Incidence of Homosexuals among Syphilitics.

The incidence of infective syphilis has increased during recent years in every country in Western Europe. In Denmark the number of cases of syphilis notified during the last 5 years, has risen steadily, and a 10-fold increase has been observed between 1957 and 1961 (48 cases notified in 1957 and 493 in 1961). In his report of an investigation of syphilis in New York, Goodman (1962) stated that 28 per cent. of early syphilis in males was acquired by homosexuals; furthermore, among 164 male cases of syphilis, 45 patients admitted only homosexual contacts, 104 patients only female contacts, and fifteen gave data of contacts with both males and females. The importance of homosexuals in the spread of infection is explained by the comparatively large number admitting both homosexual and heterosexual practices. With the increase in the number of notified cases of syphilis, a change has taken place in the male: female ratio of syphilitics. For Denmark this ratio was 1-1: 1 in 1957 and 4 6: 1 in 1961. For Copenhagen proper, the ratio in 1961 was a high as 7 3: 1, giving the impression that homosexuals with syphilis are more commonly found in urban districts. Laird (1962) reported that the male: female ratio in Great Britain rose from 2-9 :1 to 4 2 :1 between 1957 and 1961. Because of the clinical impression that male homosexuals constitute an increasing proportion of syphilitic patients, we thought it would be of interest to examine the sexual habits of male patients with early syphilis attending the venereological outpatient clinic. Present Investigation In the calendar year 1961, a total of 72 patients with newly-acquired syphilis attended the outpatient department of the Rudolph Bergh Hospital (i.e. about 15 per cent. of the total number of syphilitic patients notified in Denmark during that year). Of these 72 patients, 57 were males and fifteen females, giving a male: female ratio of 3 8 :1. Five of the 57 male patients had not been questioned closely enough about their sexual behaviour, but the case histories of the remaining 52 patients enabled us to ascertain that thirteen were homosexuals, five admitted both homoand heterosexual contacts, and the other 34 were heterosexual. Age.-There was no difference between the average ages of the two groups, 32 years for the thirteen homosexuals and 31 years for the 34 heterosexuals. Diagnosis.-The Table shows the stage at which the syphilitic infection was diagnosed, and relates the location of the primary sore to the sexual behaviour of the patient in the 47 cases who were