Basically it only affects the lead of the worm, which affects the reduction ratio and thus the mechanical advantage and speed. A two-start worm, for example, would have twice the lead of a one-start worm of the same pitch. So when mated with a gear of similar diameter it would have half the mechanical advantage and the wormgear would turn twice as fast. Similarly, for a four-start worm, the reduction is changed by a factor of four.
The additional starts do NOT, however, increase the strength of the assembly, as some mechanics believe. There is NOT more than one thread meshed with the gear at a time to share the load. There is still a single tooth transmitting torque, just like a single-start arrangement and the gear tooth strength still depends basically on its pitch. Only the helix angle of the teeth is different.
Don
Kansas City