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PubMed1986

Immunological abnormalities in asymptomatic homosexual men: correlation with antibody to HTLV-III and sequential changes over two years.

A prospective study on 100 homosexual male volunteers was designed to examine immunological function in relation to sexual activity and infection with the human T cell lymphotropic virus Type III (HTLV-III). Complete data were available for 71 men. In a comparison with 100 age-matched heterosexual men, the study group of 100 men had a significantly higher mean serum IgG level (12.1 +/- SD 2.7 g/l vs. 10.9 +/- 2.4 g/l, p less than 0.01) and a significantly lower mean number of CD4 (T4) cells (845 +/- 310 X 10(-6)/l vs. 1128 +/- 375; p less than 0.01). For the study group, seropositivity for anti-HTLV-III was present initially in 22 per cent and was associated with a higher mean level of serum IgG and lower mean number of CD4 cells. Among seropositive homosexual men a low CD4/8 ratio was attributable to low numbers of CD4 cells in those without lymphadenopathy and to high numbers of CD8 cells in those with lymphadenopathy. For the seronegative homosexual men, a low CD4/8 ratio as a result of an increased CD8 cell count was present in 12 of 60, and was associated with numerous sexual partners and semen culture positive for cytomegalovirus. In two seropositive subjects a low CD4/8 ratio due to a decrease in the CD4 cell count was predictive of the development of AIDS by some two years. For the 71 men with complete data over two years, indices of cell-mediated immunity, including mean counts of CD4 cells, the CD4/8 ratio, and score for recall of cutaneous delayed type hypersensitivity increased during the first year but not during the second year in both seropositive and seronegative subjects. These increases occurred in association with changes in sexual practices and activity, but could not be attributed to any one particular factor.

AIDS-Related Complex↗
PubMed1985

Anorectal and enteric infections in homosexual men.

Homosexual men are at increased risk for traditional sexually transmitted anorectal infections (gonorrhea, syphilis, venereal warts, herpes and chlamydial infection) and enteric infections characterized by a low infecting inoculum (hepatitis A and B, amebiasis, giardiasis, shigellosis and campylobacteriosis). Infections account for most of the gastrointestinal symptoms in homosexual men seen at sexually transmitted disease clinics, but asymptomatic and polymicrobial infections are also common. Distinguishing three syndromes-proctitis, proctocolitis and enteritis-is clinically useful because these syndromes correlate with specific microorganisms and modes of transmission. A careful anoscopic examination, rectal Gram's stain, cultures for gonorrhea and chlamydia, VDRL and darkfield examination of suspicious lesions should be routinely done when sexually active homosexual men present with unexplained gastrointestinal symptoms. Based on the history, physical examination and initial laboratory studies, patients can usually be classified as having proctitis, proctocolitis or enteritis. This distinction facilitates selection of both confirmatory diagnostic tests and antimicrobial therapy. The effectiveness of empiric treatment regimens for asymptomatic sexual contacts or for symptomatic patients in whom microbiological tests are pending has not been studied.

Anus Diseases↗
PubMedDate not supplied

Male homosexuality reconsidered.

Prevailing psychoanalytic attitudes toward male homosexuality are predisposed to the treatment of it as a psychopathological disorder. This study proposes that the appearance of disorder follows from the distortions imposed on the personality during development. Superego conflicts ensue that are relieved rather than resolved in the analysis, if the analyst shares the patient's conviction that it is sexuality that is disordered. The study's second point is the suggestion that the unifying characteristic of male homosexuals is to be found in the particular form of body narcissism that leads to same-sex choice. Third, it is proposed that analysts reconsider the likelihood that biogenetic elements enter into the homosexual outcome.

Freudian Theory↗
PubMed1985

Age, structure, and sexuality: reflections on the anthropological evidence on homosexual relations.

The paper compares selected examples of age-structured homosexuality to understand same-sex eroticism as a "predictable" outcome of particular combinations of age, gender, and kinship. Unlike traditional models of homosexuality which view it as exceptional or abnormal, cross-cultural evidence demonstrates that homosexuality is an inextricable component of the structural codes of the societies in which it appears.

Adolescent↗
PubMedDate not supplied

[Couple heterosexual dysfunction in relation to homosexual latency (author's transl)].

Clinical experience of couple and sexological consultations indicates that some symptoms find in the heterosexual couple are the expression of a nevrotic solution of latent homosexual tendencies. This means that homosexual tendencies are repressed, or actualized through an imaginary elaboration or a symbolic one, by staying unconscious or manifesting through acting in a state of obnubilation. These different situations are illustrated by sexual dysfunctions (some forms of impotence and frigidity), hostile rejection and homosexual panic, jalousy, triolism and alcoholic aspects. This brief analysis is concluded by some reflexions from the clinical, social, couple and individual points of view.

