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Health and professional characteristics of lesbian and heterosexual women physicians.

OBJECTIVE: To determine whether lesbian and heterosexual female physicians differ on health, professional, and demographic characteristics. METHODS: The Women Physicians' Health Study (WPHS), a mailed questionnaire sample survey, was completed by 4501 women physicians (59% response rate), of whom 115 were identified as lesbians and 4177 were identified as heterosexuals. Lesbian and heterosexual were defined by response to items about self-identification and sexual behavior. Dependent variables are self-reported health status and behavior and professional characteristics. RESULTS: Lesbians weighed more and were more likely to report histories of depression or sexual abuse, family histories of alcoholism, and orientation-related workplace harassment (all p = .01). On the other hand, they were more likely to comply with mammogram screening (p < .01). CONCLUSIONS: Many health status and behavior differences found in other studies of lesbian and heterosexual women were less pronounced here. This may be because the population of female physicians is more homogeneous, but perhaps also because the size of our lesbian sample was limited (n = 115). However, even with the buffer of high socioeconomic status and medical education, lesbian physicians seem to have a somewhat higher cumulative risk of disease compared to their heterosexual female colleagues.

Adult↗

Heterosexual transmission of HIV--29 states, 1999-2002.

Worldwide, the majority of human immunodeficiency virus (HIV) infections result from heterosexual transmission. To characterize heterosexual transmission of HIV infections in the United States, CDC analyzed data for 1999-2002 from the 29 states that have met CDC standards for name-based HIV/acquired immunodeficiency syndrome (AIDS) reporting for > or =4 years. This report summarizes the results of that analysis, which indicated that heterosexually acquired HIV infections represented 35% of all new HIV cases; 64% of heterosexually acquired HIV infections occurred in females, and 74% occurred in non-Hispanic blacks. To decrease the number of new heterosexually acquired HIV infections, especially among certain minority populations, culturally targeted education and prevention programs should be provided, and barriers to HIV care and prevention services should be removed.

Adolescent↗

Randomized controlled trial of adenine arabinoside 5'-monophosphate in chronic active hepatitis B: comparison of the efficacy in heterosexual and homosexual patients.

Twenty-two heterosexuals and 21 homosexuals with chronic active hepatitis B and who had HBsAg, HBeAg and hepatitis B virus DNA in serum were randomized separately to receive adenine arabinoside monophosphate or placebo. In the 10 heterosexuals and nine homosexuals who received placebo, no change in hepatitis B virus DNA level and HBeAg was observed. Among the patients who received adenine arabinoside monophosphate, seven of the 12 heterosexuals and five of the 12 homosexuals lost hepatitis B virus DNA; five heterosexuals and three homosexuals also lost HBeAg; one homosexual lost HBsAg. There was no significant differences in response between heterosexual and homosexual patients. When results were pooled, there was a significant effect of adenine arabinoside monophosphate on hepatitis B virus replication. None of the 19 patients who received placebo but 50% of the 24 patients who received adenine arabinoside monophosphate were negative for serum hepatitis B virus DNA at 10 months after treatment (p less than 0.001) and none of the 19 patients who received placebo and 33% of the 24 patients who received adenine arabinoside monophosphate were negative for HBeAg in serum (p less than 0.005). Retrospective analysis showed that disappearance of hepatitis B virus DNA after administration of adenine arabinoside monophosphate was more common (i) in patients with a low pretreatment hepatitis B virus DNA level than in patients with a high pretreatment hepatitis B virus DNA level (8/11 vs. 4/13, p less than 0.05); (ii) in patients with a high pretreatment ALT level than in patients with a low pretreatment ALT level (10/14 vs. 2/10, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A comparison of LH secretion and brain estradiol receptors in heterosexual and homosexual rams and female sheep.

This study examined endocrine components of sexual orientation of male sheep. Sexual orientation of adult rams was identified through standardized sexual performance tests. Four rams that copulated with ewes, four rams that never mounted females and copulated with males, and eight ewes were used in the experiments. Exogenous estradiol benzoate (50 micrograms, i.m.) stimulated (P < .05) a preovulatory-like LH surge 16-22 hr after administration to females. Estradiol did not (P > .05) affect LH release of heterosexual or homosexual rams. Thirty days after the estradiol challenge, sheep were euthanized and areas of the amygdala (AMY), hypothalamus (HYP), anterior pituitary (AP), and preoptic area (POA) of the hypothalamus were collected. Occupied and unoccupied content of estradiol receptors (ER) was determined. The content of ER in the amygdala of both homosexual rams and ewes was similar, but less than (P < .05) the content of ER in heterosexual rams. The ER content measured in other brain regions did not differ by sex or orientation. In summary, results from these data show that the preovulatory LH surge mechanism that is a characteristic of the female does not occur in either homosexual or heterosexual rams. Conversely, the ER content of the AMY of homosexual rams is similar to that of ewes and differs from the heterosexual male. Differences in ER content between heterosexual and homosexual rams imply that the amygdala serves as a link for input from potential mates. These data suggest that the amygdala not only plays a role in sexual behavior but may be involved in sexual orientation of rams.

