Are homosexual males a risk group for hepatitis A infection in intermediate endemicity areas?

The purpose of this study was to examine the prevalence of antibody against hepatitis A (anti-HAV) in a population of homosexual men compared with that of heterosexual men in an area of intermediate HAV endemicity (Madrid, Spain). A total of 148 patients were recruited in a Sexually Transmitted Diseases Clinic: 74 homosexuals (mean age of 28 +/- 5 years) and 74 heterosexuals (29 +/- 5 years). The prevalence of anti-HAV antibody was 47% and 43% for homo- and heterosexuals, respectively. Among the factors evaluated (age, sexual orientation and practices, travel to high HAV endemicity areas) oral-anal contact was significantly associated with a higher prevalence of anti-HAV antibody (odds ratio, 2.8; 95% confidence interval, 1.1-7.4; P = 0.03). These results indicated that in an area of intermediate endemicity young homosexual men are not at increased risk of having acquired hepatitis A infection than heterosexuals. Oral-anal contact is an independent risk factor that influences the presence of anti-HAV antibody, regardless of sexual orientation.     

An epidemiologic study of herpes simplex virus type 1 and 2 infection in Japan based on type-specific serological assays.

A seroepidemiologic study of herpes simplex virus type 1 (HSV-1) and 2 (HSV-2) was performed on Japanese adults. Serum samples collected between 1985-9 from a total of 536 healthy adults, female prostitutes, males with sexually transmitted diseases (STD), homosexual men, and pregnant women were studied by immunodot assays using HSV type-specific antigens, glycoproteins G (gG1 and gG2). HSV-1 infections correlated mostly with age and was widely prevalent among subjects < 40 years. HSV-2 prevalence varied greatly among subgroups defined by sexual activity and was associated with risk behaviours for prostitution, infection with STD, and homosexual activity. HSV-2 seroprevalence was highest among prostitutes (80%), lowest among pregnant women (7%), and intermediate in STD patients (23%) and homosexuals (24%). Because HSV-1 infection during childhood has been decreasing, primary genital HSV-2 infection, with its higher frequency of clinical manifestations, will become a greater burden to the public health in Japan.     

Risk factors for HIV infection in adults attending sexually transmitted disease clinics in Italy

We assessed prevalence and risk factors for human immunodeficiency virus (HIV) infection in 637 patients (506 men, 131 women; median age 30 years, range 17-64) attending between September 1988 and July 1989 for the first time two sexually transmitted disease (STD) clinics in Northern Italy, for suspected or STD treatment. A total of 44 subjects (6.9%, 95% confidence interval, (Cl): 4.9-8.9) were seropositive for HIV antibodies. The prevalence of HIV infection decreased with age, from 9% in patients aged 24 years or less to 3% in those aged 45 years or more (chi 21 trend 4.97, p less than 0.05). Women tended to have a lower prevalence of infection than men (5.3% versus 7.3%) but this was not statistically significant. Compared with men reporting no homosexual intercourse, HIV infection risk was about 50% higher in those reporting bisexual intercourse (age- and sex-adjusted odds ratio (OR) 1.5,95% Cl: 0.6-3.6) and about fourfold in those reporting only homosexual intercourse (OR 3.8, 95% Cl: 1.7-8.5). No clear trend in risk was observed with number of sexual partners both in men and in women. Intravenous drug users had an increased risk of HIV infection; compared with non-users, the OR was 5.6 (95% Cl: 3.0-10.5) in users, and the point estimates increased with frequency of use, from 3.3 (95% Cl: 0.8-11.5) in occasional users to 6.4 (95% Cl: 3.2-12.8) in regular users. The risk of HIV infection was 2.2 (95% Cl: 1.1-4.3) in patients reporting a history of STD, and 1.6 (95% Cl: 0.8-3.3) in those reporting syphilis.(ABSTRACT TRUNCATED AT 250 WORDS)     

A Multidimensional Measure of Sexual Orientation,Use of Psychoactive Substances,and Depression: Results of a National Survey on Sexual Behavior in France

Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity.     

