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PubMed1983

Lifestyle and antiviral antibody studies among homosexual men in Denmark.

Two-hundred and fifty-nine male homosexuals (HS) of a large and a small Danish town were studied for antibodies to various virus and their statistical relationship to sex habits, drug use and other lifestyle factors. Prevalence rates against cytomegalovirus (CMV) were 86.7% of HS men from Copenhagen and 73.3% of HS men from the smaller community of Aarhus, against 30% of a control group. Antibody prevalence in homosexuals was significantly related to number of years of homosexual activity (p less than 0.0001), number of partners (p less than 0.01), nitrite inhalant use in the past year (p less than 0.01), and independently to venereal disease during the past year (p less than 0.01). Titer levels correlated with number of years of HS activity (p less than 0.001), number of partners (p less than 0.01), and independently with nitrite use in the past year (p less than 0.01). The association between lifestyle and antibodies was not detectable for VCA-IgG, VCA-IgA, VCA-IgM, and EA antibodies to Epstein-Barr virus (EBV) or for antibodies to herpes simplex virus type 1 and type 2, parvovirus and rotavirus. In a subset of 78 HS men, T-helper/T-suppressor ratio was determined. No correlation was found between level of ratio and either prevalence or titer of antibodies against CMV, EBV-components or herpes type 1 and 2.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Homosexual preoccupation in a gero-psychiatric client: a case for psychoanalytically oriented therapy.

The author embraces the theoretical position that the failure of a girl to establish female identification is preceded by failure to individuate, which causes a regression to an earlier, symbiotic stage. She believes that this is particularly relevant in relation to the aging homosexual female, given that significant loss and separation occur in later life. The capacity to cope with separation and loss can only develop if the individual is capable of self-object differentiation. The case history of a 70-year-old female homosexual is presented to support the author's conclusion that psychoanalytically oriented therapy is the treatment of choice for the aging homosexual female.

Aged↗
PubMed1997

Rural school nurses' attitudes about AIDS and homosexuality.

The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.

Acquired Immunodeficiency Syndrome↗
PubMed2003

When therapists do not want their clients to be homosexual: a response to Rosik's article.

This commentary is a response to Rosik's "Motivational, Ethical, and Epistemological Foundations in the Treatment of Unwanted Homoerotic Attraction" (this issue). Such treatment raises complex questions that cannot be resolved by focusing on the therapist's conservative versus liberal values. Most such clients are deeply ambivalent about their homosexual attractions. The degree to which their homosexuality is "unwanted" is highly variable among them and sometimes within them over time. Clients who are exclusively homosexual are very unlikely to be able to change their sexual attractions, whereas some clients who are bisexual may be more able to "manage" their homoerotic attractions (acting only on their heterosexual feelings). Marriage and family therapists should be able to support a client along whatever sexual orientation path the client ultimately takes, and the client's sense of integrity and interpersonal relatedness are the most important goals of all.

Attitude↗
PubMed1999

Male homosexuality: absence of linkage to microsatellite markers at Xq28.

Several lines of evidence have implicated genetic factors in homosexuality. The most compelling observation has been the report of genetic linkage of male homosexuality to microsatellite markers on the X chromosome. This observation warranted further study and confirmation. Sharing of alleles at position Xq28 was studied in 52 gay male sibling pairs from Canadian families. Four markers at Xq28 were analyzed (DXS1113, BGN, Factor 8, and DXS1108). Allele and haplotype sharing for these markers was not increased over expectation. These results do not support an X-linked gene underlying male homosexuality.

Alleles↗
PubMed1984

Large-scale serological screening for cytomegalovirus antibodies in homosexual males by enzyme-linked immunosorbent assay.

We compared an enzyme-linked immunosorbent assay (ELISA) with complement fixation and radioimmunoassay in determining the presence of immunoglobulin antibodies to cytomegalovirus. Of an initial 93 serum samples tested, the correlation between ELISA and radioimmunoassay was 98.9% and that between ELISA and complement fixation was 96.1%. ELISA was used to screen 1,123 homosexual men in San Francisco. Of 479 men attending a homosexual health fair, 35 (7%) lacked cytomegalovirus antibodies by ELISA. Only 15 (2%) of 644 homosexual men attending a municipal sexually transmitted disease clinic were found to be seronegative. All but one of the seronegatives detected by ELISA were also seronegative by radioimmunoassay and complement fixation. We conclude that ELISA can be used to reliably perform large-scale screening for the presence of immunoglobulin G antibodies to cytomegalovirus.

Antibodies, Viral↗
PubMed1983

Prevalence and incidence of hepatitis A among male homosexuals.

