title: A tale of two gonorrhea epidemics: results from the STD surveillance network.
abstract: OBJECTIVE
  An increasing proportion of gonorrhea in the United States is diagnosed in the private sector, posing a challenge to existing national surveillance systems. We described gonorrhea epidemiology outside sexually transmitted disease (STD) clinic settings.
  
  
  METHODS
  Through the STD Surveillance Network (SSuN), health departments in the San Francisco, Seattle, Denver, Minneapolis, and Richmond, Virginia, metropolitan areas interviewed systematic samples of men and women reported with gonorrhea by non-STD clinic providers from 2006 through 2008.
  
  
  RESULTS
  Of 2,138 interviews, 10.0% were from San Francisco, 26.4% were from Seattle, 25.2% were from Denver, 22.9% were from Minneapolis, and 15.5% were from Richmond. A total of 1,165 women were interviewed; 70.1% (815/1,163) were ≤24 years of age, 51.3% (598/1,165) were non-Hispanic black, and 19.0% (213/1,121) reported recent incarceration of self or sex partner. Among 610 men who have sex with only women, 50.9% were ≤24 years of age, 65.1% were non-Hispanic black, 14.1% reported incarceration of self or sex partner, and 16.7% reported anonymous sex. Among 363 men who have sex with men (MSM), 20.9% were ≤24 years of age, 61.6% were non-Hispanic white, 39.8% reported anonymous sex, 35.7% reported using the Internet to meet sex partners, and 12.1% reported methamphetamine use.
  
  
  CONCLUSIONS
  These data identified two concurrent gonorrhea epidemics in minority populations: a young, black, heterosexual epidemic with frequently reported recent incarceration, and an older, mostly white MSM epidemic with more frequently reported anonymous sex, Internet use to meet sex partners, and methamphetamine use.
authors.affiliation: Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA 30333, USA. len4@cdc.gov
authors.forename: Lori Marie
authors.initials: LM
authors.lastname: Newman
authors.forename: Deborah
authors.initials: D
authors.lastname: Dowell
authors.forename: Kyle
authors.initials: K
authors.lastname: Bernstein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Donnelly
authors.forename: Summer
authors.initials: S
authors.lastname: Martins
authors.forename: Mark
authors.initials: M
authors.lastname: Stenger
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Stover
authors.forename: Hillard
authors.initials: H
authors.lastname: Weinstock
mesh_terms: D000328:Adult; D005006:Ethnicity; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008913:Minority Groups; D011159:Population Surveillance; D019529:Sexuality / Q000706:statistics & numerical data; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult