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One hundred bi- or homosexual men as well as 100 heterosexual men of similar age were asked about maternal stressful events that may have occurred during their prenatal life. A significantly increased incidence of prenatal stress was found in bisexual and, particularly, in homosexual men. This finding suggests that prenatal stress in males may represent a risk factor for the etiogenesis of sexual deviations in later life.
Four previously healthy homosexual men contracted Pneumocystis carinii pneumonia, extensive mucosal candidiasis, and multiple viral infections. In three of the patients these infections followed prolonged fevers of unknown origin. In all four cytomegalovirus was recovered from secretions. Kaposi's sarcoma developed in one patient eight months after he presented with esophageal candidiasis. All patients were anergic and lymphopenic; they had no lymphocyte proliferative responses to soluble antigens, and their responses to phytohemagglutinin were markedly reduced. Monoclonal-antibody analysis of peripheral-blood T-cell subpopulations revealed virtual elimination of the Leu-3 / helper/inducer subset, an increased percentage of the Leu-2 + suppressor/cytoxic subset, and an increased percentage of cells bearing the thymocyte-associated antigen T10. The inversion of the T/ helper to suppressor/cytotoxic ratio suggested that cytomegalovirus infection was an important factor in the pathogenesis of the immunodeficient state. A high level of exposure of male homosexuals to cytomegalovirus-infected secretions may account for the occurrence of this immune deficiency.
Acute herpes simplex virus (HSV) infection was detected in 23 of 102 consecutively examined, sexually active male homosexuals who presented with anorectal pain, discharge, tenesmus, or hematochezia, as compared with 3 of 75 homosexual men without gastrointestinal symptoms (P less than 0.01). Findings that were significantly more frequent in men with HSV proctitis than in men with proctitis due to other infectious causes included fever (48 per cent), difficulty in urinating (48 per cent), sacral paresthesias (26 per cent), inguinal lymphadenopathy (57 per cent), severe anorectal pain (100 per cent), tenesmus (100 per cent), constipation (78 per cent), perianal ulcerations (70 per cent), and the presence of diffuse ulcerative or discrete vesicular or pustular lesions in the distal 5 cm of the rectum (50 per cent). Serologic evidence indicated that 85 per cent of the men with symptomatic HSV proctitis were having their first episode of HSV-2 infection. The diagnosis of HSV proctitis is suggested by the presence of severe anorectal pain, difficulty in urinating, sacral paresthesias or pain, and diffuse ulceration of the distal rectal mucosa.
Infection with the human immunodeficiency virus type 1 (HIV-1), as demonstrated by viral cultures, has been described in some patients before antibodies to HIV-1 can be detected, but the duration and frequency of such latent infections are uncertain. We selected prospectively a cohort of 133 seronegative homosexual men who continued to be involved in high-risk sexual activity, and we cultured 225 samples of their peripheral-blood lymphocytes, using mitogen stimulation to activate the integrated HIV-1 genome. HIV-1 was isolated in blood samples from 31 of the 133 men (23 percent), 27 of whom have remained seronegative for up to 36 months after the positive culture. The other four men seroconverted 11 to 17 months after the isolation of HIV-1. In three of them, we studied cryopreserved lymphocytes obtained earlier, using the polymerase chain reaction to amplify small amounts of viral DNA, and we demonstrated that HIV-1 provirus had been present 23, 35, and 35 months before seroconversion. We conclude that HIV-1 infection in homosexual men at high risk may occur at least 35 months before antibodies to HIV-1 can be detected. A prolonged period of latency in such infections may be more common than previously recognized; the degree of infectiousness during such periods is unknown.
OBJECTIVES: To estimate the extent of the homosexual and bisexual male population in inner Sydney and HIV prevalence within this population. METHODS: Data from the 2000/2001 Sydney Gay Community Periodic Survey (SGCPS) and the Australian Study of Health and Relationships were used. RESULTS: A re-analysis of responses from men in some inner east and inner west postcode areas of Sydney indicated that: the proportion of men who identified as homosexual or bisexual ranged from 4.4% to 48.1%; from 9.8% to 51.5% of men reported same-sex experiences during their lifetime; and 12.9% to 52.8% of men had ever experienced feelings of same-sex attraction. HIV prevalence among respondents to the SGCPS in these same areas varied from 9.1% to 21.3%. CONCLUSION: These findings indicate elevated proportions of men with same-sex identity, experience or attraction living in these inner Sydney locations compared with other geographic areas and illustrate how gay communities cluster.
