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PubMed1990

Natural killer cell responses in homosexual men with early HIV infection.

Natural killer (NK) cells may be of significance in host defense against viral infections. In the present study, NK cell function was examined in relation to different phases of human immunodeficiency virus (HIV) infection. Peripheral blood mononuclear cells were tested for NK cell activity using K562 cell targets in a 51Cr-release assay. NK cell responses of 26 HIV-seronegative homosexual men were not significantly different from those of 30 heterosexual controls. NK activity was significantly lower in cells from 32 homosexual men with documented, early-phase HIV infection (average of 14 months; range of 3-27 months) as compared with that of seronegative men. The NK cell response decreased with time, since men within the first year of infection (n = 15; average of 7.8 months; range of 3-12 months) had greater NK cell activity than did those with longer duration of infection (n = 17; average of 18.3 months; range of 13-27 months). The decrease in NK cell activity did not correlate with altered numbers of cells bearing CD16 (NK) markers in these subjects. NK cell-mediated lysis and cell numbers were most severely depressed in a separate group of HIV-seropositive men who had acquired immune deficiency syndrome (AIDS). In vitro treatment with alpha-interferon (alpha-IFN) significantly enhanced NK activity of effector cells obtained from men within the first year of HIV infection but not in those with longer-term infection. Our results indicate that NK cell function decreases over time within the first 2 years of HIV infection in homosexual men, and is lowest in HIV-seropositive men with overt AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1990

Effect of knowledge of human immunodeficiency virus infection status on sexual activity among homosexual men.

One hundred thirty-four homosexual men from a prospective cohort study of AIDS risk from New York City and Washington D.C. and 139 homosexual men from a similar cohort in Copenhagen and Aarhus, Denmark were questioned regarding their sexual practices and knowledge of their human immunodeficiency virus (HIV) status over the previous 12 months. Seventy percent of Danish men and 63% of U.S. men participated in anal intercourse during the previous 12 months. Knowledge of one's own HIV status by itself did not have any significant effect on participation in anal intercourse, partner number, or condom use. Only 23% of U.S. men and 24% of Danish men always asked potential partners about their HIV status. However, men who did ask were very unlikely to choose a partner of opposite HIV status (p less than 0.006). Danish men were more likely to practice anal intercourse without a condom than were the U.S. men (p less than 0.0001); however, Danes were more likely to be in a concordant monogamous relationship than were the U.S. men (p less than 0.001). Fourteen percent of U.S. men and 21% of Danish men were not aware of their own HIV status and 52% of the U.S. cohort and 31% of the Danes had anal intercourse with a man whose status was unknown to them. Overall, only 32% of American and 53% of Danish homosexual men were practicing completely safe sex. We suggest that education to promote the need for awareness of one's own and one's partner's HIV status should be stressed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Homosexuality and psychoanalytic hypocrisy].

The author criticizes the common practice in the national and international psychoanalytic associations of denying homosexual applicants admission to training even though all parties know full well that there are more than a few homosexual psychoanalysts within their ranks, some of whom enjoy the high professional esteem of their colleagues. The author refers to his earlier article "Homosexuality and psychoanalysis" (Psyche, 1985, 39, 750-759).

Educational Measurement↗
PubMed1990

[The immune status of homosexuals ill with different forms of syphilis].

Status of the cell-mediated, humoral immunity, and nonspecific defense factors were examined before and after specific therapy in 40 homosexuals suffering from secondary relapsing and latent early syphilis. The findings evidence that changes in the cell-mediated immunity of homosexual syphilitics essentially differ from those in heterosexuals with syphilis: decreased count of T-helpers and elevated one of T-suppressors evidence impaired ratio of T-lymphocyte subpopulations and immunoregulatory cell imbalance. A significantly increased level of C4 complement component was observed, evidencing a deficiency of the complement system. These data call for the development of a scheme of immunocorrective therapy for homosexuals suffering from syphilis.

