Social and psychological factors in the distribution of STD in male clinic attenders. III Sexual activity.

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Abstract
The relation between various aspects of sexual activity and risk of infection with sexually transmitted disease (STD) was studied in 2 groups of men attending an STD clinic. Sexual promiscuity appeared to have little effect on the distribution of most STD, showing a strong association only with gonorrhea. This finding was contrary to expectation. In contrast to promiscuity, sexual orientation subgroups showed a sharp difference in incidence of the major STD. Hepatitis and syphilis occurred equally commonly among bisexual and homosexual men, but much less commonly among heterosexuals; nonspecific urethritis occurred more commonly among heterosexual men; gonorrhea, though common in all 3 groups, occurred most commonly in bisexual men and least commonly among heterosexuals. For certain STD the form of intercourse may be as important a risk factor as sexual promiscuity; the precise mechanisms by which sexual orientation influences risk of STD remain undefined.