As much as 60 percent of homosexual men, especially those who have many sex partners, may contract one sexually transmitted disease or another, according to a federally conducted survey reported in the current American Journal of Public Health.
The percentage may be even higher and many get sexually transmitted diseases more than once, the survey says.
The situation is a challenge to medicine, according to an editorial in the official journal of the American Public Health Association, the society of federal, state and local health officials.
The journal summarizes the results of a questionnaire filled out by 4,212 homosexual men from every state and Canadian province, a sample called "the largest and most diverse" yet of a homosexual population.
Sixty percent of the 3,696 respondents who answered all the questions had had at least one sexually transmitted disease.
Among all 4,212, 38 percent had had gonorrhea; 24 percent urethritis (inflammation); 18 percent venereal growths; 13 percent syphilis; 10 percent, hepatitis (liver disease, transmitted by a virus) and 9.4 percent, some form of herpes, another virus disease. Also reported were intestinal diseases like amebiasis, shigellosis and enteritis, and meningitis, a serious brain or spinal cord infection.
Sixty-six percent had had an episode of pediculosis -- infestation of head or crab lice. If these are included, then 78 percent of all respondents had experienced at least one sexually transmitted disorder.
The survey was made by the federal Centers for Disease Control by sending questionnaires to 1,800 groups listed by the National Gay Task Force and by printing an abridged version in a gay magazine.
Because those who answered in effect selected themselves, the survey cannot be considered representative of all homosexuals, said CDC's Dr. William Darrow and his co-authors. But the study is still the largest so far published on the question.
And it is unlikely, said Dr. H. Hunter Handsfield, author of the public health journal's editorial, that only once-sick homosexuals responded, since only four of 692 questions in the entire questionnaire were medical questions.
It is at the least fair to say that homosexual men who have had multiple sex exposures "are at high risk" of major disease, added CDC's Dr. James Curran.
Those at greatest risk, the survey indicates, are those who have had large numbers of partners and those who have had "anonymous or furtive" encounters in "gay baths, parks and bushes, public restrooms, bars, peep shows or pornographic moviehouses." Several surveys have shown that some homosexuals, between 8 and 12 percent, have more than 500 sex partners during their lives. In the CDC survey, the average number reported was 49.
Another important cause of disease was fecal-oral contamination, either through a direct sex act or inadvertent.
Darrow and coauthors urged public health authorities to improve services for homosexuals and encourage them to establish their own clinics.
"Two major goals for the 1980s," he said, should be education of doctors in general to recognize and "nonjudgmentally" manage these diseases, and development of strong links between public clinics and major medical centers that can provide the laboratory and other help to deal with these problems.
Curran heads a CDC task force investigating two rare, non-sexual diseases that have been killing homosexuals, a skin cancer and a form of pneumonia.