Animals↗

Heterosexual experience, marital status, and orientation of homosexual males.

The penile volume responses of homosexual males to pictures of nude women and men were measured and related to the subjects' marital status and experience of heterosexual intercourse. Single subjects with no experience of heterosexual intercourse and married subjects with a history of intercourse with only their wives showed significantly greater response to pictures of men compared to pictures of women than did single subjects with experience of heterosexual intercourse and married subjects with experience of intercourse with women additional to their wives. It was concluded that extensive experience of heterosexual intercourse with one partner did not reduce homosexual responsiveness as measured by subjects' penile response to pictures of nude men and women. It was further concluded that some homosexual males showed physiological evidence of a degree of bisexuality in addition to the behavioral evidence that they sought heterosexual physical relationships.

Adult↗

Differences between heterosexual, bisexual, and lesbian women in recalled childhood experiences.

Heterosexual, bisexual, and lesbian women recalled the extent to which they had engaged in gender conforming (female-stereotypic) behaviors and gender nonconforming (male-stereotypic) behaviors in childhood. Heterosexual women were more likely to recall having had female-stereotypic experiences as children, whereas lesbian women often recalled a childhood characterized by male-stereotypic experiences. Multiple discriminant function allowed the heterosexual women in the sample to be distinguished from the lesbian women with 80% accuracy in classification of individual cases on the basis of four recollected attributes (imagined self as a male character, wished to become a mother, preference for boys' games, and considered a tomboy as a child). However, some heterosexual women reported much the same childhood behaviors as the majority of lesbian women, and some lesbian women reported much the same childhood behaviors as the majority of heterosexual women. Such diversity raises questions about the nature of the relationship between experiences in childhood and adult sexual orientation.

Adult↗

Sensation seeking in homosexual and heterosexual males.

The study was designed to test the relationship between the personality trait of sensation seeking and homosexuality. Previous studies had shown a relationship between the trait and variety of heterosexual activity but had not shown a relationship to homosexual behavior. This study compared 19 male homosexuals associated with a gay club in a university, 16 control students belonging to a social club at the same university, 13 members of a gay church group, and 19 members of a nongay church group on conservative vs. liberal attitudes toward religion and politics, attitudes toward homosexuality, heterosexual and homosexual experience scales, and the sensation seeking scales. The control (nongay) church group had more conservative attitudes, less heterosexual experience, and lower sensation scores than the other groups. But the control university group did not differ from the gay university group on any of the sensation seeking scales and differed from the gay church group on only one of the subscales. However, the gay university group was also higher than the gay church group on this subscale, so the difference was probably a function of the younger ages of the university groups than the gay church group. It is concluded that male homosexuals, as a general group, do not differ from heterosexuals on the sensation seeking trait, although the trait might be related to variety of homosexual behavior and partners, just as it is to variety of heterosexual experience.

Adolescent↗

Childhood play activities of male and female homosexuals and heterosexuals.

This study examined the differences in childhood play behavior reported by adult male homosexuals (N = 198) and heterosexuals (N = 198) and those reported by female homosexuals (N = 198) and heterosexuals (N = 198). Two checklists with a total of 58 sports, games, and play activities were assembled: one for ages 5--8 and the other for ages 9--13. These were administered to the four samples. Monotonicity analysis (a type of factor analysis) revealed four scales within each checklist that were statistically reliable in each of the four samples. Scale and item mean comparisons revealed large significant differences between heterosexual males and females, male homosexuals and heterosexuals, and female homosexuals and heterosexuals. A majority of homosexuals reported significant degrees of cross-sex behavior in childhood play. Favorite play activities, age trends, play-related attitudes, and parent-child interactions were also examined.

Adolescent↗

Hepatitis C virus infection in a sexually active inner city population. The potential for heterosexual transmission.

The prevalence of hepatitis C virus (HCV) infection and associated risk factors in an inner city sexually active heterosexual population participating in a prospective study for the evaluation of heterosexual transmission of human immunodeficiency virus type-1 (HIV-1) were examined. Individuals with prior history of injection drug use or receipt of blood products were excluded from the study. Of 571 participants, 25 (4.4%) were seropositive for HCV, 39 (7%) for HIV, and 125 (22%) for hepatitis B virus (HBV). Multivariate analysis revealed that those with more than ten heterosexual partners in the past 5 years (OR = 3.7; 95% CI = 1.3, 10.2; P = 0.01), engaging in sexual practices more than once per week (OR = 3.3; 95% CI = 1.1, 10.1; P = 0.04), with antibody to hepatitis B core (HBc) antigen (OR = 2.9; 95% CI = 1.1, 7.4; P = 0.03), and antibody to HIV-1 (OR = 5.8; 95% CI = 1.9; 17.6; P = 0.002) were independently associated with HCV infection. These findings suggest that heterosexual transmission of HCV may occur in an inner city sexually active heterosexual population.

