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PubMed1992

Total and specific IgE in sera of HIV positive and HIV negative homosexual male (regulation of IgE synthesis in HIV infection).

In the course of HIV infection "atopic" symptoms can often be experienced (atopic dermatitis, asthmatic like symptoms in upper respiratory tract, sensitivity to drugs). Total IgE increase has been detected which is in inverse correlation with CD4 positive lymphocytes. Using semi quantitative and quantitative methods total and specific IgE levels of 30 HIV positive and 30 HIV negative homosexual men without atopic anamnestic data and symptoms have been determined. The age matched control groups were of 30 atopic men with active symptoms and 30 healthy, HIV negative heterosexual men. Determination of CD4, CD8 positive number of lymphocytes as well as B-2 microglobulin have been carried out. Total IgE level of HIV positive and HIV negative homosexuals was higher than that of the healthy controls and lower than that of the "atopic" controls. Specific IgE-s have been found more often in HIV positive and HIV negative homosexuals than in the normal controls. The correlation among CD4 and CD8 positive lymphocytes, and B-2 microglobulin level and total IgE level was not significant.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[AIDS and HIV infection among homosexual and bisexual men in Belém, Pará, Brazil, 1988-1990].

During three years (1988-1990) blood samples from 307 people were taken to test antibodies for Human Immunodeficiency Virus type 1 (HIV-1) in homo and bisexual males living in Belém, being 149 (48.5%) of the former and 158 (51.5%) of the later. All patients requested examinations spontaneously to find out their status. The ages of tested people ranged from 16 to 64 years old. Serologic diagnosis was made using an enzyme immunoassay (Abbott, São Paulo-Brasil) for screening and an indirect immunofluorescence test (FIOCRUZ, Rio de Janeiro-Brasil) for confirmation. If results were conflicting with these tests, western blot (Du Pont CO. Wilmington-USA) was performed to obtain a definitive result. Sixty-eight (22.1%) of all sera were positive. Although, the positivity in the homosexual group (26.2%) was more higher than in the bisexual group (18.3%). The positivity rate in both groups was directly proportional with the increase of age. Of course, people with less than 20 years old had only 3% of positivity, while between 20-29 had 18.1%, 30-39 had 34.5%, 40-49 had 40% and 50-59 had 50%. The projected curve of positivity, is progressive, that is to say, the risk of homo/bisexual males increases with age and is probably related to increased sexual activity. We conclude that more than one quarter of homosexual men are infected with HIV-1 in Belém.

AIDS-Related Opportunistic Infections↗
PubMed1992

Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type 1 in semen.

OBJECTIVE: To determine the prevalence and temporal expression of infectious human immunodeficiency virus type 1 (HIV-1) in the semen of HIV-1 seropositive men and to determine whether the detection of HIV-1 in semen is associated with disease stage, zidovudine treatment status, or other clinical factors. DESIGN: A microculture technique was used to detect infectious HIV-1 in semen from a cohort of 95 seropositive men. In addition, semen cultures were performed monthly for at least 6 months for 14 of the men. Information was obtained by interview and extracted from medical records to identify clinical variables associated with HIV-1 in semen. PATIENTS: Sixty HIV-1 seropositive homosexual men participating in clinical studies at the Fenway Community Health Center, Boston, Mass, and 35 HIV seropositive bisexual or heterosexual men participating in the California Partner Study of the University of California, San Francisco. MAIN OUTCOME MEASURES: Semen HIV-1 culture results, seminal leukocyte counts, Centers for Disease Control (CDC) disease stage, peripheral CD4+ cell counts, zidovudine therapy, HIV risk category. RESULTS: In the cross-sectional study, HIV-1 was cultured from the semen of nine (9%) of 95 men. Factors associated with detection of HIV-1 in semen were peripheral CD4+ cell counts of 0.20 x 10(9)/L (200/microL) or less (adjusted odds ratio [OR], 23.33; 95% confidence interval [Cl], 2.89 to 175.63); symptomatic (CDC class IV) disease (adjusted OR, 6.56; 95% Cl, 1.02 to 66.76); and seminal leukocytosis (greater than 1 x 10(9) white blood cells per liter of semen) (adjusted OR, 7.02; 95% Cl, 1.28 to 39.29). Zidovudine therapy was associated with decreased detection of HIV-1 in semen (adjusted OR, 0.04; 95% Cl, 0.00 to 0.63). In the longitudinal study of 14 men who had neither peripheral CD4+ cells counts of 0.20 x 10(9)/L or less nor seminal leukocytosis, seminal HIV-1 was detected in at least one sample from six men (43%). CONCLUSION: HIV-1 is more commonly found in semen from men with advanced HIV-1 infection and seminal leukocytosis but can also be cultured from semen of men with neither of these conditions. Zidovudine therapy may decrease the prevalence and/or titer of seminal HIV-1. However, all HIV-1-infected persons should continue to assume that they are potentially infectious through sexual contact.

