requested their HIV antibody status when they were first given the opportunity, between 1985 and 1986. A set of demographic and psychosocial predictors were tested in association with 4 possible outcome patterns of sexual behavior change during the time of antibody status disclosure. For comparative purposes, a randomly selected sample of men who did not request disclosure of their HIV antibody status was analyzed. The results revealed that, among the 177 individuals who requested disclosure, the group experiencing an adverse sexual behavior change (i.e., from low risk before disclosure to high risk after disclosure) reported, before disclosure, the highest level of mental distress and denial-fatalism coping strategies and had the lowest levels of social support compared with other groups being analyzed. The psychosocial predictor most strongly associated with adverse sexual behavior change appears to be the use of denial-fatalism coping. Such an association was not found among the nondisclosed comparison group. These results suggest that a subgroup of at-risk, well-educated, white men, with overall high knowledge of HIV transmission, may not benefit from current HIV counseling and testing. Such men at risk for adverse behavioral outcomes might be identified in advance of HIV-1 antibody testing by their psychosocial profile, and thus appropriate counseling resources could be targeted to them.

AIDS Serodiagnosis↗
PubMedDate not supplied

DNA flow cytometry of sperm from normozoospermic men in barren couples and men of proven fertility.

OBJECTIVE: To determine the extent to which sperm chromatin varies in its degree of condensation in 53 apparently normozoospermic men and in 14 men of proven fertility. METHODS: DNA flow cytometry after staining of spermatozoa with ethidium bromide and mithramycin. RESULTS: Normozoospermic men could be divided into four subgroups according to the fluorescence pattern of their sperm DNA. More than half of the normozoospermic group and all of those of proven fertility shared a similar profile with a narrow symmetrical peak of haploid fluorescence without significant sub-populations. Deviations from this pattern were generally not associated with any major differences in sperm quality. CONCLUSIONS: (a) Current criteria for normozoospermia should be expanded to include additional tests of biochemical integrity. (b) Fertilizing ability appears to be associated with a relatively homogeneous profile of sperm DNA condensation.

Analysis of Variance↗