Sexually Transmitted Diseases in Homosexual Men: Diagnosis, Treatment, and Research.

Abstract

I. General Considerations.- 1. Factors Affecting the Incidence and Management of Sexually Transmitted Diseases in Homosexual Men.- The Scope of the Problem.- Sex Education.- STD Education.- Physicians' Attitudes.- Funding for STD Control.- Future Responsibilities.- References.- 2. Sexual Practices History.- 3. Setting Up the Physician's Office for the Diagnosis and Treatment of Sexually Transmitted Diseases.- Light Sources.- Supplies.- Gram-Staining Facility.- Gonorrhea Diagnosis.- Syphilis Diagnosis.- Diagnosis of Chlamydial and Viral STDs.- Chlamydial Infections (Nongonococcal Urethritis and Lymphogranuloma Venereum).- Genital Herpes.- Molluscum Contagiosum.- Cytomegalovirus Infection.- Condylomata Acuminata (Venereal Warts).- Treatment of Condylomata Acuminata.- Medications.- Emergency Medications and Supplies.- Precautions in the Handling of Patients and Specimens.- Reference.- II. Bacterial Sexually Transmitted Diseases.- 4. Syphilis.- History.- Epidemiology.- Clinical Aspects.- Primary Syphilis.- Secondary Syphilis.- Late and Latent Syphilis.- Treatment.- Follow-Up.- Control.- Priorities for the Future.- Patient Education and Counseling.- Recent Research.- References.- 5. Gonococcal Infections.- David G. Ostrow.- Etiology.- Clinical Aspects of Uncomplicated Infections.- Gonococcal Urethritis.- Gonococcal Proctitis.- Gonococcal Pharyngitis.- Clinical Aspects of Complicated Infection.- Disseminated Gonococcal Infection.- Other Complications.- Diagnosis.- Symptomatic Urethral Gonorrhea.- Gonococcal Proctitis.- Pharyngeal Gonorrhea.- Treatment.- Special Problems in the Initial Treatment of Gonorrhea.- Treatment Failures.- Postgonococcal Urethritis.- Epidemiology of Gonococcal Infection in Homosexual Men.- Prophylaxis.- Control.- Research.- References.- 6. Nongonococcal Urethritis.- Etiology.- Diagnosis.- Treatment.- Control.- References.- III. Enterically Transmitted Diseases.- 7. Amebiasis.- Epidemiology.- Clinical Aspects.- Diagnosis.- Treatment.- Control.- Counseling.- Prevention.- Prospects for Control.- References.- 8. Giardiasis.- Epidemiology.- Clinical Aspects.- Diagnosis.- Treatment.- Control.- References.- 9. Shigellosis.- Etiology.- Epidemiology.- Clinical Aspects.- Diagnosis.- Treatment.- Control.- 10. Viral Hepatitis.- Etiology.- Clinical Aspects.- Acute Hepatitis.- Hepatitis A.- Hepatitis B.- Hepatitis Non-A/Non-B.- Complications of Acute Viral Hepatitis.- Prophylaxis.- Hepatitis A.- Hepatitis Non-A/Non-B.- Hepatitis B.- Control.- Hepatitis B Vaccine.- Long-Term Safety of the Hepatitis B Vaccine.- Counseling Homosexual Males with Hepatitis and Their Sexual Contacts.- References.- IV. Anal Disorders.- 11. Hemorrhoids, Anal Fissure, and Condylomata Acuminata.- Hemorrhoids.- Etiology.- Epidemiology.- Clinical Aspects.- Diagnosis.- Treatment.- Anal Fissure.- Clinical Aspects.- Diagnosis.- Treatment.- Condylomata Acuminata (Venereal Warts).- Etiology.- Epidemiology.- Clinical Aspects.- Diagnosis.- Treatment.- References.- 12. Trauma to the Rectum: Colorectal Foreign Bodies and Manual-Anal Intercourse.- Colorectal Foreign Bodies.- Clinical Aspects.- Diagnosis.- Treatment.- Manual-Anal Intercourse.- Clinical Aspects.- Treatment.- References.- V. Dermatologic Disorders.- 13. Scabies.- Etiology.- Clinical Aspects.- Classic Scabies.- Special Forms of Scabies.- Secondary Infections and Their Complications.- Epidemiology.- Diagnosis.- Skin Scrapings.- Biopsy.- Treatment.- Specific Agents.- Accompanying Medications.- References.- 14. Pediculosis Pubis.- Clinical Aspects.- Diagnosis.- Treatment.- Resistance.- References.- 15. Venereologic Dermatology in Homosexual Men.- Herpes Simplex (Genital and Oral).- General Considerations.- Etiology.- Epidemiology.- Clinical Diagnosis.- Laboratory Diagnosis.- Differential Diagnosis.- Canker Sore versus Herpes.- Behcet's Syndrome.- Concurrent Syphilis.- Treatment.- Prevention.- Molluscum Contagiosum.- General Considerations.- Etiology.- Clinical Manifestations.- Complications.- Diagnosis.- Differential Diagnosis.- Treatment.- Bacterial and Fungal Anogenital Infections.- Pyogenic Lesions.- Bullous Impetigo.- Bacterial Folliculitis.- Whirlpool Folliculitis.- Ringworm Infections and Candidiasis.- Tinea Cruris.- Vesicular Ringworm.- Chronic Ringworm.- Candidiasis (Moniliasis, Oidomycosis).- Differential Diagnosis.- Treatment.- Allergic Dermatitis.- Topical Medications.- Irritant Dermatitis Resulting from Topical Application.- Irritant versus Allergic Reactions.- Consort Contact Dermatitis.- Contact Dermatitis from Condoms.- Traumatic Dermatologie Problems.- Lesions Caused by Physical Injury.- Traumatic Penile Ulcers.- Sclerosing Lymphangitis of the Penis.- Lymphocele.- Edema of the Penis.- Sexual Trauma in Precipitating Psoriasis of the Anogenital Area.- References.- VI. Acquired Immune Disorders.- 16. Kaposi's Sarcoma and Other Rare Malignancies in Homosexual Men.- Epidemiology.- Kaposi's Sarcoma and Acquired Immunodeficiency Syndrome.- Etiology.- Lymphadenopathy Syndrome.- Non-Hodgkin's Lymphoma.- HLA Phenotype (DR-5) and Kaposi's Sarcoma.- Viral Influences.- Prognosis.- Diagnosis.- Therapy.- Interferon.- Thymosin Fraction 5.- Chemotherapy.- Treatment of Lymphadenopathy Syndrome.- Hospitalization.- Counseling the Patient with Kaposi's Sarcoma.- Counseling the Asymptomatic Patient.- References.- 17. Diagnosis and Treatment of Acquired Immune Deficiency States and Opportunistic Infections.- Acquired Immunodeficiency Syndrome.- Clinical and Immunologic Evaluation.- Diagnosis of Opportunistic Infections.- Candidal Infections.- Cryptococcal Meningitis.- Cryptococcosis: Pneumonia and Disseminated Disease.- Therapy of Fungal Infections.- Mycobacterial Infections.- Viral Infections.- Protozoal Infections: Pneumocystis carinii.- Toxoplasmosis.- Cryptosporidium.- Modulation of Immune Status.- Counseling the Patient with AIDS.- References.- VII. A Special Consideration.- 18. Medical Consequences of the Inhalation of Volatile Nitrites.- Appendix. Sexually Transmitted Diseases: Treatment Guidelines, 1982.