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PubMed2002

Social network, social support and the rate of decline of CD4 lymphocytes in asymptomatic HIV-positive homosexual men.

AIMS: To test a stress-disease hypothesis by investigating the influence of social network and social support factors on the course over time of the CD4 lymphocytes in an HIV-positive population of gay men. METHODS: The study is a prospective cohort study of a representative population of HIV-positive gay men, undertaken at the Department of Infectious Diseases, Malmö University Hospital. This is the only clinic providing care for HIV-positive individuals in the city of Malmö in southern Sweden (population 248,000). A total of 115 HIV-positive homosexual men, who had not received an AIDS diagnosis, were invited to take part in the study. Seventy-five men (65%) accepted to be interviewed and 64 men (56%) fulfilled the inclusion criteria for the statistical analysis. RESULTS: In a multivariate analysis adjustments were made for age, level of the first CD4 count and time since first contact with the clinic. Men with high family contact frequency had a longer half-life (20.3 years) of the CD4 lymphocyte count than men with a low family contact frequency (7.4 years) (p = 0.03). Men with high social participation also had a longer half-life of CD4 lymphocyte count (14.7 years), compared with men with low social participation (6.3 years, p = 0.10). CONCLUSIONS: The findings of this study imply the importance of social support and social network factors as modifiers of the rate of decline of the CD4 lymphocyte level, which is an important prognostic marker of survival in HIV-positive homosexual men.

Adult↗
PubMed1992

Public opinion about AIDS policies. The role of misinformation and attitudes toward homosexuals.

In an effort to better understand the cognitive and attitudinal factors underlying public opinion on AIDS-related issues, this article proposes and empirically tests a model of the relationships between (1) knowledge of HIV transmission, specifically the misinformation that AIDS can be transmitted easily through casual contact with HIV-infected persons; (2) attitudes toward homosexuals, the most prominent of the social groups presently affected by the AIDS crisis; and (3) support for restrictive public policies aimed at HIV-infected persons. Data from two nationally representative surveys conducted in December of 1985 (N = 2,308) and in July of 1987 (N = 2,095) provide evidence that misinformation about AIDS transmission and negative attitudes toward homosexuals are strong predictors of support for stringent restrictions of persons with AIDS. The findings also suggest that several background factors, in particular, education and political liberalism, may also play decisive roles in influencing levels of support for restricting those infected with the AIDS virus.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Increased human herpesvirus 8 seroprevalence in young homosexual men who have multiple sex contacts with different partners.

The objective of this study was to evaluate the behavioral risks that are associated with human herpesvirus 8 (HHV-8) infection in a cohort of young homosexual men. Seventy-nine subjects (ages 22-33 years) who completed a questionnaire about their sexual and drug use behavior over the preceding year were recruited from the San Francisco Young Men's Health Study. Plasma samples were tested for anti-HHV-8 antibodies using an indirect IFA. Thirty-eight subjects (48.1%) were infected with HHV-8. HHV-8 infection was significantly linked to an increasing number of male sex partners (P=.025, Mantel-Haenszel chi2 test for trend), suggesting a strong association between HHV-8 infection and multiple homosexual contacts.

Adult↗
PubMed1999

Evidence for concurrent epidemics of human herpesvirus 8 and human immunodeficiency virus type 1 in US homosexual men: rates, risk factors, and relationship to Kaposi's sarcoma.

We examined human herpesvirus 8 (HHV-8) seroprevalence and seroincidence among 245 homosexual men from New York City (NYC) and Washington, DC (DC) who have been followed since 1982. An immunofluorescence assay measured antibodies to a latent HHV-8 nuclear antigen. Seroprevalence was 20.4% in 1982; seroincidence was approximately 15%/year during 1982-1983 but fell sharply thereafter. NYC men had a higher seroprevalence (odds ratio, 3.43; P<.001) and seroincidence (rate ratio, 2.13; P=.01) than DC men. Risk of Kaposi's sarcoma (KS) was increased in seropositive men (adjusted relative hazard, 3.58; P=.02). Among men who were seropositive for both human immunodeficiency virus type 1 and HHV-8, the 10-year cumulative risk of KS was 39%; time from coinfection to KS diagnosis ranged from 15 to 154 months (median, 63.5 months). This study shows an epidemic of HHV-8 among US homosexual men in the early 1980s that was associated with a high risk of developing KS.

Antibodies, Viral↗
PubMed2005

A theory of scandal: Victorians, homosexuality, and the fall of Oscar Wilde.