Adolescent↗
PubMed1990

[Information about safe sex for homosexual men--a consumer assessment of the efforts hitherto made in Denmark].

Self-administered anonymous questionnaires were included in the nationwide gay magazines "Pan" and "Cock" with the object of revealing the needs and possibilities of improved health educational effort in prevention of sexually transmitted HIV infection among homosexual and bisexual men. This was undertaken in March 1988 to illustrate the utilization and satisfaction of various sources of safe sex. The investigation reveals that campaigns about safe sex have been of great interest among the section of the target group which an investigation of this type could attract. In particular, the general efforts made by the Danish Health Board have attracted attention in a very broad section of men with homosexual contacts. Among those who employ the offers specifically made for the target gay group, considerable satisfaction is expressed. Compared with this, the employment of and satisfaction with medical help are considerably less. The significance of connections with a series of sociodemographic and subcultural subgroups are illustrated. Only where the gay-specific information is concerned was a significant association observed between receipt of information and the replier's reproduction of the given information about the risks involved in use of condoms. As regards the significance of single sources for sexual behaviour, a non-significant tendency was observed for persons who had received gay-specific written information to have a lower sex risk than those who had not received this information. It is recommended that the campaign hitherto initiated should be continued with intensification of AIDS prevention among the hidden homosexual men and men with sexual contacts with both sexes.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Prevalence of cytomegalovirus, hepatitis B and HIV-1 antibodies in healthy blood donors, hospital patients, kidney transplant recipients, i.v. drug addicts and homosexuals].

Between 1987 and 1988 592 serum samples were analyzed in order to determine the prevalence of cytomegalovirus (CMV), hepatitis-B and HIV-1 antibodies among healthy blood donors and different risk groups in the region of Zurich, Switzerland. Samples from 100 healthy blood donors, 100 hospital patients, 100 renal transplant recipients, 142 iv drug addicts and 150 homosexuals were analyzed. Among 111 (74%) of the 150 homosexuals studied, antibodies against CMV were identified. On the other hand, only a third of the remaining probands proved to be anti-CMV positive (26-37%). All the groups aged between 20 and 39 years showed an increase in anti-CMV frequency with advancing age. Among the 47 homosexuals aged between 20 and 29 years, 30 (64%) were already anti-CMV positive. The relevance of CMV as a sexually transmissible disease is discussed.

Adult↗
PubMed1989

[Infection caused by the human immunodeficiency virus, hepatitis B virus and delta virus in homosexual males].

Serological markers of hepatitis B (HBV) and human immunodeficiency (HVI) viruses were investigated in the sera of 90 homosexual males. In addition, in HBsAg positive individuals antibodies against delta virus (DV) were also investigated. Forty sera (44.4%) were positive for HBV and HIV, 61 (67.7%) for HBV and 52 (57.7%) for HIV. HBsAg was detected in 8 cases (8.8%), 7 of which had positive anti-HIV sera. In no case infection by DV was detected. These data show the high prevalence of HBV and HIV infection in the study population. They also suggest that the HBsAg carrier status is more common among HIV positive homosexual males and that the investigated homosexual population has not yet been infected by DV.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[A group of homosexuals change their sex habits after information about AIDS. A questionnaire survey].

A questionnaire investigation to which 144 homosexual persons replied anonomously revealed alterations in the sexual habits after information about AIDS. Significant reduction in the annual number of partners and significantly fewer employ the more dangerous sexual practices which now occur particularly in more permanent partnerships are among the alterations started. An unchanged number still employ active anal and orogenital coitus. Employment of condoms has increased significantly, particularly in anal coitus and "casual" partners (from 3% to 82%). The majority accept the use of condoms and state that they employ more "safe sex" than prior to information about AIDS. 12% stated that they had sex with both sexes and the possibility of spread of infection from homosexual to heterosexual groups is present. The intensive informative work from the homosexuals own organisation and from public health authorities appear to have had some effect but further information and influencing are necessary if the spread of HIV infection is to be stopped.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Risk factors for human immunodeficiency virus (HIV) infection among homosexual and bisexual men in a region at low risk for AIDS: the northeastern part of Italy. AIDS and Related Syndromes Study Group.

