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PubMed2004

Use of gay Internet sites and views about online health promotion among men who have sex with men.

In May-June 2002, 4,974 men who have sex with men (MSM), average age 31 years, completed a self-administered questionnaire online accessed through two popular gay Internet sites in the UK (gaydar and gay.com UK). Most men were white (95%), employed (83%), lived in the UK (91%) and self-identified as gay (85%). Nearly half (46%) had not been tested for HIV, while 6% said they were HIV-positive. One-third (31%) reported high-risk sexual behaviour in the previous three months, i.e. unprotected anal intercourse with a partner of unknown or discordant HIV status. Nearly all the men (82%) had looked for a sexual partner on the Internet and three-quarters had been doing so for more than a year. Almost half the men (47%) said they preferred to meet men through the Internet rather than in bars or other 'offline' venues. Although nearly 40% of men said the most important reason for using these Internet sites was to find sexual partners, a further 17% said they primarily used them to have contact with other men, 16% because they were bored, 12% for entertainment, 4% because they were lonely and 3% because they were addicted to it. The majority of men in this survey had favourable attitudes towards online health promotion. Most men thought that Internet sites should allow health workers into chat-rooms (75%); would click on a banner to find out about sexual health (78%); and said if they met a health worker in a chat-room they would find out what they had to say (84%). In multivariate analysis, being HIV-positive, older age and high-risk sexual behaviour were all independently associated with an increased frequency of using the Internet to look for sex (p<0.05). The Internet has emerged as an important meeting place for men who have sex with men. As online HIV prevention initiatives are developed it will be important to monitor the extent to which the favourable attitudes seen here are reflected in preventive behaviours.

Adult↗
PubMed2005

Muscle endurance is greater for old men compared with strength-matched young men.

The purpose was to compare the time to task failure for a sustained isometric contraction performed at a submaximal intensity with the elbow flexor muscles by young and old men who were matched for strength. Eight young men (18-31 yr) and eight old men (67-76 yr) sustained an isometric contraction at 20% of maximal voluntary contraction (MVC) torque until the target torque could no longer be achieved for at least 5 s. The maximal torque exerted at the wrist was similar for the young and old men before the fatiguing task (65.9 +/- 8.0 vs. 65.4 +/- 8.7 N x m; P > 0.05), and they experienced similar reductions in MVC torque after the fatiguing contraction (31.4 +/- 10.6%; P < 0.05). The time to task failure was longer for the old men (22.6 +/- 7.4 min) compared with the strength-matched young men (13.0 +/- 5.2 min; P < 0.05), despite each group sustaining a similar torque during the fatiguing contraction (P > 0.05). The increases in torque fluctuations, electromyographic (EMG) bursting activity, and heart rate were greater for young men compared with the old men, and they were less at task failure for the old men (P < 0.05). Mean arterial pressure increased at a similar rate for both groups of men (P > 0.05), whereas the averaged EMG activity and rating of perceived exertion reached similar values at task failure for the young and old men (P > 0.05). These findings indicate that the longer time to task failure for the old men when performing the submaximal contraction was not due the absolute target torque exerted during the contraction.

Adolescent↗
PubMed1993

Condom use and sexual identity among men who have sex with men--Dallas, 1991.

Safer sex practices intended to reduce the risk for human immunodeficiency virus (HIV) infection have been vigorously promoted among men who are homosexual or bisexual (i.e., men who have sex with men). Such efforts have emphasized personal responsibility and protection of partners, and many of these men appear to have adopted risk-reducing behaviors (1). However, it is unknown whether these safer sex practices and norms have been adopted by men who have sex with men but conceal their sexual orientations or do not self-identify as homosexual or bisexual (2-7). To characterize the relation between the adoption of safer sex practices among men who have sex with men and sexual self-identity, as well as HIV information-seeking, exposure to the homosexual or bisexual community culture, and comfort in disclosing sexual identity, the Dallas County (Texas) Health Department (DCHD) conducted a survey among men who have sex with men. This report summarizes survey findings for men who reported having had sex with men and who visited DCHD clinics for anonymous HIV counseling and testing from January through June 1991.

Condoms↗
PubMed2006

Sexual behavior among men who have sex with women, men, and Hijras in Mumbai, India--multiple sexual risks.