The testosterone derivative 4,16-androstadien-3-one (AND) and the estrogen-like steroid estra-1,3,5(10),16-tetraen-3-ol (EST) are candidate compounds for human pheromones. AND is detected primarily in male sweat, whereas EST has been found in female urine. In a previous positron emission tomography study, we found that smelling AND and EST activated regions covering sexually dimorphic nuclei of the anterior hypothalamus, and that this activation was differentiated with respect to sex and compound. In the present study, the pattern of activation induced by AND and EST was compared among homosexual men, heterosexual men, and heterosexual women. In contrast to heterosexual men, and in congruence with heterosexual women, homosexual men displayed hypothalamic activation in response to AND. Maximal activation was observed in the medial preoptic area/anterior hypothalamus, which, according to animal studies, is highly involved in sexual behavior. As opposed to putative pheromones, common odors were processed similarly in all three groups of subjects and engaged only the olfactory brain (amygdala, piriform, orbitofrontal, and insular cortex). These findings show that our brain reacts differently to the two putative pheromones compared with common odors, and suggest a link between sexual orientation and hypothalamic neuronal processes.
Because of the form of sexual contact and the number of such contacts among homosexual men, physicians should be watchful for sexually transmitted infections in the homosexual community. Hepatitis B, anorectal gonorrhea, shigellosis, amebiasis, and giardiasis are now known to be among these infections. For treatment to be effective and epidemics avoided, physicians should question affected male patients about their sexual habits and advise abstinence from sexual contact until treatment is finished and cultures or smears are negative.
Three matched groups of predominantly homosexual men were compared using Weinberg and Williams' questionnaire. Two of the groups contained men who were currently heterosexually married and men who had been heterosexually married; the third group was unmarried controls. Reasons for marriage were reviewed and found to be a combination of situational factors and, to a greater extent, of the expectations of those men who married of a more negative societal reaction against homosexuality. Implications of these findings for therapy are briefly discussed.
The patient coming in with a dysphoria over his or her homosexual feelings, fantasies or behavior must be given the choice of working through the homophobia or the heterophobia. With the first choice, treatment is directed toward decreasing shame over the homosexual orientation and integrating the patient's social role and personal identity. If a move toward greater heterosexuality is chosen, techniques range from psychoanalysis to time-limited psychodynamic psychotherapy to behavioral techniques. Behavioral techniques may involve in vitro or in vivo desensitization. Issues in selecting the appropriate form of therapy are sometimes subtle and complex, and ethical issues frequently beset the therapist. The patient must be kept fully informed of his or her options, and the choice and the goals of therapy must be arrived at by both patient and therapist.
Previous investigations have indicated that the ratio of sex offenders against female children vs. offenders against male children is approximately 2:1, while the ratio of gynephiles to androphiles among the general population is approximately 20:1. The present study investigated whether the etiology of preferred partner sex among pedophiles is related to the etiology of preferred partner sex among males preferring adult partners. Using phallometric test sensitivities to calculate the proportion of true pedophiles among various groups of sex offenders against children, and taking into consideration previously reported mean numbers of victims per offender group, the ratio of heterosexual to homosexual pedophiles was calculated to be approximately 11:1. This suggests that the resulting proportion of true pedophiles among persons with a homosexual erotic development is greater than that in persons who develop heterosexually. This, of course, would not indicate that androphilic males have a greater propensity to offend against children.
To explore female sexuality, a student population of women (ages 23-35 years) in intimate relationships were stratified and matched for demographics into two samples, homosexual and heterosexual, each group consisting of 34 women. Significant differences emerged between the two groups on seven of the nine variables. The homosexual women in this study demonstrated greater interpersonal dependency, compatibility, and intimacy in their intimate relationships. The heterosexual women evidenced more positive dispositions toward sexual fantasy, greater sexual assertiveness, stronger sexual desire, and higher frequencies of sexual activity. Despite these findings, there were no significant differences between the two groups in sexual satisfaction.
After clarifying some definitions, the author attempts to identify homosexuality through the sexual individuation process and to trace its various ontogenetic inconsistencies. Two clinical case studies are provided to further illustrate the sexoanalytic treatment of ego-dystonic homosexuality.
