La familia homoparental en la realidad y la diversidad familiar actual / Homoparental family in real life and current family diversity

Son muchas las definiciones de familia desde algunas clásicas como que es "la célula o núcleo básico de la sociedad, la institución social primaria, un subsistema social o una relación social", hasta otras más complejas que, la consideran un grupo de personas relacionadas entre sí y que viven juntas. La familia es el grupo de intermediación entre el individuo, la comunidad y la sociedad. Es la familia, a pesar de las grandes transformaciones del mundo contemporáneo, hábitat natural del ser humano. En el presente siglo XXI, la familia se diversifica estructuralmente y una de las variantes de familia nuclear, puede ser las homoparentales, las cuales, están formadas por padres con orientación sexual homosexual; y si bien no se trata de un fenómeno nuevo, es en la actualidad donde se vive una intensa aceleración a partir del reconocimiento legal del matrimonio entre personas del mismo sexo en muchas naciones. Las familias homoparentales están capacitadas para educar y criar satisfactoriamente a sus hijos e hijas. La orientación sexual de los progenitores, no es un indicador que sirva para evaluar la función educadora de los padres y madres. Padres e hijos de las familias homoparentales, deben apropiarse de elementos resilientes, que les permitan crecerse, ante cualquier manifestación social, potencialmente negativa hacia ellos (AU).

There are many definitions of a family, from some classic ones like that saying that it is ". the basic cell or nucleus of the society, the primary social institution, a social sub-system and a social relation", to others, more complexes, considering it a group of inter-related persons living together. The family is the intermediary group between the individual, community and society. It is, despite the great transformation of the contemporary world, the natural habitat of the human being. In the current century, the family gets structurally diverse, and one of the variants of the nuclear family may be the homoparental one, that is formed by parents with homosexual sexual orientation. Although it is not a new phenomenon, it is nowadays when it is having an intense acceleration beginning from the legal recognition of the marriage between persons of the same sex in many nations. Homoparental families are able to educate and grow their children up satisfactorily. Parents´ sexual orientation is not an indicator useful to assess the educative function of the parents. Parents and children of homoparental families should incorporate resilient elements allowing affronting any potentially negative social manifestation against them (AU).

A case of Kaposi sarcoma in an immunocompetent, heterosexual Irish man: a discussion of etiology and viral transmission.

Four types of Kaposi sarcoma (KS) have been described, all of which are caused by human herpesvirus-8 (HHV-8).  The incidence of KS in the United States is highest among HIV-positive homosexual men and elderly men of Eastern European, Jewish, or Mediterranean descent. However, few reports describe KS in HIV-negative, immunocompetent heterosexual men in the United States. HHV-8 is transmitted largely via saliva and close sexual contact, whereas there are only a handful of reports of transmission via blood and blood products. We report a case of an HIV-negative, immunocompetent heterosexual man who acquired KS via blood transfusion. A 77-year-old immunocompetent, monogamously heterosexual, HIV-negative Irish man presented with a biopsy-proven KS lesion on the right thigh. Past surgical history included a coronary artery bypass graft, during which he received a blood transfusion from an unknown donor source.  His ecchymotic KS lesions progressed while on doxycycline, intralesional vinblastine, and topical anti-angiogenic medications.  The patient eventually achieved stabilization of KS lesions with acitretin. Our case report emphasizes the need to characterize the phenotype and transmission route of HHV-8 in heterosexual, immunocompetent patients in geographic regions with low HHV-8 seroprevalence.

HIV testing among youth in a high-risk city: prevalence, predictors, and gender differences.

While HIV is prevalent among adolescents and young adults, testing levels remain low and little is known about gender differences in HIV testing. The objectives of this study were to describe the prevalence of past-year HIV testing and evaluate associations between HIV testing and individual- and partner-level factors by gender among heterosexually experienced youth (15-24 years) in Baltimore, Maryland (N = 352). Past-year HIV testing was prevalent (60.1%) and differed by gender (69.4% among women vs. 49.6% among men, p = 0.005). For women, African-American race (AOR 3.09) and recent older partner by ≤2 years (AOR 4.04) were significantly associated with testing. Among men, only African-American race was associated with testing (OR 4.23), with no patterns identified based on risk behavior or perceived partner risk. HIV testing among adolescent and young adults was prevalent in this highly affected urban area. Findings emphasize the value of a gender lens, and provide direction for optimizing engagement in HIV testing.

