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Excretion of cytomegalovirus in semen associated with HTLV-III seropositivity in asymptomatic homosexual men.

We studied 56 asymptomatic homosexual male volunteers in Pittsburgh for 1 1/2 yr for relationships between cytomegalovirus (CMV) and human T-lymphotropic virus type III (HTLV-III) infections. CMV was most frequently isolated from semen (8%) as compared with throat washings (5.9%) and urine (0%) on initial testing of CMV-seropositive subjects. Other viruses commonly isolated from immunosuppressed patients (herpes simplex virus, adenovirus) were rarely detected in this cohort. Seropositivity to HTLV-III was significantly associated with isolation of CMV from semen in our asymptomatic cohort (odds ratio = 9.5, p = .008). These results suggest that HTLV-III infection is associated with selective, temporal activation of CMV in the genital tract of asymptomatic homosexual men.

Acquired Immunodeficiency Syndrome↗

Diminished response to recombinant hepatitis B vaccine in homosexual men with HIV antibody: an indicator of poor prognosis.

Three doses of a recombinant DNA HBV vaccine (MSD) were given to healthy male homosexuals. Seventy-eight out of 104 (77.6%) participants had detectable antibody (anti-HBs) two months after the third dose. Seroconversion occurred in only 9 out of 27 subjects (33.3%) who were anti-HIV positive compared with 69 out of 77 (89.6%) who were negative (chi 2 = 30.8; P less than .001). Fifteen of the 18 anti-HIV positive who did not mount an antibody response to the hepatitis B vaccine (anti-HBs) later progressed to persistent generalised lymphadenopathy syndrome (5), AIDS-related complex (5), and AIDS (5). Only one of the nine anti-HIV positive anti-HBs responders developed PGL (chi 2 = 10.14; P less than .005). Our results show that anti-HIV positive homosexuals are poor responders to the recombinant hepatitis B vaccine and anti-HIV positive non-responders are more likely to develop clinically apparent HIV infection.

Follow-Up Studies↗

Cytomegalovirus IgG and IgA serum antibodies in a study of HIV infection and HIV related diseases in homosexual men.

The significance of serum IgG and IgA antibodies to cytomegalovirus (CMV) at various stages of human immune deficiency virus (HIV) infection was studied in 175 homosexual men. Sera were obtained from 123 HIV seropositives [41 asymptomatic, 29 with lymphadenopathy associated syndrome (LAS), 22 with AIDS related complex (ARC), and 31 AIDS patients], 17 HIV seroconverters, and 35 HIV asymptomatic seronegatives. The sera were tested blindly for CMV IgA and IgG antibodies using the immunoperoxidase assay (IPA) and CMV infected human embryo cells. Cross-sectional analysis of CMV IgG antibodies at a titer of greater than or equal to 20 showed 87% and 100% prevalence in the HIV seronegative groups and in the HIV seropositive groups, respectively (P less than 0.05). CMV IgG antibodies at a titer of greater than or equal to 80 were present in significantly higher proportions among the HIV seropositive subjects of the various groups as compared with the HIV seronegative homosexual men. However, in the HIV seronegatives who later seroconverted to HIV, a significantly higher prevalence of CMV antibodies (35%) was detected before HIV seroconversion, as compared with the persistently HIV seronegative subjects (14.3%) (P less than 0.05). The HIV seronegatives pre-HIV seroconversion also exhibited a significantly higher geometric mean titer (GMT) of CMV IgG antibodies (62.17 +/- 0.64) as compared with the persistently HIV seronegatives (34.0 +/- 0.6) (P = 0.03). Significantly higher GMTs of CMV IgG antibodies were detected in all the HIV seropositive groups as compared with the persistently HIV seronegative group. CMV IgG antibodies were not detected in the HIV seronegative subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Immunogenicity and safety of an inactivated hepatitis A vaccine in anti-HIV positive and negative homosexual men.

The immunogenicity, reactogenicity, and safety of an inactivated hepatitis A vaccine were assessed in anti-HIV positive homosexual men. Fourteen anti-HIV positive (group 1) and 20 anti-HIV negative (group 2) men received vaccine (containing 720 ELISA units of hepatitis A antigen per dose) intramuscularly at 0, 1, and 6 months. Twelve unvaccinated anti-HIV positive men (group 3) were included as controls to evaluate disease progression. Seroconversion (anti-hepatitis V virus (HAV) > or = 20 mlU/ml) was higher in group 2 than group 1 at months 2 (100% vs. 73%) and 7 (100% vs. 77%). Group 2 had higher antibody titres than group 1 at months 1 (201 vs. 92 mlU/ml) and 7 (1,687 vs. 636 mlU/ml). The decline in CD4+ cells between months 0 and 7 was similar in groups 1 and 3 (6.4% vs. 16.2%), showing no evidence for harmful effect of the vaccine on the course of HIV infection. This hepatitis A vaccine appears safe, well tolerated, but less immunogenic in HIV positive homosexual men.

