Sarah J Willis1,2, Heather Elder2, Noelle Cocoros1, Jessica Young1, Julia L Marcus1, Karen Eberhardt3, Myfanwy Callahan4, Brian Herrick5, Michelle Weiss5, Ellen Hafer6, Diana Erani6, Mark Josephson6, Eloisa Llata7, Elaine W Flagg7, Katherine K Hsu2, Michael Klompas1,8. 1. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA. 2. Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA. 3. Commonwealth Informatics, Waltham, Massachusetts, USA. 4. Atrius Health, Boston, Massachusetts, USA. 5. Cambridge Health Alliance, Cambridge, Massachusetts, USA. 6. Massachusetts League of Community Health Centers, Boston, Massachusetts, USA. 7. Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 8. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Gonorrhea diagnosis rates in the United States increased by 75% during 2009-2017, predominantly in men. It is unclear whether the increase among men is being driven by more screening, an increase in the prevalence of disease, or both. We sought to evaluate changes in gonorrhea testing patterns and positivity among men in Massachusetts. METHODS: The analysis included men (aged ≥15 years) who received care during 2010-2017 in 3 clinical practice groups. We calculated annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive result, among men tested. Log-binomial regression models were used to examine trends in these outcomes. We adjusted for clinical and demographic characteristics that may influence the predilection to test and probability of gonorrhea disease. RESULTS: On average, 306 348 men had clinical encounters each year. There was a significant increase in men with ≥1 gonorrhea test from 2010 (3.1%) to 2017 (6.4%; adjusted annual risk ratio, 1.12; 95% confidence interval, 1.12-1.13). There was a significant, albeit lesser, increase in the percentage of tested men with ≥1 positive result (1.0% in 2010 to 1.5% in 2017; adjusted annual risk ratio, 1.07; 95% confidence interval, 1.04-1.09). CONCLUSIONS: We estimated significant increases in the annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive gonorrhea test result between 2010 and 2017. These results suggest that observed increases in gonorrhea rates could be explained by both increases in screening and the prevalence of gonorrhea.
BACKGROUND:Gonorrhea diagnosis rates in the United States increased by 75% during 2009-2017, predominantly in men. It is unclear whether the increase among men is being driven by more screening, an increase in the prevalence of disease, or both. We sought to evaluate changes in gonorrhea testing patterns and positivity among men in Massachusetts. METHODS: The analysis included men (aged ≥15 years) who received care during 2010-2017 in 3 clinical practice groups. We calculated annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive result, among men tested. Log-binomial regression models were used to examine trends in these outcomes. We adjusted for clinical and demographic characteristics that may influence the predilection to test and probability of gonorrhea disease. RESULTS: On average, 306 348 men had clinical encounters each year. There was a significant increase in men with ≥1 gonorrhea test from 2010 (3.1%) to 2017 (6.4%; adjusted annual risk ratio, 1.12; 95% confidence interval, 1.12-1.13). There was a significant, albeit lesser, increase in the percentage of tested men with ≥1 positive result (1.0% in 2010 to 1.5% in 2017; adjusted annual risk ratio, 1.07; 95% confidence interval, 1.04-1.09). CONCLUSIONS: We estimated significant increases in the annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive gonorrhea test result between 2010 and 2017. These results suggest that observed increases in gonorrhea rates could be explained by both increases in screening and the prevalence of gonorrhea.
Authors: Ross Lazarus; Michael Klompas; Francis X Campion; Scott J N McNabb; Xuanlin Hou; James Daniel; Gillian Haney; Alfred DeMaria; Leslie Lenert; Richard Platt Journal: J Am Med Inform Assoc Date: 2008-10-24 Impact factor: 4.497
Authors: Martin Holt; Toby Lea; Limin Mao; Johann Kolstee; Iryna Zablotska; Tim Duck; Brent Allan; Michael West; Evelyn Lee; Peter Hull; Andrew Grulich; John De Wit; Garrett Prestage Journal: Lancet HIV Date: 2018-06-06 Impact factor: 12.767
Authors: Emily J Weston; Robert D Kirkcaldy; Mark Stenger; Eloisa Llata; Brooke Hoots; Elizabeth A Torrone Journal: Sex Transm Dis Date: 2018-04 Impact factor: 2.830
Authors: Katherine K Hsu; Lauren E Molotnikov; Kathleen A Roosevelt; Heather R Elder; R Monina Klevens; Alfred DeMaria; Sevgi O Aral Journal: Clin Infect Dis Date: 2018-06-18 Impact factor: 9.079
Authors: Harrell W Chesson; Robert D Kirkcaldy; Thomas L Gift; Kwame Owusu-Edusei; Hillard S Weinstock Journal: Emerg Infect Dis Date: 2014-04 Impact factor: 6.883
Authors: Daniel Grace; Jody Jollimore; Paul MacPherson; Matthew J P Strang; Darrell H S Tan Journal: AIDS Patient Care STDS Date: 2017-11-29 Impact factor: 5.078