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Here's another citation that you can link from above:
Drugs. 1984 Oct;28(4):355-70. Related Articles, Links
Preventing complications of sexually transmitted disease. New treatment guidelines for an expanded spectrum of problems.
Washington AE.
Newly recognised sexually transmitted diseases have combined with the traditional venereal diseases to present clinicians with a demanding management challenge. Besides the increases in incidence of some of these diseases, many of the associated organisms are becoming more resistant to commonly used antimicrobial drugs. Predictably, accompanying this trend are increasing numbers of serious complications affecting men, women and infants. Timely and appropriate management of patients presenting with sexually transmitted diseases are imperative to stem the swelling tide of these conditions and prevent their insidious consequences. Clinicians must therefore remain knowledgeable about the effective therapies (and regimens) that are available. An update of the treatment guidelines for sexually transmitted diseases is provided in this article. As well as selecting appropriate antimicrobial regimens, it is equally important that clinicians educate their patients about their disease and its probable course, explain the administration of medications clearly to patients, and follow them up appropriately to detect resistant cases and non-compliers, and ultimately ensure effective treatment. In addition, no patient should be considered appropriately managed until his or her sexual partners have been properly dispositioned. For most patients, this will entail examining their sexual partners and treating them immediately. Execution of these treatment guidelines and management principles will help protect the reproductive capability of many women by preventing pelvic inflammatory disease, ectopic pregnancy, and infertility.
Publication Types:
Review
PMID: 6386429 [PubMed - indexed for MEDLINE]
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Throughout history, the major civilizations major religions condemned homosexuality.1 Until 1961 homosexual acts were illegal throughout America. Gays claim that the "prevailing attitude toward homosexuals in the U.S. and many other countries is revulsion and hostility....for acts and desires not harmful to anyone."3 The American Psychological Association and the American Public Health Association assured the U.S. Supreme Court in 1986 that "no significant data show that engaging in...oral and anal sex, results in mental or physical dysfunction."4 What Homosexuals DoThe major surveys on homosexual behavior are summarized below. Two things stand out 1) homosexuals behave similarly world-over, and 2) as Harvard Medical Professor, Dr. William Haseltine,33 noted in 1993, the "changes in sexual behavior that have been reported to have occurred in some groups have proved, for the most part, to be transient. For example, bath houses and sex clubs in many cities have either reopened or were never closed." Homosexual Activities (in %)US16 US13 US US18 Denmark20 US19 London27 Sydney/London26 Canada25 1940s1977 83/84 1983 1984 1983 1985 1991 ever ever ever in yr in yr in mo in mo last 6mo oral/penile 83 99 100/99 99 86 67 anal/penile 68 91 93/98 95 92 95 100 oral/anal 59 83 92/92 63 69 89 55/65 urine sex 10 23 29/ fisting/toys 22 41/47 34 fecal sex-eating 4 8 enemas 11 11 torture sex 22 37 37 public/orgy sex 61 76 88 sex with minors 37 23 24/ ORAL SEX Homosexuals fellate almost all of their sexual contacts (and ingest semen from about half of these). Semen contains many of the germs carried in the blood. Because of this, gays who practice oral sex verge on consuming raw human blood, with all its medical risks. Since the penis often has tiny lesions (and often will have been in unsanitary places such as a rectum), individuals so involved may become infected with hepatitis A or gonorrhea (and even HIV and hepatitis B). Since many contacts occur between strangers (70% of gays estimated that they had had sex only once with over half of their partners17,27), and gays average somewhere between 106 and 1105 different partners/year, the potential for infection is considerable. RECTAL SEX Surveys indicate that about 90% of gays have engaged in rectal intercourse, and about two-thirds do it regularly. In a 6-month long study of daily sexual diaries,3 gays averaged 110 sex partners and 68 rectal encounters a year. Rectal sex is dangerous. During rectal intercourse the rectum becomes a mixing bowl for 1) saliva and its germs and/or an artificial lubricant, 2) the recipient's own feces, 3) whatever germs, infections or substances the penis has on it, and 4) the seminal fluid of the inserter. Since sperm readily penetrate the rectal wall (which is only one cell