Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual,homosexual and bisexual Danes

Non‐heterosexual persons more often report adverse childhood experiences (ACEs) than heterosexuals, and they generally bear a greater burden of mental health challenges. However, population‐based data on this topic are scarce. In a nationally representative study within the Project SEXUS, one of the world''s largest cohort studies on sexual health, we used data from 57,479 individuals in Denmark to explore the interplay between ACEs and mental health problems among self‐identified heterosexual, homosexual and bisexual persons, and among self‐identified heterosexuals with or without same‐sex sexual experience. Compared to heterosexuals, non‐heterosexual persons were more likely to report most of the studied ACEs, with odds ratios (ORs) for the ACE category “abuse” ranging from 1.38 to 1.75 for homosexual women, from 1.76 to 2.65 for homosexual men, from 2.52 to 3.64 for bisexual women, and from 1.58 to 6.07 for bisexual men. Furthermore, non‐heterosexual persons had consistently and statistically significantly higher odds for mental health problems (ORs: 1.50 to 4.63). Combinations of ACEs with a non‐heterosexual identity resulted in markedly elevated odds for mental health problems, particularly among bisexual individuals. This included high odds for suicidal thoughts/attempts among bisexual persons with a history of “neglect” (women: OR=12.82; men: OR=35.24) and “abuse” (women: OR=11.81; men: OR=11.65). Among self‐identified heterosexuals, combinations of ACEs with same‐sex sexual experience were associated with consistently elevated odds for mental health problems (ORs: 2.22 to 12.04). The greater burden of ACEs among self‐identified homosexuals and, most notably, bisexuals may account for part of their excess risk of mental health problems. These findings emphasize the public health importance of preventive measures to minimize the burden of ACEs and avert their harmful long‐term effects. Moreover, they highlight the need to safeguard the welfare of children and adolescents with non‐conforming expressions of sexuality.     

A comparison of heterosexual and homosexual mating preferences in personal advertisements

Human heterosexual mating preferences have been shown to conform to predictions drawn from evolutionary theory, with men and women adopting broadly distinct strategies. Attempts to reconcile sexual selection theory with homosexual behavior have been less consistent, however, and have largely focussed on addressing two alternative perspectives: (i) that gay men and lesbians display phenotypic traits in common with opposite sex heterosexual individuals or (ii) that homosexual individuals display sex-typical, or exaggerated sex-typical phenotypes. Testing these hypotheses is complicated by sampling issues involved in the study of human sexual orientation, since obtaining standardized and comparable samples of heterosexual and non-heterosexual mating preferences is a prerequisite to analysis. Here we present a comparison of homosexual and heterosexual mating strategies in men and women using a sample of 1733 personal (‘lonely hearts’) adverts gathered from a single source. We used principal components analysis in order to expose underlying structure of the advertisements, and identify three components involving relative emphasis placed on resources, physical attractiveness and personality when offering or seeking mate characteristics. While homosexual individuals are shown to resemble their own-sex heterosexual counterparts in terms of emphasis placed on partner physical attractiveness relative to partner personality, no clear pattern emerges in other aspects of advertisement strategy. Nevertheless, there we find no evidence in support of the hypothesis that homosexual men and women are intrinsically opposite-sex typical in terms of mate preferences.     

Children of homosexuals and transsexuals more apt to be homosexual

Do the sexual inclinations of parents influence those of their children? Of 77 adult children of homosexual parents who volunteered for three different investigations, at least 23 (30%) were currently homosexual: twelve (55%) of 22 daughters and three (21%) of fourteen sons of lesbians; five (29%) of seventeen daughters and three (17%) of eighteen sons of gays; none of six sons with both a gay and a lesbian parent. At least 25 (32%) were currently heterosexual. Of the ten with transsexual parents, one of nine daughters was currently lesbian, one was currently heterosexual, and one was transsexual. The son's sexual preference was not reported. These findings suggest that parents' sexual inclinations influence their children's.     

Lifetime Victimization and Physical Health Outcomes among Lesbian and Heterosexual Women

Background

Lifetime victimization experiences, including child sexual abuse (CSA), child physical abuse (CPA), adult sexual assault (ASA), and adult physical assault (APA), are associated with health problems.

Purpose

To examine relationships between cumulative victimization and physical health among heterosexual and lesbian women and determine whether these relationships differ by sexual identity.