Oscar Wilde is considered to be the iconic victim of 19th-century English puritanism. Yet the Victorian authorities rarely and only reluctantly enforced homosexuality laws. Moreover, Wilde's sexual predilections had long been common knowledge in London before his trial without affecting the dramatist's wide popularity. Focusing on the seemingly inconsistent Victorian attitudes toward homosexuality and the dynamics of the Oscar Wilde affair, this article develops a general theory of scandal as the disruptive publicity of transgression. The study of scandal reveals the effects of publicity on norm enforcement and throws into full relief the dramaturgical nature of the public sphere and norm work in society.

Drama↗
PubMed1997

Seroprevalence of human papillomavirus types 6 and 16 capsid antibodies in homosexual men.

Human papillomavirus (HPV) has been implicated in the pathogenesis of anal carcinoma, which is increased in homosexual men. Little is known about the serologic response to HPV in normal or immunosuppressed men; therefore, HIV-infected and -uninfected homosexual men were screened for HPV-6 and -16 capsid antibodies. HIV-infected men had increased HPV DNA detection but did not significantly differ in the prevalence of serum HPV antibodies. HPV-6 DNA detection and the presence of anal warts were significantly correlated with serum antibody overall and in the HIV-infected subgroup. HPV-16 DNA detection was not significantly correlated with serum antibody overall or in either subgroup; however, HIV-infected men with high-grade anal squamous intraepithelial lesions were significantly more likely to have HPV-16 antibodies. HIV-infected men are able to generate an antibody response to HPV, and a lack of serum HPV antibodies cannot explain the increased HPV-associated disease seen in HIV-infected men.

AIDS-Related Opportunistic Infections↗
PubMed1998

Prevalence and risk factors for human papillomavirus infection of the anal canal in human immunodeficiency virus (HIV)-positive and HIV-negative homosexual men.

One of the groups at highest risk of anal cancer is homosexual and bisexual men. Like cervical cancer, anal cancer is associated with human papillomavirus (HPV) infection. Anal HPV infection was characterized in a study of 346 human immunodeficiency virus (HIV)-positive and 262 HIV-negative homosexual and bisexual men. Anal HPV DNA was detected in 93% of HIV-positive and 61% of HIV-negative men by polymerase chain reaction. The spectrum of HPV types was similar in HIV-positive and HIV-negative men, with HPV-16 the most common type. Infection with multiple HPV types was found in 73% of HIV-positive and 23% of HIV-negative men. Among HIV-positive men who were positive by hybrid capture for group B HPV types (16/18/31/33/35/39/45/51/52/56/58) or group A types (6/11/42/43/44), lower CD4 cell levels were associated with higher levels of group B DNA (P = .004) but not group A DNA. These data suggest increased replication of the more oncogenic HPV types with more advanced immunosuppression.

AIDS-Related Opportunistic Infections↗
PubMed1997

Seroprevalence of and risk factors for hepatitis A infection among young homosexual and bisexual men.

To evaluate hepatitis A infection among young homosexual and bisexual men, 411 men aged 17-22 years were surveyed at 26 public venues in San Francisco and Berkeley. Seroprevalence of hepatitis A infection was 28.0% (95% confidence interval [CI], 23.7%-32.6%). Recent infection was evident in 3.3% of susceptible men (95% CI, 1.6%-5.9%). Independent predictors of hepatitis A infection were Latino ethnicity (odds ratio [OR] = 5.3; 95% CI, 3.1-8.9), having > or = 50 lifetime male sex partners (OR = 1.8; 95% CI, 1.1-3.0), less than high school education (OR = 2.2; 95% CI, 1.2-4.1), and being a high school graduate (OR = 1.7; 95% CI, 1.0-2.9). Independent predictors of recent infection were less than high school graduate (OR = 7.6; 95% CI, 1.9-30.5), insertive anal intercourse (OR = 5.6; 95% CI, 1.0-32.8), and sharing needles without cleaning them (OR = 32.1; 95% CI, 3.0-346). Hepatitis A is a common infection in young homosexual men and is associated with sexual and drug-using behaviors.

Adolescent↗
PubMedDate not supplied

Isospora belli diarrheal infection in homosexual men.

Unsporulated Isospora belli oocysts were detected in the stool specimens of three homosexual men. The oocysts were ellipsoidal measuring 23-33 X 12-15 micron. It is acid fast with modified cold kinyoun stain (MCK) and reveals orange fluorescence with the Truant's stain. Sheather's sucrose flotation method is effective in concentrating Isospora oocyst as with other coccidial oocysts. One specimen showed many Charcot-Leyden crystals. All three patients responded to treatment. Isosporiosis is rare in this country and is endemic in the tropics and subtropics. Although one case acquired the infection after returning from an endemic area, the other two cases had no travel history. This raised the suspicion that this, like other parasitic infections (amebiasis, giardiasis, cryptosporidiosis) may be sexually transmitted. Such exotic parasitic infections in homosexual men during the outbreak of the acquired immunodeficiency syndrome adds another unusual infectious agent to the differential diagnosis of diarrheal disease in this high risk group of population.