In a study of 689 male homosexuals 290 (42%) were found to have antibodies to hepatitis A virus. The 399 men who did not have antibodies were followed up for up to 690 days, and 35 cases of hepatitis A were detected. The attack rate at the end of the study was 14%. The incidence climbed steadily, indicating that the cases of hepatitis A did not occur in clusters. Statistical analysis showed that the prevalence of antibodies to hepatitis A virus was significantly correlated with the duration of homosexual activity (p less than 0.006), and this was independent of age. The incidence of hepatitis A was found to be correlated with the number of different sexual partners in the preceding six months. It is concluded that hepatitis A is a sexually transmitted disease among homosexual men in countries with a low rate of exposure to hepatitis A during childhood.

Adolescent↗
PubMed1984

Seroepidemiology of HTLV-III antibody in Danish homosexual men: prevalence, transmission, and disease outcome.

Sera taken from 250 Danish homosexual men in December 1981 as part of a prospective study of the acquired immunodeficiency syndrome (AIDS) were examined for the presence of HTLV-III antibody with an enzyme-linked immunosorbent assay. Antibody was present in 22 (8.8%) of the men. Seropositivity was most strongly associated with sexual exposure to men in the United States (relative risk 3.5; p less than 0.007). Increased frequency of anal receptive intercourse was also independently associated with seropositivity (p less than 0.05), but age, years of homosexual experience, number of homosexual partners, and use of nitrite inhalant were not independent risk factors. The frequency of seroconversion from absence to presence of HTLV-III antibody appeared to be about 1% a month in this community during December 1981 to February 1983. Of the 22 men who were originally seropositive, two (9%) subsequently developed AIDS as defined by the Centre for Disease Control and two (9%) others the AIDS related complex. Blood was taken in addition from two of the men to develop AIDS earliest in Denmark (diagnosed 1981) at the same time as the initial survey in 1981; both were seropositive. The spread of HTLV-III from high to low risk areas and the subsequent appearance of illnesses related to AIDS in the seropositive group support the hypothesis that HTLV-III is causally related to the development of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Outcome of untreated infection with Entamoeba histolytica in homosexual men with and without HIV antibody.

Among homosexual men the prevalence of infection with Entamoeba histolytica is high. To determine the clinical importance of this infection 55 homosexual men carrying the parasite were investigated in detail. No clinical, serological, or histological evidence of invasive amoebiasis was found in any of them. The patients were not treated and were followed up for 12 to 29 months (mean 21.6 months), during which period none developed symptoms that could be attributed to E histolytica. Spontaneous loss of the parasite occurred in 17 patients, some of whom later became reinfected. Sixteen patients had antibody to human immunodeficiency virus, and infection with E histolytica showed the same benign course in them as in the patients who did not have antibody. Throughout the study classification of the isolates of E histolytica consistently showed that they belonged only to non-pathogenic zymodemes. The findings provide further evidence that E histolytica in homosexual men is a commensal organism.

Animals↗
PubMed1993

Clinical symptoms associated with seroconversion for HIV-1 among misusers of intravenous drugs: comparison with homosexual seroconverters and infected and non-infected intravenous drug misusers.

OBJECTIVE: To study the clinical symptoms associated with seroconversion for HIV-1 among misusers of intravenous drugs. DESIGN: Case-control study in cohorts of drug misusers and homosexual men. SETTING: Outpatient clinic, Municipal Health Service, Amsterdam. SUBJECTS: Misusers of intravenous drugs from our prospective cohort who seroconverted for HIV. Controls were drug users positive for HIV, drug users negative for HIV, and homosexual men who had seroconverted. RESULTS: Five out of 18 (28%) drug users were admitted to hospital with bacterial pneumonia in the four to six months between their last visit at which they were HIV negative and their first visit when they were HIV positive. For comparison none of the 27 homosexual men who seroconverted for HIV, three out of 177 (2%) drug users negative for HIV, and 10 out of 112 (9%) drug users positive for HIV reported bacterial pneumonia. One out of the 18 drug users who seroconverted suffered from oesophageal candidiasis at the time of seroconversion. Other clinical symptoms did not differ between drug users who seroconverted and those who remained negative for HIV, probably due to the high background morbidity among the drug users. CONCLUSIONS: Seroconversion to HIV-1 among intravenous drug misusers is associated with bacterial pneumonia. Those drug users with previously negative test results for HIV who are admitted to hospital for bacterial pneumonia should be tested to detect primary infection with HIV-1.

Bacterial Infections↗
PubMed1993

Sexually transmitted diseases and HIV-1 infection among homosexual men in England and Wales.

