BACKGROUND: Utah’s gonorrhea rates have increased statewide from 9.8 cases per 100,000 persons in 2011 to 52.1 cases per 100,000 in 2015. Analysis of surveillance data suggested a shift in the affected populations from primarily men who have sex with men (MSM) to the heterosexual population; from 2011 to 2015, infections among males increased 369%, while infections among females increased 623%. The vast majority of cases, 94.4%, resided in the Wasatch front. In order to improve public health’s response to the rapid increase in gonorrhea cases, the Utah Department of Health conducted a study to identify the risk factors associated with gonorrhea infection.
METHODS: Cases >18 years of age with a gonorrhea infection within the past 90 days were enrolled from within the Wasatch front (counties include Davis, Morgan, Salt Lake, Utah, and Weber). Controls were recruited using Utah Behavioral Risk Factor Surveillance System (BRFSS) and were matched on sex, age group, and county. After verbal consent, cases and controls were interviewed with a 39-question survey assessing demographic information and risk factors. Only cases with 2:1 match were analyzed. Data was analyzed using SAS.
RESULTS: One hundred ninety-one adult gonorrhea case (34% female, 66% male) and 382 adult controls (34% female, 66% male) were enrolled in the study. Cases were more likely to claim drug use (OR=3.7) than controls, 95% CI [2.4, 5.6]. Among those who claimed drug use in the past 90 days, cases were more likely to claim methamphetamine use, OR=20.5, 95% CI [2.6, 159.3]. Females cases were more likely to claim methamphetamine use than male cases, OR=5.3, 95% CI [1.7, 5.3]. Both males and female cases were more likely to claim the use of an app or website to meet a sex partner, OR=17.4, 95% CI [8.6, 35.3], OR=6.8, 95% CI [2.3, 20.0], respectively. All the female cases claiming the use of an app or website to meet partners were heterosexual. Among male cases claiming the use of apps or websites to meet sex partners 76.7% were MSM, 6.7% claimed to be MSMW, 16.7% claimed to be MSW.
CONCLUSIONS: Results showed cases were more likely to claim drug use and the use of websites and apps to meet sex partners than controls. These findings provide valuable insight into the risk factors which will assist in implementing targeted and effective interventions.