Lm. David et al., GENITAL COLONIZATION AND INFECTION WITH CANDIDA IN HETEROSEXUAL AND HOMOSEXUAL MALES, Genitourinary medicine, 73(5), 1997, pp. 394-396
Objectives: To determine the penile, perianal, and oropharyngeal candi
dal colonisation rates among homosexual and heterosexual males attendi
ng an STD clinic. To determine the prevalence of balanitis and candida
l balanitis in the two groups. Subjects: 252 heterosexual and 210 homo
sexual male patients attending consecutively the STD clinic in Coventr
y, England. Design: A prospective study recording sexual behaviour, re
levant history, symptoms, and examination. Specimens for candida cultu
re were collected from the glans penis, perianal area, and oropharynx.
Results: Among the 462 men studied, penile, perianal, and oropharynge
al colonisation rates were 74 (16%), 70 (15%), and 116 (25%) respectiv
ely. On examination, 47 (10%) were found to have balanitis. Of the 74
patients with penile colonisation, 26 (37%) were symptomatic and 20 (2
7%) had balanitis. The 223 heterosexual and the 196 homosexual males w
ho had sexual intercourse within 3 months had comparable colonisation
rates of candida on the penis, perianal area, and oropharynx. Balaniti
s was seen in 31 heterosexuals (14%) and candidal balanitis in 16 (7%)
; the incidence was significantly less in homosexuals where balanitis
was seen in 12 (6%) and candidal balanitis in four (2%). Conclusions:
Itching or burning sensations after sex were the most common symptoms
associated with penile colonisation with candida and were present in m
ore than one third. Candidal balanitis was commoner in those who had v
aginal than those who had anal intercourse within 3 months.