Trends in Sexually Transmitted Diseases in Homosexually Active Men in King County, Washington, 1980–1990

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Abstract
Trends in sexually transmitted diseases (STDs) in homosexually active men were analyzed in King County, Washington (USA), from 1980 to 1990. New-problem visits to the public STD clinic declined from 4142 in 1980 to 509 in 1988 (.sbd.88%), then rose to 937 (+84%) in 1989, and 527 in the first half of 1990. Cases of gonorrhea in homosexually active men treated at the STD clinic plus private sector cases of rectal gonorrhea in men fell from 955 in 1982 to 33 in 1988 (97%), then rose to 102 in 1989 (+209%). Similar trends were observed for several other STDs. Of 109 Neisseria gonorrhoeae isolates from homosexual or bisexual men in 1988 to 1989, 46 (42%) belonged to 3 auxotype/serovar classes; one of these was a penicillinase-producing strain (PPNG), the first appearance of PPNG in substantial numbers in homosexually active men in King County. The remaining 58% of isolates were distributed among 20 strains. These data imply substantial reductions in the frequency of high-risk sexual behavior in homosexually active men in King County over most of the 1980s, followed by an increased frequency of unsafe behavior after 1988. Maintenance of sexual safety may require increased educational effort and societal support as time passes.