Comparative prevalence rates of sexually transmitted diseases in heterosexual and homosexual men

Abstract

This study compared prevalence rates of most common sexually transmitted diseases (STD) in heterosexual and homosexual men who made respectively 12,201 and 5324 visits to an STD clinic over 18 months. Overall, homosexual men were significantly (p < 0.001) more likely than heterosexual men to have gonorrhea (30.31% vs. 19.83%), early syphilis (1.08% vs. 0.34%) and anal warts (2.90% vs. 0.26%) but less likely to have nongonococcal urethritis (NGU) (14.63% vs. 36.40%, p < 0.001), herpes genitalis (0.93% vs. 3.65%, p < 0.001), pediculosis pubis (4.30% vs. 5.35%, p < 0.005), scabies (0.42% vs. 0.76%, p < 0.02), and genital warts (1.68% vs. 6.69%, p < 0.001). In most cases the differences in rates remained significant (p < 0.05) when corrected for age and race. It is speculated that higher rates of gonorrhea and syphilis result from a larger mean number of sexual contacts, more potential sites of infection, and more hidden and asymptomatic disease, while the lower rates of the other STD result from a lesser susceptibility of anal mucosa to the causative agent(s) of NGU, herpes genitalis, and venereal warts or from a lack of pubic apposition (pediculosis pubis).