Adult↗
PubMed1986

Syphilis in HTLV-III infected male homosexuals.

Out of 100 male homosexual persons screened for AIDS, 54 were found to be HTLV-III antibody positive. Of these, 34 (63%) had a positive history of syphilis, as compared to 16 (35%) of the 46 HTLV-III antibody negative persons (P less than 0.01). In the HTLV-III antibody positive group 12 (22%) had had more than three syphilis infections as compared to none in the negative group (P = 0.02). The frequency of a previous primary, secondary, and latent syphilitic infection was different in the two groups. During the 1970s and early 1980s the incidence of syphilis in the U.S.A. and in Denmark was increasing, but from 1982 the incidence decreased markedly, possibly a consequence of the fear of AIDS, which appeared in 1981-82. It is speculated that the high frequency of syphilis among homosexual men might have been a co-factor for the acquisition of the HTLV-III infection.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Seroprevalence of HHV-8 antibodies in HIV-positive homosexual men without Kaposi's sarcoma and their clinical follow-up.

Human herpesvirus 8 (HHV-8) has been associated with Kaposi's sarcoma (KS). Because KS is most frequently seen in HIV-positive homosexual men, we retrospectively evaluated the seroprevalence of HHV-8 in this risk group and compared the clinical history and clinical course of the HHV-8-negative and HHV-8-positive groups. The study was performed by analyzing banked serum samples from asymptomatic HIV-positive men. HHV-8 seropositivity was determined by an indirect immunofluorescence test. A total of 56% of patients (42/75) were seropositive for anti-HHV-8 IgG antibodies as opposed to 12% of 40 age-matched HIV-negative controls. Median CD4 counts at study entry were significantly lower in the HHV-8-positive group than in the HHV-8-negative group (520 vs 686); however, the percentage decrease during a 30-month follow-up did not differ significantly. KS developed in two patients during follow-up; both were HHV-8-positive and had CD4 counts of less than 200/microL at the time of clinical manifestation. One HHV-8-positive patient in whom AIDS developed died of infectious complications. The longest follow-up in the HHV-8-positive cohort without development of KS was 81 months. We conclude that HHV-8 has a high seroprevalence in asymptomatic, homosexual, HIV-positive persons. An HHV-8 infection can precede the development of KS by many years. Immunosuppression below a certain threshold may trigger the clinical manifestation of KS.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Transmission of human immunodeficiency virus infection presumed to have occurred via female homosexual contact.

We describe a 24-year-old woman infected with the human immunodeficiency virus (HIV) whose sole risk behavior was prior sexual contact with an HIV-infected woman. Our patient's clinical course suggests that viral transmission occurred during the beginning of their sexual relationship. Our case, combined with those previously reported, provides evidence that female homosexual activity can be a risk behavior for acquisition of HIV infection. Seroprevalence studies, however, have not provided evidence for transmission of HIV by this behavior. These studies, combined with the sparse number of individual case reports, suggest that female homosexual activity is an inefficient mechanism of HIV transmission.

Adult↗
PubMed1995

Infection with Chlamydia trachomatis lymphogranuloma venereum serovar L1 in homosexual men with proctitis: molecular analysis of an unusual case cluster.

Among 767 rectal isolates of Chlamydia trachomatis obtained from men over the period 1981-1991, 7 were found to be a rare lymphogranuloma venereum serovar, L1. These isolates were from rectal specimens taken from five male patients in 1982-1983. Six of the seven isolates were available for DNA sequencing studies. All six of these isolates shared the same DNA sequence in the major outer membrane protein (MOMP) gene variable domains and had different MOMP sequences than did the prototype L1, L2, and L3 strains, suggesting a point source outbreak. All five patients infected with serovar L-1 were homosexual men who had symptomatic proctitis characterized by rectal pain, discharge, tenesmus, abnormalities seen on anoscopy, and leukocytes seen on gram stains of rectal specimens. We conclude that an unrecognized point source outbreak of the rare chlamydial L1 serovar occurred among homosexual men in Seattle in 1982-1983, and that the clinical manifestations of L1 infection may be less severe than those of L2 infections.

Adult↗
PubMed2001

A comparison of high-risk sexual behaviour and HIV testing amongst a bar-going sample of homosexual men in London and Edinburgh.

