Sexually Transmitted Diseases  >  Tracking the Hidden Epidemics 2000 (1999 data)

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Gonorrhea

Gonorrhea is a sexually transmitted bacterial disease. Reported gonorrhea rates declined steadily until the late 1990s. From 1985 to 1996, rates of the disease decreased nearly 10 percent annually (Fox, CDC, 1998). However, rates stabilized between 1996 and 1997, and between 1997 and 1999, gonorrhea rates increased by nine percent (DSTDP, CDC, 2000). This increase, combined with signs of an increase in gonorrhea among gay and bisexual men, is reason for concern.

Rates of infection remain high among adolescents, young adults, and African Americans. Gonorrhea remains a major cause of pelvic inflammatory disease (PID) and subsequent infertility and tubal pregnancies in women. Additionally, studies have shown that gonorrhea can facilitate HIV transmission and may be contributing significantly to the spread of HIV in the south. There is a critical need to reach populations that remain at high risk for gonorrhea with intensified prevention and treatment efforts. Gonorrhea can be easily cured, if detected early, and the long-term consequences can be prevented.

• An estimated 650,000 cases of gonorrhea occur each year in the United States (Cates, 1999).
• Cases reported to CDC are believed to represent about half of all annual infections. While an underestimate of actual cases, these reports provide a good indication of trends in the disease.
• The reported gonorrhea rate in the United States remains the highest of any industrialized country and is roughly 50 times that of Sweden and eight times that of Canada.
• Researchers have seen alarming indications that gonorrhea may be on the rise among gay and bisexual men-men who have sex with men (MSM). In the mid-1980s, reports of increased condom use and reduced risky sexual practices accompanied dramatic decreases in rectal gonorrhea among MSM in several cities (Fox, CDC, 1998). Yet, data from cities throughout the country suggest that this trend may be reversing, and that gonorrhea cases may be resurging with the prospect of facilitating the spread of HIV in the gay community.
  • One 26-city study, the Gonococcal Isolate Surveillance Project, reported that from 1994 to 1999, the proportion of gonorrhea cases among msm more than doubled from six per-cent to13 percent (DSTDP, CDC, 2000).
  • In King County, Washington-which includes the city of Seattle-researchers reported marked increases in both gonorrhea and syphilis cases among MSM. Most notably, while the county had no cases of early syphilis in 1996, 88 cases were reported between 1998 and the first half of 1999, 85 percent of which were in gay and bisexual men. These men reported having multiple partners and frequently engaging in unprotected anal intercourse.
  • In San Francisco, the incidence of rectal gonorrhea in males increased from 21 cases per 100,000 population in 1994 to 38 cases per 100,000 population in 1997.

This rise in gonorrhea rates should serve as a wake-up call to all people at risk-including gay and bisexual men-that high-risk sexual behaviors continue to have very real consequences.

A Closer Look at Gonorrhea

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