SUMMARYWe describe three related studies of possible aetiological risk factors for sexually transmitted diseases (STDs) in men attending an STD clinic. In this paper we present the results for a variety of social and demographic variables traditionally associated with STD. In contrast to the results in the next two papers, these were largely negative. Occurrence rates of overall STD or of hepatitis, syphilis, gonorrhoea, or non-specific urethritis (NSU) had no aetiologically relevant association with age, nationality, marital status, social class, occupation, non-sexual social contact, drug abuse, or aggressive attitudes and behaviour. Gonorrhoea, however, was the only STD which correlated with alcohol abuse and with eating out rather than at home. We conclude that, with the possible exception of gonorrhoea, social factors contribute little to the distribution of STD risk within the study population.
We report on the relation between various aspects of sexual activity and risk of infection with sexually transmitted disease (STD) in two groups of men attending an STD clinic. Sexual promiscuity appeared to have little effect on the distribution of most STDs, showing a strong association only with gonorrhoea. This finding was contrary to expectation but consistent with the results reported in the first two papers in this series. In contrast to promiscuity, however, sexual orientation subgroups showed a sharp difference in incidence of the major STDs. Hepatitis and syphilis occurred equally commonly among bisexual and homosexual men, but much less commonly among heterosexuals; NSU occurred more commonly among heterosexual men; and gonorrhoea, though common in all three groups, occurred most commonly in bisexual men and least commonly among heterosexuals. For certain STDs the form of intercourse may be as important a risk factor as sexual promiscuity but the precise mechanisms by which sexual orientation influences risk of STD remain undefined.
SUMMARY Using standardised questionnaires we examined the possible contributions of psychiatric illness, delinquent and other abnormal personality traits, and disturbed attitudes to sex to the risk of sexually transmitted disease (STD) infection in men attending an STD clinic. We found certain differences in personality and in attitudes between the clinic sample and control men. These differences, however, a) were not comparable with those found in groups of clinically abnormal subjects, b) were confined to homosexual and bisexual men, and c), with the possible exception of gonorrhoea, were not related to risk of STD infection.
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