Some moral problems posed by sexually transmitted disease.

The prevalence of each sexually transmitted disease in the community is due to interaction between the seed (or agent), the soil (or host), and the social and moral climate. Both syphilis and gonorrhoea are perhaps milder diseases than formerly. This may be due to changes in the host, and also to the fact that an infection that produces severe symptoms is more likely to be diagnosed, treated, and cured than one that does not, so that the latter is selectively bred in the community. Gonorrhoea is more often clinically silent in women and in passive homosexual men than in heterosexual men; thus only 22 of 100 infected women who attended a clinic came because of symptoms (Dunlop, 1963). Hence the reservoir of that disease is found largely in women, so that, if the social climate encourages promiscuity by women or by homosexual men, the incidence of the infection in that group must increase. If sexual intercourse were to be carried on with one partner only, syphilis and gonorrhoea would disappear. Promiscuity may be heterosexual or homosexual; thus no less than 72 per cent. of the cases of infectious syphilis diagnosed in 1962 in men at St. Mary's Hospital occurred in homosexuals (Jefferiss, 1963). It is clear that successful marriage protects both partners from many of the difficulties of life including sexually-transmitted disease; it is also likely that those persons more able to stand the stresses of life make the more stable marital partners. The concept of a sexual morality based upon the value of fidelity to the individual, to the family, and to the community supports the exclusive relationship of marriage; but such a 'community morality' appears much more tenuous and fragile than sexual morality based on religious belief-which is now declining. If promiscuity is accepted morally and practised by the community, then many other new factors in the social climate increase the infection rate; these include the increasing mobility of the population, the