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An ultrastructural examination of the squamocolumnar junction of the cervix of patients infected with Neisseria gonorrhoeae is described. Gonococci were found to become firmly attached to stratified squamous epithelium, a process that appeared to be initiated by activity of the cytoplasmic membrane of superficial squames. By contrast, gonococci were not found attached to, or even closely associated with, mucus-secreting columnar epithelium. Gonococcal growth, as evidenced by numbers of organisms and surface vesicle formation, appeared most active in cervical secretions, chiefly on exfoliated squames, but also lying free. Survival after phagocytosis by polymorphonuclear leukocytes was found not to be unique to gonococci, and it is suggested that continual phagocytic recycling minimizes the significance of this occurrence. It seems probable that persistence of gonorrhea in the female depends upon the adherence of gonococci to stratified epithelium, where they are protected from phagocytosis, and the infectivity of gonorrhea arises from the ability of gonococci to divide rapidly on the surface of exfoliated squames, from where they are released into secretions.

Objectives: To detect and quantify current risk factors for HIV seroconversion among gay men seeking repeat tests at sexual health clinics. Design: Unmatched case control study conducted in London, Brighton and Manchester, UK. Methods: 75 cases (recent HIV positive test following a negative test within the past 2 years) and 157 controls (recent HIV negative test following a previous negative test within the past 2 years) completed a computerassisted self interview focused on sexual behaviour and lifestyle between HIV tests. Results: Cases and controls were similar in sociodemographics, years since commencing sex with men,

The effect of non-heterosexual factors on the vaginal flora has been studied. Ninety-one lesbians attending a specialist genitourinary medicine service for lesbians were studied. Bacterial vaginosis (BV) was diagnosed in 51.6% of them. While most of the women had previously had a male sexual partner, the presence of BV was not associated with a male sexual partner in the previous 12 months. A detailed analysis of lesbian sexual practices in the group did not relate BV to any sexual practice which would have the propensity to pass vaginal secretions from one to the other.

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