The Epidemiology of Gonorrhea Among Men Who Have Sex With Men in Stockholm, Sweden, 1990-2004

The authors' objectives for the current study were to analyze the spread of gonorrhea among Stockholm men who have sex with men (MSM) regarding HIV status, serovars, and the site of infection. The distribution of serovars among HIV-positive and HIV-negative MSM were then compared.

From 1990 to 2004, clinical and epidemiologic data were collected for all MSM diagnosed with gonorrhea at a clinic primarily serving the MSM community. Neisseria gonorrhoeae strains were serotyped.

Of the 721 patients included, 840 gonorrhea episodes produced 1,039 isolates. A sharp rise was seen during the 2000s. Ten percent of the cases were HIV-positive. During the last seven years, the proportional of pharyngeal infections increased significantly (P<0.001), from 15 percent to 38 percent. A large variation of serovars (n=66) was observed, but just five were present >10 years. A significant difference (P=0.001) in distribution of serovars correlated to HIV status was found.

"Gonorrhea is a marker for HIV infection in MSM, but the increase in gonorrhea may be associated with genital-oral sexual practice rather than with high-risk sexual practice," the authors concluded.

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