Methods

Large samples of heterosexual (n = 482) and lesbian women (n = 394) were interviewed. Questions included lifetime victimization experiences and physical health problems.

Results

Compared to women who reported no childhood victimization, those who reported experiencing both CSA and CPA were 44% more likely to report health problems and women who experienced all four types of victimization (CSA, CPA, APA, ASA) were nearly 240% as likely to report physical health problems. Interaction analyses revealed the association between victimization and physical health did not differ by sexual identity.

Conclusions

Although lesbians were more likely to report all types of victimization, results suggest that victimization conferred increased physical health risks regardless of sexual identity.     

Lesbian health care. What a primary care physician needs to know.

Many primary care physicians take care of lesbians and women sexually active with women without being aware of their patients'' sexual orientation. These women have unique medical and psychosocial needs that each physician must consider. Lesbian identity or being sexually active exclusively with women influences care in areas such as sexually transmitted diseases, risk of human immunodeficiency virus infection, counseling, cancer risk, screening, parenting, depression, alcohol use, and violence. We review an approach to taking a history with all women that facilitates open, comfortable communication with lesbians. We also review specific medical and psychosocial areas of primary care in which caring for lesbians is different from caring for other women. Further research is needed on lesbian health issues to provide appropriate guidelines to clinicians.     

Homosexual women have less grey matter in perirhinal cortex than heterosexual women

Is sexual orientation associated with structural differences in the brain? To address this question, 80 homosexual and heterosexual men and women (16 homosexual men and 15 homosexual women) underwent structural MRI. We used voxel-based morphometry to test for differences in grey matter concentration associated with gender and sexual orientation. Compared with heterosexual women, homosexual women displayed less grey matter bilaterally in the temporo-basal cortex, ventral cerebellum, and left ventral premotor cortex. The relative decrease in grey matter was most prominent in the left perirhinal cortex. The left perirhinal area also showed less grey matter in heterosexual men than in heterosexual women. Thus, in homosexual women, the perirhinal cortex grey matter displayed a more male-like structural pattern. This is in accordance with previous research that revealed signs of sex-atypical prenatal androgenization in homosexual women, but not in homosexual men. The relevance of the perirhinal area for high order multimodal (olfactory and visual) object, social, and sexual processing is discussed.     

Face perception is modulated by sexual preference

Face perception is mediated by a distributed neural system in the human brain . The response to faces is modulated by cognitive factors such as attention, visual imagery, and emotion ; however, the effects of gender and sexual orientation are currently unknown. We used fMRI to test whether subjects would respond more to their sexually preferred faces and predicted such modulation in the reward circuitry. Forty heterosexual and homosexual men and women viewed photographs of male and female faces and assessed facial attractiveness. Regardless of their gender and sexual orientation, all subjects similarly rated the attractiveness of both male and female faces. Within multiple, bilateral face-selective regions in the visual cortex, limbic system, and prefrontal cortex, similar patterns of activation were found in all subjects in response to both male and female faces. Consistent with our hypothesis, we found a significant interaction between stimulus gender and the sexual preference of the subject in the thalamus and medial orbitofrontal cortex, where heterosexual men and homosexual women responded more to female faces and heterosexual women and homosexual men responded more to male faces. Our findings suggest that sexual preference modulates face-evoked activation in the reward circuitry.     

Biological and psychosocial determinants of male and female human sexual orientation

Some propositions on male and female sexual orientation will be considered. Some of these are established; others are more speculative. The aim is to offer some notes towards a coherent, comprehensive theory of sexual orientation. 1. The distinction between butch and femme lesbians seems real rather than a social construct. 2. High levels of prenatal steroid hormones seem to be causally associated with the sexual orientation of butch lesbians. However it is not established whether the causal process operates prenatally or postnatally (or both). This is so because prenatal hormone levels are thought to correlate positively with postnatal hormone levels. And high postnatal hormone levels may facilitate homosexual behaviour as a consequence of sensation-seeking. 3. Male bisexuals also are interpreted to have been exposed to high prenatal testosterone levels. But (for reasons similar to those outlined above in regard to butch lesbians) it is unclear whether these have a direct prenatal effect on the brain or whether they are precursors of high postnatal testosterone levels, which are associated with male bisexual orientation by promoting sensation-seeking behaviour. 4. Postnatal learning processes seem to be causally involved in the sexual orientation of some femme lesbians and some exclusive male homosexuals. 5. Some homosexual men have genes that predispose to their sexual orientation. 6. The same may apply to some lesbians, but such genes have not, as far as I know, been identified. 7. People (of both sexes) who engage in same-sex sexual behaviour may be classified simultaneously in two ways, viz (1) 'active' vs 'passive' and (2) those who do and those who do not engage (or consider engaging) in sex with members of the opposite sex. Ex hypothesi, some of the 'active' ones initiate some of the 'passive' ones. The active ones are driven more by hormones and the passive ones by psychosocial factors. The active males contain a substantial proportion of self-identified bisexuals; and the active females a substantial proportion of self-identified butches. 8. These two active categories (butch lesbians and male bisexuals) share a number of endocrinological, psychological, morphological and behavioural features vis-a-vis their exclusively homosexual and heterosexual peers. Methods of testing some of these ideas are presented.     