CD4-Positive T-Lymphocytes↗
PubMed1992

Nutritional status and food intake in human immunodeficiency virus infection. GI/HIV Study Group.

Nutritional status and food intake of HIV+ and HIV- homosexual men that were free from enteric pathogens were compared. Food intake (7-day weighed record), anthropometry, and D-xylose excretion were measured in 44 patients (9 HIV-, 35 HIV+). HIV+ patients were found to be thinner, based on anthropometric measurements of skinfold thickness (p < 0.05) and percentage body fat (p < 0.05), and they also tended to be lighter than the HIV- patients. No differences were observed in the arm muscle mass or the food intake of the two groups. In the HIV+ patients, regression analysis was used to correlate changes in nutritional status with progression of the disease, using CD4+ lymphocyte count as a measure of severity. A decrease in CD4 count positively correlated with a decrease in weight (r = 0.48, p < 0.01), body mass index (r = 0.41, p < 0.05), and arm muscle area (r = 0.42, p < 0.01). Energy intake (r = 0.67, p < 0.01), serum albumin (r = 0.52, p < 0.01), and D-xylose excretion (r = 0.57, p < 0.0001) also positively correlated with CD4 count. Multiple regression analysis revealed a relationship between CD4 count, weight, and energy intake, indicating that as the disease progresses, a decline in weight is seen parallel to a reduction in food intake. These data indicate that changes in body composition and nutritional status are present throughout the stages of HIV disease, though no causal relationships can be interpreted from this study. The initial changes appear to be due to loss of fat stores, as determined by anthropometry.(ABSTRACT TRUNCATED AT 250 WORDS)

Anthropometry↗
PubMed1992

Specific antibody responses to synthetic peptides of HIV-1 p17 correlate with different stages of HIV-1 infection.

Antibodies were determined against five synthetic peptides (epitopes) of HIV-1 p17 in the sera of an immunologically and clinically well-characterized cohort (N = 292) of HIV-1 seronegative and HIV-1 seropositive high-risk homosexual men, HIV-1 seropositive i.v. drug abusers (IVDA), and AIDS patients. The synthetic peptides, representing the entire HIV-1 p17 protein sequence were: HGP-33 (aa 1-33), HGP-19 (aa 34-52), HGP-35 (aa 51-85), HGP-30 (aa 85-114), and HGP-17 ala (aa 114-131). The presence of one or more peptide-specific antibodies in the sera of all of the HIV-1 p17-positive subjects indicated that all five peptides contain B-cell epitopes. No antibodies were found in the sera of heterosexual controls, HIV-1 seronegative high-risk men, or asymptomatic HIV-1 seropositive but p17 antibody-negative study subjects. Significant differences in antibody recognition profiles to the peptide epitopes were found among the various study groups. A significantly higher proportion of HIV-1 seropositive IVDA had antibodies specific to HGP-17 ala (aa 114-131), HGP-35 (aa 51-85), and HGP-33 (aa 1-33) compared to the HIV-1 p17-positive asymptomatic homosexuals. The epitope-specific antibody responses reflected the clinical status of the HIV-1-infected study subjects, and declined to nondetectable levels as the patient progressed to ARC/AIDS. This decline preceded by several months the reduction in the antibody titer against the intact HIV-1 p17 and p24 proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

Women in the HIV epidemic.