Recalled Sex-typed Behavior in Childhood and Sports’ Preferences in Adulthood of Heterosexual,Bisexual, and Homosexual Men from Brazil,Turkey, and Thailand

This research used interview and questionnaire data from homosexual (n = 177), bisexual (n = 157), and heterosexual (n = 544) men between 20 and 30 years of age among lower class men and university students in three countries: Brazil, Thailand, and Turkey. The main goal of the study was to examine the recalled childhood sex-typed behavior and adult sports preferences that distinguish homosexuals from bisexuals and heterosexuals. In all three cultures and both social groups, homosexual men were almost always more likely as children to have wanted to be a girl, to cross-dress, to play with girls, to do girls’ tasks, and to practice fewer sports. They were also less likely to bully others or to engage in physical fights. As children, homosexual men were more likely to prefer swimming and playing volleyball rather than soccer and, as adults, they preferred watching gymnastics and swimming over soccer. The bisexuals scored intermediate mostly in “desire to be a girl” and “cross-dressing,” although they were much closer to the heterosexuals. These results, coupled with previous cross-cultural research, suggest that cross-gender behavior in childhood may characterize most male homosexuals regardless of their cultural milieu.     

Suicidality and Sexual Orientation: Differences Between Men and Women in a General Population-Based Sample From The Netherlands

Homosexuality has been shown to be associated with suicidality and mental disorders. It is unclear whether homosexuality is related to suicidality, independently of mental disorders. This study assessed differences in lifetime symptoms of suicidality (death ideation, death wishes, suicide contemplation, and deliberate self-harm) between homosexual and heterosexual men and women, controlling for lifetime psychiatric morbidity. Interaction effects of age and the role of perceived discrimination were also examined. Data were collected on a representative sample of the Dutch population aged 18–64 years. Classification as heterosexual or homosexual was based upon reported sexual behavior in the preceding year. Of those sexually active, 2.8% of 2,878 men and 1.4% of 3,120 women had had same-sex partners. Homosexual men differed from their heterosexual counterparts on all four suicide symptoms (OR ranging from 2.58 to 10.23, with higher ORs for more severe symptoms), and on the sum total of the four symptoms; homosexual women only differed from heterosexual women on suicide contemplation (OR=2.12). Controlling for psychiatric morbidity decreased the ORs, but among men all associations were still significant; the significance for suicide contemplation among women disappeared. Younger homosexuals were not at lower risk for suicidality than older homosexuals in comparison with their heterosexual counterparts. Among homosexual men, perceived discrimination was associated with suicidality. This study suggests that even in a country with a comparatively tolerant climate regarding homosexuality, homosexual men were at much higher risk for suicidality than heterosexual men. This relationship could not only be attributed to their higher psychiatric morbidity. In women, there was no such clear relationship.     

Evaluation of occupational transmission of hepatitis A virus among wastewater workers

To provide information concerning potential occupational transmission of hepatitis A virus (HAV) among wastewater workers in a large city in the United States, a cross-sectional survey was performed using a saliva test to detect antibodies to HAV (anti-HAV). Fifty-nine (20%) of 302 participants tested positive for anti-HAV. After controlling for the confounding effects of age and race, wastewater work was not significantly associated with an increase in the prevalence of anti-HAV (prevalence ratio = 1.3; 95% confidence interval 0.7 to 2.4). Additionally, when examining only the wastewater workers, no statistically significant occupational risk factors for anti-HAV were identified. The results of this survey are consistent with the position of the Centers for Disease Control and Prevention regarding groups at risk for HAV infection.     

AIDS and heterosexual anal intercourse

Heterosexual anal intercourse is rarely discussed in the scientific literature. Review of the literature suggests the silence is linked to ethnocentric discomfort about it among researchers and health care providers, coupled with the misconception that anal sex is a homosexual male practice, not heterosexual. Review of surveys of sexual practices suggest that heterosexual anal intercourse is far more common than generally realized, more than 10% of American women and their male consorts engaging in the act with some regularity. Sexually transmitted disease (STD) data, especially where only the rectum is infected with gonorrhea or other STD agents, buttresses survey data. Considerably more heterosexuals engage in the act than do homosexual and bisexual men, not all of whom participate in anal coitus. Anal intercourse carries an AIDS risk for women greater than that for vaginal coitus, just as receptive anal intercourse carries a very high risk for males. Infection with the AIDS virus is increasingly documented in women engaging in anal coitus with infected males, in America, Europe, and Latin America. Women in Western countries are less likely to continue HIV infectivity chains than are males engaging in same-gender anal intercourse.     