OBJECTIVE: To examine surveillance data for evidence of changing sexual behaviour and continuing transmission of HIV-1 among men who have sex with men. DESIGN: Analytic study of surveillance data on sexually transmitted diseases. SETTING: England and Wales. MAIN OUTCOME MEASURES: Number of cases of rectal gonorrhoea and newly diagnosed HIV infection in homosexual men. RESULTS: New cases of gonorrhoea among men attending genitourinary medicine clinics increased by 7.7% in 1989 and by 4.2% in 1990. Reports of rectal isolates of Neisseria gonorrhoeae also rose and the male to female ratio for patients with rectal gonorrhoea changed from 0.3:1 during 1988-9 to 2.6:1 in 1990-1. Although the overall number of cases of acute hepatitis B fell during 1988-91, 81 and 82 homosexual men were infected in 1990 and 1991 respectively compared with 50 and 42 in 1988 and 1989. 1526 men had HIV-1 infection diagnosed in 1991, the largest number since 1987. Twenty eight of the 97 (29%) men who seroconverted between January 1989 and December 1991 were aged less than 25. The proportion of men aged 15-19 who were found to be infected with HIV-1 at their first test increased from an average of 2.4% up to 1990 to 4.7% in the first nine months of 1991. The prevalence of HIV infection in men under 25 attending genitourinary medicine clinics in London was 17% compared with 7.8% outside London. CONCLUSION: Unsafe sexual behaviour and HIV transmissions have increased among homosexual men after a period of decline. Recent HIV transmissions may disproportionately affect younger men.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Treatments of homosexuality in Britain since the 1950s--an oral history: the experience of professionals.

OBJECTIVE: To investigate the experiences of professionals who administered and evaluated treatments for homosexuality in Britain since the 1950s. DESIGN: A nationwide study based on qualitative interviews. PARTICIPANTS: 30 health professionals who developed and practised treatments for homosexuality. RESULTS: A range of treatments were developed to make homosexuals into heterosexuals, the most common of which were behavioural interventions. Treatments were based on little evidence of effectiveness and were open to the criticism that legal or social pressures coerced patients. Treatments did not become mainstream within British mental health services. With hindsight, professionals realised that they had not appreciated the influence of social context on sexual behaviour. Most now regarded same sex attraction as compatible with psychological health, although a small minority considered that the option to try to become heterosexual should still be available to patients who desire it. CONCLUSIONS: Social and political assumptions sometimes lie at the heart of what we regard as mental pathology and serve as a warning for future practice.

Aged↗
PubMed2006

Attempted suicide, psychological health and exposure to harassment among Japanese homosexual, bisexual or other men questioning their sexual orientation recruited via the internet.

OBJECTIVE: To investigate the rates of attempted suicide and its association with psychological distress, experiences of bullying and verbal harassment, and demographic characteristics among Japanese homosexual, bisexual or other men questioning their sexual orientation. DESIGN: A cross-sectional design using Japanese participants recruited through the internet. RESULTS: Of the 1025 respondents, 154 (15%) of the men reported a history of attempted suicide, 716 (70%) showed high levels of anxiety and 133 (13%) showed high levels of depression. 851 (83%) experienced school bullying and 615 (60%) were verbally harassed because of being perceived by others as homosexual. Independent correlates of attempted suicide were psychological distress, history of being verbally harassed, history of sex with a woman, history of meeting a male through the internet, disclosing sexual orientation to six or more friends and not having a university degree. CONCLUSIONS: Mental health services and prevention programmes are needed to deal with the psychological consequences of social stigma for Japanese men who are homosexual, bisexual or questioning their sexual orientation.

Adolescent↗
PubMed1975

Homosexuality and the medical profession: a behaviourist's view.

That a homosexual -- man or woman -- is neither a sinner nor a sick person is the thesis of this paper by an authority on sexual deviation. Therefore, such a man or woman neither needs penance and pardon nor cure in the medical sense. Nevertheless such individuals sometimes need the help of doctors and must be treated with understanding. The medical profession also has, in the view of the behaviourist school of psychiatrists, of which Dr Bancroft is a member, the duty of influencing social attitudes towards homosexuals. Obviously homosexuals who come into conflict with the law are special cases, and must be treated as such but this is not 'medical' treatment so much as social control even if drugs and other forms of therapy are used.

Attitude↗
PubMed2005

Increase of sexually transmitted infections, but not HIV, among young homosexual men in Amsterdam: are STIs still reliable markers for HIV transmission?

