Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students.

OBJECTIVES: This study documented risk behaviors among homosexually and bisexually experienced adolescents. METHODS: Data were obtained from a random sample of high school students in Massachusetts. Violence, substance use, and suicide behaviors were compared between students with same-sex experience and those reporting only heterosexual contact. Differences in prevalence and standard errors of the differences were calculated. RESULTS: Students reporting same-sex contact were more likely to report fighting and victimization, frequent use of alcohol, other drug use, and recent suicidal behaviors. CONCLUSIONS: Students with same-sex experience may be at elevated risk of injury, disease, and death resulting from violence, substance abuse, and suicidal behaviors.     

Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey

OBJECTIVES: This study examined the risk of psychiatric disorders among individuals with same-sex sexual partners. METHODS: Data are from the National Comorbidity Survey, a nationally representative household survey. Respondents were asked the number of women and men with whom they had sexual intercourse in the past 5 years. Psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria were assessed with a modified version of the Composite International Diagnostic Interview. RESULTS: A total of 2.1% of men and 1.5% of women reported 1 or more same-sex sexual partners in the past 5 years. These respondents had higher 12-month prevalences of anxiety, mood, and substance use disorders and of suicidal thoughts and plans than did respondents with opposite-sex partners only. Decomposition showed that the elevated same-sex 12-month prevalences were largely due to higher lifetime prevalences. Ages at onset and persistence of disorders did not differ between the same-sex and opposite-sex subsamples. CONCLUSIONS: Homosexual orientation, defined as having same-sex sexual partners, is associated with a general elevation of risk for anxiety, mood, and substance use disorders and for suicidal thoughts and plans. Further research is needed to replicate and explore the causal mechanisms underlying this association.     

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.     

有自杀意念的男同性爱者/双性爱者滋病高危行为研究

目的 探讨男同性爱者(gay)与双性爱者(Bi)中有自杀意念者的艾滋病高危行为特征,并分析其与自杀意念相关的危险因素.方法 采用定向抽样法对gay/Bi人群进行横断面调查.从有效问卷中获取有自杀意念者,并依照自杀意念组的年龄情况在无此意念者中选取比较组进行比较.结果 调查的gay/Bi中有自杀意念者占20.2％.自杀意念组性向为同性、婚姻状况为未婚者多于比较组(P＜0.05).自杀意念组在曾经向同性买性、近一年性交时曾出过血、曾去外地与陌生同性性交、16岁前曾遭受成年同性性虐待、有性施虐与受虐行为、有过主动或被动吻肛行为、有过主动或被动指交行为、每周饮酒至少一次或更多、曾因性向和/或同性性活动受到gay伤害、曾因性向和/或同性性活动受到异性爱者伤害等方面的比例显著高于对照组(P＜0.05).多因素logistic回归模型提示曾因性向和/或同性性活动受到gay( Waldx2=6.637,P=0.010)及异性爱者(Waldx2=5.835,P=0.016)伤害是导致自杀意念产生的危险因素.结论 有自杀意念的gay/Bi与艾滋病相关的高危性行为显著多于无此意念者.减少社会对gay与Bi人群的歧视及伤害可能对遏制艾滋病的流行有一定作用.     

Sexual Aggression Experiences Among Male Victims of Physical Partner Violence: Prevalence,Severity, and Health Correlates for Male Victims and Their Children

Although research has documented the prevalence and health correlates of sexual aggression among women who have experienced severe partner violence (PV), no research has documented the parallel issues among male victims of severe PV. Research also suggests that children of female victims of both physical and sexual PV have worse mental health than children of female victims of physical PV only, but no research has assessed the mental health of children whose fathers experienced both physical and sexual PV. We surveyed 611 men who experienced physical PV from their female partners and sought help. We assessed the types and extent of various forms of PV, the men’s mental and physical health, and the mental health of their oldest child. Results showed that almost half of the men experienced sexual aggression in their relationship, and 28 % severe sexual aggression. Increasing levels of severity of sexual aggression victimization was associated with greater prevalence and types of other forms of PV. In addition, greater levels of severity of sexual aggression victimization among the men was significantly associated with depression symptoms, post-traumatic stress disorder symptoms, physical health symptoms, and poor health, and attention deficit and affective symptoms among their children. These associations held after controlling for demographics and other violence and trauma exposure. Discussion focused on the importance of broadening our conceptualization of PV against men by women to include sexual aggression as well.     

Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population

Most surveys of the prevalence of psychiatric disorders among lesbians and gay men find no increased risk in comparison with heterosexuals. However, the majority of this work has relied on convenience samples drawn from the visible lesbian and gay community. The authors examined differences in 1-year prevalence of six psychiatric syndromes among sexually active individuals in the 1996 National Household Survey of Drug Abuse who reported either exclusive heterosexuality (n = 9,714) or having any same-gender sex partners (n = 194) in the prior year. Although nearly three quarters of homosexually active individuals did not meet criteria for any of the six syndromes assessed, in multivariate logistic regression analyses, homosexually active men were more likely than other men to evidence major depression and panic attack syndromes. In contrast, homosexually active women were more likely than other women to be classified with alcohol or drug dependency syndromes. Both men and women reporting any same-gender sex partners were more likely than others to have used mental health services in the year prior to interview. These findings suggest a small increased risk among homosexually active populations in 1-year psychiatric morbidity and use of mental health care services.     

男男性接触者性伴网络特征与HIV传播

目的了解男男性接触者（MSM）性伴网络特征,探讨人类免疫缺陷病毒/性传播疾病（HIV/STDs）从该人群向普通人群传播的途径,为开展HIV/STDs的预防与控制提供依据.方法以同性恋酒吧为研究现场,以其中男男性接触者为对象进行匿名问卷调查.调查内容包括社会人口学特征、HIV/STDs感染状况、性伴类型及数量等.结果某市酒吧中MSM的HIV和STDs感染报告率分别为3.4%和10.3%;多性伴现象在MSM中普遍存在,且性伴类型广泛.在最近2个月中,50.0%的MSM有同性偶然性伴,17.8%有同性商业性伴,63.8%目前有同性固定性伴.曾有过异性性伴者为55.7%.拥有3种类型性伴者为19.5%,4种类型性伴者为12.6%.拥有不同类型性伴的MSM亚群之间相互关联,核心亚群为拥有异性性伴和拥有同性商业性伴亚群.结论 MSM以多维的性伴网络相互连接,不仅在MSM人群内部具有HIV/STDs的多向传播通道,而且已经形成了向普通人群传播的桥梁.     

Sexual violence among a cohort of injection drug users

The objective of this study was to determine the prevalence of, and factors associated with, sexual violence in childhood, adolescence and adulthood, among injection drug using men and women. The Vancouver Injection Drug User Study is a prospective cohort of injection drug users (IDU) begun in 1996. The analysis included all individuals who completed the baseline questionnaire who responded to a question about sexual assault. Multivariate modeling was used to determine and to what extent a history of sexual violence at different ages is predictive of HIV risk and other health risk behaviors. HIV prevalence was calculated as the total current number of HIV-positive individuals in the cohort. Of the 1437 eligible individuals, 36% reported a lifetime history of sexual violence; 68% of women, and 19% of men (p<0.001). After adjusting for fixed sociodemographics, these individuals were more likely to have ever been in the sex trade, to knowingly share needles/rigs with HIV-positive people, to have attempted suicide, to have ever accidentally overdosed, to binge on alcohol, and to have been diagnosed with a mental disorder/disability. The prevalence of child sexual abuse in this cohort is 21%; 33% for women, and 13% for men. The data show a dose-response relationship between age at first sexual violence and most risk behaviors examined. These relationships are further mediated by gender. The prevalence of HIV among individuals who ever experienced sexual violence was 25%, compared to 19% among those who never experienced sexual violence (p=0.006). Sexual violence, and especially child sexual abuse, is highly prevalent among this cohort, particularly among women. Child sexual abuse has worse consequences for both genders than sexual violence later in life. Nevertheless, women and men are affected differently by sexual violence at different ages, and this has significant implications for health promotion programs, and specifically HIV prevention.     

男男性接触者中异性爱者与素质性同性爱者艾滋病高危性行为比较

目的探讨中国男男性接触者（MSM）中异性爱者与素质性同性爱者（gay）艾滋病高危性行为状况。方法采用定向抽样方法，对9城市2250例MSM进行匿名问卷调查，比较其中异性爱组与gay组的高危性行为。结果异性爱组累计同性性伴数（平均13．8个）、近6个月同性性伴数（平均3．8个）、累计同性口交性伴数（平均10．5个）和同性肛交性伴数（平均12．4个），均低于gay组；在婚异性爱组累计女性性伴数（平均4．9个）、近6个月女性性伴数（平均1．7个），均高于在婚gay组。异性爱组同性性交安全套使用率（68．8％）低于gay组；但最近1次同性肛交安全套使用率（91．3％）、与女性性交安全套使用率（63．7％）均高于gay组；两组最近1次同性肛交安全套使用率（分别为91．3％、71．0％）均高于最近1次同性口交安全套使用率。异性爱组最近1年曾参加群交百分率（9．9％）、性交时自己或对方出血过百分率（16．7％）、到外地并与当地男性性交百分率（11．4％），曾向同性买性百分率（4．6％）、16岁前遭遇过成年男性实施的强迫性交百分率（4．2％），均低于gay组。结论MSM中异性爱者与gay的高危性行为存在诸多差异，为有效阻断HIV传播，干预工作应选择重点亚人群进行。     

