Gonorrhea, Mycoplasma and Vaginosis Diseases at a Glance
- More than 20 million new sexually transmitted diseases (STDs) occur annually in the United States.
- In the United States, chlamydia is currently the most common reported STD. It is also the most common cause of pelvic inflammatory disease in women.
- Urethritis is a common presenting symptom of STDs in both men and women.
- Diagnosis can usually be made through direct microscopy, culture, and/or newer diagnostic methods such as nucleic acid amplification tests.
- Early and appropriate antimicrobial therapy of STDs results in good prognosis.
- Prevention of STDs includes sexual abstinence or safe sex practices.
More than 600,000 people are estimated to acquire new gonococcal infections in the United States yearly according to the Centers for Disease Control and Prevention (CDC), although only about half are actually reported through the public health system. This makes gonorrhea the second most commonly reported infectious disease in the United States, second only to chlamydia. The rate of new infections declined after the implementation of a national gonorrhea control program in the United States during the mid-1970s and continued to decrease through the late 1990s. It has since stabilized at near 100 cases per 100,000 population.1 The prevalence of infection may have decreased due to sexually transmitted disease (STD) screening programs that have incorporated immediate, on-site, single-dose treatment, when indicated. Safer sex practices in response to the human immunodeficiency virus (HIV) epidemic may also be a factor contributing to the decline of new gonorrheal infections. The highest rate of reported gonococcal infections is among sexually active teenagers and young adults, aged 15–24. There is notable ethnic disparity, with the reported gonorrhea rate in African-Americans being twenty times higher and in Hispanics twice as high when compared to Caucasians.1 Such racial disparity is multifactorial and may be due to differences in accessibility to health care, lack of use of available resources, and sexual partner preferences. Risk factors for acquisition of gonorrheal infection include new or multiple sex partners, younger age, unmarried status, commercial sex work, minority ethnicity, substance and alcohol abuse, lower socioeconomic and educational levels, inconsistent condom use, and any previous STD infection. Prior gonorrhea is an especially important risk factor for acquisition of a new gonococcal infection, as recidivism is particularly common.2 As is true of most STDs, alcohol ingestion to the point of inebriation is associated with risky sexual behavior, including unprotected intercourse and sex with multiple partners, and is thus a major factor in acquisition of gonorrhea.3
Since the 1980s, prevalence rates among men and women have been similar in all age categories, although for any given age range, the prevalence will be slightly higher in women. The highest rates in women are for those between the ages of 15 and 19 years and in men between the ages of 20 and 24 years.1 However, one should never exclude the diagnosis of ...