thick) causing immunologic damage, and tearing or bruising of the anal wall is very common during anal/penile sex, these substances gain almost direct access to the blood stream. Unlike heterosexual intercourse (in which sperm cannot penetrate the multilayered vagina and no feces are present),7 rectal intercourse is probably the most sexually efficient way to spread hepatitis B, HIV syphilis and a host of other blood-borne diseases. Tearing or ripping of the anal wall is especially likely with "fisting," where the hand and arm is inserted into the rectum. It is also common when "toys" are employed (homosexual lingo for objects which are inserted into the rectum--bottles, carrots, even gerbils8). The risk of contamination and/or having to wear a colostomy bag from such "sport" is very real. Fisting was apparently so rare in Kinsey's time that he didn't think to talk about it. By 1977, well over a third of gays admitted to doing it. The rectum was not designed to accommodate the fist, and those who do so can find themselves consigned to diapers for life. FECAL SEX About 80% of gays (see Table) admit to licking and/or inserting their tongues into the anus of partners and thus ingesting medically significant amounts of feces. Those who eat or wallow in it are probably at even greater risk. In the diary study,5 70% of the gays had engaged in this activity--half regularly over 6 months. Result? --the "annual incidence of hepatitis A in...homosexual men was 22 percent, whereas no heterosexual men acquired hepatitis A." In 1992,26 it was noted that the proportion of London gays engaging in oral/anal sex had not declined since 1984. While the body has defenses against fecal germs, exposure to the fecal discharge of dozens of strangers each year is extremely unhealthy. Ingestion of human waste is the major route of contracting hepatitis A and the enteric parasites collectively known as the Gay Bowel Syndrome. Consumption of feces has also been implicated in the transmission of typhoid fever,9 herpes, and cancer.27 About 10% of gays have eaten or played with [e.g., enemas, wallowing in feces]. The San Francisco Department of Public Health saw 75,000 patients per year, of whom 70 to 80 per cent are homosexual men....An average of 10 per cent of all patients and asymptomatic contacts reported...because of positive fecal samples or cultures for amoeba, giardia, and shigella infections were employed as food handlers in public establishments; almost 5 per cent of those with hepatitis A were similarly employed."10 In 1976, a rare airborne scarlet fever broke out among gays and just missed sweeping through San Francisco.10 The U.S. Centers for Disease Control reported that 29% of the hepatitis A cases in Denver, 66% in New York, 50% in San Francisco, 56% in Toronto, 42% in Montreal and 26% in Melbourne in the first six months of 1991 were among gays.11 A 1982 study "suggested that some transmission from the homosexual group to the general population may have occurred."12 URINE SEX About 10% of Kinsey's gays reported having engaged in "golden showers" [drinking or being splashed with urine]. In the largest survey of gays ever conducted,13 23% admitted to urine-sex. In the largest random survey of gays,6 29% reported urine-sex. In a San Francisco study of 655 gays,14 only 24% claimed to have been monogamous in the past year. Of these monogamous gays, 5% drank urine, 7% practiced "fisting," 33% ingested feces via anal/oral contact, 53% swallowed semen, and 59% received semen in their rectum during the previous month. OTHER GAY SEX PRACTICESSADOMASOCHISM as the Table indicates, a large minority of gays engage in torture for sexual fun. Sex with minors 25% of white gays17 admitted to sex with boys 16 or younger as adults. In a 9-state study,30 33% of the 181 male, and 22% of the 18 female teachers caught molesting students did so homosexually (though less than 3% of men and 2% of women engage in homosexuality31). Depending on the study, the percent of gays reporting sex in public restrooms ranged from 14%16 to 41%13 to 66%,6 9%16, 60%13 and 67%5 reported sex in gay baths; 64%16 and 90%18 said that they used illegal drugs. Fear of AIDS may have reduced the volume of gay sex partners, but the numbers are prodigious by any standard. Morin15 reported that 824 gays had lowered their sex-rate from 70 different partners/yr. in 1982 to 50/yr. by 1984. McKusick14 reported declines from 76/yr. to 47/yr. in 1985. In Spain32 the average was 42/yr. in 1989. Medical Consequences of Homosexual SexDeath and disease accompany promiscuous and unsanitary sexual activity. 70%25 to 78%x,13 of gays reported having had a sexually transmitted disease. The proportion with intestinal parasites (worms, flukes, amoeba) ranged from 25%18 to 39%19 to 59%.20 As of 1992, 83% of U.S. AIDS in whites had occurred in gays.21 The Seattle sexual diary study3? reported that gays had, on a yearly average:
No wonder 10% came down with hepatitis B and 7% contracted hepatitis A during the 6-month study. Effects on the LifespanSmokers and drug addicts don't live as long as non-smokers or non-addicts, so we consider smoking and narcotics abuse harmful. The typical life-span of homosexuals suggests that their activities are more destructive than smoking nd as dangerous as drugs. Obituaries numbering 6,516 from 16 U.S. homosexual journals over the past 12 years were compared to a large sample of obituaries from regular newspapers.23 The obituaries from the regular newspapers were similar to U.S. averages for longevity; the medium age of death of married men was 75, and 80% of them died old (age 65 or older). For unmarried or divorced men the median age of death was 57, and 32% of them died old. Married women averaged age 79 at death; 85% died old. Unmarried and divorced women averaged age 71, and 60% of them died old. The median age of death for homosexuals, however, was virtually the same nationwide--and, overall, less than 2% survived to old age. If AIDS was the cause of death, the median age was 39. For the 829 gays who died of something other than AIDS, the median age of death was 42, and 9% died old. The 163 lesbians had a median age of death of 44, and 20% died old. Two and eight-tenths percent (2.8%) of gays died violently. They were 116 times more apt to be murdered; 24 times more apt to commit suicide; and had a traffic-accident death-rate 18 times the rate of comparably-aged white males. Heart attacks, cancer and liver failure were exceptionally common. Twenty percent of lesbians died of murder, suicide, or accident--a rate 487 times higher than that of white females aged 25-44. The age distribution of samples of homosexuals in the scientific literature from 1989 to 1992 suggests a similarly shortened life-span. The Gay LegacyHomosexuals rode into the dawn of sexual freedom and returned with a plague that gives every indication of destroying most of them. Those who treat AIDS patients are at great risk, not only from HIV infection, which as of 1992 involved over 100 health care workers,21 but also from TB and new strains of other diseases.24 Those who are housed with AIDS patients are also at risk.24 Those who are housed with AIDS patients are also at risk.24 Dr. Max Essex, chair of the Harvard AIDS Institute, warned congress in 1992 that "AIDS has already led to other kinds of dangerous epidemics...If AIDS is not eliminated, other new lethal microbes will emerge, and neither safe sex nor drug free practices will prevent them."28 At least 8, and perhaps as many as 30 29 patients had been infected with HIV by health care workers as of 1992. The Biological SwapmeetThe typical sexual practices of homosexuals are a medical horror story --imagine exchanging saliva, feces, semen and/or blood with dozens of different men each year. Imagine drinking urine, ingesting feces and experiencing rectal trauma on a regular basis. Often these encounters occur while the participants are drunk, high, and/or in an orgy setting. Further, many of them occur in extremely unsanitary places (bathrooms, dirty peep shows), or, because homosexuals travel so frequently, in other parts of the world. Every year, a quarter or more of homosexuals visit another country.20 Fresh American germs get taken to Europe, Africa and Asia. And fresh pathogens from these continents come here. Foreign homosexuals regularly visit the U.S. and participate in this biological swapmeet. The Pattern of InfectionUnfortunately the danger of these exchanges does not merely affect homosexuals. Travelers carried so many tropical diseases to New York City that it had to institute a tropical disease center, and gays carried HIV from New York City to the rest of the world.27 Most of the 6,349 Americans who got AIDS from contaminated blood as of 1992, received it from homosexuals and most of the women in California who got AIDS through heterosexual activity got it from men who engaged in homosexual behavior.23 The rare form of airborne scarlet fever that stalked San Francisco in 1976 also started among homosexuals.10 Genuine CompassionSociety is legitimately concerned with health risks-- they impact our taxes and everyone's chances of illness and injury. Because we care about them, smokers are discouraged from smoking by higher insurance premiums, taxes on cigarettes and bans against smoking in public. These social pressures cause many to quit. They likewise encourage non-smokers to stay non-smokers. Homosexuals are sexually troubled people engaging in dangerous activities. Because we care about them and those tempted to join them, it is important that we neither encourage nor legitimize such a destructive lifestyle.