Sexually transmitted diseases among foreigners in Italy. Migration Medicine Study Group.

A sentinel surveillance system for the control of sexually transmitted diseases (STD) among foreigners was developed in Italy in 1991. From January 1991 to June 1995, 4030 foreigners with a new STD episode were reported. More than one-third of them were North-Africans. The most frequent STDs were non-specific urethritis and genital warts among men, and non-specific vaginitis and latent syphilis among women. The overall HIV prevalence was 5%, with large differences in rates in people from different continents. Very high HIV-positivity rates were observed among homosexuals and homosexual IDUs from Central-South America, with 39.1% and 77.8% seropositive individuals respectively. These data stress the need for increased knowledge of both the spread of risk factors for STDs among immigrants. Particular attention should be paid to counselling procedures focused on the prevention of risk behaviours for acquiring STDs and HIV infection.     

The seroepidemiology of hepatitis A and B in a Japanese town.

Sera collected from 1,118 healthy children and adults aged between four years and 90 years during the period 1989 to 1990, were tested for serological markers of hepatitis A virus (HAV) [antibody to HAV (anti-HAV)] and hepatitis B virus (HBV) [hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBsAb)]. The overall prevalence rates of anti-HAV, HBsAg, and anti-HBV were 20.2%, 0.36%, and 5.1%, respectively. No body was found to be positive for anti-HAV below 30 years of age but more than 70% of the adults aged 50 years or over were positive for anti-HAV. The level of exposure of HAV infection is declining in Japan and paradoxically at the same time a vast majority of people are becoming susceptible to more severe illness. The fall in prevalence of HBsAg possibly represents the positive impact of ongoing vaccination programs and other preventive measures against HBV.     

Homosexuality and psychiatric disorders: correlation not shown

A secondary analysis of part of the data collected for the Netherlands mental-health survey and incidence study, revealed that homosexual men and women have a higher chance of psychiatric disorders than heterosexuals. However, there are some serious doubts about the reliability and validity of these results. These concern the validity of the measuring instrument used for homosexual populations (the Composite International Diagnostic Interview), the representativeness of the sample of homosexuals participating in the study, and the statistical analysis of the raw data. In discussing their analysis, the authors pay too little attention to methodological flaws, which might explain their findings. In general, they seem to underestimate the methodological and ethical complications associated with this type of comparative research. Therefore, the study offers no hard scientific evidence to support the contention that homosexuals show a much higher rate of psychiatric disorders in comparison to heterosexuals.     

Antibodies to hepatitis A virus in Italian patients with chronic liver disease.

To improve our knowledge for future hepatitis A virus (HAV) vaccination strategies we carried out a multicentre study on naturally acquired immunological protection against HAV in patients with chronic hepatitis in Italy. We enrolled 830 consecutive patients with chronic hepatitis on their first observation at one of the six Italian liver units participating in the study. Six hundred and fifty-eight patients (79.3%) were positive for total anti-HAV and 172 (20.7%) were negative. The anti-HAV negative patients were younger (median age 33, range 11-78) than the anti-HAV positive (median age 56, 18-87). There was a higher prevalence of cases with circulating anti-HAV among the 508 patients residing in southern Italy than in the 322 residing in northern Italy (88.8% vs. 64%, P < 0.001). No significant difference in the anti-HAV prevalence was observed between patients from northern Italy and those from southern Italy aged 0-30 years or in those over 60 years, while in those 31-60 years old there was a higher prevalence of anti-HAV positive patients from southern Italy (90.2% vs. 65.8%, P < 0.0001). Of the patients with liver cirrhosis in this study, only 3 of the 26 (11.5%) from northern Italy and 8 of the 228 (3.5%) from southern Italy had no immunological protection against HAV infection. The data suggest that the number of patients with chronic liver disease without naturally acquired immunity against HAV is substantial in Italy, particularly in the north of the country, and that new vaccination strategies are needed.     