Is risk of Kaposi's sarcoma in AIDS patients in Britain increased if sexual partners came from United States or Africa?

OBJECTIVE--To determine whether the risk of Kaposi''s sarcoma in patients with AIDS is increased by sexual contact with groups from abroad with a high incidence of Kaposi''s sarcoma. DESIGN--Analysis of risk of Kaposi''s sarcoma in patients with AIDS, according to country of origin of their sexual partners. SETTING--United Kingdom. PATIENTS--2830 patients with AIDS reported to the Communicable Disease Surveillance Centre and the Communicable Disease (Scotland) Unit up to March 1990, of whom 566 had Kaposi''s sarcoma. MAIN OUTCOME MEASURES--Percentage of patients with AIDS who had Kaposi''s sarcoma. RESULTS--537 of 2291 homosexual or bisexual men (23%) with AIDS had Kaposi''s sarcoma; 10% (14/135) of the men and women who acquired HIV by heterosexual contact had Kaposi''s sarcoma. None of the 316 subjects who acquired HIV through non-sexual routes had Kaposi''s sarcoma. Kaposi''s sarcoma was more common among homosexual men whose likely source of infection included the United States (171/551, 31%) or Africa (9/34, 26%) than among those infected in the United Kingdom (119/625, 19%) (p less than 0.05). CONCLUSION--The data suggest that Kaposi''s sarcoma is caused by a sexually transmissible agent which was introduced into the British homosexual population mainly from the United States [corrected].     

Perceived Sexual Orientation Based on Vocal and Facial Stimuli Is Linked to Self-Rated Sexual Orientation in Czech Men

Previous research has shown that lay people can accurately assess male sexual orientation based on limited information, such as face, voice, or behavioral display. Gender-atypical traits are thought to serve as cues to sexual orientation. We investigated the presumed mechanisms of sexual orientation attribution using a standardized set of facial and vocal stimuli of Czech men. Both types of stimuli were rated for sexual orientation and masculinity-femininity by non-student heterosexual women and homosexual men. Our data showed that by evaluating vocal stimuli both women and homosexual men can judge sexual orientation of the target men in agreement with their self-reported sexual orientation. Nevertheless, only homosexual men accurately attributed sexual orientation of the two groups from facial images. Interestingly, facial images of homosexual targets were rated as more masculine than heterosexual targets. This indicates that attributions of sexual orientation are affected by stereotyped association between femininity and male homosexuality; however, reliance on such cues can lead to frequent misjudgments as was the case with the female raters. Although our study is based on a community sample recruited in a non-English speaking country, the results are generally consistent with the previous research and thus corroborate the validity of sexual orientation attributions.     

Evidence against a relationship between dermatoglyphic asymmetry and male sexual orientation

