Repeated Gonorrhea: An Analysis of Importance and Risk Factors

Abstract

This study was designed to assess the epidemiological importance of repeated infections due to Neisseria gonorrhoeae and to analyze variables potentially associated with repeated gonorrhea. The retrospective analysis was of 7,347 patients seen during one year, and the prospective study was of a stratified randomly selected sample of 429 patients. The 492 retrospectively identified repeaters constituted 0.06% of the county population and 6.7% of the clinic population. The 492 repeaters had 21.6% of the cases of gonorrhea reported from the county and 29.4% of the cases reported from the clinic. The repeaters tended to be younger than those without repeated infection (P less than 0.001), male (62%), black (81.7%), and residents of areas of lower socioeconomic status than those who were not repeaters (P less than 0.001). Most repeaters (73.5%) had not graduated from high school. Repeaters did not have significantly greater numbers of sex partners (P greater than 0.05) or greater exposure to prostitutes or clients than those who did not have repeated infections and less frequently had sexual contact while symptomatic. Intensive follow-up of the small number of high-risk repeaters and their contacts could result in a major reduction in the number of reported cases of gonorrhea.

Features of Urethritis in a Cohort of Male Soldiers

“…It is clear that individuals with repeated infections contribute disproportionately to the overall STD clinic burden [3,9,22,[29][30][31][32][33]. The ability to identify early those individuals who are likely to become reinfected would thus provide a potential avenue to channel clinics' limited prevention and screening resources more effectively.…”

“…The ability to identify early those individuals who are likely to become reinfected would thus provide a potential avenue to channel clinics' limited prevention and screening resources more effectively. Previous studies of gonococcal reinfection have focused predominantly on demographic characteristics (young age, male sex, lower socioeconomic status, minority race, single marital status, and unemployment) [9,30,31,34,35] and geographic characteristics [3,22] for defining this core. Lundin et al found in 1977 that social and psychological characteristics of repeaters were distinct from those of nonrepeaters [36].…”

Repeat Infection With Chlamydia and Gonorrhea Among Females: A Systematic Review of the Literature

“…Because the focus of the analysis was repeat infection rather than treatment failure, antibiotic efficacy studies, which generally have short-term follow-up, were not included in our analysis. Twenty-three studies were excluded because reinfection rates were not stratified by sex [11][12][13][14][15][16][17][18][19][20][21] or specific etiology (chlamydia or gonorrhea), 13,14,[21][22][23][24] the publication was a nonpeer-reviewed letter, 25 data were duplicative of already published material, 26 -28 reinfection rates could not be calculated using the data provided, 29 -32 or initial infection was not laboratory-confirmed. 33 Specific study design, proportion of females retested, diagnostic test type used, length of follow-up, geographic region, and population demographics were not considered in the inclusion and exclusion criteria.…”

Gonorrhea Reinfection Among Sexually Transmitted Disease Clinic Attendees in Baltimore, Maryland

“…6,[22][23][24][25][26][27] Gonorrhea reinfections after treatment have consistently found to be associated with male gender, 23,25 black race, 23,[25][26][27][28][29] younger age, 23,25,26 low socioeconomic status, [25][26][27][28] and increased number of sexual partners. 25,26,29 In Baltimore, we have shown that those with reinfections were more likely to live closer to other repeaters. 6 However, most studies of reinfection are limited to retrospective cohorts defined through clinic or health department data, where most infections detected are through testing those with clinical symptoms.…”