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PubMedDate not supplied

Awareness and use of hepatitis B vaccine among homosexual male clients of a Boston community health center.

Factors associated with awareness and acceptance of hepatitis B vaccine were identified among 150 homosexual male clients of a Boston community health center. Five percent of the subjects were unaware of hepatitis B and 25 percent had a history of hepatitis. Among the remaining 106 men, 68 percent were aware of the vaccine, and 25 percent of these had been vaccinated. Awareness of vaccine was associated with education beyond the baccalaureate level. Factors associated with vaccination included at least one prior visit to the health center, having health insurance, and extent of knowledge of the effects of hepatitis B. Among those not vaccinated, 68 percent would like to be but were deterred by the perceived high cost of the vaccine. The predominant reason given by the 31 percent who have decided not to be vaccinated was the perception that they were not at risk because of monogamous sexual relationships, or "safer" sexual practices. Strategies for maximizing vaccine use among homosexually active men should focus on increasing both awareness of the vaccine and appropriate perceptions of risk.

Adult↗
PubMed1990

Anal intraepithelial neoplasia and anal papillomavirus infection among homosexual males with group IV HIV disease.

Ninety-seven male homosexuals with the acquired immunodeficiency syndrome or other group IV human immunodeficiency virus disease were studied for anal human papillomavirus infection and intra-anal cytological abnormalities. Human papillomavirus DNA was detected in 52 subjects (54%), and 38 subjects (39%) were found to have abnormal anal cytological findings; anal intraepithelial neoplasia was detected in 15 specimens (15%). Abnormalities on anal cytological smear were significantly associated with the presence of human papillomavirus DNA, with a risk ratio of 4.6. Infection with multiple human papillomavirus types was common (12%) and was associated with a risk ratio for cytological abnormalities of 39.0. Median T4 counts of subjects with abnormal cytological findings were significantly lower than those with normal findings. These studies indicate that immunosuppressed male homosexuals have a high prevalence of anal human papillomavirus infection and anal intraepithelial neoplasia, and this population may be at significant risk for the development of anal cancer.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Sexual transmission efficiency of hepatitis B virus and human immunodeficiency virus among homosexual men.

The relative sexual transmission efficiency of hepatitis B virus (HBV) and human immunodeficiency virus type 1 (HIV-1) was investigated by a prospective study of homosexual men in Pittsburgh, Pa, from the Multicenter AIDS Cohort Study. During the 30-month follow-up, 19.8% and 7.8% of the initially seronegative HBV and HIV-1 groups were estimated to seroconvert to HBV and HIV-1, respectively. The significantly higher cumulative HBV seroconversion rate occurred despite a much lower prevalence of hepatitis B carriers (7% were hepatitis B surface antigen positive) compared with HIV-1 carriers (22% were HIV-1 antibody positive). The sexual exposure profile of HBV and HIV-1 seroconverters was similar during the 6 months prior to seroconversion, supporting the link between anal intercourse and acquisition of either infection. However, insertive, not receptive, anal intercourse was the major risk factor identified for HBV seroconversion, suggesting that transurethral exposure is an important mode of transmission. These data suggest that HBV is transmitted 8.6-fold more efficiently than HIV-1 among homosexual men studied and underscore the benefits of both HBV immunization and use of condoms during intercourse to prevent HBV infection.

Cohort Studies↗
PubMed1990

[Clinical manifestations of acquired immunodeficiency syndrome (AIDS), with reference to cases reported in Japan and our observations on two of HIV-infected homosexuals].

This article provides an overview of the clinical presentations of human immunodeficiency virus (HIV) infection, including some of the early and less severe diseases, such as acute HIV infection, persistent generalized lymphadenopathy (PGL) and acquired immunodeficiency syndrome (AIDS) related complex (ARC), and full-blown AIDS. The salient features of 24 cases of AIDS reported in Japan were summarized. There was no difference in clinical features between hemophiliacs (16 cases) and homosexual males (8 cases), except for a preponderance of cases of cytomegalovirus infection in the latter group. The new prognostic staging system, based on physiologic deficits, for AIDS was applicable to Japanese patients with AIDS. In addition, a three-year follow-up study on two of HIV-infected homosexuals was presented.

AIDS-Related Complex↗
PubMed1990

Relationship between AIDS latency period and AIDS survival time in homosexual and bisexual men.

