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
Judson FN. Fear of AIDS and gonorrhea rates in homosexual men
(Letter). Lancet 1983;II:159-60.
CDC. Prevention of acquired immune deficiency syndrome (AIDS):
report of inter-agency recommendations. MMWR 1983;32:101-3.
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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