Sex with Men Before Coming-Out: Relation to Sexual Activity and Sexual Risk-Taking Behavior

This study examined the difference in sequence of coming-out and first same-sex experience in relation to risk-taking behavior in a sample of Dutch gay and bisexual men. A questionnaire assessed age of disclosure (coming-out) and age of first same-sex experience, and information on sexual history, sexual relationships, and sexual behavior. It was found that 68% of respondents engaged in their first same-sex experience before coming-out. This proportion increased with age. Men who had sex with men before coming-out reported more lifetime sex partners and more casual sex partners in the past 6 months than men in which this sequence was reversed. In addition, among this group a higher proportion of men reported STDs, engaging in anal intercourse with casual partners in the previous 6 months, and unprotected anal sex with casual sex partners in the recent past, compared to men who came out before having their first same-sex experience. The extent to which external factors (such as tolerance toward homosexuals) or internal factors (such as personality factors) can account for the difference in sexual behaviors in general and sexual risk-taking behavior in particular could be subject of further study.     

Differences in Sexual Risk Behaviors Between College Students with Same-Sex and Opposite-Sex Experience: Results from a National Survey

The goal of this study was to identify differences in the sexual health behaviors (condom use and number of sexual partners) between college students with same-sex sexual experiences and those with only opposite-sex partners. Data from a random sample of American university students were gathered as part of the 1997 College Alcohol Study. Odds ratios were estimated for consistent condom use and multiple sex partners for students with same-sex or both-sex sexual partners compared to those with exclusively heterosexual contacts. Five percent of respondents reported ever having a same-sex partner. Significant differences in safer-sex practices were found between groups. Females with both-sex experience and males with both-sex or only same-sex experiences were more likely to report multiple recent sexual partners than their peers with only opposite-sex partners. Odds ratios of consistent condom use were lower for men with only same-sex experience than among those with only opposite-sex partners. Findings have implications for sexual health education on the college campus. Consistent condom use remains low among college students. Education programs should emphasize the importance of limiting the number of lifetime sex partners, especially among students with same-sex experiences.     

Prevalence of Masturbation and Associated Factors in a British National Probability Survey

A stratified probability sample survey of the British general population, aged 16 to 44 years, was conducted from 1999 to 2001 (N = 11,161) using face-to-face interviewing and computer-assisted self-interviewing. We used these data to estimate the population prevalence of masturbation, and to identify sociodemographic, sexual behavioral, and attitudinal factors associated with reporting this behavior. Seventy-three percent of men and 36.8% of women reported masturbating in the 4 weeks prior to interview (95% confidence interval 71.5%–74.4% and 35.4%–38.2%, respectively). A number of sociodemographic and behavioral factors were associated with reporting masturbation. Among both men and women, reporting masturbation increased with higher levels of education and social class and was more common among those reporting sexual function problems. For women, masturbation was more likely among those who reported more frequent vaginal sex in the last four weeks, a greater repertoire of sexual activity (such as reporting oral and anal sex), and more sexual partners in the last year. In contrast, the prevalence of masturbation was lower among men reporting more frequent vaginal sex. Both men and women reporting same-sex partner(s) were significantly more likely to report masturbation. Masturbation is a common sexual practice with significant variations in reporting between men and women.     

Same-Sex Behavior and Health Indicators of Sexually Experienced Filipino Young Adults