Acquired Immunodeficiency Syndrome↗

Fraternal birth order and the maternal immune hypothesis of male homosexuality.

In men, sexual orientation correlates with an individual's number of older brothers, each additional older brother increasing the odds of homosexuality by approximately 33%. It has been hypothesized that this fraternal birth order effect reflects the progressive immunization of some mothers to Y-linked minor histocompatibility antigens (H-Y antigens) by each succeeding male fetus and the concomitantly increasing effects of such maternal immunization on the future sexual orientation of each succeeding male fetus. According to this hypothesis, anti-H-Y antibodies produced by the mother pass through the placental barrier to the fetus and affect aspects of sexual differentiation in the fetal brain. This explanation is consistent with a variety of evidence, including the apparent irrelevance of older sisters to the sexual orientation of later born males, the probable involvement of H-Y antigen in the development of sex-typical traits, and the detrimental effects of immunization of female mice to H-Y antigen on the reproductive performance of subsequent male offspring. The maternal immune hypothesis might also explain the recent finding that heterosexual males with older brothers weigh less at birth than heterosexual males with older sisters and homosexual males with older brothers weigh even less than heterosexual males with older brothers.

Birth Order↗

Homosexual tandem running as selfish herd in Reticulitermes speratus: novel antipredatory behavior in termites.

We investigated the predator avoidance mechanism of post-swarming alates of the lower subterranean termite, Reticulitermes speratus Kolbe. In some lower termites, homosexual tandem running is observed in addition to ordinary heterosexual tandem running. An experiment designed to compare the risk of predation by a termite-hunting ant, Brachyponera chinensis Emery, showed that homosexual tandem running reduced the predation risk until termites encounter the opposite sex. Since an individual ant cannot capture two dealates at once, one of the two dealates forming a tandem can escape while the ant captures its partner. Therefore, the "post-encounter risk" of individuals running in tandem was lower than that of single individuals. The "encounter risk" with predatory ants was also examined using a mathematical model considering the increased detectability of the predator due to enhanced size of the prey unit. It was suggested that tandem running reduces the predation risk of both participants, even when the enhanced encounter risk was taken into account. In males, competition for the back position was often observed, and consequently, the male at the back was always larger than the male in front. When a male-male tandem encountered a female, the back male won the female more often than the front male. This result suggested that male-male tandem running should result in selection pressure in favor of vigorous males. In conclusion, tandem running decreases the individual predation risk through the dilution effect, and it also plays a role as a mechanism of indirect sexual selection.

Animals↗

Hepatitis B and Delta virus infection among heterosexuals, homosexuals and bisexual men.

The hepatitis B virus (HBV) and hepatitis Delta virus (HDV) infection rates were estimated in patients attending a venereal disease outpatient clinic: 759 heterosexuals and 154 homosexual-bisexual men. The anti-HBc prevalence was higher in homo-bisexual men (68.8 per 100) than in heterosexuals (41.8 per 100), whereas HBsAg was roughly the same in the two groups (about 6 per 100). The anti-HBc prevalence rate among heterosexuals was higher than that estimated in hospital personnel from the same geographical area. A positive association between anti-HBc prevalence and present or past sexually transmitted diseases (STD) was found among homo-bisexual men. Anti-HBc was also positively associated with herpes simplex type 2 antibodies in both heterosexuals and homo-bisexual men. These data are consistent with the hypothesis that sexual behavior also plays a role in the spread of infection among heterosexuals. Ten of the 46 HBsAg-positive subjects were anti-HDV positive: 6 of the 36 heterosexuals and 4 of the 10 homosexuals. All HDV-positive subjects had present or past STDs. These findings suggest sexual transmission of HDV infection.

Age Factors↗

Risk of AIDS in HIV seroconverters: a comparison between intravenous drug users and homosexual males.

A multicentre cohort study was conducted in Italy to estimate the risk of developing AIDS in 261 intravenous drug users and 89 homosexual males for whom the seroconversion period was known. Four years after HIV seroconversion, AIDS incidence, estimated by Kaplan-Meier survival technique, was 13.8% for intravenous drug users and 16.2% for homosexual males; the difference was not statistically significant. These findings suggest that four years after seroconversion the risk of developing AIDS in HIV seropositive intravenous drug users is no higher than that of subjects who acquired HIV infection through sexual contact.