Hall and Kimura (1994) studied the relation between dermatoglyphic asymmetry and male sexual orientation in a sample of 66 homosexual and 182 heterosexual men. They found that more homosexual men possessed a leftward dermatoglyphic asymmetry than did heterosexual men. In this paper, we report a comparative study about the relationship between sexual orientation and dermatoglyphic characteristics, including 60 homosexual men, 76 heterosexual men, and 60 heterosexual women, recruited from the general population, and also from a gay-rights nongovernmental organization, in Salvador, Brazil. Ulnar loops were the most frequent dermatoglyphic pattern in all groups, followed by whorls, arches, and radial loops. A chi-square analysis comparing the frequencies of the patterns in the three groups only showed an excess of ulnar loops in women (p < 0.05) and arches in men (p < 0.01), but did not reveal significant differences between homosexuals and the other groups studied. There was no significant difference between gay and straight men on total ridge count. We found a preponderance of rightward asymmetry in homosexual and heterosexual men, as well as in heterosexual women. Our results do not agree with Hall and Kimura's data indicating that more gay men possessed the minority leftward asymmetry than did straight men. There was no significant difference in leftward asymmetry in the sample studied. The results reported in this paper do not support any relation between dermatoglyphic asymmetry and male sexual orientation, and, thus, any hypothesis concerning a biological intrauterine contribution to adult sexual orientation somehow associated with dermatoglyphic development.     

Human immunodeficiency viruses in patients attending a sexually transmitted disease clinic in London, 1982-7.

OBJECTIVE--To determine the prevalence of infection with the human immunodeficiency virus (HIV) in all patients attending a London sexually transmitted disease clinic over four weeks at the end of 1987 and to see how it varied from that in similar samples studied between 1982 and 1986. DESIGN--Anonymous testing of serum samples from consecutive heterosexual and homosexual patients having routine serological investigations for syphilis. Testing was for anti-HIV-I, anti-HIV-II, and hepatitis B core antibody (anti-HBc) and P24 antigen. Age, nationality, sexual orientation, and past sexually transmitted diseases were recorded for each patient. Gonorrhoea rates by quarters were analysed among homosexual and bisexual men and heterosexual men and women from 1981 to 1987. SETTING--Outpatient department of genitourinary medicine. PATIENTS--A total of 1074 patients attending consecutively for syphilis serology. Thirty five homosexual and bisexual men were excluded (these were regular attenders as part of a prospective study of the natural course of HIV infection). MEASUREMENTS AND MAIN RESULTS--The prevalence of anti-HIV-I in homosexual and bisexual men in 1987 was 25.6% (64/250). Results in the same clinic population between 1982 and 1984 had shown a rise in prevalence, which flattened out in 1985-6 and continued at that level. Among heterosexual attenders in 1987 the prevalence of anti-HIV-I was 1% (women 4/412; men 4/377), which contrasted with a prevalence of 0.5% (women 2/395; men 3/757) in January 1986. One homosexual man was seropositive for anti-HIV-II and seronegative for anti-HIV-I. Among homosexual and bisexual men the rate of gonorrhoea had declined by an average of 2.7% a year since 1981, such that by 1987--and for the first time in the clinic--there was no significant difference in the rates between these men and heterosexual men and women. CONCLUSIONS--The appearance of HIV-I infection among heterosexuals indicates a need for more aggressive education programmes and intervention strategies along the lines adopted for homosexual men. Surveillance for HIV-II infection is needed to provide information for future policy in national screening programmes.     

HIV infection in patients attending clinics for sexually transmitted diseases in England and Wales. Collaborative Study by Consultants in Genitourinary Medicine and the Public Health Laboratory Service.

A national study of the prevalence of HIV antibody designed to monitor sexual spread of HIV infection in England and Wales was made of homosexual and heterosexual patients attending sexually transmitted disease clinics in four districts in 1985, seven in 1986, and 14 in 1987. Patients were invited to participate and were counselled. Among homosexual men in two clinics in south east England, HIV antibody was found in 92 (12.9%) of 711 in 1985, 65 (15.2%) of 428 in 1986, and 81 (14.6%) of 556 in 1987: corresponding findings in the other regions were 16 (5.0%) of 321, 41 (6.3%) of 654, and 21 (3.1%) of 678. The prevalence of HIV antibody was higher in homosexual than bisexual men, in patients aged 25 years or more, or with one or more specified minor complaints. Among heterosexual patients in the south east in 1986, HIV antibody was found in seven (3.0%) of 230 men and three (1.3%) of 233 women and in 1987 in 10 (1.0%) of 962 men and seven (0.7%) of 949 women. In other areas corresponding findings in 1986 were two (0.2%) of 950 men and three (0.4%) of 752 women and in 1987 were three (0.06%) of 5312 men and one (0.02%) of 4778 women. All but one of the heterosexual patients with the antibody were intravenous drug abusers or had had sexual contacts in or were from an area abroad with a high prevalence of AIDS. Failure to identify a heterosexual patient with HIV antibody not in a risk group (other than that of being an attender at the clinic) or who did not have a sexual partner in a risk group suggests that their prevalence in the patient population of the clinics in the south east is less than one in 700 and in the other regions less than one in 3000. Refusals to participate increased during the study but comparisons of patients who agreed and refused in terms of age, the presence of symptoms suggesting AIDS, travel abroad, and number of sexual partners a month showed little evidence of selective bias.     