We identified 277 homosexual and bisexual men diagnosed with acquired immune deficiency syndrome (AIDS) whose estimated human immunodeficiency virus (HIV) seroconversion dates, ranging from 1977-85, could be well approximated. These men were from a cohort of 6,705 homosexual and bisexual men originally recruited for studies of sexually transmitted hepatitis B in San Francisco in 1978-80. We compared the time from HIV seroconversion to the initial disease diagnostic of AIDS (AIDS latency period) with the time from first AIDS diagnosis to death (AIDS survival time) and found no significant overall correlation between latency period and survival time. Both Kaplan-Meier and Cox proportional hazard stepwise analyses found the initial AIDS diagnosis to be significantly associated with latency period, with individuals first diagnosed with Kaposi's sarcoma (KS) having a shorter latency but longer survival than those first diagnosed with Pneumocystis carinii pneumonia (PCP) or other AIDS diagnoses. Individuals with KS tended to be diagnosed earlier in the epidemic compared to those with PCP and other non-KS diagnoses. The AIDS survival time was significantly associated with the initial AIDS diagnosis but not with the estimated year of seroconversion, the year of first AIDS diagnosis, age at seroconversion, or racial/ethnic group. The information presented here on the relationship between the AIDS latency period and survival times suggests a model for the pathogenesis of HIV infection in which there is continual deterioration of the immune system. The wider use of antiviral and prophylactic therapies both preceding and following a diagnosis of AIDS may change this model as both latency and survival times are improved.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[The rate of detecting Chlamydia in male homosexuals with syphilis].

A total of 159 homosexuals suffering from various forms of syphilis, aged 17 to 71, were screened for chlamydial antigen with the use of fluorescent monoclonal antibodies. Asymptomatic urogenital chlamydiosis was detected in 33 of 107 (30.8 percent) homosexual syphilitics. In 52 patients the material was collected simultaneously from the throat, urethra, and rectum; Chlamydia were detected in 71.2 percent of these.

Adolescent↗
PubMed1990

[The penetration of HIV into the population of Moscow homosexuals and its spread].

The article deals with the epidemiological investigation of cases of HIV infection among the population of homosexuals. 119 representatives of this population were checked in their sexual contacts; of these, 13 persons proved to be infected with HIV. HIV infection was found to penetrate into the homosexual population of the USSR from the countries of Western Europe and the USA by sexual route. In 1988 the intensive spread of this infection began.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Growing yams and men: an interpretation of Kimam male ritualized homosexual behavior.

This paper explores the meaning of Kimam (Irian Jaya) male ritualized homosexual behavior by placing the behavior within a broad cultural context. It demonstrates that males claim to foster the growth of yams and to make men from boys by manipulating the processes of fertilization. One aspect of this manipulation involves the transfer of sperm from older males to boys. Exploration of Kimam ideas of death and burial rituals suggests that members of one village sector see their fertility as under attack by males of the opposite sector. At the conclusion of mortuary ceremonies, the two sectors engage in competitive feasts in which the successful control of fertility is symbolized by the presentation of finished products of male vitality: yams and children, especially boys. The analysis indicates that an understanding of homosexual behavior requires that attention not be restricted to the sexual behavior itself, but rather include various domains of meaning associated with it.

Ceremonial Behavior↗
PubMed1986

Nucleic acid cytometry of homosexual-associated lymphoproliferative disease.

Twenty-six reactive lymph nodes and 5 malignant lymphomas from homosexual males were studied by acridine orange flow cytometry (AO-FCM) for determination of ploidy, proliferation, and RNA characteristics. Two reactive lymph nodes showed ploidy abnormalities as compared with none of 27 reactive lymph nodes from nonhomosexual patients. The homosexual-associated (HA) lymphadenopathy had a higher mean proliferative activity (11.2% versus 5.6%) and higher ribonucleic acid (RNA) content (1.11 versus 0.96) than non-HA counterparts. The proliferative activity of HA lymphadenopathy was also higher than follicular small cleaved cell lymphoma, and not dissimilar to that of follicular large cell lymphoma. These findings indicate that HA-reactive lymphadenopathy is a hyperproliferative state associated with high cellular RNA content and rare DNA-abnormal stemlines. One HA lymphoma had an abnormal stemline by AO-FCM, compared with 9 of 15 (63%) non-HA high grade lymphomas. This lymphoma also demonstrated an abnormal karyotype (47,XY, +12, t[8;22]) by classic cytogenetic studies. The mean proliferative activity and RNA content of HA lymphomas was higher than non-HA counterparts (37% versus 22.5% and 2.48 versus 1.73, respectively). The proliferation and RNA features of HA lymphoma were on higher planes than non-HA lesions histologically comparable. Thus, in addition to differences in clinical presentation, histologic subtype, stage distribution, and therapeutic response, HA lymphomas have DNA/RNA characteristics different from those of counterparts in the general population.

Adult↗
PubMed1989

Cellular and humoral immunity in various cohorts of male homosexuals in relation to infection with human immunodeficiency virus.