Differences in testing, stigma, and perceived consequences of stigmatization among heterosexual men and women living with HIV in Bengaluru, India.

Approximately 2.4 million people in India are living with HIV. Gender inequality affects HIV prevention, detection, and management. The purpose of this paper was to describe gender differences in the experience of living with HIV in Bengaluru, India. A subsample of n = 313 (159 men and 154 women) from a larger cohort was used for these analyses. Participants were recruited through AIDS service organizations. They completed an interviewer-administered survey assessing HIV testing experience, types of stigma, and perceived consequences of stigmatization. The majority of men (67%) reported getting HIV tested because of illness, while women were more likely to be tested after learning their spouse's HIV-positive status (42%). More men (59%) than women (45%, p<0.05) were tested in private care settings. Men reported significantly higher mean levels of internalized stigma (men: M=0.71, SD = 0.63; women: M=0.46, SD = 0.55; p<0.001), whereas the women reported significantly higher scores for enacted stigma (men: M=1.30, SD = 1.69; women: M=2.10, SD = 2.17; p<0.001). These differences remained significant after controlling for potential socio-demographic covariates. Following their diagnosis, more women reported moving out of their homes (men: 16%; women: 26%; p<0.05). More men (89%) than women (66%; p<0.001) reported to have modified their sexual behavior after being diagnosed. These findings suggest that the experience of living with HIV and HIV stigma varies by gender in this population. Suggestions for a gender-based approach to HIV prevention and stigma reduction are provided.

An examination of sexual orientation group patterns in mammographic and colorectal screening in a cohort of U.S. women.

PURPOSE: Underutilization of cancer screening has been found especially to affect socially marginalized groups. We investigated sexual orientation group patterns in breast and colorectal cancer screening adherence. METHODS: Data on breast and colorectal cancer screening, sexual orientation, and sociodemographics were gathered prospectively from 1989 through 2005 from 85,759 U.S. women in the Nurses' Health Study II. Publicly available data on state-level healthcare quality and sexual-orientation-related legal protections were also gathered. Multivariable models were used to estimate sexual orientation group differences in breast and colorectal cancer screening, controlling for sociodemographics and state-level healthcare quality and legal protections for sexual minorities. RESULTS: Receipt of a mammogram in the past 2 years was common though not universal and differed only slightly by sexual orientation: heterosexual 84 %, bisexual 79 %, and lesbian 82 %. Fewer than half of eligible women had ever received a colonoscopy or sigmoidoscopy, and rates did not differ by sexual orientation: heterosexual 39 %, bisexual 39 %, and lesbian 42 %. In fully adjusted models, state-level healthcare quality score, though not state-level legal protections for sexual minorities, was positively associated with likelihood of being screened for all women regardless of sexual orientation. CONCLUSIONS: Concerns have been raised that unequal healthcare access for sexual orientation minorities may adversely affect cancer screening. We found small disparities in mammography and none in colorectal screening, though adherence to colorectal screening recommendations was uniformly very low. Interventions are needed to increase screening in women of all sexual orientation groups, particularly in areas with poor healthcare policies.

Marketing HIV prevention for heterosexually identified Latino men who have sex with men and women: the Hombres Sanos campaign.

This article describes the development process of Hombres Sanos, a social marketing campaign to promote HIV testing and condom use for heterosexually identified Latino men who have sex with men and women. The steps included qualitative formative research and a social marketing analytic framework to understand our target audience better, identify incentives and barriers to risk reduction, guide product development, define an optimal promotional campaign, and inform the selection of campaign platforms. A better grasp of the authors' target beneficiaries' needs and values led to an innovative dual strategy for audience segmentation and targeting. The campaign had consumer-centered, culturally sensitive, and theory-driven communication materials. The authors found communication materials and events to be appealing and effective. The campaign was well received among the wider community, and evaluation showed promising results among Latino men in general and among heterosexually identified Latino men who have sex with men and women in particular. The authors provide a step-by-step overview of the project's formative research, including research methods and findings, and how these were translated into a social marketing campaign. In addition, the authors discuss the challenges encountered in this process and the potential of social marketing to reduce HIV risk among Latinos.

Risk of breast cancer mortality among women cohabiting with same sex partners: findings from the National Health Interview Survey, 1997-2003.