Correlates of sexual orientation in the German Democratic Republic

From 5469 participants of a sexual inquiry in the German Democratic Republic, 90 homosexual and 107 heterosexual women and men were selected, aged 16–30. A comparison was made concerning aspects of leisure time and sexual life. Some differences appear with regard to leisure time between homosexual and heterosexual women and men. The importance of love and sexuality is as great for young homosexuals as it is for young heterosexuals, but the mode and quantity of their specific sexual activities differ. Homosexual women appear to be more sexually active than heterosexual women on some study parameters.     

Changing epidemiology of hepatitis A infection in Izmir, Turkey

The seroprevalence study was conducted in order to determine the current seroepidemiology hepatitis A in Izmir, Turkey and to evaluate the epidemiological shift in HAV serostatus. Blood samples collected from 595 subjects aged 1-60 years were analyzed for anti-HAV IgG antibodies. The current study results were compared with those of a previous study conducted in 1998 involving the same location. There was a marked decrease in the prevalence of anti-HAV between 1998 and 2008. While anti-HAV seroprevalence rates in the current study were 4.6% in children aged 1-4 years, 23% in children aged 10-14 years, and 85% in young adults aged 20-29 years, the prevalence rates were 36% in the 1-4 years age group, 65% in the 10-14 years age group, and 95% in young adults in the previous study, indicating a shift in HAV seroprevalence from the younger to the higher age groups. As HAV infection in childhood is decreasing, the pool of susceptible adolescents and young adults is increasing in Izmir, Turkey. The majority of adolescent population is susceptible to HAV infection. The potential risk of HAV epidemics still exists. The situation of Turkey, suggested to need for mass immunization. Also, introduction of hepatitis A vaccination into the national immunization schedule of Turkey should be considered.     

Sociodemographic characteristics and sexual behavior of bisexual men in France: implications for HIV prevention. The French National Survey on Sexual Behavior Group.

The French National Survey on Sexual Behavior was used to identify sociodemographic characteristics and sexual behavior of bisexually active men, as distinct from both homosexually and heterosexually active men. In regard to number of partners and frequency of unprotected vaginal sex, bisexuals were similar to multipartnered heterosexuals. On sociodemographic criteria, they differed from both homosexuals and heterosexuals. Bisexual men reported fewer partners than homosexuals but seemed more likely to engage in risk behavior related to the acquired immunodeficiency syndrome (AIDS), and they were less likely to have ever had a human immunodeficiency virus (HIV) test. These results justify prevention efforts specially adapted for bisexuals.     

HIV infection and sexual behaviour among homosexual and bisexual men in Bratislava

OBJECTIVE: To determine sexual behaviour and HIV prevalence in a sample of homosexual and bisexual men in Bratislava. PATIENTS AND METHODS: Participants were recruited at gay discotheque in Bratislava in February and June 1996. Saliva samples were collected for testing the presence of anti-HIV antibodies and a questionnaire regarding sexual practice was completed. RESULTS: In the study 170 men (1st discotheque) and 124 men (2nd discotheque) were enrolled. The prevalence of antibodies against HIV was 5.4% and 1.6%, respectively. A group of 119 attenders (mean age: 25 years) was voluntarily questioned about their sexual lifestyle and related behaviour. Sexual orientation of participants was following: 66.4% homosexuals, 20.2% bisexuals, 13.4% others. Most responders were single and did not ever been married (86.55% vs. 12.6%, respectively). The figures of sexual intercourse were: steady partners: 45.38%, non-steady partners: 49.58%. More individuals were using condoms (70.58% vs. 15.97%, respectively), while only 28.57% were using them by each chance sexual intercourse. 6.7% responders suffered from an other STD and 3.36% were intravenous drug users. CONCLUSION: The HIV prevalence (5.4% and 1.6%) was relatively low. Considering the high prevalence of unsafe sexual practice further spread of HIV infection among homosexual men in Slovakia is to be expected.     