Straight but Not Narrow; Within-Gender Variation in the Gender-Specificity of Women’s Sexual Response

Gender differences in the specificity of sexual response have been a primary focus in sexual psychophysiology research, however, within-gender variability suggests sexual orientation moderates category-specific responding among women; only heterosexual women show gender-nonspecific genital responses to sexual stimuli depicting men and women. But heterosexually-identified or “straight” women are heterogeneous in their sexual attractions and include women who are exclusively androphilic (sexually attracted to men) and women who are predominantly androphilic with concurrent gynephilia (sexually attracted to women). It is therefore unclear if gender-nonspecific responding is found in both exclusively and predominantly androphilic women. The current studies investigated within-gender variability in the gender-specificity of women’s sexual response. Two samples of women reporting concurrent andro/gynephilia viewed (Study 1, n = 29) or listened (Study 2, n = 30) to erotic stimuli varying by gender of sexual partner depicted while their genital and subjective sexual responses were assessed. Data were combined with larger datasets of predominantly gyne- and androphilic women (total N = 78 for both studies). In both studies, women reporting any degree of gynephilia, including those who self-identified as heterosexual, showed significantly greater genital response to female stimuli, similar to predominantly gynephilic women; gender-nonspecific genital response was observed for exclusively androphilic women only. Subjective sexual arousal patterns were more variable with respect to sexual attractions, likely reflecting stimulus intensity effects. Heterosexually-identified women are therefore not a homogenous group with respect to sexual responses to gender cues. Implications for within-gender variation in women’s sexual orientation and sexual responses are discussed.     

The interstitial nuclei of the human anterior hypothalamus: an investigation of variation with sex, sexual orientation, and HIV status

The interstitial nuclei of the human anterior hypothalamus (INAH1-4) have been considered candidates for homology with the sexually dimorphic nucleus of the preoptic area of the rat. Volumetric sexual dimorphism has been described for three of these nuclei (INAH1-3), and INAH3 has been reported to be smaller in homosexual than heterosexual men. The current study measured the INAH in Nissl-stained coronal sections in autopsy material from 34 presumed heterosexual men (24 HIV- and 10 HIV+), 34 presumed heterosexual women (25 HIV- and 9 HIV+), and 14 HIV+ homosexual men. HIV status significantly influenced the volume of INAH1 (8% larger in HIV+ heterosexual men and women relative to HIV- individuals), but no other INAH. INAH3 contained significantly more neurons and occupied a greater volume in presumed heterosexual males than females. No sex difference in volume was detected for any other INAH. No sexual variation in neuronal size or density was observed in any INAH. Although there was a trend for INAH3 to occupy a smaller volume in homosexual men than in heterosexual men, there was no difference in the number of neurons within the nucleus based on sexual orientation.     

Birth order and sexual orientation in men: evidence for two independent interactions

Birth order is correlated with male sexual orientation, but the reason(s) for this relationship is unclear. In the present study, data from a Canadian sample of homosexual and heterosexual men (N=604) were used to present evidence of two independent birth order interactions--one with height and the other with parental age--predicting sexual orientation in men. If these findings prove reliable, it raises the possibility that different aetiological factors underlie the birth order/sexual orientation relationship in men.     

Sexual Orientation and Functional Pain in U.S. Young Adults: The Mediating Role of Childhood Abuse

Objective

Pain without known pathology, termed “functional pain,” causes much school absenteeism, medication usage, and medical visits. Yet which adolescents are at risk is not well understood. Functional pain has been linked to childhood abuse, and sexual orientation minority youth (gay, lesbian, bisexual, “mostly heterosexual,” and heterosexual with same-sex sexual contact) are more likely to be victims of childhood abuse than heterosexuals, thus may be at greater risk of functional pain.

Methods

We examined sexual orientation differences in past-year prevalence of functional headache, pelvic, and abdominal pain and multiple sites of pain in 9,864 young adults (mean age = 23 years) from a large U.S. cohort. We examined whether childhood abuse accounted for possible increased risk of functional pain in sexual minority youth.