BACKGROUND: Lesbians and bisexual women are more likely than other women to evidence a unique mix of common breast cancer risk factors. It is not known if this results in greater breast cancer mortality risk. We investigate possible sexual orientation-related differences in risk for fatal breast cancer in a large representative U.S. sample of married and cohabiting women. METHODS: Between 1997 and 2003, the National Health Interview Survey (NHIS) interviewed married or cohabiting female participants, aged 18-80 years inclusively, who reported either a male (n=136,174) or female (n=693) coresidential relationship partner. These records are linked to the National Death Index to provide information on mortality status as of December 31, 2006. Employing these data, we estimated the age-adjusted relative risk (RR) and its 95% confidence interval (CI) for mortality attributed to breast cancer using a Cox proportional hazard model. RESULTS: Women in same-sex couples, compared to women in different-sex relationships, had greater age-adjusted risk for fatal breast cancer (RR=3.2, CI 1.01-10.21) but did not differ in their overall risk for mortality. CONCLUSIONS: Our findings provide tentative support that sexual orientation is differentially linked to risk of fatal breast cancer. These findings underscore the need to investigate further breast cancer morbidity and mortality risk among women with minority sexual orientation.

A construção social e política pela não-discriminação por orientação sexual / The social and political construction of the non-discrimination based on sexual orientation

Este artigo busca apontar e compreender, no contexto brasileiro, a construção de uma rede social, política e jurídica de combate à discriminação por orientação sexual. Para tanto, vale-se de uma abordagem genealógica das condições de possibilidade para a emergência da discriminação por orientação sexual como questão social, bem como para a criação de instrumentos jurídicos e sociais de enfrentamento e ações afirmativas pela liberdade de expressão sexual. Consideram-se como aspectos importantes nesse processo a atuação dos movimentos sociais contra a discriminação de gênero e sexo; a dimensão da saúde, sobretudo no que diz respeito à epidemia da Aids nos anos 80; e a resposta do Estado frente a esse contexto.

This paper seeks to understand, in the Brazilian context, the construction of a social, political and juridical network aimed to fight discrimination linked to sexual orientation. To do so, we used a genealogical approach to define the conditions of possibility to the emergence of sexual orientation discrimination as a social issue, as well as the creation of social and legal instruments and affirmative actions to ensure freedom of sexual expression. We consider as important aspects in this process the role of social movements against gender discrimination, the health dimension concerning aids epidemic in the 1980's and the government response to it.

Heterosexual anal sexuality and anal sex behaviors: a review.

Little research addresses the role of anal sexuality and anal sexual behaviors as a widely practiced but relatively less frequent element of a heterosexual sexual repertoire. However, the importance of anal sex in sexual health is increasingly well-defined by epidemiological and clinical studies. This article reviews existing data on a range of heterosexual anal sex practices and provides conceptual and methodological recommendations for new research.

O terceiro sexo revisitado: a homossexualidade no Archives of Sexual Behavior / Third sex revisited: homosexuality in the Archives of Sexual Behavior

Uma das primeiras teorias científicas sobre a homossexualidade é a ideia de "terceiro sexo", desenvolvida na segunda metade do século XIX, em que o homossexual era visto como possuidor de uma "alma feminina em um corpo masculino". Com o objetivo de analisar se e como determinadas teorias contemporâneas sobre a homossexualidade se articulam à ideia de "terceiro sexo", foi feito um levantamento de 211 artigos sobre homossexualidade, publicados no periódico Archives of Sexual Behavior entre 1971 e 2006. Os artigos foram divididos em cinco categorias: Psicológicos, Biomédicos, Sociológicos/Culturais, HIV e Outros. Analisamos dois grupos de artigos da categoria Biomédicos. O primeiro grupo analisado engloba pesquisas que procuram estabelecer uma relação entre homossexualidade na vida adulta e "comportamento atípico" em crianças (como meninas preferirem bolas a bonecas e vice-versa). No segundo grupo de artigos, os pesquisadores buscam por diferenças anatômicas entre homossexuais e heterossexuais (como a proporção do comprimento dos dedos, ou o tamanho do pênis), que seriam indicadores de "níveis anormais" de hormônios pré-natais, responsáveis pela lateralização cerebral, que por sua vez definiria a orientação sexual. Concluímos que ambos os grupos de artigos estão calcados numa visão da heterossexualidade como característica distintiva de gênero, que aproxima, de um lado, o homem homossexual às mulheres heterossexuais e, do outro, as mulheres homossexuais aos homens heterossexuais. Este tipo de raciocínio possui grande similaridade com a teoria do "terceiro sexo"; entretanto, noções mais vagas ou metafísicas - como "alma" ou "mente" - são substituídas agora por outra mais concreta e física - o cérebro.

