To the Editor.
—A high prevalence of sexually transmitted diseases (STDs) in a disadvantaged community is often ascribed to a high rate of sexual partner change. This assumption can perpetuate adverse cultural stereotypes and produce a sense of hopelessness because of the difficulties in effecting a sustained change in sexual behavior in remote communities that have complex social structures. We present data from an isolated Australian community that suggest an alternative explanation for the high prevalence of STDs.The prevalence of a specific STD at endemic equilibriumin a community is dependent on 3 factors: the time for which an individual is infectious, the probability of transmission during sexual intercourse, and the rate of sexual partner change.1 The probability of transmission may be similar for different racial groups, but the rate of sexual partner change and the duration of infectiousness may vary between communities. In particular, the duration of infectiousness
Fairley CK, Bowden FJ, Gay NJ, Paterson BA, Garland SM, Tabrizi SN. Sexually Transmitted Diseases in Disadvantaged Australian Communities. JAMA. 1997;278(2):117-118. doi:10.1001/jama.1997.03550020049032