Correlates of gonorrhoea among African Americans in North Carolina

Rates of gonorrhoea (GC) infections are highest among African Americans in the USA, but risk factors for GC in this population have not been well defined. The purpose of this study was to study these risk factors. We used secondary analysis of cross-sectional data from a population-based case-control study of African Americans, aged 18-59 years, in rural North Carolina, USA. A history of past infection was 2.4 times (95% confidence interval [CI]: 1.3, 4.4) as likely among men (35%) than women (18%). Among men, a history of gonorrhoea was associated with earlier age at first intercourse (adjusted Odds Ratio [aOR] = 2.0 95% CI [1.2, 3.4]), substance use (aOR = 4.4 95% CI [1.1, 17.9]), and having a partner who had been incarcerated (aOR = 18.1 [2.8, 118.0]). Among women, factors associated with GC included diagnosis of another STD (aOR = 5.9 [1.9, 16.9]), lifetime number of sex partners (aOR = 1.9 [1.1, 3.4]), and a sex partner who used drugs (aOR = 4.1 (1.3, 12.9)). In conclusion, African Americans with a history of GC are likely to have traditional STD risk factors, including partners at high risk for sexually transmitted disease (STD). STD screening is warranted upon entry to treatment facilities for substance abuse or correctional facilities.