Increased consultations and numbers of sexually transmitted diseases at the STD clinic of Utrecht, 1994-2002

OBJECTIVE: To determine trends in numbers of visitors and their demographic characteristics, reasons for visit, number of STDs and high-risk groups. DESIGN: Secondary analysis of registration data. METHOD: Data of every client that visited the STD clinic in Utrecht, the Netherlands, were aggregated from 1994 to 2002 in order to analyse trends. RESULTS: The number of visitors as well as the number of STDs rose strongly over the period investigated. The age of the visitors decreased. In 1994 17% of the visitors was born outside the Netherlands, in 2002 6%. The majority of the clients (56%) visited the STD clinic to get themselves tested preventively and 27% came because of symptoms. Visitors with symptoms or who were warned by others had a three-fold increased risk of having an STD. Other risk groups were: homosexual men, visitors born outside the Netherlands and visitors who have had an STD before. Groups with an increased risk of having a Chlamydia trachomatis infection were: visitors aged under 34 years old and visitors born in Morocco, Surinam and the Antilles. The number of Chlamydia infections rose sharply among homosexual male visitors. CONCLUSION: The increase in the number of visitors and of STD requires an increase in STD prevention, aimed at high-risk groups. More research is needed into the limited help-seeking behaviour of immigrants and more attention needs to be paid to Chlamydia trachomatis infections among homosexual men.     

HIV seropositivity in promiscuous heterosexual, homosexual and bisexual men and patients voluntarily reporting for screening in Hungary between 1 January 1986 and 31 December 1989

The cumulative seroprevalence was 5.21% among the homo/bisexual men in the four years. As well as in Budapest, we experienced the increase of seroprevalence in the country, too, after a decrease in 1988. The cumulative seroprevalence was 0.44% with men and 0.04% with women in the group of the voluntary reporters in the mentioned period. The same indexes were 0.07% for men and 0.019% for women in the group of the STD patients. Seroprevalence with men increased significantly in the last year. Hungary belongs to the low-incidence area among the European countries, even though the group of homosexuals can be considered moderately infected, seroprevalence is increasing in Budapest as well as in the country and heterosexuals are also affected.     

高流行区甲型肝炎疫苗免疫方案研究

目的探讨甲型肝炎高流行区疫苗免疫方案。方法观察新生儿母传抗ＨＡＶ抗体的衰减及处于甲型肝炎流行不同阶段儿童甲型肝炎病毒感染率随年龄上升的规律。结果新生儿母传抗体的阳性率按ｌｏｇｉｓｔｉｃ曲线下降,１３个月内从９７．４％下降为５．０％;非流行期儿童甲型肝炎病毒感染率从１．５岁起随年龄上升,２岁前保持在１０％以内;流行期儿童甲型肝炎病毒感染率随年龄增加而起点提前,速度加快。鉴于甲型肝炎发病随年龄上升的起点滞后于感染,认为甲型肝炎高流行区新生儿甲型肝炎母传抗体向自然感染抗体转换的“窗口期”是在出生后１２～２４个月。结论根据流行情况与经济条件,儿童适宜的甲型肝炎疫苗免疫时机一般选择在１２～２４月龄     

中国六省（区）性病门诊男性就诊者艾滋病相关行为特征及HIV感染状况 影响因素研究

目的 了解中国6省(区)15～90岁性病门诊男性就诊者的艾滋病知识知晓、艾滋病相关行为及HIV感染等状况,分析其HIV感染的影响因素.方法 根据全国艾滋病哨点监测实施方案(试行)操作手册的要求,汇总广西、广东、河南、四川、云南和江西6省(区)2009-2010年国家级性病门诊男性就诊者哨点监测数据.对上报数据进行“清洗”,剔除不合格数据后用SPSS18.0软件进行统计分析.结果 6省(区)共汇总性病门诊男性就诊者资料64 003份,15～49岁组55 220人,≥50岁组8783人(13.7％).两组人群的艾滋病知识总知晓率(69.6％vs.80.1％)、近3个月发生过商业性行为的比例(34.1％vs.36.6％)、近3个月发生过临时性行为的比例(18.7％vs.28.4％)、发生同性肛交性行为的比例(0.7％vs.1.4％)、最近一年做过HIV抗体检测的比例(14.3％vs.17.1％)均为≥50岁组低于15 ～ 49岁组.而≥50岁组HIV抗体阳性检出率高于15 ～49岁组(1.1％vs.0.7％).对≥50岁组多因素logistic回归分析结果显示,有固定性伴(OR=0.588,P=0.034)、发生过同性肛交性行为(OR=5.226,P=0.006)与HIV抗体阳性有关.结论 发生高危性行为(包括同性肛交性行为)是≥50岁性病门诊男性就诊者感染HIV的主要危险因素.