There is some evidence for a genetic influence on sexual orientation. However, gay men have fewer children than heterosexual men. Increased fecundity in the biological relatives of gay men could offset this selection pressure. We measured family size in gay (n = 301) and heterosexual (n = 404) men, attending clinics for sexually transmitted infections. The main outcome measure was the number of each man's uncles and aunts, first cousins, siblings, nephews and nieces, and his own children. With the exception of the participants' own offspring, mean family size of each category of relatives was significantly larger for gay men (paternal and maternal total OR = 1.02, CI = 1.01-1.03). This remained the case after adjustment for other predictors of family size (paternal and maternal total OR = 1.02, CI = 1.00-1.03). We found increased fecundity in the relatives of gay men and this is one explanation of how a genetic influence might persist in spite of reduced reproductive fitness in the gay phenotype. There are, however, a number of alternative explanations for our finding, including unknown psychological and social factors, which might mediate the association between family size and sexual orientation.
Objective: To identify factors which determine whether and when patients will disclose infection with genital herpes to sexual partners. Methods: The sample was 26 women and 24 men attending a herpes clinic in a sexually transmitted disease clinic. Semistructured interviews yielded quantitative data and also qualitative data which were subjected to content analysis. Results: Characteristics of partners were very important in determining whether disclosure occurred. Respondents were less likely to tell partners regarded as casual. Perception of the likely reaction of partners was important in deciding whether to tell. Many respondents assumed that they were not infectious if they were not currently having an attack or if they were taking antiviral medication. The decision whether to tell tended to be based on considerations of likely discovery and of honesty towards the partner rather than control of transmission. Of patient characteristics only self rated depressed mood was related to disclosure to the most recent partner. Conclusions: Perception of the partner and anticipated partner response is crucially important in determining whether and when disclosure of genital herpes infection occurs. G enital herpes simplex virus (HSV) infection is a stigmatised disease associated with a severe psychological disturbance in some patients and with fears of transmission to partners. The issue of telling partners is an important one for many patients and something they often ask for advice on. However, little is known about the determinants or manner of disclosure. METHODS SampleA convenience sample of 24 male and 26 female patients attending a herpes clinic at St Mary's Hospital, London was studied. Median sample age was 34 (range 19-68 years). All patients had had herpes for at least 1 year, 12 less than 5 years, 20 for 5-10 years, and 18 over 10 years. Mean annual reported attack frequency when not taking antiviral drugs was 9.4 (SD 6.2), median attack duration was 7 days. At interview 45 patients were taking antiviral medication and all had had antiviral experience; 57% reported being recurrence free on medication. MethodologyRespondents were given a semistructured interview schedule covering demographics, disease duration, attack frequency, perceived trigger factors, perceived impact on health, and experience with antiviral treatment. They were asked to report on their last three sexual partners since having contracted genital herpes, including the nature of the relationship, whether they had informed them, what had influenced their decision to tell, the reaction of their partners, and what the impact was on the relationship in the longer term. Not all patients had three such partners but all had at least one.Sessions were tape recorded and transcripts entered into the NUDIST program and a content analysis carried out. Emergent categories were identified by the rater from the transcripts, a sample of categorisations was then checked by a second rater and any disagreements resolved.Quantitative data analysis was implem...
Little research has focused specifically on disclosure among HIV+ Black Africans living in the UK; however, the available evidence suggests that this population may be reluctant to disclose to significant others. Forty-five HIV+ Black African men and women were recruited from a London HIV clinic. Semi-structured interviews gathered information on: disclosure, social support, mental and physical health, medication adherence, acculturation and the perceived prevalence of stigma. Both qualitative and quantitative analyses were conducted. The majority of the participants had disclosed to one significant other and there was an inverse association between perceived stigma and disclosure. Disclosure could not be predicted by any of the respondent characteristics identified in the study; rather, disclosure decisions were reasoned, interpersonal in nature and many of the motivations were specific to the individual. There was little evidence to suggest that those who disclosed to more than one other gained additional benefits in physical or mental well-being. Clinicians seeking to assist members of this population to disclose need to assess the specific reasons for and barriers against disclosure for that individual.
Relationship factors, in particular duration, were key predictors of partner disclosure of anogenital warts. In terms of individual characteristics, only anxiety was significantly different in disclosers and non-disclosers. Perceptions of stigma and expected outcome of disclosure were not significantly different in the two groups. Of particular relevance to those considering whether or not to disclose, partner response was significantly more supportive than disclosers expected and disclosers expressed significantly less regret about their disclosure decision than did non-disclosers.
This review is based on a MEDLINE/PSYCHINFO search for all papers on psychological aspects of vulvar vestibulitis syndrome (VVS) published 1995-2002. VVS is a condition in which painful patches appear on the vulva which make intercourse painful. Causation, natural history and prevalence of VVS are unknown. Attempts to identify psychological characteristics typical of women with VVS have not yielded consistent results with some studies suggesting high levels of psychopathology and others not. It is suggested that inconsistencies in findings reflect not only decisions by women about whether and how to access health care but also the health care system acting to actively filter those reaching specialist services and selecting those with particular psychological characteristics. There is no compelling evidence that VVS per se is associated with any particular psychological or behavioural characteristics other than the sort of difficulties in sexual functioning which might be expected with chronic vulval pain. However there is evidence for high levels of psychological distress in some samples of women with VVS being seen in secondary care.
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