[Sociopathologic behavior and repeated infection with venereal disease].
BACKGROUND
The sexually transmitted diseases (STDs) comprise a large group of infections produced by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasme, protozoa, fungi, parasites, and viruses. A considerable number of sexually transmitted diseases patients are STD repeaters. As reported by Marjanovitsh and Laloshevitsh [2], in Belgrade, among patients who during the years 1985 and 1986 visited the City Department for Skin and Veneral Diseases, because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). In Richert et al. [6] study over 30% of all patients who in one year visited sexually transmitted diseases clinic in Dade County, Florida, returned with a new infection within 3 years of their index visit. The aim of this study was to test the hypothesis that there is a relationship between antisocial behaviour and repeated STD.


METHODS
Case-control study was performed in the population of Belgrade, from June 1997 to April 1998. Participants were recruited among patients attending the City Department for Skin and Venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The group comprised 101 patients who in their personal histories already had STD two or more times. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who in their personal histories have never had STD or had it only once (13% of controls). All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behaviour, as well as data on use of sedatives, smoking habit and sport activity, and data on antisocial behaviour (alcohol abuse, prostitution, drug abuse, prosecution for minor and criminal offences) were collected from all participants by an anonymous questionnaire. In the present paper only data on antisocial behaviour are presented. In the analysis of data chi 2 was used.


RESULTS
According to the results obtained, STD repeaters in comparison to their controls used more frequently alcohol (17.8%:0.9%) and drug 18.8%:3.8%), had more frequently sex for money (17.8%:2.8%), and were more frequently prosecuted for minor offences (58.4%:24.8%) and criminal offences (24.8%:4.3%). All these differences were statistically significant (p < 0.01).


CONCLUSIONS
In the present study STD repeaters consumed alcohol more frequently than their controls, especially hard liquors, and 55.5% of them had used alcohol at the time of STD infection. In the study of Myliueva et al. [4], 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle [5] found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has depressive effect on the central nervous system, reduces anxiety and increases libido. In this study STD repeaters in comparison with their controls were significantly more frequently drug users (the majority of them inhaled drugs). In several studies conducted in the USA [7, 8] the increase of gonorrhea and syphilis was related to drug use. Upchurch et al. [9] reported that individuals with repeated episodes of gonorrhea were frequently intravenous drug abusers. Drugs are most frequently used by young people, at ages of the highest sexual activity. While most of the subjects developed sexual disinterest and dysfunction with prolonged crack cocaine use, some of them become more sexually promiscuous and consequently contracted sexually transmitted diseases more often. Inciardi /10/ found that 1/3 of men who had exchanged sex for crack (or for money needed to by crack) had 100 or more sex partners during a 30-day period prior to study recruitment. Cleghorn et al. (ABSTRACT TRUNCAT
Bjekić
M
M
Institute of Epidemiology, School of Medicine, Belgrade.
Vlajinac
H
H
Marinković
J
J
D000328:Adult; D003415:Crime; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000635:transmission*; D019966:Substance-Related Disorders; D015022:Yugoslavia