In the United States, the majority of women with HIV/AIDS are women whose lives have been touched by injection drug use--their own or that of their sexual partners. The pattern of opportunistic infections in women is more similar to that of injection drug users than that of homosexual men. Specific complications associated with a woman's reproductive tract include persistent Candida vaginitis, human papillomavirus infections, cervical dysplasias, and, possibly, pelvic inflammatory disease. Childbearing decisions for women with HIV infection are complex and culturally mediated. Meeting the challenge of providing high quality services to women with HIV infection requires major changes in the service delivery system.

Female↗
PubMed1992

A parametric family of correlation structures for the analysis of longitudinal data.

In epidemiological settings, we are often faced with numerous short time series, and a parsimonious parametrization of the correlation structure is desired in order to optimize the efficiency of the estimation procedure. We propose a damped exponential correlation structure for modeling multivariate Gaussian outcomes. The correlation between two observations separated by s units of time is modeled as gamma s theta, where gamma is the correlation between elements separated by one s-unit, and theta is a damping parameter. For (theta = 0), (theta = 1), and theta----infinity), the correlation structures of compound symmetry, first-order autoregressive, and first-order moving average processes are obtained. Although the AR(2) dependency structure, and the combination of random effects and AR(1) errors are not special cases of the proposed parametric family, these structures can be well approximated within the family for short time series. Maximum likelihood methods for parameter estimation and interpretations of intermediate models (0 less than theta less than 1) are discussed in the context of modeling pulmonary function in an adult population in The Netherlands and T-cell subsets in homosexual men infected with human immunodeficiency virus Type I.

Adult↗
PubMed1977

Therapeutic regimens for anorectal gonococcal infection in males.

Anorectal gonococcal infection is particularly prevalent in women and homosexual men. Although the currently recommended Public Health Service therapeutic regimens for uncomplicated gonorrhea appear to be effective also for anorectal gonorrhea in women, their efficacy for anorectal infection in men has not been adequately evaluated. We report a case of gonococcal proctitis in a homosexual man that did not respond to therapy with ampicillin plus probenecid and tetracycline, but subsequently responded to spectinomycin therapy. Currently available therapeutic regimens for anorectal gonococcal infection in males are reviewed.

Adult↗
PubMedDate not supplied

Sexual patterns and human immunodeficiency virus infection among homosexuals in Taiwan.

Between 1988 and 1991, 64 homosexual men and 43 bisexual men were screened for human immunodeficiency virus (HIV) in Southern Taiwan; 5 of them were found to carry HIV antibodies. According to a self-administered questionnaire completed before screening, the average age of the men in the study group was 27 years, and the average duration of practiced homosexuality was 3.8 years. Occupations included student, merchant, laborer, officer, and soldier, and many of the men (45/107) had some junior college or university level education. A relatively high proportion (48/107) of these subjects reported having only 1 sexual partner, and there was a significant association between HIV antibody status and number of sexual partners (P = 0.025). Of the 107 subjects, 58 had practiced anal intercourse and more than a third of them (37/107) indicated that they had participated in receptive anal intercourse, 42 in insertive anal intercourse, and 21 in both of the above. All five carriers of HIV had practiced receptive anal intercourse, in which transmission of HIV from inserter to receptor was highly likely (P = 0.004). Of the men who came forward for HIV testing, the bisexual men tended to be older and often married.

Adult↗
PubMed1992

[Sexually transmitted infections in HIV-positive persons].

In 1989 and 1990, newly-acquired sexually transmitted bacterial disease was found in 41 HIV-antibody-positive men seen at a sexually transmitted disease (STD) clinic in Copenhagen. In 38 homo/bisexual men, the new STD was transmitted from a male contact in 36 cases and from a female contact in two cases. In three male intravenous drug users, the new STD was transmitted from a female contact. In two men, the HIV-infection was first diagnosed together with the new STD, the other men had been aware of their HIV-infection for a mean period of 38 months. Gonococcal infections were diagnosed in 33 men, Chlamydial infections in ten men and syphilis in three men. Anorectal gonococcal infections were found in 13 men, corresponding to 43% and 30% of the total number of anorectal gonococcal infections in 1989 and 1990 respectively. The data presented might indicate a relapse to unsafe sexual practices among homosexual men in Copenhagen. This could influence the HIV prevalence as at least 12% of the contacts were known to be HIV-antibody-negative.

