Gonorrhea in the HIV era: a reversal in trends among men who have sex with men.
OBJECTIVE
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 MSM.
Fox
K K
KK
Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-02, Atlanta, GA 30333, USA. kfox@cdc.gov
del Rio
C
C
Holmes
K K
KK
Hook
E W
EW
Judson
F N
FN
Knapp
J S
JS
Procop
G W
GW
Wang
S A
SA
Whittington
W L
WL
Levine
W C
WC
D000328:Adult; D003151:Community Health Centers / Q000706:statistics & numerical data; D017050:Episode of Care; D004917:Erythromycin / Q000032:analysis; D006069:Gonorrhea / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D020010:Heterosexuality / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009344:Neisseria gonorrhoeae / Q000187:drug effects / Q000302:isolation & purification*; D021841:Safe Sex; D018571:Sentinel Surveillance; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology; D014526:Urethritis / Q000209:etiology
D004917:Erythromycin