Gonorrhea in the HIV era: a reversal in trends among men who have sex with men

Abstract

A B S T R A C TObjectives. Gonorrhea cases among men who have sex with men (MSM) declined in the early years of the HIV epidemic. We evaluated more recent trends in gonorrhea among MSM through the Centers for Disease Control and Prevention's Gonococcal Isolate Surveillance Project.Methods. Isolates and case information were collected from 29 US sexually transmitted disease (STD) clinics. Gonococcal urethritis cases among MSM were compared with those among heterosexual men, and cases among MSM in 1995 to 1999 were compared with earlier MSM cases.Results. Of 34 942 cases, the proportion represented by MSM increased from 4.5% in 1992 to 13.2% in 1999 (P< .001). Compared with heterosexuals, MSM were older, more often White, and more often had had gonorrhea previously, although fewer had had gonorrhea in the past year. MSM with gonorrhea in 1995 to 1999 were slightly older than those with gonorrhea in 1992 to 1994, and a higher proportion had had gonorrhea in the past year.Conclusions. MSM account for an increasing proportion of gonococcal urethritis cases in STD clinics. Given recent evidence that gonorrhea may facilitate HIV transmission, these trends demand increased attention to safe sexual behaviors and reducing STDs among

Behavioral Risk Disparities in a Random Sample of Self-Identifying Gay and Non-Gay Male University Students

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“…Since its inception GISP has provided valuable information that has been used to update the CDC’s Sexually Transmitted Diseases (STD) Treatment Guidelines as well as provided data used by CDC to modify the treatment recommendations for gonorrhea in real time. For example, data from GISP was pivotal in alerting public health officials about the increasing prevalence of gonorrhea among MSM in the late 1990’s (125), the recommendation to avoid the use of fluoroquinolones among MSM with gonorrhea in 2004 (75) and, in 2007, the recommendation that fluoroquinolones should not be used for any patient that presents with gonorrhea, leaving ESCs as the only remaining class of antimicrobials recommended for treatment of gonorrhea (126). Furthermore, in 2010, due to concerns regarding emergence of ESC resistance CDC introduced recommendations for dual antimicrobial therapy.…”

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