Nongonococcal Urethritis

Abstract

The etiology of urethritis in homosexual men differs from its etiology in heterosexual men in at least two major ways. First, it is quite clear that the relative frequencies of gonorrhea and nongonococcal urethritis are different for the two groups. Homosexual men have predominantly gonococcal urethritis (GU), and, in many areas of the United States, heterosexual men have predominantly nongonococcal urethritis (NGU). The relative frequency of GU/NGU is also related to race, but this may be for different reasons. In sexually transmitted disease (STD) clinics, heterosexual black men with urethritis more often have GU than NGU, while the reverse is true for heterosexual white men. This has suggested to some that blacks may be more susceptible to gonorrhea and whites more susceptible to NGU. However, in a United States Navy cohort study¹ done recently on an aircraft carrier, it was found that black men had a higher risk of GU than white men, but they also had a higher risk of NGU. GU is more symptomatic than NGU; it is therefore possible that racial or cultural differences in the response to symptoms account for some of the differences in apparent frequency of GU and NGU in various population groups in the STD clinic setting.