Homosexually-acquired venereal disease.

In a paper read in London to the Medical Society for the Study of Venereal Diseases in 1955 it was shown that of 1,000 consecutive patients with early syphilis and gonorrhoea, which were among those seen at the venereal diseases clinic of St. Mary's Hospital, London, in 1954, 84 (8-4 per cent.) admitted that they had been infected by homosexual contact (Jefferiss, 1956). A similar investigation at the same clinic 11 years later has shown that in the first 3 months of 1965, of a total of 1,997 new male cases of all diagnoses, 281 (14 per cent.) admitted homosexual contact: 31 (62 per cent.) of fifty cases of early syphilis and 89 (14 7 per cent.) of 604 cases of gonorrhoea. There are two reasons why the true figures may be even higher. First, homosexual patients with urethral gonorrhoea will often not admit to the male source of the disease, and secondly only those cases ofproctitis inwhich the gonococcus was actually found were classed as "gonorrhoea" although there were many others with proctitis which we had good reason to suspect on historical or clinical grounds as being gonococcal but in which we were unable to prove the disease bacteriologically. At first sight it would seem that there has been an increase in the number of male cases of homosexually-acquired venereal disease, but this apparent increase may be due to the fact that patients are now less unwilling to admit to the source of their disease, that physicians are more on the look out for it than before, and that a clientele of homosexuals has built up at this clinic as one patient tends to recommend another. My own impression is that, though the total number of cases has increased pari passu with the heterosexual increase, the actual proportion has changed little. Syphilis nowadays appears to be more common among homosexuals than heterosexuals. In 1961 at St. Mary's, 81 (72 per cent.) of 113 male cases of