The Philippines is one of seven countries in which HIV incidence has recently increased—much of this increase has been among men who have sex with men. Despite this trend, knowledge on sexuality and same-sex behaviors in the Philippines is limited. This study examines same-sex behavior, sexual outcomes, substance use, and psychological distress among young adults participating in the 2005 Cebu Longitudinal Health and Nutrition Survey (CLHNS). We use gender-stratified, multivariate models to compare young adults who reported same-sex behaviors and those who did not. Among a cohort of 1,912 Filipino young adults (ages 20–22), 58.2 % were sexually experienced and 15.1 % of them reported same-sex sexual contacts or romantic relationships. Compared to females, more males reported same-sex sexual contact (19.4 vs. 2.3 %) or same-sex romantic relationships (9.2 vs. 4.1 %). Young adults reporting same-sex behavior had higher odds of smoking, drug use, perceived stress, and more sexual partners as compared to their peers. Males who reported same-sex behavior initiated sex earlier than those males who did not report same-sex behaviors. There were no significant differences in depressive distress. Earlier sexual initiation and higher levels of substance use among Filipino young adults engaging in same-sex behavior highlight the need to address unique health issues within this population. Mixed findings for depressive distress and perceived stress indicate that further investigation is needed to explore the potential impacts of same-sex status on mental health outcomes, particularly in lower- and middle-income countries such as the Philippines.     

Gender differences in risk factors for attempted suicide among young adults: findings from the Third National Health and Nutrition Examination Survey

PURPOSE: To identify the significant factors associated with attempted suicide among men and women, and determine whether socioeconomic status (SES) and social support indictors, health risk factors, and lifetime history of medical and psychiatric illnesses can explain gender differences in attempted suicide. METHODS: We used data from 3357 men and 4004 women aged 17 to 39 years, who completed a mental disorder diagnostic interview as a part of the Third National Health and Nutrition Examination Survey, 1988-1994. Adjusted odds ratios (ORs) were calculated for the association between risk factors and attempted suicide. RESULTS: The prevalence of lifetime attempted suicides was 7.58% (SE, 0.66) in women and 3.69% (SE, 0.49) in men. In men, low income and smoking were associated with attempted suicide, while attempted suicide in women was associated with poor self-evaluated health, low educational attainment, and drug use. A history of medical and psychiatric illnesses was associated with attempted suicide in both genders, for cancer/pulmonary disease, OR=2.89 (95% CI, 1.25-6.67) in men and 1.94 (1.09-3.45) in women; for major depressive disorder, OR=9.86 (5.08-19.14) in men and 5.00 (3.19-7.83) in women. The significant gender difference of attempted suicide prevalence remained after being adjusted for risk factors selected. CONCLUSION: There were significant gender differences in the risk factors for attempted suicide among young adults, and the gender difference in the prevalence of lifetime attempted suicides could not be explained by differential exposure to risk factors selected.     

Same-Sex Sexual Orientation,Childhood Sexual Abuse,and Suicidal Behavior in University Students in Turkey

This questionnaire study investigated the prevalence of, and interrelationships among, self-reported same-sex sexual orientation, childhood sexual abuse, and suicidal behavior in 1262 university students in Turkey. Approximately 7% of the sample reported lifetime or current same-sex sexual attractions, 5% reported that they engaged in same-sex sexual behavior, and almost 2% self-identified as either homosexual or bisexual. Overall, almost 10% of the sample acknowledged some form of a same-sex sexual orientation. Twenty-eight percent of the participants reported at least one instance of sexual abuse during their childhood. Almost 42% of the students reported suicidal ideation during the past 12 months or lifetime, and 7% reported that they attempted to kill themselves during their lifetime or in the past 12 months. Five hypotheses about the interrelationships among same-sex sexual orientation, childhood sexual abuse, and suicidal behavior were developed and tested in the study. Self-reported childhood sexual abuse was associated with same-sex sexual behavior. Participants who engaged in same-sex sexual behavior and those who identified themselves as homosexual or bisexual perceived more distance between themselves and their fathers than those who did not. Being sexually abused by someone of ones own sex was related to same-sex sexual orientation in male participants but not in female participants. Childhood sexual abuse was found to be an independent predictor of both suicidal ideation and attempts during the past 12 months. Only identifying oneself as homosexual or bisexual was associated with an increased risk for suicidal ideation during the past 12 months.     

Sex in Australia: homosexual experience and recent homosexual encounters

OBJECTIVE: To describe the prevalence and features of homosexual experience and recent homosexual encounters among a representative sample of Australian adults. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years from all States and Territories. The overall response rate was 73.1% (69.4% among men and 77.6% among women). RESULTS: Overall, 8.6% of women and 5.9% of men reported some homosexual sexual experience in their lives (p<0.001); these figures fell to 5.7% and 5.0% respectively (p=0.106) when non-genital sexual experience was excluded. 1.9% of men and 1.5% of women reported homosexual experience in the past year. Men who reported homosexual experience reported more same-sex partners than did women (means 31.6 and 3.2, p<0.001), and men and women who identified as homosexual or bisexual reported more sexual partners in total than those who identified as heterosexual. Respondents reporting homosexual experience were significantly more likely to be from an English-speaking background, have higher levels of education, live in a major city, and report a white-collar or managerial/professional occupation. Women who reported homosexual experience were less likely to have a middle or high income. In the most recent homosexual encounter, genital touching was the most commonly reported practice, and oral sex was reported much more frequently than in heterosexual encounters. CONCLUSION: Homosexually and bisexually identified men and women had higher total numbers of partners than heterosexuals. Improved societal attitudes towards homosexuality are likely to lead to further increases in estimates of the prevalence of homosexual experience in the community.     

