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Background: As with other inflammatory Sexually Transmitted Infections (STIs) gonococcal infection can facilitate transmission of HIV infection. Our objectives were to assess the proportion of HIV co-infection among individuals diagnosed with gonorrhea (GC) and describe demographic and behavioral characteristics of co-infected individuals.
Methods: GC cases reported to the Chicago Department of Public Health (CDPH) were matched to the enhanced HIV/AIDS Reporting System (eHARS). Co-infection (GC/HIV) was defined as occurring within 2 months of GC infection. Behavioral data were extracted from eHARS. Poisson regression models were used to estimate the association between prior GC and HIV seroconversion.
Results: Between 2000 - 2012, a total of 142,419 GC cases were reported to CDPH. During the same time period, 417(0.3%) GC cases were diagnosed with HIV within the 60 days of GC infection. The proportion of co-infected men increased from 0.22% of GC cases in 2000 to 1.14% in 2012(p-value<.0001) while proportion of co-infected women did not change (from 0.08% to 0.10%). Among co-infected individuals, men represented 85.1% (355/417), the majority of which were MSM (73.2%). Overall, the rate of GC/HIV co-infections per year was highest among Black males ages 15-24 and 24-34; 14.3 and 13.7 per 100,000, respectively. In a Poisson model, Black race (OR=2.3, 95% CI: 1.9-2.7), other race (OR=1.8, 95% CI: 1.3-2.2), and age groups 15-24 (OR= 2.6, 95% CI: 2.2 to 3.1), 25-34 (OR= 2.6, 95% CI: 2.1 to 3.0) were significantly associated with GC/HIV co-infection.
Conclusions: Our findings suggest that from 2000 to 2012 the proportion of co-infected men increased steadily by 418%. Young Black males are at increased risk for the acquisition of HIV within 60 days of GC infection. The changing epidemiology of GC in Chicago highlights the need for obtaining behavioral data for all reportable STIs and real-time STI and HIV data matching.