Erectile Dysfunction↗
PubMed1983

Acquired immunodeficiency syndrome, opportunistic infections, and malignancies in male homosexuals. A hypothesis of etiologic factors in pathogenesis.

The acquired immunodeficiency syndrome (AIDS) occurs in a subgroup of male homosexuals having sexual contact with a large number of partners. Uncommonly, AIDS has also been diagnosed in Haitians, hemophiliacs, and intravenous drug users and their infants. Manifestations include autoimmune disturbances, opportunistic infections, Kaposi's sarcoma, chronic lymphadenomegaly, non-Hodgkin's lymphoma, or squamous cell carcinoma. The hypothesis receiving most consideration is that a yet-to-be-identified virus causes AIDS. An alternative view is that repeated sexual involvement with multiple partners, in a subgroup of male homosexuals, exposes the men to the immunosuppressive impact of cytomegalovirus (CMV) and allogeneic semen. Antibody to asialo-Gm1 and other antigens on sperm react with and impair lymphoid cells. We propose a biphasic process. First, a reversible acquisition phase of impaired T-cell immunoregulation permits reactivation of Epstein-Barr virus (EBV), and autoantibodies are produced by the activated B cells. If sexual activity continues at a high level, accumulating immune defects, including destruction of thymic epithelium, lead to a second, self-sustaining phase wherein cytotoxic lymphocytes fail to eliminate herpesvirus-infected cells. Evidence is mounting that Kaposi's sarcoma is caused by CMV and that EBV is responsible for the B-cell lymphomas in these patients. Multiple factors, rather than a novel virus, probably induce AIDS in male homosexuals. If this hypothesis is correct, then rational bases for prevention and intervention can be designed.

Acquired Immunodeficiency Syndrome↗
PubMed1984

B lymphocyte changes in homosexual men with generalized lymphadenopathy.

Studies of B and T lymphocytes were done on homosexual men with generalized lymphadenopathy, homosexuals without any clinical symptoms, and on normal heterosexual controls. In vitro proliferative responses induced by pokeweed mitogen (PWM) and phytohemagglutinin (PHA) were determined, as was the polyclonal plaque-forming cell (PFC) response to PWM. A decreased proliferative response to PWM and PHA was observed in mononuclear cells from patients with generalized lymphadenopathy and in some of the asymptomatic individuals. In addition, the mononuclear cells of these groups showed a reduced PFC response to PWM, which was not due to a kinetic difference. Serum immunoglobulins, particularly IgG, were elevated in most of the patients with generalized lymphadenopathy. T cell changes including reduced T helper/suppressor ratios were observed in most of the symptomatic and in some of the asymptomatic homosexuals. The reduced proliferative and differentiative responses of mononuclear cells to PWM may be compatible with a B cell abnormality, in addition to a previously described T cell dysfunction.

Adult↗
PubMed1984

Nature/nurture: reflections on approaches to the study of homosexuality.

There is understandable apprehension by many people towards claims that biology plays a significant role in the etiology of homosexuality. These worries should not be allowed to deter any such work on sexual orientation. It is argued that the only proper way to evaluate biological analyses is against the full background of Darwinian evolutionary theory. Moral issues pertaining to biological research on homosexuality are addressed. Finally, it is urged that both biological and environmental factors be considered in rendering a true picture of homosexuality.

Gender Identity↗
PubMed1984

Sexually transmitted disease among homosexuals.

During the last 10 years the health care needs of homosexuals have been receiving increasing attention. However, in their attempts to provide health care to this group, physicians must be familiar with the various lifestyles of homosexuals and the types of infection to which they are susceptible. This paper summarizes the results of recent studies and proposes guidelines for the prevention and treatment of sexually transmitted disease among homosexuals.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Immunological characterization of homosexual males.

