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American Journal of Epidemiology Vol. 121, No. 5: 637-644
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

DECREASED HELPER T LYMPHOCYTES IN HOMOSEXUAL MEN

II. SEXUAL PRACTICES

JAMES J. GOEDERT1, ROBERT J. BIGGAR1, DEBORAH M. WINN1, DEAN L. MANN2, DAVID P. BYAR3, DOUGLAS M. STRONG4, RICHARD A. DIGIOIA5, RONALD J. GROSSMAN6, WILLIAM C. SANCHEZ5, RONALD G. KASE1, MARK H. GREENE1, ROBERT N. HOOVER1 and WILLIAM A. BLATTNER1

1 Environmental Epidemiology Branch, Division of Cancer Etiology, National Cancer Institute Bethesda, MD
2 Laboratory of Human Carcinogenesis, Division of Cancer Etiology, National Cancer Institute Bethesda, MD
3 Biometry Branch, Division of Cancer Etiology, National Cancer Institute Bethesda, MD
4 Department of Surgery, Uniformed Services Uni versity of the Health Sciences Bethesda, MD
5 Private practice Washington, DC
6 Private practice New York, NY

Reprint requests to Dr. James J. Goedert, Environ mental Epidemiology Branch, National Cancer Institute, Landow Building, Room 3C-19, Bethesda, MD 20205.

Received for publication June 19, 1984. Revision received September 28, 1984. Goedert, J. J. (Environmental Epidemiology Branch, Nd, Bethesda, MD 20205), R. J. Biggar, D. M. Winn, D. L Mann, D. P. Byar, D. M. Strong, R. A. DiGlola, R. J. Grossman, W. C. Sanchez, R. G. Kase, M. H. Greene, R. N. Hoover, and W. A. Blattner. Decreased helper T lymphocytes in homosexual men. I. Sexual contact in high-incidence areas for the acquired immunodeficlency syndrome. Am J Epldemloi 1985;121:637–44.

In June 1982, the sexual practices of 245 homosexual male outpatients of private physicians were evaluated In relationship to decreased numbers of helper T lymphocytes, an abnormality that is characteristic of the acquired immunode ficiency syndrome (AIDS). Three risk groups were defined a prlorl–85 high-risk men from centrel Manhattan ("New York"), 98 intermedlate-,Isk men from Wash ington, DC, with AIDS-area homosexual contacts ("Washington-exposed"), and 64 low-risk Washington, DC, men without such contacts ("Washington-unex posed"). An increasing number of homosexual partners was correlated with decreasing helper I-cell counts (R = –0.29, p = 0.009) and decreasing helper.suppressor T-cell ratios (R = –0.32. p = 0.005) In the entire study group combined and in New York subjects separately. Suppressor T-cell counts were unrelated to the number of partners in all three groups. Increasingly frequent receptive anal intercourse correlated with decreasing helper T-cell counts most clearly in the New York City group (R = –0.23, p = 0.04), somewhat less so in the Washington-exposed group (R = –0.18, p = 0.07), and not at all in the Washington-unexposed group (R = –0.09, p = 0.48). ThIs association persisted In the New York and Washington-exposed groups after adjusting for seven other sexual practices, the number of homosexual partners, and five other potentially confounding variables. A transmissible agent associated with receptive anal Intercourse best explains these data. The cause of these low helper T-ceIl counts may also be the cause of AIDS.

homosexuality; immunity; cellutar immunologic deficiency syndromes regres sion analysis; retrovlrus irnfections; semen


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