How Good Is Your Rule of Thumb? Validating Male-to-Female Case Ratio as a Proxy for Men Who Have Sex With Men Involvement in N. gonorrhoeae Incidence at the County Level

Stenger, Mark; Bauer, Heidi M.; Klingler, Ellen; Bell, Teal R.; Donnelly, Jennifer A.; Eaglin, Margaret; Jespersen, Megan; Madera, Robbie; Mattson, Melanie; Torrone, Elizabeth

doi:10.1097/olq.0000000000000720

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…16 As a result, the male-to-female case rate ratio can be used as a proxy for gonorrhea rates among MSM when gender of sex partner is unknown. 11 However, gonococcal infection can be asymptomatic in men, so observed case rates are heavily influenced by screening practices. Observed increases among men may be a reflection of increased screening or could represent other epidemics among higher-risk populations, such as commercial sex workers or those in correctional facilities.…”

Section: Discussionmentioning

confidence: 99%

Narrative Review: Assessment of Neisseria gonorrhoeae Infections Among Men Who Have Sex With Men in National and Sentinel Surveillance Systems in the United States

Weston¹,

Kirkcaldy²,

Stenger³

et al. 2018

Sexual Trans Dis

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To assess trends in Neisseria gonorrhoeae among gay, bisexual, and other men who have sex with men (MSM), we reviewed existing and published gonorrhea surveillance data in the United States. Data identified in this review include the following: national gonorrhea case report data and data from 3 other surveillance programs, the Gonococcal Isolate Surveillance Project (GISP), the STD Surveillance Network (SSuN), and National HIV Behavioral Surveillance.Rates of reported cases of gonorrhea among men increased 54.8% in 2006 to 2015 compared with a 2.6% increase among women. Since 2012, the rate of reported gonorrhea cases among men surpassed the rate among women; the male-to-female case rate ratio increased from 0.97 in 2012 to 1.31 in 2015. The proportion of gonococcal urethral isolates collected in the Gonococcal Isolate Surveillance Project that were collected from MSM increased from 21.5% to 38.1% in 2006 to 2015. In 2009 to 2015, the percent of MSM who tested positive for rectal and oropharyngeal gonorrhea in sexually transmitted disease (STD) clinics increased by 73.4% and 12.6%, respectively. Estimated rates of gonorrhea among MSM increased by 151% in 2010 to 2015 in jurisdictions participating in the STD Surveillance Network. Data from the National HIV Behavioral Surveillance demonstrate that testing for gonorrhea among MSM increased by 23.1% between 2011 and 2014.Together, surveillance data suggest a disproportionate burden of gonorrhea among MSM in the United States and suggest increases in both screening and disease in recent years. Because each data source has inherent limitations and biases, examining these data from different systems together strengthens this conclusion.

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Section: Discussionmentioning

confidence: 99%

Narrative Review: Assessment of Neisseria gonorrhoeae Infections Among Men Who Have Sex With Men in National and Sentinel Surveillance Systems in the United States

Weston¹,

Kirkcaldy²,

Stenger³

et al. 2018

Sexual Trans Dis

Self Cite

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“…We attempt to enhance the current view of NG morbidity by more fully visualizing the geographic heterogeneity of county-level absolute and relative disparities in NHB and NHW female gonorrhea cases in the United States. We focus on gonorrhea among women because the reproductive sequalae are more severe in cisgender women as compared with men, and rates in men may be more sensitive to the local epidemiology of gonorrhea in men who have sex with men, 16 as well as the geographic heterogeneity of the men who have sex with men population 17 . These maps depict the number and geographic distribution of NHB and NHW women experiencing differential rates of reported gonorrhea cases in the United States and highlight locations where intensive control and prevention measures may have the largest impact on reducing racial disparities.…”

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confidence: 99%

It Is Not Just the Southeast—Geographically Pervasive Racial Disparities in Neisseria gonorrhoeae Between Non-Hispanic Black and White US Women

et al. 2022

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Genomic epidemiology and population structure of Neisseria gonorrhoeae in Norway, 2016–2017

et al. 2020

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This study presents the nationwide epidemiology of Neisseria gonorrhoeae , using whole-genome sequencing of all culture-positive cases, which comprise roughly 40 % of all cases of gonorrhea reported in Norway from 2016 to 2017. Isolates were assigned to sequence types and Bayesian analysis clusters and variation in genes coding for antibiotic resistance was linked to phenotypic resistance data. The study also included isolates taken from the same patients from different anatomical sites at one or more time points. Comparing these isolates allows for observation of patterns of infections, i.e. multiple reinfections of genetically related clones vs. reinfections of genetically distant clones, and quantification of the genomic variation of closely related isolates from samples taken from a patient within the same day. Demographically, the patients in the study could be split into two groups; one group of patients from the capital with a high proportion of men who have sex with men (MSM), and another consisting of young adults with transmission primarily between males and females from outside the capital. Some clusters of N. gonorrhoeae were restricted to one of these two demographic groups. Pairwise comparison of multiple isolates from the same patients revealed that most were reinfected with different clones. Observations of frequent reinfections in patients is a concern and should be taken into account in the development of improved information and treatment guidelines.

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How Good Is Your Rule of Thumb? Validating Male-to-Female Case Ratio as a Proxy for Men Who Have Sex With Men Involvement in N. gonorrhoeae Incidence at the County Level

Abstract: Male-to-female case ratio for gonorrhea at the county level is a reliable proxy measure indicating MSM involvement in gonorrhea case incidence and should be used by STD programs to tailor their programmatic mix to include MSM-specific interventions.

Cited by 3 publications

References 11 publications

Narrative Review: Assessment of Neisseria gonorrhoeae Infections Among Men Who Have Sex With Men in National and Sentinel Surveillance Systems in the United States

Narrative Review: Assessment of Neisseria gonorrhoeae Infections Among Men Who Have Sex With Men in National and Sentinel Surveillance Systems in the United States

It Is Not Just the Southeast—Geographically Pervasive Racial Disparities in Neisseria gonorrhoeae Between Non-Hispanic Black and White US Women

Genomic epidemiology and population structure of Neisseria gonorrhoeae in Norway, 2016–2017

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