Repeat Infections Among Minnesota Gonorrhea Cases, 2009 – 2010

Background: Identifying demographic and geographic characteristics of repeat gonorrhea (GC) cases may enable public health agencies to direct services toward populations at risk for re-infection.

Objectives: To determine the geographic and demographic characteristics of persons who have repeat gonorrhea infections in Minnesota.

Methods: Data from the Minnesota Department of Health STD Surveillance System were analyzed using SAS 9.2 to determine the number of recurrent infections among gonorrhea cases diagnosed in Minnesota during 2009 and 2010. Demographic and geographic variables among cases with repeat infections were compared to cases with single diagnoses to determine re-infection rates by race, ethnicity, age group, gender and geographic location.

Results: Of the 4,447 reported GC cases during the study period, 687 cases (15%) were considered to be repeat infections. Among the 4,079 individuals with GC reported during the study period, 319 (8%) were determined to have at least one repeat infection (range: 1 to 3 repeat infections). Re-infected cases were mostly Black (57%), female (57%), non-Hispanic (84%), 15-19 years old (35%), and from Minneapolis or St. Paul (54%), compared to non-repeat cases (47% Black, 57% female, 66% non-Hispanic, 34% between 20 and 24 years old, and 50% from Minneapolis/St. Paul). Fourteen percent of repeat female cases were pregnant at their initial diagnosis, compared to 11% of non-repeat cases. The median time between initial diagnosis and initial treatment was 1 day (range: 0 to 108 days) among repeat cases. Fifty-nine percent of cases with repeat infection were tested due to the presence of symptoms.

Conclusions: Some disparities among persons with repeat GC infections remain evident among Minnesota cases.

Implications for Programs, Policy, and Research: Strategies for reducing re-infection should be tailored for populations at risk for re-infection.