![[ Visit Client Website ]](images/banner.gif)
Background: California (CA) gonorrhea (GC) cases increased to >50,000 in 2015. We sought to analyze GC epidemiologic data to determine the proportion of cases that could be targeted for STD screening and treatment interventions.
Methods: As part of CDC’s STD Surveillance Network, CA conducts enhanced surveillance on a 2.5% simple random sample of reported GC cases via patient interview and provider follow-up. Prevention opportunities were defined by the following mutually exclusive hierarchy of cases based on key programmatic partnerships: STD contacts (all providers seeing GC cases), HIV-positive individuals (HIV care providers), HIV-negative/unknown men who have sex with men (MSM) (pre-exposure prophylaxis (PrEP) providers), cases/partners with recent incarceration (history) (correctional facilities), and all reproductive-age females (family planning/reproductive health services providers).
Results: Of 1,646 sampled cases from January 2015-May 2016, 550 were interviewed (33.4% interview rate) (median age: 27 years (IQR: 22-35)): 366 (66.6%) were male (of whom 63.6% were MSM) and 359 (65.3%) were symptomatic. Of interviewed cases, by our hierarchy, 110 (20.0%) were STD contacts, 43 (7.8%) were HIV-positive, 147 (26.7%) were HIV-negative/unknown MSM, 63 (11.5%) had recent incarceration (history) and 100 (18.2%) were reproductive-age females. Overall, 84.2% of GC cases were accounted for by factors that are potential STD screening/treatment intervention opportunities. Of the remaining 87 (15.8%) GC cases not yet accounted for above, 79 (90.8%) were symptomatic.
Conclusions: By utilizing enhanced surveillance risk factor data, we identified potential priority GC programmatic partnerships: HIV providers, PrEP providers, correctional facilities, and family planning/reproductive health services providers. Schools may be a key venue for STD services; however, data were not available to assess. The promotion of ongoing STD screening and treatment in these settings, in addition to encouraging partner treatment among all providers treating GC cases, could allow us to interrupt transmission for the vast majority of GC cases in CA.