Prevalence and determinants of HIV infection were assessed in 127 homosexual and bisexual men in the northeastern part of Italy. The overall prevalence of HIV seropositivity was still rather low: 20% (95% confidence interval -CI- 13-27%). The most important risk factor for acquiring HIV infection turned out to be having has sexual intercourses in high-risk areas. Relative risks (RRs) for those who have travelled and had sex in North Europe and in the U.S., were, respectively, 2.7 (95% CI: 1.0-7.3) and 5.6 (95% CI: 1.2-25.9). A significantly increased risk was also seen for having a steady sexual partner (RR = 3.1, 95% CI: 1.3-7.5). Use of nitrite inhalants, high number of occasional sexual partners and habitual receptive anal intercourses were also associated with elevation of risk, whereas prostitution was not. The present study confirms the patterns of HIV spread among homosexual and bisexual men from high-risk areas to low-risk areas and prompts urgent educational intervention, in order to prevent the epidemics of AIDS among Italian homosexuals from reaching the size documented in other countries.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Phenotypic and functional correlations in circulating lymphocytes of prodromal homosexuals and patients with AIDS.

Findings of selected phenotypic and functional parameters demonstrated significant aberrations in both prodromal homosexual males and patients with AIDS. An impaired blastogenic response to T-cell dependent B-cell mitogen was associated with a significant decrease in percentage of helper T cells but appeared unrelated to the percentage of suppressor T cells. The functional subsets of the latter were further defined by a panel of monoclonal antibodies (Leu8, Leu15, and HLA-DR) applying dual color flow cytometric techniques. In both homosexuals at risk and in AIDS patients, activated suppressor cells with the phenotype Leu2+Leu15+ and Leu2+HLA-DR+ were elevated while the reciprocal cytotoxic Ts cells (Leu2+Leu15- and Leu2+HLA-DR-) were depressed. Both subsets of suppressor precursor cells and effector cells (Leu2+Leu8+ and Leu2+Leu8-) were elevated particularly in high risk homosexual males. These results suggest a defective feedback loop that regulate both helper and suppressor T cells as well as B-lymphocyte functions and may explain the clinical manifestation of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Antibody to human lymphotropic virus type III: immunologic status of homosexual contacts of patients with the acquired immunodeficiency syndrome and the acquired immunodeficiency-related complex.

Twenty homosexual men who reported having sexual contact with homosexual men who had the acquired immunodeficiency syndrome (AIDS) or the AIDS-related complex were examined to determine their clinical status, immunologic profiles, and the presence of antibody to the human T-cell lymphotropic virus type III (HTLV-III). Of the 20, eight men had one or more signs or symptoms of the AIDS-related complex and 12 were asymptomatic. Antibodies to HTLV-III were present in 14 (70%) of 20 of the sexual contacts as compared with four (10%) of 40 healthy homosexuals without known contact with a patient who had AIDS (P less than .0001). Seropositive contacts had significantly higher mean counts of suppressor lymphocytes and lower helper: suppressor ratios (P less than .05 and .005, respectively) and higher serum levels of IgG than seronegative contacts (P less than .05). It was not possible to determine significant differences in sexual practices, drug use, length of relationship, or numbers of different sexual partners between symptomatic and asymptomatic contacts or between seropositive and seronegative contacts in this study.

AIDS-Related Complex↗
PubMed1987

Papillomavirus antigens in anorectal condyloma and carcinoma in homosexual men.