Minimal research has investigated the prevalence of sexual disorders in homosexual men. We examined sexual performance concerns, problems, and satisfaction in a convenience sample of 197 homosexual men who attended a health seminar. Sexual dysfunction and sexual concerns were found to be common problems. Almost all men reported some sexual difficulty over their lifetime, and more than half reported a current sexual difficulty. A further 25% of the sampled men identified other sexual concerns as well. Despite these figures, most participants-whether single, dating, or in a relationship-reported average to above-average sexual satisfaction. Correlates of sexual satisfaction included more liberal attitudes toward human sexuality, greater comfort with men's sexual attractions to other men, lower levels of internalized homophobia, and greater satisfaction with one's relationship status. Painful receptive anal intercourse appeared to be a common, yet previously underacknowledged, difficulty. Almost half of the respondents described HIV/AIDS as having a negative impact on their sexual functioning, with most reporting an increase in fear of sex as the major negative outcome.
The objective of the paper was to describe awareness of HIV medications and HIV viral load, and to assess the impact of HIV medications (including highly active antiretroviral therapy) and notions of viral load on sexual risk practices. This was an exploratory cross-sectional study of a non-random sample of 395 homosexually active Latino men in New York City. An anonymous self-administered questionnaire was used focusing on perceptions about HIV/AIDS, HIV treatment medications and viral load, risk perceptions, HIV status, and sexual partners and practices in the past 6 months. HIV-positive participants taking HIV medications, those who knew their viral loads, and those who had undetectable viral loads did not report significantly different frequencies of high-risk (receptive or insertive) unprotected anal intercourse (UAI) in comparison to other HIV-positive individuals in the sample. Perceptions about HIV status (assuming same status) and viral load (penetrating partner or letting partner penetrate one) were related to significantly higher high-risk UAI in the past 6 months. HIV prevention strategies for homosexually active Latino men should not only address the basic issue of assuming similar HIV status but also need to examine misconstructions of the transmissibility of HIV as a result of undetectable viral load.
This paper seeks to outline the range and type of heterosexual behaviour in a large non-clinic cohort of homosexually active males. A cohort of 930 homosexually active men were interviewed as part of a prospective study of the seroprevalence of HIV. The paper indicates that over 60% of these men have had at least one sexual experience with a female and that about 90% of these males have engaged in vaginal intercourse with a female. Twelve per cent of the cohort had sexual contact with females in the last year, and 5% had sex with females, in the month preceding interview. Amongst these behaviourally bisexual males the number of female partners is significantly lower than the number of male partners. However, the proportion of female partners with whom penetration occurs is very much higher than for male partners.
The purpose of this experimental study was to identify key factors influencing the intention of nurses (n = 102) to provide care at home to AIDS or leukaemia patients, homosexual or heterosexual. Ajzen's theory of planned behaviour with the addition of personal normative belief borrowed from Triandis's theory defined the theoretical framework. Homophobia and social desirability were also assessed as control variables. All nurses completed a self-administered and anonymous questionnaire after reading one of the four randomly-assigned vignettes that described the context of care. Sexual orientation of the patient influenced the personal normative belief (p < 0.05), and type of disease affected significantly perceived subjective social norm (p < 0.05). The regression of intention on all variables yielded an adjusted R2 of 0.48 (p < 0.0001), with perceived behavioural control, personal normative belief, attitude and homophobia being the significant predictors. In conclusion, nurses need to be better informed, better prepared and have better skills in order to provide appropriate care to homosexual AIDS patients.
A great deal of research has been conducted into the stressful experiences that befall HIV-infected individuals. In this review we have focused on the work that has been conducted with HIV-positive homosexual males and have examined issues concerning the measurement, nature and consequences of stressful life events. It is apparent that, in consort with most other life events research, the measurement of events in this patient group is affected by methodological difficulties. Such difficulties may have, in particular, led to the observation by some investigators that HIV-positive homosexual men experience greater numbers of such events than their HIV-negative counterparts. It is also evident that, while some of these events are typical of those faced by individuals with other life threatening conditions, others are peculiar to this patient group. Research into the consequences of these events for emotional and behavioural functioning indicate that the effects are far-reaching. Similarly, data on the consequences of stressful events for immune function suggest that they may play a role in the progression of the disease, although these data are equivocal.
The HIV epidemic has had major impact on men who have sex with men in China. Most current studies view male-to-male sex as a behavioural dimension or variable affecting HIV infection, paying little attention to the socio-cultural meanings of homosexuality and their impacts on men's experiences with HIV/AIDS. This oversight has impeded understanding of the health practices of this population. Based on a qualitative study of experiences of Chinese people living with HIV/AIDS, this paper explores the complex processes in which men who have sex with men struggle and negotiate with their sexuality, family obligations, and this disease. To facilitate Chinese men who have sex with men in responding effectively to HIV and AIDS, researchers and practitioners should take into account a wide range of contextual factors including desired gender roles, family obligations, homophobia, and HIV-related stigma that contribute to current constructions of 'homosexuality' in China.