OBJECTIVES: The incidence of HIV and STIs increased among men who have sex with men (MSM) visiting our STI clinic in Amsterdam. Interestingly, HIV increased mainly among older (> or =35 years) MSM, whereas infection rates of rectal gonorrhoea increased mainly in younger men. To explore this discrepancy we compared trends in STIs and HIV in a cohort of young HIV negative homosexual men from 1984 until 2002. METHODS: The study population included 863 men enrolled at < or =30 years of age from 1984 onward in the Amsterdam Cohort Studies (ACS). They had attended at least one of the 6 monthly follow up ACS visits at which they completed a questionnaire (including self reported gonorrhoea and syphilis episodes) and were tested for syphilis and HIV. Yearly trends in HIV and STI incidence and risk factors were analysed using Poisson regression. RESULTS: Mean age at enrollment was 25 years. The median follow up time was 4 years. Until 1995 trends in HIV and STI incidence were concurrent, however since 1995 there was a significant (p<0.05) increase in syphilis (0 to 1.4/100 person years (PY)) and gonorrhoea incidence (1.1 to 6.0/100 PY), but no change in HIV incidence (1.1 and 1.3/100 PY). CONCLUSIONS: The incidence of syphilis and gonorrhoea has increased among young homosexual men since 1995, while HIV incidence has remained stable. Increasing STI incidence underscores the potential for HIV spread among young homosexual men. However, several years of increasing STIs without HIV, makes the relation between STI incidence and HIV transmission a subject for debate.

Adult↗
PubMed2004

Lessons from the syphilis outbreak in homosexual men in east London.

OBJECTIVES: To describe the epidemiology, presentation, and diagnosis of early syphilis in 103 homosexual men in east London. METHODS: A retrospective study using data from KC60 returns, the Health Protection Agency (HPA) enhanced surveillance forms and case notes. RESULTS: 40 cases of primary (PS), 40 of secondary (SS) and 23 of early latent syphilis were identified, 33% co-infected with HIV. 41% had concurrent sexually transmitted infections (STIs). Pain featured in 35% of PS and itch in 13% of rashes. Dark ground microscopy (DGM), performed in 44 of the symptomatic cases, was positive in 37 (84%) allowing early management. Initial syphilis serology was negative in 15/40 (37%) cases of PS. 51% and 49% opted for parenteral and oral treatment, respectively. In 53/103 (51%) cases oral sex was the only risk factor. 86% of infections were UK acquired. Only 4% of contacts were seen. CONCLUSION: This outbreak, reflecting the resurgence of syphilis across the United Kingdom, highlights several important points. Painful chancres and itchy rash are common presentations. DGM is a highly sensitive diagnostic tool. Initial negative serological screening tests are common in PS and sero-surveillance for 3 months is recommended. The high prevalence of concomitant STIs indicates ongoing unprotected sexual intercourse. Oral sex is a significant risk factor and is a distinctly "unsafe" practice. Conventional partner notification is ineffective. Other methods of screening of the at-risk homosexual population are warranted. Continued education is required to reduce STI acquisition in homosexual men.

Adolescent↗
PubMed1977

Hepatitis B antigen and antibody in a male homosexual population.

Sera from 600 male homosexual patients were tested for hepatitis B antigen (HBs Ag) and its antibody (HBs Ab). Thirty-one men (5-2%) were positive for HBs Ag. Testing for HBs Ab by immuno-osmoelectrophoresis 33 men (5-5%) were positive. However, sera of 85 patients negative for HBs Ab by routine methods were examined for HBs Ab by radioimmune assay. Thirty (35%) sera were found to be positive. No absolute correlation between the detection of HBs Ag, or previous history of hepatitis, jaundice, or current hepatitis was found. Similarly there was little correlation between presence of HBs Ab and this history. These observations suggest that the male homosexual population represents a pool of individuals within which the hepatitis B virus is readily transmitted, mainly as a subclinical infection although clinical hepatitis does occur in some patients. It is suggested that further work is necessary to determine whether the high antibody rate in male homosexuals is related more to sexual practice than to promiscuity.

Adolescent↗
PubMed1981

Sexual behaviour and sexually transmitted disease patterns in male homosexuals.

Male homosexual behaviour is not simply either "active" or "passive", since penile-anal, mouth-penile, and hand-anal sexual contact is usual for both partners, and mouth-anal contact is not infrequent. A simplified method for recording sexual behaviour--a "sexual behaviour record (SBR)"--can be of value in determining the sites to be investigated and as a basis for further epidemiological questioning. Mouth-anal contact is the reason for the relatively high incidence of diseases caused by bowel pathogens in male homosexuals. Trauma may encourage the entry of micro-organisms and thus lead to primary syphilitic lesions occurring in the anogenital area. Similarly, granuloma inguinale, condylomata acuminata, and amoebiasis may be spread from the bowel of the passive homosexual contact. In addition to sodomy, trauma may be caused by foreign bodies, including stimulators of various kinds, penile adornments, and prostheses.

Anal Canal↗