We describe the same-sex partnerships and sexual risk behavior of men attending sexually transmitted infection (STI) clinics in Mumbai, India. The HIV prevalence among 2,381 men sampled was 14%; 62% had a documented STI. Almost all men reported sex with women; additionally, 13% also reported having sex with other men, 13% reported sex with Hijras (male-to-female transgenders), and 11% had sex with all 3 genders. Men who had sex with men and/or Hijras as well as women, reported having greater numbers of partners, including female sex workers (FSW), and were more likely to engage in insertive anal and oral sex with women. The prevalence of HIV was higher among men having sex with Hijras (14%) or with all 3 genders (13%) than among men having sex with men and women (8%). A high proportion of men who attend STI clinics in Mumbai are behaviorally bi- or tri-sexual and have multiple partners with whom they engage in risky sex. STI/HIV prevention programs should not assume that men only have sex with women.

Adolescent↗
PubMed2006

Obesity, body image, and unsafe sex in men who have sex with men.

Little is known about the relationship among body weight, body image, and HIV/AIDS sexual risk behaviors. We examined this issue in a midwestern U.S. metropolitan area community sample of 316 men who have sex with men, a group at relatively high risk for HIV/AIDS. All data were self-reported by questionnaire using standard items to assess current body image, height and weight, and HIV/AIDS sexual risk behaviors. Logistic regression models were used to estimate cross-sectional associations. Forty-nine (15%) of the 316 men were classified as obese, and 56 (18%) had unsafe sex in the past three months. Normal weight or overweight men were 3.6 times more likely than obese men to have had unsafe sex, after adjusting for differences in body image and age. Men with better body image were 1.4 times more likely than men with lower body image to have had anal sex, after adjusting for differences in body weight and age. Non-obese men were no more or less likely than were obese men to have engaged in anal sex or in any sex in the past three months. This is the first study showing a positive relationship between below-obese body weight and unsafe sex and between better body image and anal sex in men who have sex with men. Future research should investigate these novel findings, perhaps using other study designs and data collection tools with less measurement error. Advances in knowledge about HIV/AIDS risk factors, including body weight and body image, could potentially contribute to more effective approaches to reducing this risk.

Adult↗
PubMed2003

The fear of prostate cancer in men with lower urinary tract symptoms: should symptomatic men be screened?

OBJECTIVE: To explore the concerns and worries in men with uncomplicated lower urinary tract symptoms (LUTS, but no evidence of prostate cancer) relating to their symptoms. PATIENTS AND METHODS: There is no current prostate cancer screening programme in the UK. Evidence suggests that men with LUTS have the same risk of prostate cancer as aged-matched asymptomatic men. However, most men with LUTS are 'screened' with a digital rectal examination (DRE) and prostate specific antigen (PSA) testing as part of routine assessment. Whether this screening offers any benefit to patients and whether national screening for prostate cancer and subsequent early treatment offer any long-term survival or quality of life benefit is uncertain. Thus 30 men with uncomplicated LUTS were qualitatively interviewed to explore their concerns and worries about their symptoms. Interviews were transcribed verbatim and subjected to content analysis using validated techniques. RESULTS: Of the 30 men, 22 (73%) expressed a fear of prostate cancer at the time of their initial presentation. This fear was independent of race, social class and symptom severity; older men were less worried. Of the 22, 15 (68%) stated that after reassurance their symptoms were less bothersome and easier to cope with. CONCLUSIONS: These findings suggest there is a considerable gain in health by explicitly addressing the concerns of prostate cancer in men with uncomplicated LUTS. Informing these men of their true risk of prostate cancer (before or after a DRE and PSA estimate) may alleviate much of the bother associated with their symptoms. Despite no evidence of any greater risk of prostate cancer than in asymptomatic men, symptomatic men should continue to be screened after appropriate counselling.

Decision Making↗
PubMed2003

Applying a social identity paradigm to examine the relationship between men's self-esteem and their attitudes toward men and women.

The authors used a psychometrically robust measure of attitudes toward men in applying a social identity framework to obtain a better understanding of the previous finding of a significant positive relationship, among men, between self-esteem and attitudes toward men. Two studies of that issue are reported. Northern Irish university students (N = 106 men) participated in the 1st study, and 56 English university students participated in a replication. In both studies, participants completed measures of attitudes toward men and women before and after an experimental intervention that was designed to produce a threat to self-esteem regarding their identity as men. The findings suggested that, following such a threat, men with a high positive regard toward men will have enhanced self-regard toward men and will tend to view women more negatively. The present findings also suggested that the application of social identity theory and the method used in the present research in investigating that theory are very relevant to the understanding of the relationship between men's self-esteem and their attitudes toward men and women.