The relationship between infection with human immunodeficiency virus (HIV) and various immunological parameters was studied in: (a) healthy controls; (b) homosexual individuals from the AIDS risk group without anti-HIV antibodies; (c) idem, but with anti-HIV antibodies; (d) patients with persistent generalized lymphadenopathy (PGL); (e) patients with AIDS-related syndrome; (f) patients with AIDS and opportunistic infections. In each group, consisting of 15-20 individuals, the following parameters were studied: absolute numbers of CD4+ and CD8+ cells; ratio CD4+/CD8+; cellular immune responses as measured in vivo by delayed-type hypersensitivity (DTH) and in vitro; and antibody response in vivo after immunization with a low dose of keyhole limpet haemocyanin. Healthy HIV antibody-positive individuals and patients with persistent generalized lymphadenopathy already showed a decreased CD4+/CD8+ ratio, mainly due to an increase in the number of CD8+ cells. The ratio in the AIDS-related syndrome and AIDS groups was even lower, but this was now due to low numbers of CD4+ cells while the number of CD8+ cells was normal. The lymphocyte proliferative response was low in the HIV antibody-positive group, normal in the group with persistent generalized lymphadenopathy and profoundly decreased in the AIDS-related syndrome and AIDS groups. DTH was enhanced in the PGL group and diminished in both ARC and AIDS. Compared to healthy controls, the antibody response upon immunization with a low dose of keyhole limpet haemocyanin was depressed (although not absent) in all groups studied, even in HIV antibody-negative homosexuals. In the HIV antibody-positive group, the severity of the impairment of the various parameters of immunocompetence was not related to the presence of HIV antigenaemia.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Defective T cell colony formation and IL-2 receptor expression in HIV-infected homosexuals: relationship between functional abnormalities and CD4 cell numbers.

HIV infection is known to induce a progressive T helper/inducer (CD4) lymphopenia and to impair the functional activities of residual cells. The present studies examined the relationship between the CD4 cell count and three functional assays: T cell colony formation in semisolid media, the capacity of PHA-stimulated cells to express IL-2 receptors, and their ability to synthesize and secrete IL-2. Cells from antibody-positive homosexuals with normal numbers of CD4 cells (greater than 700/microliters) showed defective reactivity in two assays, colony growth, and IL-2 receptor expression. These defects became progressively more pronounced in homosexuals with moderate (400-700 cells/microliters) and severe (less than 400/microliters) reductions in assays for IL-2 production by PHA-stimulated lymphocytes. Mixing experiments suggest that cells from HIV-infected men nonspecifically inhibit the colony growth of normal cells; this abnormality could be reversed by addition of exogenous IL-2. These data suggest that defective colony growth and reduced IL-2 expression are functional abnormalities directly resulting from HIV infection. Furthermore, these changes can precede the CD4 lymphopenia induced by this viral infection.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Incidence of HIV infection among homosexuals].

In the period 1985-1988 blood samples were examined of 1297 homosexual and bisexual men. The samples were sent by health service units from the whole country. Anti-HIV antibodies were demonstrated by the EIA method and confirmed by the Western blot technique in the serum of 35 subjects (2.7%). In the second half of 1988 a rise was observed in the number of infections among the tested subjects (10.3%). In Poland similarly as in West Europe and the USA, homosexual and bisexual males are the group of high risk for HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Evidence that prior immune dysfunction predisposes to human immunodeficiency virus infection in homosexual men.

To investigate the role of host susceptibility to HIV-1 infection, we studied subsequent seroconversion in 161 individuals, initially seronegative to HIV-1, who underwent skin testing for cutaneous anergy at an index visit within a prospective study of homosexual men. There were 23 seroconversions in these men by 45 months following the skin testing, yielding a crude rate of seroconversion of 14.3%. While results of purified protein derivative (PPD), Candida, and Trichophyton skin tests were not associated with subsequent course, anergy to dinitrochlorobenzene (DNCB) was predictive of subsequent seroconversion. Kaplan-Meier estimates for the risk of seroconversion during 45 months of follow-up in those men initially anergic and reactive to DNCB were 28.9 and 11.1%, respectively, yielding a relative risk of 2.6 (p = 0.006). The estimated relative risk was stable with adjustment by Cox regression for annual number of male sexual partners and frequency of receptive anal intercourse, and was not sensitive to various changes in the definition of seroconversion time and of eligibility criteria. These data suggest that an impaired host immune status may be associated with an increased risk of HIV-1 infection that is independent of risk of exposure to the virus, supporting earlier speculations that HIV-1 may itself be opportunistic. The notion of varying host susceptibility to infection, at least with regard to sexual transmission in homosexual men, may help to explain the frequent observation of individuals who have been repeatedly exposed to the virus and yet have remained uninfected.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Knowledge of AIDS and of transmission risks of HIV infection in a group of homosexual people. A questionnaire study].