Squamous cell carcinoma of the cervix and vulva has been associated with infection by human papillomavirus. Recent epidemiologic studies have observed more anal carcinoma among single than married men. To investigate this association between human papillomavirus and squamous proliferative lesions of the anus, we studied eight homosexual or bisexual men with recent diagnoses of anorectal carcinoma and six older patients of unknown sexual orientation with similar diagnoses 20 to 30 years ago. Using an immunohistochemical stain for papillomavirus, we found evidence of its presence in the carcinomas of five (63%) of the eight homosexual men and in two (33%) of the six older patients. Only one homosexual patient had the acquired immunodeficiency syndrome. In the possibly immunocompromised patient, human papillomavirus antigen is present in anorectal dysplasia and carcinoma.

Adult↗
PubMed1986

Modulation in vitro of immune parameters in homosexual males with the preclinical complex of symptoms related to acquired immune deficiency syndrome by azimexon.

In search of potential therapeutic agents for the acquired immunodeficiency syndrome (AIDS) among homosexual males, we studied in vitro the immunorestorative effect of azimexon in patients with this syndrome. Since a reduction in the ratio between helper inductor and suppressor/cytotoxic T-cell subsets (OKT-4/OKT-8) seems to be the hallmark of the syndrome, we measured azimexon-induced numerical changes in T-cell subsets and correlated them with changes in a simultaneously tested T-cell function as measured by the xenogeneic local graft-versus-host reaction (GVHR). Following incubation of peripheral blood mononuclear cells from 10 homosexual subjects with 10 micrograms/ml of azimexon at 37 degrees C for 1 h, the median number of T cells defined by the OKT-8 phenotype declined from 0.6 X 10(3) to 0.33 X 10(3)/mm3 (p less than 0.02), resulting in an increase in the OKT-4/OKT-8 ratio from 0.65 to 1.37 (p less than 0.01). There were no numerical changes in T cells defined by OKT-3 and OKT-4 phenotypes. Similar decreases in OKT-8-defined T cell occurred among eight heterosexual controls. The restoration of the OKT-4/OKT-8 ratio among the homosexual subjects was associated with a significant improvement in their T-cell function. Thus, the median volume of the local GVHR increased from 38.2 to 63.5 mm3 (p less than 0.02). Parallel changes in OKT-4/OKT-8 ratio and changes in local GVHR following incubation with azimexon were observed. These results suggest that azimexon may be an important immunorestorative agent. Clinical trials with this agent in patients with AIDS or its preclinical complex of symptoms seem warranted.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Evolution of acute hepatitis B in homosexual men to chronic hepatitis B. Prospective study of placebo recipients in a hepatitis B vaccine trial.

To determine whether the frequency of chronic hepatitis B in homosexual men reflects the high rate of acute hepatitis B or an altered response to hepatitis B, 236 homosexual men were prospectively followed up after entry into the placebo group of a hepatitis B vaccine trial. Sixty-six participants (28.0%) developed hepatitis B ten to 18 months after entering the study. Only four (6.1%) of the 66 had persistence of hepatitis B beyond six months, similar to reports in nonhomosexual subjects. This study suggests that the high rate of acute hepatitis B is the major factor contributing to the high prevalence of chronic hepatitis B in homosexual men, rather than an altered host response. Clinical features of the acute illness could not be used to identify patients who developed chronic hepatitis B.

Acute Disease↗
PubMed1988

Sexual partner selectiveness effects on homosexual HIV transmission dynamics.