Adult↗
PubMed1992

Impact of HIV testing and counseling on subsequent sexual behavior.

To assess sexual behavior changes after voluntary HIV testing and routine counseling, we interviewed 235 persons at 2 anonymous test sites in North Carolina. Among the 57 (24%) persons returning for follow-up 1 year later, 70% were male; 44% were black, 37% were homosexual, 10% were bisexual; and 16% were HIV positive. Overall, 28% of returnees at the initial visit and 33% on the follow-up visit admitted to having 2 or more sexual partners in the past month. At the initial interview and at follow-up, 21% of returnees reported condom use in the past month. Homosexual men were significantly less likely to use condoms during anal sex over time (58% non-use initially vs. 74% non-use at follow-up, p = 0.04). No significant net change in high-risk sexual behaviors was found at follow-up. Overall findings indicate that the standard HIV testing and counseling provided by health departments anonymously and free of charge does not result in elimination of high-risk sexual behaviors or initiation of safer sex behaviors among those at high risk for HIV infection.

AIDS Serodiagnosis↗
PubMed1992

[AIDS in Germany: clinical manifestations of AIDS].

Since 1982, voluntary anonymous reports that meet the criteria of the WHO/CDC-AIDS definition are being collected by the Federal Health Office. By December 31st, 1989 a total of 4,306 AIDS cases has been registered. More than 80% of the reported cases are homo- and bisexual men and injection drug-users. The remaining cases are divided between hemophiliacs, persons who get infected by heterosexual contacts, blood transfusion recipients, and children infected pre- or perinatally. In 16% of all cases AIDS was diagnosed only on the basis of a Kaposi's sarcoma (KS) and in another 6% on the basis of KS and an opportunistic infection (OI). KS occurred mostly in homo- and bisexual men. The relative proportion of KS has steadily decreased from 30% up to 1986 to less than 20% in 1989. The overall incidence of KS decreased mainly due to the decrease of KS in homosexual men with AIDS. OI were diagnosed in 70% of the cases. Pneumocystis-carinii-pneumonia is most frequent (47%), followed by candida-oesophagitis (19%) and toxoplasmosis of brain in 9.5%. A malignant lymphoma was diagnosed in 3% of the cases. Furthermore, HIV-encephalopathy was seen in 2.8% and HIV-wasting-syndrome in 1.6% of cases. There is a different spectrum of diseases at the first manifestation of AIDS diagnosed in injecting drug-users. The reasons for this may be due to different life-style in this group.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The fate of Don Juan: the myth and the man.

The literary character of Don Juan has offered an opportunity to study certain characteristics in an adult man who began a behavior pattern in adolescence that resembled the legendary and mythical Don Juan. Power and dominating control issues were paramount defenses against a narcissistic depression in this man as seen in his relationships with women and in the transference relationship with me. The transference data have been put to use in providing a formulation for an explanation of the phenomena observed. Other clinical data concerning women and some homosexual men are presented in a more abbreviated fashion. This research effort is a retrospective construction of the dynamics that led to this man's neurosis. In my opinion, a self psychological interpretation offers the more felicitous fit than the classic oedipal interpretation. In fact, at first I tried interpretations based on classic oedipal theory--concerning issues of competition with me as father and fear of retaliation and castration--but this strategy resulted in little or no response. More important than symptomatic response, however, the data minimally and weakly supported those interpretations. To be sure, there were and still are competitive and phallic oedipal issues. Moreover, when the patient's mother died, he was drawn into a closer relationship with his father, a relationship accompanied by wishes and fantasies of taking his mother's place. These wishes were quite real, but, as the analysis preceeded, this negative oedipal configuration occupied a much less prominent place in the dynamics. Power and control issues dominated the clinical picture, masking a depression emanating from a deeper narcissistic focus. Interpretation of these narcissistic issues provided my patient with the relief he was seeking, while the main effect of the antidepressant medication was to help him sleep. By giving him something, a deeply seated wish was gratified and was in keeping with an idealized mother transference.