To help clarify the nature and pathogenesis of the syndrome of severely opportunistic infection associated with immune deficiency in young homosexual males, we investigated the immunological characteristics of a group of 33 young homosexual men. These young men all had the prodrome to the syndrome which included a history of multiple sexual partners and multiple sexually transmitted diseases. In addition, they all had a past history of mild to moderate viral, bacterial, parasitic, or fungal infections and had used recreational drugs. Within this group of patients, there were five men who had Kaposi's sarcoma. Compared to the 21 normal heterosexual individuals, the homosexual men were found to be anergic to a battery of recall antigens (52% versus 19%); to be hyporesponsive to mitogen stimulation (pokeweed, 30.7 x 10(-3) versus 65.3 x 10(-3) cpm, p less than or equal to 0.005; concanavalin A, 32.2 x 10(-3) versus 60.1 x 10(-3) cpm, p less than or equal to 0.006); and to have lower helper T-cells (18% versus 34.6%, p less than or equal to 0.01), inverted helper:suppressor T-cell ratios (0.85 versus 1.92, p less than or equal to 0.01), and an elevated serum thymosin alpha 1 level (1473 versus 524 pg/ml, p less than or equal to 0.001). These data suggest that the immunological defect precedes the syndrome. The mechanism of this phenomenon is unclear; however, the repeated viral infection combined with drug usage may be responsible. The five patients with Kaposi's sarcoma were compared as a group to the other patients without cancer and found to be more severely immunodeficient. This suggests that the immune suppression by the malignant disease is superimposed on the preexisting deficiency.

Adult↗
PubMed1983

Induction of antibody to asialo GM1 by spermatozoa and its occurrence in the sera of homosexual men with the acquired immune deficiency syndrome (AIDS).

Compared to healthy homosexual and heterosexual men, homosexual men with acquired immune deficiency syndrome (AIDS) possessed significantly higher levels of IgG antibody to the neutral glycolipid asialo GM1 (ganglio-N-tetraosylceramide) (P less than 0.01). Of 31 homosexuals with AIDS, 36% possessed levels of this antibody that were at least two standard deviations above the mean of the healthy men. Furthermore, asialo GM1 antibody could be removed from serum by adsorption with spermatozoa. Weekly rectal insemination of male rabbits with rabbit semen also led to the appearance of antibody to asialo GM1 by 15 weeks. These results suggest that asialo GM1 is a component of ejaculated spermatozoa and demonstrate that rectal insemination by itself can lead to the production of antibodies to this glycolipid in the rabbit. In addition, asialo GM1 antibodies may be of value as a serological marker for the early detection of individuals with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Immunological abnormalities in South African homosexual men.

Immunological tests of cell-mediated immunity (CMI), serological tests for antibodies to sexually transmitted and possibly immunosuppressive viruses, determination of serum immunoglobulin levels, full blood counts and serotyping for the HLA-DRw5 antigen were performed in 10 homosexual men with a mean age of 35 years (range 21-59 years). Five of these were associates of a patient who had died of confirmed acquired immunodeficiency syndrome (AIDS). At the time of investigation 9 of the men were apparently healthy and 1 had active pulmonary tuberculosis. Only in 2 subjects were no abnormalities of CMI found; they were 23 and 28 years of age and, interestingly, were also the only 2 whose sera were negative for antibodies to cytomegalovirus (CMV) and for the other viruses investigated. Of the remainder, 1 was lymphopenic, 6 had increased numbers of circulating suppressor T lymphocytes, 4 had reduced delayed-type hypersensitivity skin responses to recall antigens, and in 6 mitogen-induced lymphocyte transformation was decreased. Of these 8 subjects, 4 and 2 had antibodies to hepatitis B surface and core antigens respectively and 1 was positive for hepatitis B surface antigen and HBe antigen. The most severe abnormalities were observed in individuals who were seropositive for both CMV and hepatitis B virus. These findings indicate the existence of acquired immunosuppression in some members of the South African homosexual community. On the basis of these findings an immunological classification of potential sufferers of AIDS in the male homosexual community is proposed.

Acquired Immunodeficiency Syndrome↗
PubMed1980

Common psychiatric problems in homosexual men and women consulting family physicians.

This paper describes the commoner psychiatric difficulties of homosexual patients seen in a family practice. It is written primarily to aid general practitioners in deciding who should be referred to a psychiatrist. Recent developments in the study of homosexuality indicate that homosexual persons are no more likely than heterosexuals to suffer psychiatric problems. Practical suggestions are made for management and counseling, and some of the misconceptions about the gay community are dispelled.

Adjustment Disorders↗
PubMed1980

Prenatal stress as possible aetiogenetic factor of homosexuality in human males.

Out of 865 homosexual males who were registered by venerologists in 6 districts of the GDR highly significantly more homosexuals were born during the stressful war and early postwar period of the Second World War, i.e. between 1941 and 1947 (with a maximum of relative frequency in 1944-1945), than in the years before or after this critical period. This finding suggests that stressful prenatal (or perinatal) events may represent an aetiogenetic factor for homosexuality in human males.

Female↗
PubMed1994

[HIV infections and their prophylaxis in the homosexual community of the Gdansk province].

