Background: Inequalities in Neisseria gonorrhoeae (gonorrhea) burden by sexual minority status in the United States are difficult to quantify. Sex of sex partner is not routinely collected for reported cases. Population estimates of men who have sex with men (MSM) necessary to calculate case rates have not been available until recently. For these reasons, trends in reported gonorrhea rates among MSM have not been described across multiple jurisdictions.
Methods: We estimated of the number of MSM cases reported in 6 jurisdictions continuously participating in the STD Surveillance Network 2010–2015 based on interviews with a random sample of cases. Data were obtained for Baltimore, Philadelphia, New York City, San Francisco, California (excluding San Francisco), and Washington State. Estimates of the MSM, heterosexual male (MSW) and female populations were obtained from recently published estimates and census data. Case rates and rate-ratios were calculated comparing trends in reported cases among MSM, heterosexual males and women.
Results: The proportion of male gonorrhea cases among MSM varied by jurisdiction (range: 20% to 98%). Estimated MSM rate increased from 1369 cases per 100,000 in 2010 to 3435 cases per 100,000 in 2015. Between 2010 and 2015, the MSM-to-Women gonorrhea rate ratio increased from 13:1 to 24:1, and the MSM-to-MSW gonorrhea rate ratio increased from 16:1 to 31:1.
Conclusions: Estimated gonorrhea rate among MSM increased in a network of 6 geographically diverse US jurisdictions. Estimating the size of this population, determining MSM among reported cases and estimating rates are essential first steps for better understanding the changing epidemiology of gonorrhea.
This study describes an increasing trend in the rate of gonorrhea among men who have sex with men in 6 jurisdictions in the United States based on recently published men who have sex with men population data and representative case information.
From the *Division of STD Prevention, US Centers for Disease Control & Prevention; †New York City Department of Health and Mental Hygiene, Bureau of STD Control, Queens, NY; ‡Philadelphia Department of Public Health, STD Control Program, Philadelphia, PA; §California Department of Public Health, STD Control Branch, Richmond, CA; ¶Washington State Department of Health, Olympia, WA; ∥San Francisco Department of Public Health, San Francisco, CA; and **Baltimore City Health Department & Johns Hopkins School of Medicine, Baltimore, MD
Acknowledgments: The authors wish to acknowledge the contributions of state and local interviewers, data managers, epidemiologists and public health professionals collaborating in SSuN. An early version of this analysis concept using different periods, different denominator data and fewer years of data was presented as a poster at the 21st biennial meeting of the International Society for STD Research in Brisbane, Australia, September 2015.
Financial support: This project was supported by the U.S. Centers for Disease Control and Prevention through cooperative agreement number PS13-1306 (STD Surveillance Network).
Conflict of interest: None declared.
Correspondence: Mark Stenger, MA, Division of STD Prevention, US Centers for Disease Control and Prevention, Mail Stop E-63 1600 Clifton Road NE Atlanta, GA 30329. E-mail: email@example.com.
Received for publication January 13, 2017, and accepted February 22, 2017.