Acquired Immunodeficiency Syndrome↗

Hepatitis C virus infection in homosexual men: a seroepidemiological study in gay clubs in north-east Italy.

Seroprevalence of Hepatitis C virus (HCV), Hepatitis B virus (HBV) and HIV antibodies was studied in a group of 259 apparently healthy homosexual men of the Veneto Region (Italy). Subjects were recruited between 1987 and 1989 from homosexual men's clubs. Seropositivity was evaluated in relation to main risk factors associated with the lifestyle and sexual behaviours of this population. Serological evaluation revealed an overall prevalence of HCV infection of 18.9% in the study population as a whole, but on breaking the samples down into three subgroups according to optical density (O.D.) values and to the year of sera collection, different seroprevalences were observed. Prevalence of anti-HCV was higher in 1987 and steadily decreased in 1988 and 1989; 4.1% of subjects gave positive results at O.D. greater than 2.0, while 6.2% were positive at O.D. between 0.8 and 2.0 and 9.6% at O.D. between cut-off and 0.8. Anti-HCV positivity was not correlated with HIV nor HBV positivity. No correlation was found between HCV seropositivity and either the type of anogenital intercourse or sexual promiscuity, but the prevalence increased (p = n.s.), as observed for HIV (p less than 0.05) and HBV (p = n.s.), with the number of intercourses per month. Epidemiological and preventive aspects arising from the investigation are discussed herein.

Adolescent↗

Acute fulminant toxoplasma meningoencephalitis in a homosexual man.

A homosexual man with a history of sexually transmitted infections including recent giardiasis and high cytomegalovirus (CMV) titer was admitted with generalized weakness, headache, and depression. He rapidly became comatose and developed signs of increased intracranial pressure. CT scan revealed a right cerebral lesion. Pathologic examination disclosed an acute necrotizing granulomatous toxoplasmosis involving the cerebrum. This case represents an example of an opportunistic infection in a male homosexual associated with fulminant clinical course, probably on the basis of immune deficiency.

Acute Disease↗

Immunogenicity of human immunodeficiency virus (HIV) reverse transcriptase: detection of high levels of antibodies to HIV reverse transcriptase in sera of homosexual men.

Immunoglobulin isolated from sera of homosexual men infected with human immunodeficiency virus (HIV) inhibited the reverse transcriptase (RT) activity of HIV. The inhibitory activity was specifically directed against HIV RT, and not against other mammalian retrovirus RT, including human T-lymphotropic virus type I. The relative titer of anti-RT antibody was significantly higher in asymptomatic men than in patients with lymphadenopathy or acquired immune deficiency syndrome (AIDS)-related complex. There was no correlation between the relative titer of anti-RT antibody and the relative titers of antibodies to major virion structural protein as determined by the enzyme-linked immunosorbent assay (ELISA) technique. These data suggest that antibodies to HIV RT may be related to the clinical status and possibly to the different degree of HIV replication in HIV-infected homosexual men.

AIDS-Related Complex↗

Defective T-cell response to PHA and mitogenic monoclonal antibodies in male homosexuals with acquired immunodeficiency syndrome and its in vitro correction by interleukin 2.

We studied the ability of phytohemagglutinin (PHA) and two anti-T-cell monoclonal antibodies OKT3 and Pan T2, to induce proliferation and interleukin 2 (IL2) production in peripheral blood lymphocytes (PBL) from 21 homosexual patients: 12 with Kaposi's sarcoma (KS), 4 with reactive lymphadenopathy, and 5 with opportunistic infections. All patients with KS and opportunistic infections had significantly lower mitogen-stimulated DNA synthesis, as compared to the controls, irrespective of the mitogen used (P less than 0.01). The patients with lymphadenopathy exhibited significantly lower responses only in the OKT3 assay as compared to normals (P = 0.009). The production of endogenous IL2 was significantly lower in PBL cultures from patients with KS and with opportunistic infections, irrespective of the mitogen used, as compared to healthy male controls, and also significantly lower in the Pan T2-stimulated cultures from patients with lymphadenopathy. The addition of highly purified IL2 was able to restore partially lymphocyte proliferation in vitro in the presence of these mitogens in all patients. Our studies demonstrate (1) that male homosexuals even without clinical manifestations of immunodeficiency frequently exhibit a proliferative T-cell defect when anti-T-cell monoclonal antibodies rather than PHA are used as mitogens, (2) that this proliferative defect is associated with defective IL2 production, and (3) that this defect is at least in part correctable in vitro by highly purified IL2.

