RISK-FACTORS FOR URETHRITIS IN HETEROSEXUAL MEN - THE ROLE OF FELLATIO AND OTHER SEXUAL PRACTICES

Background: Nonchlamydial nongonococcal urethritis (NGU) is a common s exually transmitted disease (STD) in heterosexual men, Prior studies h ave suggested that NGU may be acquired by insertive oral sex, Goal: To assess the association of oral sex and other sexual practices with no nchlamydial NGU in heterosexual men in order to better understand this syndrome and to guide its prevention and treatment, Risk factors for urethral gonorrhea and chlamydial infection were explored to contrast, vith NGU, Study Design: A retrospective case-control study was conduct ed among heterosexual men attending an STD clinic during 1993 and 1994 . The study included 4,848 men who were sexually active within the pri or 2 months and had urethral specimens obtained for Gram's stain, cult ure for Neisseria gonorrhoeae, and culture for Chlamydia trachomatis. Results: Insertive oral sex was not shown. to be an independent risk f actor for NGU. Independent predictors of nonchlamydial NGU by multivar iate analysis included African-American race (odds ratio [OR] 3.71, 95 % confidence interval [95% CI] 3.06 to 4.50) and having greater than o r equal to two sex partners in the prior 2 months (OR 1.45, 95% CI 1.2 0 to 1.75), History of using condoms ''always'' was negatively associa ted with NGU (OR 0.59, 95% CI 0.43 to 0.79), gonorrhea (OR 0.31, 95% C I 0.17 to 0.56), and chlamydial infection (OR 0.67, 95% CI 0.44 to 1.0 3), Conclusions: This study supports the sexually transmitted nature o f nonchlamydial NGU but did not confirm an association with oral sex, However, the analysis was compromised by the rarity of insertive oral sex as patients' only sexual exposure, Consistent condom use protects against all causes of sexually acquired urethritis.