Results

Sexual minority youth, except for gays and lesbians, were at higher risk of functional pelvic and abdominal pain and multiple sites of pain than heterosexuals. Gay and lesbian youth had elevated prevalence only of abdominal pain. Childhood abuse accounted for 14% to 33% of increased experience of multiple sites of pain in minority youth.

Conclusions

Youth who identify as “mostly heterosexual” or bisexual or who identify as heterosexual and have had same-sex partners comprised 18% of our sample. Clinicians should be aware that patients with these orientations are at elevated risk of functional pain and may be in need of treatment for sequelae of childhood abuse. Conventional categorization of sexual orientation as heterosexual or homosexual may fail to distinguish a large number of youth who do not wholly identify with either group and may be at elevated risk of health problems.     

Mate preferences and choices for facial and body hair in heterosexual women and homosexual men: influence of sex,population, homogamy,and imprinting-like effect

Recent research has reported that male body and facial hair influence women's mate preferences. However, it is not clear whether such preferences are typical for women or for individuals who prefer males as sexual partners. Here we explored body and facial hair in preferred and actual partners among men and women who prefer men as sexual partners. Including homosexual individuals provides a unique opportunity to investigate whether evolved mating psychologies are specific to the sex of the individual or sex of the partner. Based on an online survey of 1577 participants from Brazil and the Czech Republic, we found that, on average, homosexual men preferred hairier stimuli than heterosexual women, supporting past findings that homosexual men have strong preferences for masculine traits. Preferences for facial and body hair appear to be influenced less by sex of the preferred partner than sex of the individual, pointing to a possible sex-specific mating psychology. Further, Brazilians preferred bigger beards than Czechs, which was positively associated with the self-reported amount of beardedness in Brazil, suggesting that familiarity effects underpin cross-cultural differences in preferences for facial hair. Moreover, homosexual men preferred a self-similar degree of beardedness, and Czech women preferred a similar degree of beardedness as their fathers had during their childhood. However, these effects were not associated with the level of facial hair in their actual partners; in general, mate preferences and actual mate choices for facial and body hair differed. Thus, individual differences in some self-reported characteristics, cultural factors, and aspects of personal experience may modulate differences in preferences for masculine traits.     

Epidemiological investigation of the first case of AIDS detected in a citizen of the USSR

The penetration and spread of infection caused by human immunodeficiency virus has been detected in the USSR. The infection was brought by a homosexual who got infected in East Africa in 1982. In the USSR he infected 5 out of his 22 sexual partners who, in their turn, transferred the infection to 3 women in heterosexual intercourse. One of these women gave birth to a seropositive child. As the result of blood transfusion from a donor infected via a homosexual contact, 5 blood recipients got infected.     

University students' knowledge of, and attitudes towards, hiv and AIDS, homosexuality and sexual risk behaviour: a questionnaire survey in two finnish universities

Summary This study describes Finnish university students' knowledge and attitudes towards HIV and AIDS, homosexuality and sexual risk behaviour. Finnish-speaking students were randomly selected from all registered students at two universities in Finland (N=9715, n=950). The data were collected by using a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire on sexual risk behaviour developed by Held and Chng. The total response rate was 35% (n=333). The data were analysed using quantitative statistical methods. Normally distributed data were analysed by t-test and one-way ANOVA, with Bonferroni corrections. Non-normally distributed data were analysed using the Mann-Whitney U-test and Kruskal-Wallis test, followed by a post-hoc test. The majority of students were familiar with HIV and AIDS, including its mode of transmission. However, there were still some misconceptions concerning HIV and AIDS. The oldest students and women had a more positive attitude towards people living with HIV and AIDS (PLWHA). Of patients with HIV or AIDS, intravenous drug users were perceived most negatively. Male students had more homophobic attitudes. Students who reported that religion had an important role in their lives had significantly stricter attitudes towards sexual risk behaviour. Students' knowledge correlated positively with general attitudes towards HIV and AIDS. Knowledge about HIV and AIDS will lead to more positive attitudes towards HIV and AIDS as a disease, towards those infected as well as homosexual people. There is a need to focus on preventive health care and sexual health promotion by educating young people and changing their attitudes towards sexual risk behaviour.