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Repeat Gonorrhea Diagnosis Rates and Associated Characteristics, STI Surveillance Network, 2016-2022.

Christina M Schumacher1,2, Roshani Fernando3, Tiago Rampe4

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Individuals with multiple gonorrhea diagnoses (repeat-GC) were analyzed by sexual orientation and gender identity. Men who have sex with men had the highest repeat-GC rates, highlighting key groups for STI prevention efforts.

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Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease Prevention

Background:

  • Multiple gonorrhea diagnoses (repeat-GC) identify individuals at higher risk for STIs.
  • Understanding repeat-GC rates across diverse populations is crucial for targeted prevention strategies.

Purpose of the Study:

  • To determine repeat-GC rates and associated characteristics by sexual orientation and gender identity.
  • To identify key populations for enhanced STI prevention interventions.

Main Methods:

  • Retrospective cohort study using enhanced surveillance data from 2016-2021 across seven jurisdictions.
  • Analysis included randomly sampled, interviewed gonorrhea cases, with follow-up until repeat-GC diagnosis or end of 2022.
  • Poisson regression was used to assess differences in repeat-GC rates, adjusting for follow-up time during the COVID-19 pandemic.

Main Results:

  • Among 21,743 individuals, men who have sex with men (MSM) had the highest repeat-GC rate (182.3 per 1,000 person-years).
  • Repeat-GC was associated with a prior gonorrhea diagnosis, HIV status, and infection site (rectal/pharyngeal for MSM).
  • Men not reporting male partners and women living with HIV showed higher repeat-GC rates.

Conclusions:

  • Prior gonorrhea diagnosis, HIV status, and infection site are key characteristics associated with repeat-GC.
  • Routine STI surveillance data can identify individuals for targeted follow-up and novel prevention interventions.
  • Prioritizing high-risk groups like MSM can improve gonorrhea control efforts.