References1. Karlen A. SEXUALITY And HOMOSEXUALITY. NY Norton, 1971. 2. Pines B. BACK TO BASICS. NY Morrow, 1982, p. 211. 3. Weinberg G. SOCIETY AND THE HEALTHY HOMOSEXUAL. NY St. Martin's, 1972, preface. 4. Amici curiae brief, in Bowers v. Hardwick, 1986. 5. Corey L. & Holmes, K.K. Sexual transmission of Hepatitis A in homosexual men. "New England Journal of Medicine," 1980302435- 38. 6. Cameron P et al Sexual orientation and sexually transmitted disease. "Nebraska Medical Journal," 198570292-99; Effect of homosexuality upon public health and social order "Psychological Reports," 1989, 64, 1167-79. 7. Manligit, G.W. et al Chronic immune stimulation by sperm alloan- tigens. "Journal of the American Medical Association," 1984251 237-38. 8. Cecil Adams, "The Straight Dope," THE READER (Chicago, 3/28/86) [Adams writes authoritatively on counter-culture material, his column is carried in many alternative newspapers across the U.S. and Canada]. 9. Dritz, S. & Braff. Sexually transmitted typhoid fever. "New England Journal of Medicine," 19772961359-60. 10. Dritz, S. Medical aspects of homosexuality. "New England Journal of Medicine," 1980302463-4. 11. CDC Hepatitis A among homosexual men --United States, Canada, and Australia. MMWR 199241155-64. 12. Christenson B. et al. An epidemic outbreak of hepatitis A among homosexual men in Stockholm, "American Journal of Epidemiology," 1982115599-607. 13. Jay, K. & Young, A. THE GAY REPORT. NY Summit, 1979. 14. McKusick, L. et al AIDS and sexual behaviors reported by gay men in San Francisco, "American Journal of Public Health," 1985 75493- 96. 15. USA Today 11/21/84. 16. Gebhard, P. & Johnson, A. THE KINSEY DATA. NY Saunders, 1979. 17. Bell, A. & Weinberg, M. HOMOSEXUALITIES. NY Simon & Schuster, 1978. 18. Jaffee, H. et al. National case-control study of Kaposi's sarcoma. "Annals Of Internal Medicine," 198399145-51. 19. Quinn, T. C. et al. The polymicrobial origin of intestinal infection in homosexual men. "New England Journal of Medicine," 1983309576-82. 20. Biggar, R. J. Low T-lymphocyte ratios in homosexual men. "Journal Of The American Medical Association," 19842511441-46; "Wall Street Journal," 7/18/91, B1. 21. CDC HIV/AIDS SURVEILLANCE, February 1993. 22. Chu, S. et al. AIDS in bisexual men in the U.S. "American Journal Of Public Health," 199282220-24. 23. Cameron, P., Playfair, W. & Wellum, S. The lifespan of homo- sexuals. Paper presented at Eastern Psychological Association Convention, April 17, 1993. 24. Dooley, W.W. et al. Nosocomial transmission of tuberculosis in a hospital unit for HIV-invected patients. "Journal of the American Medical Association," 19922672632-35. 25. Schechter, M.T. et al. Changes in sexual behavior and fear of AIDS. "Lancet," 198411293. 26. Elford, J. et al. Kaposi's sarcoma and insertive rimming. "Lancet," 1992339938. 27. Beral, V. et al. Risk of Kaposi's sarcoma and sexual practices associated with faecal contact in homosexual or bisexual men with AIDS. "Lancet," 1992339632-35. 28. Testimony before House Health & Environment Subcommittee, 2/24/92. 29. Ciesielski, C. et al. Transmission of human immunodeficiency virus in a dental practice. "Annals of Internal Medicine, 1992116 798-80; CDC Announcement Houston Post, 8/7/92. 30. Rubin, S. "Sex Education Teachers Who Sexually Abuse Students." 24th International Congress on Psychology, Sydney, Australia, August 1988. 31. Cameron, P. & Cameron, K. Prevalence of homosexuality. "Psychology Reports," 1993, in press; Melbye, M. & Biggar, R.J. Interactions between persons at risk for AIDS and the general population in Denmark. "American Journal of Epidemiology," 1992135593-602. 32. Rodriguez-Pichardo, A. et al. Sexually transmitted diseases in homosexual males in Seville, Spain, "Geniourin Medicina," 1990 66;423-427. 33. AIDS Prognosis, Washington Times, 2/13/93, C1. |
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