Adolescent↗

A cognitive profile of homosexual men compared to heterosexual men and women.

Matched groups of homosexual men, heterosexual men, and heterosexual women (n = 38 per group) were tested on three measures of spatial ability and two measures of fluency that typically reveal sex differences. For the three spatial tests and one of the fluency tests, the mean performance of homosexual men fell between those of the heterosexual men and women. The pattern of cognitive skills of homosexual men was different from that of heterosexual men: homosexual men had lower spatial ability relative to fluency. The cognitive pattern of homosexual men was not significantly different from that of heterosexual women. In addition, the results suggest that homosexual men classified on the basis of hand preference may form two subgroups that differ in cognitive pattern. These findings are compatible with the hypothesis that there is a neurobiological factor related to sexual differentiation in the etiology of homosexuality.

Adolescent↗

Nonmonotonic relation of autogynephilia and heterosexual attraction.

In this study I investigated the relation between normal heterosexual attraction and autogynephilia (a man's propensity to be sexually aroused by the thought or image of himself as a woman). The subjects were 427 adult male outpatients who reported histories of dressing in women's garments, of feeling like women, or both. The data were questionnaire measures of autogynephilia, heterosexual interest, and other psychosexual variables. As predicted, the highest levels of autogynephilia were observed at intermediate rather than high levels of heterosexual interest; that is, the function relating these variables took the form of an inverted U. This finding supports the hypothesis that autogynephilia is a misdirected type of heterosexual impulse, which arises in association with normal heterosexuality but also competes with it.

Adolescent↗

The development of gender schemata about heterosexual and homosexual others during adolescence.

Perceptions of heterosexual and homosexual individuals were investigated among 12-, 16-, and 20-year-old French adolescents. Participants described heterosexual and homosexual males and females with typical masculine and feminine personality traits. Overall, they perceived heterosexual males as having more masculine traits than homosexual males. The 16- and 20-year-olds perceived homosexual males as more feminine than heterosexual males, whereas the reverse was observed in 12-year-olds. Furthermore, the 12-year-olds perceived heterosexual females as more feminine than homosexual females, a difference that disappeared in the older age groups. Results support the view of early adolescence as a crucial period in the development of gender schemata about sexually significant others.

Adolescent↗

Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I.

Studies of heterosexual HIV transmission have consistently found anal intercourse to be a highly predictive risk factor for seroconversion. Yet most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex transmission. The health risks of anal sex appear to be severely underestimated by a substantial proportion of sexually active women and men in North and Latin America as well as parts of South Asia, Africa, and other regions. Among heterosexuals reported rates of condom use are nearly universally lower for anal than for vaginal intercourse. This review examines anal sex among the general population, including its prevalence in various world regions, related sociocultural factors, and other associated health problems including anorectal STDs, Hepatitis B infection, and HPV-related anal cancer in women. U.S. survey and other data suggest that, in terms of absolute numbers, approximately seven times more women than homosexual men engage in unprotected receptive anal intercourse. Research among higher risk subpopulations, including bisexual men, injecting drug users, female sex workers, inner-city adolescents, and serodiscordant heterosexual couples, indicates that persons particularly at risk of being infected by or transmitting HIV are also more likely to practice anal sex. Considering this finding, along with the much greater efficiency for HIV infection as well as lower rates of condom usage, a significant proportion of heterosexual transmission in some populations is due to anal intercourse. This typically stigmatized and hidden sexual practice must be given greater emphasis in AIDS/STD prevention, women's care, and other health promotion programs.

Adolescent↗

Heterosexual transmission of acquired immunodeficiency syndrome: international perspectives and national projections.

The heterosexual transmission of the acquired immunodeficiency syndrome (AIDS) has been documented in the United States by national surveillance data and heterosexual partner studies since the beginning of the epidemic. However, the efficiency of heterosexual transmission and related risk factors remain unclear. Viral transmission from males to their female sexual partners is well documented, although in the United States instances of female-to-male transmission have been observed less frequently. On the other hand, in parts of Africa and Haiti, AIDS appears to be a bidirectional, heterosexually transmitted disease that often occurs concurrently with other sexually transmitted diseases. Although a widespread heterosexual epidemic of AIDS could evolve in the United States, it seems more plausible that, like other sexually transmitted diseases, AIDS will settle in limited segments of the community characterized by certain high-risk behaviors.

Acquired Immunodeficiency Syndrome↗

Independent epidemics of heterosexual and homosexual HIV infection in South Africa--survival differences.