BACKGROUND: This study compared high-risk sexual and HIV testing behaviour amongst homosexual men recruited from gay bars in London and Edinburgh. METHODS: A cross-sectional survey monitoring high-risk sexual and HIV testing behaviour using a self-completed questionnaire was conducted in November and December 1996. RESULTS: Two thousand, three hundred and ninety-seven questionnaires were returned (1,366 recruited in London and 1,031 in Edinburgh), with a response rate of 77%. A larger proportion of men surveyed in London had had unprotected anal intercourse (UAI) with one or more male partners in the previous year (35%) than in Edinburgh (30%). Men recruited in Edinburgh were less likely to have had an HIV test (54%) than men in London (63%). In both surveys, 25% of men who reported UAI with partners of the same HIV status as themselves also reported never having had an HIV test. CONCLUSIONS: The observed dissimilarities in the HIV epidemic in the two cities may be accounted for by the differences in self-reported high-risk sexual and HIV testing behaviours between the two populations. A large proportion of men in both cities continue to engage in high-risk sexual behaviour suggesting continued transmission of HIV in these populations. Thus, there is a continued need for innovative and relevant health promotion amongst homosexual men in the UK.

AIDS Serodiagnosis↗
PubMed1977

Neisseria meningitidis in the anal canal of homosexual men.

Cultures were obtained from the oropharynx, urethra, and anal canal of 157 homosexual men. Neisseria gonorrhoeae was identified in 30 men (19.1%), Neisseria meningitidis in 32 men (20.4%), and Neisseria lactamicus and Branhamella catarrhalis in one man each. N. gonorrhoeae was isolated from the anal canal of three men (1.9%), and N. meninititidis was identified in the anal canal of seven men (4.5%). These findings suggest that confirmatory tests are indicated for homosexual males with rectal isolates presumptively identified as N. gonorrhoeae.

Anal Canal↗
PubMed1978

Anogenital infection with Neisseria meningitidis in homosexual men.

Among monosexual men anal infection with Neisseria meningitidis was more prevalent (15 of 731 men) than expected and significantly more prevalent than urethral infection with N. meningitidis (three of 669 men, P less than 0.01). Anal infection was also significantly more prevalent among homosexual men than among heterosexual women (two of 1,197 women, P less than 0.001). These differences in rates of prevalence may be best explained by a preference of meningococci for anal mucosa and by the common homosexual practice of oral-anal sexual contact. Serogrouping of the 17 anal and three urethral isolates revealed a broad representation of serogroups often found in meningococcal pharyngeal carriage in the community. Of 14 patients who returned for a test-of-cure culture within seven days of treatment with an antibiotic regimen recommended for anogenital gonococcal infection, each was culture-negative for N. meningitidis. Minor and symptoms in three men and profuse urethral discharges in two men resolved with treatment.

Ampicillin↗
PubMed1982

Hepatitis B in homosexual men: prevalence of infection and factors related to transmission.

Of 3,816 homosexual men examined in five sexually transmitted disease clinics in the United States, 6.1% had hepatitis B surface antigen, 52.4% had antibody to hepatitis B surface antigen, and 3.0% of the men who had no other indicator of infection with hepatitis B virus (HBV) had antibody to hepatitis B core antigen. The rate of seropositivity for HBV indicated by the presence of one or more of these serologic markers was 61.5%; seropositivity was significantly related to the duration of regular homosexual activity and to the number of nonsteady male sexual contacts in the four months before the patients were interviewed. Anal-genital intercourse, oral-anal intercourse, and rectal douching were significantly related to evidence of HBV infection, but oral-oral contact and oral-genital contact were not. Trauma to the rectal mucosa is a feature common to the practices that were significantly related to seropositivity for HBV.

Adolescent↗
PubMed1983

Three-step stool examination for cryptosporidiosis in 10 homosexual men with protracted watery diarrhea.

Cryptosporidiosis, a zoonosis caused by Cryptosporidium species, is a newly recognized coccidial protozoan infection causing severe protracted watery diarrhea in humans. In August 1981, the first case of cryptosporidiosis in a homosexual man with acquired immune deficiency syndrome (AIDS) was reported; diagnosis was determined by intestinal biopsy. It is necessary to adopt a simple laboratory diagnostic procedure to screen large numbers of suspected cases. A three-step stool examination was developed to demonstrate Cryptosporidium oocysts and the diagnostic and infective stages of the infection in 10 homosexual men with AIDS. This is a less invasive, less costly, and more sensitive test than intestinal biopsy and has been designed to prevent confusion caused by yeast cells that are frequently present in stool, leading to a false diagnosis. The examination consists of preliminary differential determination by iodine wet mount, definitive identification by modified Kinyoun acid-fast staining, and a more effective method of concentrating oocysts, by Sheather's sugar cover-slip flotation method.

Acquired Immunodeficiency Syndrome↗