That’s correct. The subscription is done on a per account basis. For example, I have one application with the Account Activity API that currently has three subscriptions registered, corresponding to three different Twitter accounts. The application receives all of the relevant events for all three accounts (each event message has an identifying for_user_id: field that shows the account that the event relates to).
Sending Tweets is not related to the Account Activity API, and requires the regular statuses/update endpoint and a pair of account access tokens and secrets for each account.