Adolescent↗
PubMed1975

Evocability of a slight positive oestrogen feedback action on LH secretion in castrated and oestrogen-primed men.

Orchidectomized heterosexual men suffering from prostatic cancer with suppressed serum LH values by oestrogen priming exhibited a slight, but significant surge of LH secretion following oestrogen injection. In contrast, orchidectomized and oestrogen-primed heterosexual men with unsuppressed serum LH levels as well as intact heterosexual men did not display any positive oestrogen feedback action on LH secretion, as it was observed in intact homosexual men.

Aged↗
PubMed1977

Examining the homosexual male for sexually transmitted diseases.

Homosexual men may be deterred from seeking an examination for sexually transmitted diseases because it would require an open admission of sexual preference. For these diseases to be controlled, gay men must be motivated to be examined for sexually transmitted diseases. If a medical or health professional feels unable to respond to a gay patient's needs, he should refer the patient to someone who deals well with gay patients. Health care services must be offered in a way that minimizes the anxiety many homosexuals associate with examination and treatment for sexually transmitted diseases.

Anxiety↗
PubMed1978

The relationship of perceived societal hostility, conformity, and psychological adjustment in homosexual males.

The present study examined the relationship between the perception by homosexual males of positive or negative societal reaction to homosexuality (PSR), their degree of conformity to heterosexual norms, and their degree of psychological adjustment. In this study respondents with high PSR were those who perceived negative societal reaction to homosexuality. Respondents with low PSR were those who perceived positive societal reaction. The study differentiated between the effects of putative societal reaction and actual societal reaction and was based on a three-group sample of homosexual men who (a) were, (b) had been, or (c) had never been heterosexually married. Findings showed that putative societal reaction was a critical variable producing conformity and psychological maladjustment in homosexual males.

Adaptation, Psychological↗
PubMedDate not supplied

The gay bowel syndrome: clinico-pathologic correlation in 260 cases.

The clinical and pathological findings in a group of 260 homosexual men comprising 10% of a private proctologic practice are reviewed. A clinical pattern of anorectal and colon diseases encountered with unusual frequency in these homosexual patients is termed the gay bowel syndrome. The clinical diagnoses in decreasing order of frequency include condyloma acuminata, hemorrhoids, nonspecific proctitis, anal fistula, perirectal abscess, anal fissure, amebiasis, benign polyps, viral hepatitis, gonorrhea, syphilis, anorectal trauma and foreign bodies, shigellosis, rectal ulcers and lymphogranuloma venereum. 60 anorectal and sigmoid biopsies from 51 patients failed to disclose evidence of specific infection other than condyloma acuminata. Of 21 patients with biopsy diagnosis of nonspecific proctitis, 8 had a specific infection which was detected by other means,--5 cases of shigellosis and one case each of gonorrheal proctitis, amebiasis and lymphogranuloma venereum. In evaluating proctologic problems in the gay male, all of the known sexually transmitted diseases should be considered. Shigellosis, amebiasis and viral hepatitis should be included. Microbiological evaluation is essential. Concurrent infections with 2 or more pathogens should be anticipated. Chlamydia trachomatis, an important cause of nonspecific urethritis in the general population, is high on the list of possible causes of the nonspecific proctitis present in 31 of the 260 patients.

Abscess↗
PubMed1992

Sexual behavior patterns of customers of male street prostitutes.

Information about male customers of male prostitutes, including sociodemographic and life-style characteristics, sexual and drug use behaviors, and knowledge about HIV infection were collected from a convenience sample of 211 male street prostitutes and a convenience sample of 15 male customers as part of a feasibility study. Data from these two groups indicate that despite knowledge of HIV infection and its transmission, customers engage in high-risk sexual and drug use behaviors with prostitutes. Because there is a high HIV infection rate within the male prostitute sample (175/1000) and because these customers for the most part describe themselves as bisexual or heterosexual, it is likely that male customers of male prostitutes serve as a vector of transmission of HIV infection to their other partners including the heterosexual population.

Adult↗