One of the first scientific theories about homosexuality is the "Third sex" theory, developed in late 1900's. According to this theory, the homosexual male had a "female soul in a male body". With the aim of analyzing if and how contemporary theories about homosexuality are related to the idea of the "Third sex", we reviewed 211 papers about homosexuality, published in the Archives of Sexual Behavior from 1971 to 2006. The papers were classified in five categories: Psychological, Biomedical, Sociological/Cultural, HIV and Others. We analyzed two groups of papers included in the "Biomedical" category. The first group encompasses studies that try to establish a relationship between homosexuality in adulthood and "atypical gender behavior" in childhood (for instance, how girls preferred balls instead of dolls and vice-versa). In the second group, the studies searched for anatomic differences between homosexual and heterosexual individuals (such as length of the fingers and of the penis) that would indicate "abnormal levels" of pre-natal hormones, these being responsible for the cerebral lateralization that defines sexual orientation. We concluded that both groups of papers are based on a view of heterosexuality as a distinctive characteristic of gender that links homosexual males to heterosexual females and vice versa. This type of approach has great similarity with the 19th century theory of the "Third sex"; however, vague and metaphysical concepts, such as "soul" and "mind", have been replaced by more concrete and physical concepts such as "brain".

Going beyond "ABC" to include "GEM": critical reflections on progress in the HIV/AIDS epidemic.

A considerable number of studies have sought to identify what factors accounted for substantial reductions in HIV seroprevalence after several countries deployed "ABC" (abstinence, be faithful, condom use) strategies. After much public discourse and research on ABC success stories, the Joint United Nations Programme on HIV/AIDS 2004 epidemic report indicated that nearly 50% of infected people worldwide were women, up from 35% in 1985. In light of the feminization of HIV/AIDS, we critically assess the limitations of ABC strategies. We provide 3 additional prevention strategies that focus on gender relations, economics, and migration (GEM) and can speak to the new face of the epidemic. Pressing beyond ABC, GEM strategies provide the basis for a stronger central platform from which national efforts against HIV/AIDS can proceed to reduce transmission risks.

Contextual factors and the black-white disparity in heterosexual HIV transmission.

ABSTRACT African-Americans have the highest rates of human immunodeficiency virus (HIV) transmission, including heterosexual transmission, in the United States. Although numerous factors probably contribute to the extreme racial disparity, reasons for its persistence remain poorly explained. Mathematical modeling demonstrates that concurrent sexual partnerships speed transmission of HIV through sexual networks more effectively than does serial monogamy, for the same total number of sexual partners. This paper examines the evidence that the social and economic environment for many African-Americans discourages long-term monogamy and promotes concurrent sexual partnerships, which may, in turn, fuel the HIV epidemic in this population.

"Red tips for hot lips": advertising cigarettes for young women in Britain, 1920-70.

The girl or woman smoker is a twentieth-century phenomenon. In 1900, smoking was invariably associated with sexually deviant womanhood. Today, smoking is firmly, if contentiously, established as a feminine practice in British society. This article examines one aspect of the twentieth-century feminisation of smoking in Britain, namely, the ways in which smoking practices have been presented as appropriate for young women in the period 1920-70. Advertisements featured in magazines for young women aged 15-29 years have been chosen as a particularly apt medium through which to explore some of the ways in which cigarettes and smoking practices have been delineated and infused with meaning. These advertisements constituted a discourse for the circulation of messages about the relationship of women to cigarettes. Findings reveal a number of shifts in cigarette advertisements featured in Women's magazines from 1920 to 1970. Firstly, during the 1930s and early 1940s, advertisements were, in contrast to later counterparts, preoccupied with establishing smoking as a feminine practice. Key to processes by which smoking was feminised were various mechanisms whereby the cigarette was depicted as part of the presentation of a heterosexual identity and where smoking practices were embedded in heterosexual relations and rituals. Secondly, there was a discernible shift in the way women were addressed by advertisements, from potential women smokers in the 1930s to more general consumers in the 1960s. Thirdly and relatedly, the significance attached to women smoking changed between 1920 and 1970. In the 1930s, smoking was utilised to signify that women were "modern"; in the period 1960-70, smoking served to indicate that women were recognised, and accorded status, as consumers.