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Declining Rates of Rectal and Pharyngeal Gonorrhea Among Males--New York City

The rates of rectal and pharyngeal gonorrhea for New York City males aged 15-44 years* has declined from 129 per 100,000 males in that age group in 1980 to 74/100,000 in 1983--the lowest level in the past 7 years. This decrease is most evident in the area with the highest rates--Manhattan--where reported rectal and pharyngeal gonorrhea rates declined from 485/100,000 in 1980 to 201/100,000 in 1983--a 59% decrease (Figure 1). In other areas of New York City, the rates of rectal and pharyngeal gonorrhea have declined slightly since 1980, but the initial rates outside Manhattan were much lower. Gonorrhea rates for females 15-44 years old have risen over the same period from 587/100,000 females in that age group to 624/100,000 in 1983 (Figure 1).

The majority of New York City rectal and pharyngeal gonorrhea was reported from one New York City Department of Health sexually transmitted disease (STD) clinic in Manhattan, whose patients are primarily homosexual males. At this clinic, culture testing for pharyngeal and rectal gonorrhea is provided to all males identified as being at risk for contracting gonorrhea due to same-sex contact. Based on analyses of second- and fourth-quarter data from each year, the percentage of positive rectal cultures declined from 30.3 in 1980 to 16.5 in 1983, and the percentage of positive pharyngeal cultures declined from 6.8% in 1980 to 2.4% in 1983 (Table 4). First clinic visits by males decreased by 4.3% from 18,434 in fiscal year 1980 to 17,635 in fiscal year 1983. Reported by S Schultz, MD, S Friedman, MD, A Kristal, DrPH, DJ Sencer, MD, New York City Dept of Health; Div of Sexually Transmitted Diseases, Center for Prevention Svs, AIDS Activity, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: Since 1980, reported pharyngeal and rectal gonorrhea rates among New York City males 15-44 years old have shown consistent annual decreases, while the reported rates of gonorrhea for females in the same age group have increased during the same period. In Manhattan, the greatest decreases in male pharyngeal and rectal gonorrhea rates occurred in 1982 and 1983.

The percent decreases in infection were substantially greater than either the percent decreases in clinic attendance or total cultures taken. Hence, it is unlikely that changes in testing or clinic attendance account for a large portion of the declines. A similar decrease in gonorrhea incidence has been reported among homosexual males attending a public clinic in Denver, Colorado (1).

The major gonorrhea decreases in 1982 and 1983 coincide with the period of heightened awareness and concern about the incidence of acquired immunodeficiency syndrome (AIDS) among homosexual males. U.S. Public Health Service recommendations stress the importance of reducing the numbers of sexual partners for preventing AIDS among homosexual males (2). Similar recommendations have been developed and widely distributed by the American Association of Physicians for Human Rights and many local groups concerned with the health of homosexual males. Recently, a reduction of the number of sexual partners among homosexual males has been documented in Madison, Wisconsin (3). The substantial and persistent declines in gonorrhea among homosexual males in New York City suggest that prevention efforts have succeeded in reducing the incidence of this short-incubation-period sexually transmitted infection. Further sustained efforts should help in reducing the incidence of AIDS among homosexual males.

References

  1. Judson FN. Fear of AIDS and gonorrhea rates in homosexual men (Letter). Lancet 1983;II:159-60.

  2. CDC. Prevention of acquired immune deficiency syndrome (AIDS): report of inter-agency recommendations. MMWR 1983;32:101-3.

  3. Golubjatnikov R, Pfister J, Tillotson T. Homosexual promiscuity and the fear of AIDS (Letter). Lancet 1983;II:681. *1980 Census data.



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