From 1985 to the end of 1993, 15,000 investigations were performed in total, for HIV infection in the Province of Gdańsk. Positive results of the tests were found in 316 persons, over 60% of whom being intravenous drug-addicts. In the group of persons reporting the possibility of infection through sexual contacts, the infection was found only in 15 out of 1755 studied subjects. Among homosexuals the infection was found in four out of 167 persons who underwent the investigation. In the whole group of 316 infected subjects this accounted for 1.2%. The above mentioned numbers are certainly too low. The causes of this should be seen in generally low attendance rate to the tests connected with low social awareness. However, in persons with different sexual orientation this is caused also by the fear of manifestation of their pecularity. In the activities for the control of HIV epidemic spreading in Poland indispensable is multi-sided educational initiative including the whole population, in which great help may be provided by homosexuals themselves. An evidence of this may be the results as yet of the cooperation between representatives of health care and homosexuals, discussed in the present paper.

Adult↗
PubMed1995

Differences in perception of risk for HIV infection with steady and non-steady partners among homosexual men.

In this study it was assessed whether homosexual men who practiced unprotected anogenital intercourse with steady and non-steady partners subjectively perceived their behaviors to be risky. Data were collected from 165 homosexual participants in an ongoing cohort study who reported unprotected anal sex. A variety of psychological factors which could possibly explain why some men were at risk but did not perceive their behavior as such, were investigated. This study showed that the majority of men who engaged in sexual risk behaviors within their primary relationship did not subjectively appraise their behavior as risky. The factors found to explain this discrepancy were not having had sex with a partner known to be HIV infected or to have AIDS (for couples of unknown serostatus) and not having had friends or relatives who were ill or had died (for seronegative couples). Homosexual men who had unprotected anal sex with casual partners generally were aware of the risk involved in their behavior.

Adult↗
PubMed1994

Are children at risk for sexual abuse by homosexuals?

OBJECTIVE: To determine if recognizably homosexual adults are frequently accused of the sexual molestation of children. DESIGN: Chart review of medical records of children evaluated for sexual abuse. SETTING: Child sexual abuse clinic at a regional children's hospital. PATIENTS: Patients were 352 children (276 girls and 76 boys) referred to a subspecialty clinic for the evaluation of suspected child sexual abuse. Mean age was 6.1 years (range, 7 months to 17 years). DATA COLLECTED: Charts were reviewed to determine the relationships of the children to the alleged offender, the sex of the offender, and whether or not the alleged offender was reported to be gay, lesbian, or bisexual. RESULTS: Abuse was ruled out in 35 cases. Seventy-four children were allegedly abused by other children and teenagers less than 18 years old. In 9 cases, an offender could not be identified. In the remaining 269 cases, two offenders were identified as being gay or lesbian. In 82% of cases (222/269), the alleged offender was a heterosexual partner of a close relative of the child. Using the data from our study, the 95% confidence limits, of the risk children would identify recognizably homosexual adults as the potential abuser, are from 0% to 3.1%. These limits are within current estimates of the prevalence of homosexuality in the general community. CONCLUSIONS: The children in the group studied were unlikely to have been molested by identifiably gay or lesbian people.

Adolescent↗
PubMed1993

Comparison of clinical symptoms of human immunodeficiency virus disease between intravenous drug users and homosexual men.

BACKGROUND: To compare the prevalence of human immunodeficiency virus (HIV)-related clinical symptoms among male intravenous drug users and homosexual men stratified by HIV serostatus and CD4 cell levels. METHODS: A cross-sectional sample using concurrent longitudinal studies of the natural history of HIV-1 infection among intravenous drug users (N = 539) and homosexual men (N = 932) was recruited in Baltimore, Md. Participants were administered a risk behavior interview and physical examination, and had hematologic tests evaluated in a similar calendar period. RESULTS: Both risk groups demonstrated an inverse relationship between frequency of symptoms and CD4 cell count. Fever, night sweats, and lymphadenopathy were not evaluated because pilot data suggested a confounding association with drug injection. Among those with mild to moderate immune suppression, intravenous drug users were significantly more likely than homosexual men to experience fatigue, weight loss, diarrhea, and shortness of breath; to have oral candidiasis, palpable spleen, and lower mean weight on physical examination; and abnormal hematocrit, platelets, and total lymphocyte counts. However, participants in either risk group with CD4 cell levels below 0.2 x 10(9)/L experienced similar frequency of all clinical symptoms. Self-reported oral candidiasis increased fourfold with HIV infection and was as likely in both groups at all CD4 cell levels. Duration and recency of intravenous drug use was not significantly associated with the higher frequency of most clinical symptoms. CONCLUSION: Social factors are an important consideration in evaluating the association between clinical symptoms and HIV immunosuppression. Except for oral candidiasis, there are limitations for the use of clinical symptoms as intermediate outcome measures for HIV infection among intravenous drug users.

Adult↗