A self-administered, confidential survey of respondents' history of selected sexually transmitted disease (STD) was conducted in 1987-88 among adults enrolled in a multicenter study of cardiovascular disease. Respondents (and response rates) included 535 white men (78 percent), 694 white women (89 percent), 262 black men (48 percent), and 472 black women (64 percent), ages 21 to 40 years at the time of the survey. Among those who were heterosexually active, 43 percent of black women, 37 percent of black men, 33 percent of white women, and 21 percent of white men reported ever having had at least one STD in the survey. A history of syphilis or gonorrhea was more commonly reported by blacks than whites; a history of genital herpes, chlamydia, or genital warts was more commonly reported by women than men. Independent risk factors for having had at least one STD in the survey included female sex; use of cocaine, amphetamines, or opiates; and lifetime number of sex partners. The number of sex partners was the most predictive risk factor. Black race was a significant marker for other, unidentified STD risk factors. The data show a high prevalence of a lifetime history of STD among young heterosexual urban U.S. adults with possible implications for the future spread of human immunodeficiency virus infection.