A questionnaire investigation among 430 homosexual persons all of whom were members of an organization for homosexuals was completed by 144 (33%). These replies showed that they knew about HIV infection, risk behaviour and "safe sex". Their knowledge about the signs of HIV infection and AIDS was, however, more limited. The replies were compared with an age-matched group of the male population. The results of the investigation provide reasons to suppose that the information campaigns have been of value but information to prevent spread of infection is still necessary. In addition, further information is necessary about the subjective signs of HIV-infection so that persons in whom these signs develop may be offered the best possible treatment as early as possible.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Immune changes in male homosexuals--predisposing factors for HIV seroconversion.

Israel is still a low incidence country for AIDS and thus the temporal relationships between various cofactors and HIV infection can be more easily determined. We have studied a cohort of 243 asymptomatic male homosexuals (MHS) during the last 4 years. At the beginning of the study, 40% had significant decreases in the peripheral blood lymphoid populations, signs for reactivation of CMV and EBV infections, and elevated serum levels of interferon. There was no difference in the prevalence of these immune derangements between seropositive and seronegative individuals. In the course of 4 years' follow-up, the prevalence of these immune derangements has remained the same though being significantly more severe in the HIV seropositive subjects. HIV seroconversion did not exceed 8% (about 2% annually) and was related to the immune impairments found when first seen at the beginning of the study. The results suggest that immune impairments are common among asymptomatic MHS, precede HIV infection, and probably contribute to the increased risk for AIDS among male homosexuals.

Antibodies, Viral↗
PubMed1989

Risk of developing AIDS in HIV-infected cohorts of hemophilic and homosexual men.

The latency period and/or incidence of the acquired immunodeficiency syndrome (AIDS) may differ in persons infected with the human immunodeficiency virus by different routes or having different "cofactors." We compared 79 hemophilic men in Pennsylvania and 117 homosexual and bisexual men in California, all having known dates of infection and long postinfection observation periods, to examine these hypotheses. By 1987, twenty-one percent of the hemophilic and 27% of the homosexual men had developed AIDS. However, seroconversion patterns differed for the two groups, and when this was taken into account, the conditional odds ratio for AIDS was 1.20. Kaplan-Meier survival analysis showed no significant difference in the cumulative proportion with AIDS, from time of infection. These results are limited by the small size and geographically localized nature of our study populations, but they suggest that currently the relative length of human immunodeficiency virus infection is of primary importance in comparing disease outcome for different populations.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Comparative analysis of CD4-4B4 and CD4-2H4 lymphocyte subpopulations in HIV negative homosexual, HIV seropositive and healthy subjects.

A comparative analysis of subsets (4B4 and 2H4) within the CD4 lymphocyte subpopulation was made by double marker analysis among 23 healthy heterosexual, 16 healthy HIV seronegative high-risk homosexuals and 82 HIV seropositive subjects. Data show that the significant increase in CD4 lymphocytes observed among seronegative homosexuals corresponds mainly to an increase in CD4-4B4 positive cells while CD4-2H4 subset levels remain comparable to healthy heterosexual controls. A decrease both in CD4-4B4 and CD4-2H4, parallel to a decrease in CD4 subpopulation, was observed in asymptomatic seropositive carriers (SPC) and patients with ARC syndrome (AIDS-related complex) or AIDS (acquired immunodeficiency syndrome). Interestingly, an absolute decrease in CD4 subpopulation in patients with asymptomatic lymph node enlargement (LAS), is chiefly accounted for by a decrease in CD4-4B4 subset. The values of CD4-2H4 subset are significantly higher than those observed for SPC patients and are close to the normal values. These observations are of interest, as no differences between SPC and LAS patients could be detected when CD3, CD4 and CD8 subpopulations were studied.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Comparative immunogenicity of plasma and recombinant hepatitis B virus vaccines in homosexual men.

A randomized, double-blind clinical trial of plasma-derived and DNA recombinant hepatitis B virus vaccines was conducted in 186 homosexual men. Nine months after the immunization series (three doses) began, the seroconversion rate in the plasma vaccine group was 88% (68/77); this was significantly higher than the 74% (60/81) response rate of the recombinant vaccine group. Men positive for antibody to the human immunodeficiency virus (HIV) had a considerably higher nonresponse rate to either vaccine than expected in non-HIV-infected homosexual men. The odds ratios of nonresponse to hepatitis B virus vaccine for HIV-seropositive vs HIV-seronegative subjects were 12.0 (95% confidence interval, 1.7 to 89.3) and 13.6 (95% confidence interval, 2.3 to 148.3) for the plasma and DNA recombinant vaccines, respectively.

Adult↗