Adolescent↗
PubMedDate not supplied

Humoral immune responses in healthy heterosexual, homosexual and vasectomized men and in homosexual men with the acquired immune deficiency syndrome.

In homosexual men, the acquired immune deficiency syndrome (AIDS) is associated with sexual promiscuity and the appearance of circulating immune complexes (CICs) and antibodies to spermatozoa which crossreact with lymphoid cells. A comparative study was initiated to determine whether similar humoral responses existed in 38 heterosexual men lacking sperm antibodies, 13 heterosexuals with sperm antibodies, 42 heterosexual vasectomized men, 22 healthy homosexual men, 26 homosexuals with lymphadenopathy and 16 with AIDS or Kaposi's sarcoma (KS). Sperm antibodies were detected in 12% of the vasectomized heterosexual men, 23% of the healthy homosexuals, 35% of the lymphadenopathy patients and 44% of the men with KS-AIDS. IgG reactive with peripheral blood T lymphocytes was present in only 3% of heterosexuals lacking sperm antibody and 5% of vasectomized men. In contrast, 23% of heterosexuals with sperm antibody, 36% of healthy homosexuals, 31% of men with lymphadenopathy and 62% of KS-AIDS patients were positive in this assay. Antibodies to the neutral glycolipid asialo GM1 were found in none of the vasectomized men, 3% of the heterosexuals without and 8% with sperm antibodies, 17% of healthy homosexuals and 38% and 31% in patients with lymphadenopathy or KS-AIDS, respectively. Lastly, the incidence of CICs, determined by the Raji cell assay, was 0% in vasectomized men, 3% in heterosexuals lacking sperm antibody, 31% in heterosexuals with sperm antibody, 69% in healthy homosexuals, 81% in lymphadenopathy patients and 87% in KS-AIDS. In the homosexuals with lymphadenopathy and KS-AIDS, levels of CICs, T cell-reactive IgG and asialo GM1 antibody were positively correlated (p less than 0.01). Sperm antibody levels were negatively correlated (p less than 0.01) with CICs levels and T cell reactive IgG in heterosexuals and lymphadenopathy and KS-AIDS patients. The results demonstrate that vasectomized men do not manifest at all, and that non-vasectomized heterosexuals with sperm antibodies manifest to a much lesser extent the range of humoral immune responses exhibited by the three homosexual groups. Thus, the route of sperm immunization and/or exposure to autologous vs. heterologous spermatozoa may be of critical importance for eliciting specific immune responses.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Sexual activity, fertility and contraceptive use in middle-aged and older men: Men in Australia, Telephone Survey (MATeS).

BACKGROUND: With limited information regarding fertility and sexual activity in the older population, men's behaviour, attitudes and concerns were explored in a representative population of middle-aged and older men using the Men in Australia, Telephone Survey (MATeS). METHODS: A stratified random national sample of 5990 men participated in a standardized computer-assisted telephone interview. Equal numbers in the age strata 40-49, 50-59, 60-69 and >or=70 years were surveyed with findings census-standardized to the national population. Broad aspects of men's health and well-being, including reproductive health, were explored. RESULTS: The majority of men were sexually active in the last 12 months (age-standardized proportion, 78.3%) with approximately 37% of men aged >or=70 years still continuing sexual activity. Overall, 12.2% of men had never fathered children, of whom most (7.7%) had chosen not to have children. Questioning on failed attempts to produce a pregnancy suggested an involuntary infertility rate of 7.6%. The age-standardized vasectomy rate was 25.1%, with 5.6% of vasectomized men having no children. Although 9.2% of vasectomized men regretted sterilization, only 1.4% had undergone vasectomy reversal. CONCLUSIONS: Continuing sexual activity, fertility and contraception needs in middle-aged and older men suggests that education and service delivery must be more appropriately directed to an ageing population.

Adult↗
PubMed1989

Increased mortality in men with ST segment depression during 24 h ambulatory long-term ECG recording. Results from prospective population study 'Men born in 1914', from Malmö, Sweden.

