GENITAL COLONIZATION AND INFECTION WITH CANDIDA IN HETEROSEXUAL AND HOMOSEXUAL MALES

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.