The rate of drug-resistant gonorrhea more than doubled nationally from 2002 to 2003, and this stubborn sexually transmitted disease was 12 times more prevalent among homosexual and bisexual men than heterosexual men, federal health officials said yesterday.
“National and regional data show that drug-resistant gonorrhea is a rapidly emerging health concern, particularly for gay and bisexual men,” Dr. John Douglas, director of the U.S. Centers for Disease Control and Prevention’s STD (sexually-transmitted disease) prevention programs.
Noting the sharp rise in gonorrhea resistant to oral antibiotics known as fluoroquinolones, including Cipro (ciprofloxacin), among men who have same-sex relations, CDC officials yesterday advised homosexual and bisexual men against using such drugs as a first-line treatment.
The officials recommended that homosexual and bisexual men use an injectable antibiotic, ceftriaxone, which must be administered by a doctor, and a medication called cefixime. The latter is available only in liquid form in the country.
Dr. Douglas said heterosexuals can continue to use fluoroquinolones, which have been popular because they are cheap, available in pill form and taken in single doses, to treat gonorrhea because of the low incidence rate among that population.
About 80 percent of the 700,000 to 800,000 Americans infected with gonorrhea each year are heterosexuals.
Gonorrhea declined in the country for two decades before making a comeback in the late 1990s. It can cause infertility, chronic pelvic pain and arthritis if untreated.
Dr. Douglas said the rise in drug-resistant gonorrhea parallels increases in cases of syphilis and HIV, the AIDS virus, also seen among homosexual and bisexual men in recent years.
He suggested that this population may be relaxing safe-sex practices, using illegal substances such as crystal methamphetamines that disrupt judgment, and meeting more sexual partners over the Internet.
“The data indicate an increase in risk-taking behavior,” he said.
The announcements yesterday came on the eve of the release of an article in the CDC’s Morbidity and Mortality Weekly Report about the rise in drug-resistant gonorrhea.
The article points out that because of increased prevalence of this disorder in Asia, the Pacific Islands (including Hawaii) and California, “fluoroquinolones are no longer recommended for treating gonorrhea acquired in those locations.”
Regional data support national findings that drug-resistant gonorrhea is primarily a problem of homosexual and bisexual men. The Massachusetts State Laboratory Institute said that from January through August last year, the condition was identified more than six times more often in isolates of gay and bisexual men than in heterosexual men. The rates were 11.1 and 1.8 percent, respectively.
Similarly, New York City’s Department of Health found drug-resistant gonorrhea nearly eight times more common among men whose sex partners are male than among heterosexual men from January to July last year. The rates were 12.5 and 1.6 percent, respectively.
Please read our comment policy before commenting.