'Men born in 1914', from Malmö, Sweden, is a cohort study of the morbidity and mortality of cardiovascular diseases among 68-year-old men in an urban population. Ambulatory long-term ECG recording was part of the health examination that these men were invited to undergo in 1982. Five hundred attended (80.5%) of the 621 invited. Ninety-eight of the 394 men in whom the ECG recording was technically satisfactory had at least one episode with horizontal or downsloping ST segment depression greater than or equal to 0.1 mV. The median total duration of ST segment depression was 135 min. 90% of these episodes were not preceeded by any increase in heart rate. In only eight of the 47 men who reported an occurrence of chest symptoms during the recording period did ST segment depression and chest symptoms occur simultaneously. 43 months after the health examination, 33 (8.4%) men had died. The mortality in men without ST segment depression and without any history of coronary heart disease was 6.5%. The incidence of fatal and non-fatal myocardial infarction in men without ST depression greater than or equal to 0.1 mV and without a history of IHD was 2.3%. Men with ST depression greater than or equal to 0.1 mV in comparison with this group had a 4.4 times greater relative risk. The risk in men with both ST segment depression greater than or equal to 0.1 mV and history of coronary heart disease was 16.0 times greater. This study shows that asymptomatic ST segment depression is a frequent finding in elderly men. The occurrence of asymptomatic ST segment depression is associated with an increased cardiovascular mortality. This increased mortality is independent of a history compatible with angina pectoris or previous myocardial infarction.

Aged↗
PubMed2005

Are men with erectile dysfunction more likely to have hypertension than men without erectile dysfunction? A naturalistic national cohort study.

PURPOSE: : We examined whether men with erectile dysfunction (ED) are more likely to have hypertension than men without ED in a managed care setting. MATERIALS AND METHODS: : We used a naturalistic cohort design to compare hypertension prevalence rates in 285,436 men with ED to that in 1,584,230 men without ED from 1995 through 2001. We also used a logistic regression model to isolate the effect of ED on the likelihood of hypertension after controlling for subject age, census regions and 9 concurrent diseases. The ED and the nonED cohort came from a nationally representative, managed care claims database that covers 51 health plans and 28 million members in the United States. Finally, the prevalence rate difference between members with and without ED, and the OR of having hypertension were calculated. RESULTS: : The hypertension prevalence rate was 41.2% in men with ED and 19.2% in men without ED. After controlling for subject age, census region and 9 concurrent diseases the OR was 1.383 (p <0.0001), which implies that the odds for men with ED to have hypertension were 38.3% higher than the odds for men without ED. CONCLUSIONS: : Men with ED were more likely to have hypertension than men without ED. This evidence supports the hypothesis that ED shares common risk factors with hypertension. It also suggests that men with ED and clinicians could use ED as an alerting signal to detect and treat undiagnosed hypertension earlier.

Adolescent↗
PubMed2006

Reading men's faces: women's mate attractiveness judgments track men's testosterone and interest in infants.

This study investigated whether women track possible cues of paternal and genetic quality in men's faces and then map perception of those cues onto mate attractiveness judgments. Men's testosterone concentrations served as a proxy for genetic quality given evidence that this hormone signals immunocompetence, and men's scores on an interest in infants test were chosen as prima facie markers of paternal quality. Women's perceptions of facial photographs of these men were in fact sensitive to these two variables: men's scores on the interest in infants test significantly predicted women's ratings of the photos for how much the men like children, and men's testosterone concentrations significantly predicted women's ratings of the men's faces for masculinity. Furthermore, men's actual and perceived affinity for children predicted women's long-term mate attractiveness judgments, while men's testosterone and perceived masculinity predicted women's short-term mate attractiveness judgments. These results suggest that women can detect facial cues of men's hormone concentrations and affinity for children, and that women use perception of these cues to form mate attractiveness judgments.

Attitude↗
PubMed1997

Nasopharyngeal flora in HIV seropositive men who have sex with men.

