Sexually transmitted diseases in homosexual adolescents

In 1986, an estimated 13 million cases of sexually transmitted diseases (STDs) were diagnozed in the United States, with the highest incidence rates within the adolescent age group. Homosexual adolescent men are at particularly high risk for STDs. Because of the myriad clinical of STD in gay men, these diseases are often not recognised as sexually transmitted. In this paper, the epidemiology and clinical features of STDs in gay adolescents are discussed. The sexual history is emphasized as an integral tool in developing a differential diagnosis. A priori, the sexual history also can give a risk-assessment profile for STD. Clinical aspects of STD are reviewed using a syndrome approach, and the diagnostic workup is outlined for the etiologic agents most likely implicated in each syndrome. Clinical signs and symptoms of urethritis, genital ulcers and papular lesions, pharyngitis, and hepatitis are reviewed. Sexually acquired gastrointestinal disorders are described. As the AIDS epidemic continues, disease prevention, risk reduction, and patient education are becoming more important. Current recommendations for "safer sex" practices are reviewed.