Test–Retest Reliability and Predictors of Unreliable Reporting for a Sexual Behavior Questionnaire for U.S. Men

Accurate knowledge about human sexual behaviors is important for increasing our understanding of human sexuality; however, there have been few studies assessing the reliability of sexual behavior questionnaires designed for community samples of adult men. A test–retest reliability study was conducted on a questionnaire completed by 334 men who had been recruited in Tucson, Arizona. Reliability coefficients and refusal rates were calculated for 39 non-sexual and sexual behavior questionnaire items. Predictors of unreliable reporting for lifetime number of female sexual partners were also assessed. Refusal rates were generally low, with slightly higher refusal rates for questions related to immigration, income, the frequency of sexual intercourse with women, lifetime number of female sexual partners, and the lifetime number of male anal sex partners. Kappa and intraclass correlation coefficients were substantial or almost perfect for all non-sexual and sexual behavior items. Reliability dropped somewhat, but was still substantial, for items that asked about household income and the men’s knowledge of their sexual partners’ health, including abnormal Pap tests and prior sexually transmitted diseases (STD). Age and lifetime number of female sexual partners were independent predictors of unreliable reporting while years of education was inversely associated with unreliable reporting. These findings among a community sample of adult men are consistent with other test–retest reliability studies with populations of women and adolescents.     

Sexual Orientation Disparities in Sexually Transmitted Infections: Examining the Intersection Between Sexual Identity and Sexual Behavior

The terms MSM (men who have sex with men) and WSW (women who have sex with women) have been used with increasing frequency in the public health literature to examine sexual orientation disparities in sexual health. These categories, however, do not allow researchers to examine potential differences in sexually transmitted infection (STI) risk by sexual orientation identity. Using data from the National Longitudinal Survey of Adolescent Health, this study investigated the relationship between self-reported STIs and both sexual orientation identity and sexual behaviors. Additionally, this study examined the mediating role of victimization and STI risk behaviors on the relationship between sexual orientation and self-reported STIs. STI risk was found to be elevated among heterosexual-WSW and bisexual women, whether they reported same-sex partners or not, whereas gay-identified WSW were less likely to report an STI compared to heterosexual women with opposite sex relationships only. Among males, heterosexual-identified MSM did not have a greater likelihood of reporting an STI diagnosis; rather, STI risk was concentrated among gay and bisexual identified men who reported both male and female sexual partners. STI risk behaviors mediated the STI disparities among both males and females, and victimization partially mediated STI disparities among female participants. These results suggest that relying solely on behavior-based categories, such as MSM and WSW, may mischaracterize STI disparities by sexual orientation.     

Psychiatric symptoms and substance use disorders in a nationally representative sample of American adolescents involved with foster care

PurposeTo ascertain the prevalence of psychiatric symptoms and substance use disorders among adolescents with a lifetime history of foster care placement, using data from a nationally representative sample of U.S. adolescents.MethodsWe studied adolescents aged 12–17 years in the public use file of the 2000 National Household on Drug Abuse (n = 19,430, including 464 adolescents with history of foster care placement). Psychiatric symptoms and substance use disorders were ascertained through direct interviewing of adolescents. Logistic regression analyses were used to estimate the odds of past-year psychiatric symptoms and substance use disorders among adolescents involved with foster care, as compared to those without a lifetime history of foster care placement (comparison group).ResultsAdolescents involved with foster care had more past-year psychiatric symptoms, and especially more conduct symptoms, and past-year substance use disorders than those never placed in foster care. Adolescents involved with foster care were about four times more likely to have attempted suicide in the preceding 12 months (adjusted odds ratio [AOR] 3.95; 95% confidence interval [CI] 2.78, 5.61), and about five times more likely to receive a drug dependence diagnosis in the same period (AOR 4.81; 95% CI 3.22, 7.18).ConclusionsAdolescents involved with foster care have a higher prevalence of psychiatric symptoms and drug use disorders than those never placed in foster care. Additionally, the results of this study suggest that they may be at elevated risk for suicide attempts.