OBJECTIVES: To assess, in men who were infected with the human immunodeficiency virus (HIV) and who identified themselves as having had sex with men; the nasopharyngeal prevalence of Neisseria gonorrhoeae, N meningitidis, Corynebacterium diphtheriae, and candida species; oral sexual behaviour; the relation between oral flora and oral sexual behavior. METHOD: Nasopharyngeal swabs were taken from HIV seropositive men for culture. The men were also asked to complete a self administered questionnaire. RESULTS: 390 men were recruited; 286 (73.3%) provided nasopharyngeal samples and questionnaires; 41 (10.5%) provided nasopharyngeal samples only; 63 (16.2%) provided questionnaires only. From the 327 nasopharyngeal samples N meningitidis was cultured in 49 (15%) and candida species in 165 (50.5%). Cultures for N gonorrhoeae and C diphtheriae were all negative. Data from the 349 completed questionnaires indicated that 285 men were practising oro-penile sex, over 90% did not consistently use condoms; 150 men were practising oro-anal sex, one used dental dams. In those providing both nasopharyngeal samples and sexual behaviour data meningococcal carriage was identified in 40 (17.5%) of the 228 men practising receptive oro-penile sex, compared with one (2.3%) of the 43 non-practisers (p < 0.025); in 21 (20%) of the 105 men practising insertive oro-anal sex, compared with 17 (12.5%) of the 136 non-practisers (p = 0.12). No correlation was identified between yeast carriage and oro-genital sex. CONCLUSION: Oro-genital sex, usually without barrier protection, is common among HIV infected men who have sex with men. It appears to be associated with increased meningococcal carriage but is autonomous to candida species isolation. Routine screening for nasopharyngeal N gonorrhoeae is not deemed necessary.

Candida↗
PubMed2002

Testosterone substitution of hypogonadal men prevents the age-dependent increases in body mass index, body fat and leptin seen in healthy ageing men: results of a cross-sectional study.

INTRODUCTION: In healthy men, body weight and total fat content increase with advancing age, while serum testosterone levels decrease. In order to elucidate whether a causal relationship between these phenomena exists, we investigated the influence of testosterone or human chorionic gonadotrophin substitution on body mass index (BMI), total fat mass and serum leptin in testosterone-treated and untreated hypogonadal patients in comparison with ageing eugonadal men. METHODS: In a cross-sectional study, the inter-relationships of body weight, total fat mass, serum sex hormones and leptin were analysed in untreated hypogonadal men (n=24; age 19-65 years), treated hypogonadal men (n=61; age 20-67 years) and healthy eugonadal men (n=60; age 24-78 years). Total fat mass was assessed by bioimpedance measurement. Univariate and multiple linear regression analysis was used to detect possible differences. RESULTS: In eugonadal men, serum testosterone levels decreased with advancing age (correlation coefficients: r=-0.71; P<0.0001), while BMI (r=0.39; P=0.002), total fat content (r=0.51; P<0.0001) and leptin (r=0.48; P<0.0001) increased significantly. In untreated hypogonadal patients, an increase in BMI (r=0.50; P=0.013) and total fat mass (r=0.41; P=0.044) was also observed with advancing age. However, in substituted hypogonadal patients, no age-dependent change in BMI (r=0.067; P=0.606), body fat content (r=-0.083; P=0.522), serum testosterone (r=-0,071; P=0.59) or serum leptin (r=-0.23; P=0.176) was found. CONCLUSION: Since testosterone-substituted older hypogonadal men show BMI and fat mass similar to those of younger eugonadal men and since non-treated hypogonadal men are similar to normal ageing men, testosterone appears to be an important factor contributing to these changes. Thus ageing men should benefit from testosterone substitution as far as body composition is concerned.

Adipose Tissue↗
PubMed2005

[Total antioxidant capacity of blood plasma in healthy men and in men with coronary heart disease].

BACKGROUND: The aim of the study was to determine the level of total antioxidant capacity (TAC) of blood plasma in healthy men and in men with coronary heart disease differentiated by their level of physical activity. MATERIAL AND METHODS: The study was carried out in the two groups of age-adjusted men. Group I comprised 100 healthy men aged 56.6 +/- 8.5 years and group II involved 100 men with identified coronary heart disease aged 56.6 +/- 7.2 years. BMI was determined in every participant. Level of energy expediture was determined by calculating the amount of hours per week spent for different recreational sports activities. Spectrophotometric method FRAP (Ferric Reducing Ability of Plasma) was applied to estimate total antioxidant capacity of blood plasma. RESULTS: Values of absorbance describing level of total antioxidant capacity of blood plasma in 1', 3' and 10' minut of reaction time window differed between groups. Men with coronary heart disease were characterised by higher antioxidant defense system than healthy ones. Energy expediture expressed in kcal per week was statistically higher in healthy subjects. In healthy men positive correlation was found between level of total antioxidant capacity (in 1', 3' and 10' minut of reaction time window) and BMI (p< or = 0.05). Statistically significant negative correlation was found for TAC and level of energy expediture. Among men with coronary heart disease there was statistically significant positive correlation between the values of total antioxidant capacity (in 1', 3' and 10' minut of reaction time window) and BMI. There was no statistically significant correlation neither between age and TAC, nor between energy expediture and TAC. CONCLUSIONS: The level of total antioxidant capacity estimated with FRAP method was higher in men with coronary heart disease in comparison with healthy men. Antioxidant potential was higher along with the increase of BMI in both groups. Increased energy expenditure was related to decreased total antioxidant capacity, but only in healthy men.

