National notifiable disease data indicate that there were 99 cases of gonorrhea for every 100,000 persons in the United States in 2009, the lowest recorded gonorrhea rate in US history. However, the extent to which declining case reports signify a reduction in prevalence is unknown.
Gonorrhea prevalence was estimated among 16- to 24-year-old men and women entering the National Job Training Program (NJTP) between 2004 and 2009. Multivariate logistic regression was used to assess the probability of testing positive for gonorrhea over time.
A total of 95,184 men and 91,697 women were screened for gonorrhea upon entry to the NJTP between 2004 and 2009. For women, gonorrhea prevalence increased from 2004 (2.6%) to 2006 (2.9%), then decreased steadily through 2009 (1.8%). For men, prevalence increased from 2004 (1.3%) to 2005 (1.6%), then decreased through 2009 (0.9%). Gonorrhea prevalence among black women decreased from 3.6% in 2004 to 2.5% in 2009 and was 2 to 4 times higher than prevalence among white women. Likewise, prevalence among black men decreased from 2.0% to 1.5% and was 8 to 22 times higher than prevalence among white men. After adjusting for gonorrhea risk factors, the odds of women and men testing positive for gonorrhea decreased by 50% and 40%, respectively, from 2004 to 2009.
Declining trends in gonorrhea infection among NJTP entrants are similar to those observed in gonorrhea case report data, suggesting that the decrease in case reports is due to a decrease in prevalence. However, targeted interventions are needed to reduce gonorrhea infections in populations with disproportionate risk.
Gonorrhea prevalence declined among young women and men entering the National Job Training Program from 2004–2009. However, blacks continue to have a higher burden of infection compared to whites.
From the *Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and †Division of Applied Sciences, Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA
The authors thank the Department of Labor and Office of Job Corps for their cooperation. The authors also thank Carlos Roca and the Center for Disease Detection for providing the data used in this analysis.
The findings and conclusions in this report have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.
Correspondence: Heather Bradley, PhD, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS E-02, Atlanta, GA 30333. E-mail: firstname.lastname@example.org.
Received for publication May 11, 2011, and accepted August 8, 2011.