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P19 Prevalence and Correlates of Pharyngeal Gonorrhea Among Young People Attending Public STD Clinics

Tuesday, March 9, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Marjan Javanbakht, PhD1, Sarah Guerry, MD2, Pamina Gorbach, DrPH1, Ali Stirland, MBChB, MSc2, Michael Chien, PhD, (c)2 and Peter Kerndt, MD, MPH2, 1Department of Epidemiology, UCLA, Los Angeles, CA, 2Sexually Transmitted Disease Program, Los Angeles County Department of Public Health, Los Angeles, CA
Handout

Background: Gonorrhea is the second most common notifiable disease in the US, with the highest reported rates among those 15 – 24 years of age. Because the prevalence of oral sex among young people is relatively high and condom use with this behavior is low the contribution of oral sex to gonorrhea transmission and maintenance of infection among this population may be more important than expected despite the lower transmissibility with oral sex.

Objectives: To identify factors associated with pharyngeal gonorrhea among young people attending public STD clinics. 

Methods: We conducted a cross-sectional study of clients attending public STD clinics between May 2006 and December 2007 in Los Angeles County, CA.  Those included in this study were 15-24 years, reported oral sex and were tested for pharyngeal gonorrhea using nucleic acid amplification tests.  

Results: Among the 11,160 clients 15-24, 64% reported oral sex in the past 90 days, with more than half (n=3,778) tested for pharyngeal gonorrhea. The overall prevalence of pharyngeal gonorrhea was 5.8% (n=219). After adjusting for age, race/ethnicity, and reason for visit (i.e., STD contact), women who reported substance use (adjusted odds ratio [AOR]=1.80; 95% Confidence Interval [CI] 1.11-2.93) and those diagnosed with uro-genital gonorrhea (AOR=27.8; 95% CI 16.9-46.0) were more likely to be diagnosed with pharyngeal gonorrhea.  Similarly, uro-genital gonorrhea infections were an independent predictor of pharyngeal gonorrhea among heterosexual men (AOR=34.0; 95% CI 20.0-57.62), while both uro-genital and rectal gonorrhea infections were associated with pharyngeal gonorrhea in MSM (AOR=9.98; 95% CI 2.21-45.16 and AOR=4.97; 95% CI 1.98-12.46 respectively).

Conclusions: The prevalence of pharyngeal gonorrhea among young people was relatively high and significantly higher among those with concurrent non-pharyngeal gonorrhea infections, even after controlling for other risk factors.

Implications for Programs, Policy, and/or Research:These findings have implications for treatment and prevention strategies.

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