Adult↗
PubMed2005

Voluntary weight reduction in older men increases hip bone loss: the osteoporotic fractures in men study.

To test the hypothesis that weight loss in older men is associated with increased rates of hip bone loss regardless of adiposity and intention to lose weight, we measured body weight, body composition, hip bone mineral density (BMD), and intention to lose weight in a cohort of 1342 older men enrolled in the Osteoporotic Fractures in Men (MrOS) study and followed them prospectively for an average of 1.8 yr for changes in weight and BMD. The adjusted average rate of change in total hip BMD was 0.1%/yr in men with weight gain, -0.3%/yr in men with stable weight, and -1.4%/yr in men with weight loss (test for trend, P < 0.001). Higher rates of hip bone loss were observed in men with weight loss regardless of category of body mass index, body composition, or intention to lose weight. Even among obese (body mass index, > or =30 kg/m2) men trying to lose weight, those with documented voluntary weight reduction experienced an increase in hip bone loss (average rate of change in total hip BMD, 0.5%/yr in those with weight gain, -0.1%/yr in those with stable weight, and -1.7%/yr in those with weight loss; test for trend, P < 0.001). Older men who experience weight loss have increased rates of hip bone loss, even among overweight and obese men undergoing voluntary weight reduction.

Aged↗
PubMed1976

Gonorrhoea in the asymptomatic patient: presentation and the role of contact tracing for heterosexual men and women and for homosexual men.

Clinically silent gonorrhoea is the major problem in the control of the disease. Only 12 per cent of infected women reported in 1974 because of symptoms, compared with 97 per cent of infected heterosexual men and only 35 per cent of homosexual men with gonococcal proctitis alone. Homosexual men, compared with heterosexual men, had twice as many subsequent sexual contacts after infection and had a higher incidence of early syphilis. Eighty-four per cent had experienced passive anorectal intercourse. Ninety-seven per cent of men with gonococcal urethritis reported because of symptoms, but occasionally (particularly after unsuccessful treatment) urethral gonorrhoea in men may be clinically silent and even require tests of the overnight urethral secretion for diagnosis. For women, and for homosexual men who have had passive anorectal (or oral) intercourse, the indication for attendance for tests for gonorrhoea should be having run the risk, and not the presence of symptoms. Routine tests of the anorectum for gonorrhoea are essential in cases of 80 women at risk, and for most homosexual men since over 80 per cent of these men will have had passive anorectal intercourse. Because gonococcal infections following treatment-failure are often clinically silent in both women and men, symptoms cannot be relied upon to indicate such failure. Follow-up smears and cultures are always essential.

Anal Canal↗
PubMed1990

Homosexual and bisexual men's coping with the AIDS epidemic: qualitative interviews with 10 non-HIV-tested homosexual and bisexual men.

This paper describes how the threat of HIV infection is appraised and coped with by homosexual and bisexual men. Very little is known about men who do not want to be HIV tested, thus non-HIV-tested homosexual and bisexual men have been interviewed in depth about themes concerning their lives during the AIDS epidemic. Men with sexual risk behaviour appeared to be very reluctant to participate, and therefore six men with safe sexual behaviour and four men with unsafe sexual behaviour were interviewed. The results showed that all the men were well informed about AIDS and preventive measures. Reasons for not wanting a test were fear of psychological distress caused by a possible positive test and the fact that no treatment is available. The men who had adopted safe sex appraised their sex lives to have suffered a minor loss but found that sexuality played a subordinate role compared to trust and friendship. The men with risk behaviour considered sexuality to play an important role in their lives. They found condoms a barrier to intimacy and used defensive strategies to manage stress. Most of them were able to exchange social support with their network but had difficulties in setting their own limits. All four men had experienced undertreated traumatic events in their past. The results indicate that knowledge of AIDS and satisfactory social support do not necessarily result in safe sexual behaviour. The role of undertreated traumatic events forming barriers against adopting safe sexual practices should be further studied. Proposals are put forward for future health education programmes.

Acquired Immunodeficiency Syndrome↗