Risk factors for and trends in gonorrhea incidence among persons infected with HIV in the United States

AIDS. 2001 Jun 15;15(9):1149-55. doi: 10.1097/00002030-200106150-00010.


Objective: To determine the risk factors for and trends in gonorrhea infections among HIV-infected persons.

Design: Longitudinal review of medical records of HIV-infected patients.

Methods: We analyzed data about HIV-infected patients obtained from 1991 to 1998 in over 100 facilities participating in the Adult/Adolescent Spectrum of HIV Disease Project.

Results: The overall incidence of gonorrhea was 9.5 cases per 1000 person--years. Factors associated with higher gonorrhea incidence (P < 0.01) included younger age, male--male sex, black race, HIV infection without AIDS (namely AIDS-defining opportunistic illness or CD4 cell count < 200 x 10(6) cells/l), and recent recreational use of injection or non-injection drugs. There was an increase in the trend among men who have sex with men (P < 0.01) and a decrease in the trend among patients with heterosexual contact as their HIV exposure risk (P < 0.01). Among injection drug users there was no significant trend from 1991 to 1996, but there was an increase in gonorrhea incidence from 6.6 cases/1000 person-years in 1997 to 16.3 cases/1000 person--years in 1998.

Conclusions: Following HIV diagnosis, some individuals continue to practice risky sexual behaviors which result in gonorrhea and may transmit HIV. The increase in the trend in gonorrhea incidence among HIV-infected men who have sex with men is of particular concern because it suggests an increase in risky sexual behaviors. These findings indicate a need for effective HIV prevention strategies that involve reducing risky sexual behaviors in HIV-infected persons.

Publication types

  • Multicenter Study

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology*
  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Gonorrhea / epidemiology*
  • HIV-1*
  • Homosexuality, Male
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Substance Abuse, Intravenous
  • United States / epidemiology