Deterministic simulation models are used to show that HIV transmission dynamics in homosexual populations can be strongly affected by sexual partner selectiveness. The type of selectiveness or biased mixing examined is where individuals with similar new partnership formation rates are more likely to form a pair than would be expected by chance. The effect of such selectiveness could be strong even when the total number and distribution of new sexual partnerships and sex acts remains constant. This means that in order to predict the future course of HIV transmission and identify the populations at highest risk, we must have information not only on the frequency of new sexual partnerships and types of sex acts, but also on who has sex with whom. Given high sexual partner selectiveness, some groups of homosexuals with low rates of sex and new sex partners would take many decades before a single introduction would generate an epidemic. Epidemics in these groups can be markedly accelerated by only modest contact with higher risk groups. Even in very low activity groups, which if isolated would have no epidemic, an important proportion of their members can be infected when they are not selective. The relative risks of AIDS in groups making high numbers of new sexual partnerships compared to groups making low numbers are markedly affected by sexual partner selectiveness. The models developed were examined using information collected in 1984 from the Coping and Change Study in collaboration with the Chicago Multicenter AIDS Cohort Study. This population was divided into activity groups by the rate at which individuals established new sexual partnerships and then a structure of new sexual partnerships between these activity groups was defined consistent with available data. Even without introducing any behavior change in the models, the proportion of the homosexual population infected was seen to level off temporarily at around 50% after several years as a consequence of saturation in the high risk groups when lower risk groups were not yet being consumed by the epidemic process. Most sex in the study population is casual or anonymous. The sample selection procedures were biased toward individuals who engage in such sex. There is, however, a large group of individuals that avoids the casual and anonymous sex scene. Simulated epidemics indicated that under a variety of conditions, the population that does not engage in casual and anonymous sex could experience an epidemic of HIV infection quite some time after the epidemic in the population that does has waned.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1987

Active immunization against hepatitis B: immunogenicity of a recombinant DNA vaccine in females, heterosexual and homosexual males.

Three groups of subjects (58 females, 54 heterosexual males, and 50 homosexual males) received three doses of a recombinant DNA yeast-derived hepatitis B vaccine according to a 0, 1, and 6 month vaccination schedule. Local and general side effects were mild. Seroconversion rates after three injections were not significantly different between the groups. Females showed a significantly higher anti-HBs response than both groups of males, and heterosexual males had higher antibody titres than homosexual males. Among the four homosexual non-responders, three were carriers of the human immunodeficiency virus.

Adolescent↗
PubMed1988

Empirical therapy for the management of acute proctitis in homosexual men.

An effective empirical treatment regimen would provide a more rapid and less expensive approach to the management of homosexual men with acute proctitis. We conducted a randomized trial in 129 homosexual men who presented with acute proctitis, comparing treatment with an empirical regimen (4.8 million U of aqueous penicillin G procaine intramuscularly and 1.0 g of probenecid orally, followed by 100 mg of oral doxycycline twice daily for seven days) with specific therapy for each infection as it was recognized. Therapy with the empirical regimen resulted in more rapid resolution of the symptoms of proctitis, the objective signs of proctitis, and the infecting microorganisms. However, nearly one fourth of the patients, primarily those with unrecognized herpes simplex virus proctitis, did not respond to empirical therapy. We recommend empirical therapy coupled with appropriate pretreatment diagnostic testing for the initial management of acute proctitis in homosexual men with no clinical evidence of acquired immunodeficiency syndrome or AIDS-related complex.

Adolescent↗
PubMed1988

The association between genital ulcer disease and acquisition of HIV infection in homosexual men.

We analyzed the association of herpes simplex virus (HSV) infection and syphilis, the two most common causes of genital ulceration in homosexual men, with human immunodeficiency virus (HIV) infection in 200 men enrolled between 1983 and 1986 into a study evaluating the microbial causes of acute proctitis. Infection with HIV was independently associated with a history of syphilis, serologic evidence of syphilis, a history of HSV infection, and antibody to HSV-2. Antibody to HIV was not associated with a history of other genital infections or with antibody to Chlamydia trachomatis or HSV-1. Similar associations were observed in 111 asymptomatic homosexuals seen for HIV screening. Men who presented with primary HSV proctitis had a lower prevalence of HIV antibody than those with preexisting HSV-2 antibody (44% vs 68%); this suggests that HSV-2 infection antedated HIV infection. These data suggest that genital ulcerative diseases are an important risk factor for the acquisition of HIV infection in homosexual men; measures directed at control of these diseases may reduce the transmission of HIV in this population.

Adult↗