Survival with HIV infection is shorter in sub-Saharan Africa than in developed countries. The pattern of HIV transmission in our region has changed from homosexual to heterosexual, with viral subtypes similar to those in North America/Europe and Central Africa, respectively. We compared survival for the two transmission patterns after AIDS, and after the first CD4+ lymphocyte counts < 200/microliter and < 50/microliter, for adults presenting 1988-1993. Antiretroviral therapy was excluded. There were 180 homosexuals (63% White, 56% employed) and 314 heterosexuals (67% Black, 34% employed). Extrapulmonary tuberculosis was the AIDS-defining diagnosis in 36/90 heterosexuals and 5/58 homosexuals (p < 0.0001). Survival after AIDS was longer in heterosexuals (p = 0.0015), but AIDS occurred earlier as shown by their higher CD4+ count at AIDS onset (median 98/microliter vs. 40/microliter; p = 0.036). Survival was similar in the two groups after first CD4+ count < 200/microliter and < 50/microliter. Race, socioeconomic status and morbidity are markedly different in the two transmission groups. AIDS occurs with less severe immune suppression in heterosexuals, with correspondingly longer survival. Survival after defined CD4+ counts, however, is remarkably similar.

AIDS-Related Opportunistic Infections↗

Do bisexual men play a significant role in the heterosexual spread of HIV?

BACKGROUND AND OBJECTIVES: To assess the potential role of bisexual men in the transmission of HIV to women. STUDY DESIGN: The study population consisted of homosexual men participating in a longitudinal cohort study on HIV and AIDS in Amsterdam, the Netherlands, which started in 1984. Between April and November 1991, an additional questionnaire was administered concerning sexual behavior with both male and female partners in the last 6 months. RESULTS: Of these men, 27% described their sexual preference as bisexual or heterosexual. In the last 6 months, 23 (3%) had heterosexual contacts. Vaginal intercourse was the sexual technique most practiced. Anal intercourse with a female partner was rare. Four heterosexual active HIV positive men always used condoms when having heterosexual contact (1 missing). Of the 18 heterosexually active HIV seronegative men, 12 did not use condoms consistently with their female partner(s). Two of these 12 men also had unprotected insertive anogenital intercourse with male partners, which conveys a small transmission risk in the window period in the case of a seroconversion. CONCLUSION: Widespread transmission of HIV from these homosexual men in this study is not likely. However, the studied men are most probably not representative for homosexual men in Amsterdam, the Netherlands. Further study on the potential role that bisexual men play in the HIV transmission to women is therefore needed.

Acquired Immunodeficiency Syndrome↗

Prevalence of sexually transmitted infections and high-risk sexual behaviors in heterosexual couples attending sexually transmitted disease clinics in Peru.

OBJECTIVES: The objectives of this study were to determine the prevalence of sexually transmitted infection (STIs) in heterosexual couples and the sexual behaviors associated with their acquisition. GOAL: The goal of this study was to better direct educational efforts to decrease STI among heterosexual couples in Lima, Peru. STUDY DESIGN: We conducted a case-control study in 195 heterosexual couples without HIV infection who attended 2 sexually transmitted disease clinics in Lima, Peru. A case was defined as an individual with one or more newly diagnosed STIs such as gonorrhea, chlamydia, trichomoniasis, herpes simplex, syphilis, mycoplasma, or ureaplasma. RESULTS: Thirty-three percent of individuals (41 men and 89 women) had at least one STI and 26 couples (13%) had the same STI detected. Men who have sex with men (MSM) accounted for 13% of all men, had higher rate of STIs and higher risk behaviors than non-MSM. Ureaplasma infection was the most prevalent STI found in both men and women and was associated with oral sexual contact. In heterosexual pairs, condom use during anal sex occurred less than 10% of the time. CONCLUSIONS: The heterosexual couples in sexually transmitted disease clinics have high-risk behaviors and STIs are frequent. The educational effort concerning prevention of STIs requires higher effort.

Adolescent↗

Antibodies to cytomegalovirus in homosexual and heterosexual men attending an STD clinic.

We studied the prevalence of antibody to cytomegalovirus (CMV) in 262 men (132 homosexual, 20 bisexual, and 108 heterosexual) attending the sexually transmitted diseases (STD) clinic at this hospital. Antibody to CMV at a titre of 1/4 or more was found in 92% of the homosexuals, 80% of the bisexuals, and 56% of the heterosexuals (p less than 0.0001). Among heterosexuals, but not homosexuals, nationality and social class showed a significant association with antibody to CMV. In both heterosexuals and homosexuals a history of gonorrhoea was more common in patients with antibody to CMV than in those without it. A similar finding was seen in heterosexual men with a history of non-specific urethritis (NSU). Using a series of log linear models, sexual orientation was shown to be the most important determinant of antibody to CMV in this population.

Adolescent↗