Acquired Immunodeficiency Syndrome↗

Homosexual incest.

Within the past two years, we have encountered two cases where homosexual incest seemed to be a potent predisposing factor in extreme pathological behavior. In order to better understand what we were contending with, an extensive search and review of the literature was undertaken and the two case histories analyzed in detail. Our conclusions include: (1) that homosexual incest is at times unrecognized by therapists and therefore not dealt with to alleviate torment and sometimes to avert tragic consequences; and (2) that it is underreported so that information is lacking and essential dialogue on dynamics and treatment rarely occurs. It is hoped that this article will stimulate awareness of the phenomenon and foster exchange of ideas regarding etiology, psychodynamics, and intervention.

Adult↗

Psychopathology in self-identified female-to-male transsexuals, homosexuals, and heterosexuals.

The comparative self-esteem and psychological well-being of female-to-male transsexuals, homosexuals, and heterosexuals (patient and nonpatient) were studied. Results indicated that individual candidates for sex-change surgery varied appreciably in self-concept and adjustment, and as a group were indistinguishable from psychiatric controls. Nonpatient homosexuals and heterosexuals demonstrated the most positive self-esteem and level of adjustment.

Adolescent↗

Sex role endorsement among homosexual men across the life span.

This study assessed the sex role endorsement of homosexual men at different ages across the life span. A sample of homosexual men from dignity chapters in the northeastern, midwestern, southern, southwestern, and western United States was mailed a demographic questionnaire and th Bem Sex Role Inventory. Respondents were classified into four age brackets and categorized as androgynous, masculine, feminine, and undifferentiated. A pattern of diverse sex role endorsement was found from adolescence to maturity in which gay men were equally androgynous, masculine, feminine, and undifferentiated at each age level. This finding contradicted an earlier study of heterosexual men that reported increasing numbers of androgynous males with age. The contrast suggests that the sex role endorsement of gay men may be very different from their heterosexual counterparts. It was further suggested tht gay men are capable of meshing masculine and feminine aspects of their personalities early as well as later in life, that gay men do not comprise a homogeneous group, and that the stereotype of cross-gender role endorsement is unfounded.

Age Factors↗

Heterosexual and homosexual coercion, sexual orientation and sexual roles in medical students.

Rape has been conceptualized on a dimension of normal male behavior. The Koss and Oros (1982) study used a questionnaire that allowed men to respond only as sexual aggressors of women, and women only as victims of men. Medical students' responses to a modified questionnaire, in which both sexes reported being aggressors and/or victims, revealed that relatively comparable proportions of men and women were victims of coercive experiences: 35% of women and 30% of men experiencing constant physical attempts to have sexual activity. Forms of coercion not involving threat or use of force were more common, more exclusively heterosexual, and carried out by more equivalent percentages of men and women. 15% of women and 12% of men felt initially coerced into sexual activity but then enjoyed it. Threat or use of force to attempt to or to obtain intercourse were employed by 4% of men and 2% of women and experienced by 5% of both sexes. Half the male victims and female aggressors and a quarter of the male aggressors and female victims who reported such coercion stated it was homosexual. The ratio of homosexual/heterosexual feelings reported by male, but not female, students correlated with the degree of the homosexual coercion they both carried out and experienced. The degree of sexual coercion carried out by men and women correlated with their masculine sex role scores, suggesting, if the dimensional concept of rape is valid, that rape is on a continuum with masculine rather than male behaviors.

Adult↗

Sex habits, recent disease, and drug use in two groups of Danish male homosexuals.

Interviewed to obtain the first quantitative data from Scandinavia on lifestyle factors of possible importance for their health were 259 Danish male homosexuals. The frequency of various sex acts, frequency of change in partner, visits to the United States, sexual contacts with victims of the immune suppression syndrome, education, smoking and drug habits, and recent medical problems were recorded. Of those interviewed, 170 were from the Danish capital, Copenhagen, and 89 were from a smaller provincial town, Aarhus. Sexual habits and most other factors were very similar in men from the two cities. Furthermore, the sex habits of those who had visited a venereal disease clinic were similar to those of the group as a whole except for a frequent change of partners. Our data on level of sexual activity resemble those available for the San Francisco Bay area of 1970. The Copenhagen men, however, had more partners per year, had more sexual contact with U.S. citizens and immune suppression syndrome victims, and more had used nitrite inhalation than the men in Aarhus. The frequency of venereal disease was the same in the two groups, but the Danish cases of Kaposi's sarcoma and the acquired immune deficiency syndrome all have come from the Copenhagen area. Two of those interviewed have developed AIDS subsequent to homosexual contact with a case of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