What is Gonorrhea?

Gonorrhea is the second most commonly reported infectious disease in the United States.[1] According to the CDC, “African-Americans remain the group most heavily affected by gonorrhea, with a rate in 2005 that was eighteen times greater than the rate for whites.”[2] Worldwide, about sixty-two million cases occur each year.[3]

Gonorrhea is highly contagious, especially for women. Through a single act of intercourse with an infected partner, the male has a 20 percent chance of contracting it from an infected female, but the female has about a 70 percent chance of being infected from a man who has the disease.[4] When a person is infected with one STD, it often makes his or her body more likely to be infected with others. In the case of gonorrhea, the infected person is three to five times as likely to get HIV if exposed.[5] Furthermore, men with a history of gonorrhea are twice as likely to develop bladder cancer.[6]

When a person is infected, his or her symptoms vary, depending upon the individual and what part of the body is infected. Some experience a discharge from the genitals and painful urination. Women can suffer from abnormal bleeding, and men from swelling around the testicles. This may be a sign of epididymitis in the male, a condition that can lead to infertility if not treated. In a woman, gonorrhea may spread to the uterus and fallopian tubes, leading to Pelvic Inflammatory Disease (PID), which can cause infertility. Infected mothers may also pass the disease to their babies during birth, which can lead to blindness, joint disorders, and a life-threatening blood infection in the child. However, if a woman receives treatment for gonorrhea, she can reduce the risk of infecting her baby.

The majority of infected men will show symptoms of the disease within days of contracting it. However, many women will experience no initial symptoms.[7] For men and women alike, the disease can remain undetected even though the person’s mouth may be infected. If the disease is detected, it can be treated with antibiotics.

Doctors have noticed, however, that gonorrhea is becoming increasingly resistant to the antibiotics used to treat it. One specialist remarked, “Gonorrhea has now joined the list of other superbugs for which treatment options have become dangerously few.”[8] According to the CDC, “Resistance is especially worrisome among men who have sex with men (MSM), where resistance was nearly eight times higher than among heterosexuals (29 percent vs. 3.8 percent).”[9]

Gonorrhea can be transmitted by means of intercourse, oral sex, and anal sex. The National Institutes of Health reported that condom use reduces the risk of gonorrhea for men. But “the available epidemiologic literature does not allow an accurate assessment of the degree of protection against gonorrhea infection in women offered by correct and consistent condom use.”[10] Studies published since the NIH report estimate that the condom can reduce the risk of gonorrhea by about half.[11] Therefore, even correct and consistent condom use does not eliminate the risk of contracting the disease.

The findings are especially dismal for those who report inconsistent condom use. According to one medical journal, “Inconsistent condom use was not protective against HIV and STDs, and significantly increased the risks of infections such as gonorrhea and chlamydia. Inconsistent condom use may actually be an ‘enabling’ process allowing individuals to persist in high-risk behaviors with a false sense of security.”[12] This study is not the only one to show that those who use condoms less than perfectly are more likely to contract STDs than those who do not use condoms at all.[13]

The reason for this, as the journal explained, is that those who report condom use may be more likely to engage in risky behavior (such as having multiple sexual partners). According to one researcher, “The number-one determinant of whether a person will catch a sexually transmitted disease is the number of lifetime sexual partners. We seem to go out of our way as a government and a nation to avoid telling people that, but we hand out a lot of free condoms.”[14]

[1]. Centers for Disease Control, “Trends in Reportable Sexually Transmitted Diseases in the United States, 2005,” Division of STD Prevention (December 2006), 3.
[2]. “Trends in Reportable Sexually Transmitted Diseases,” 3.
[3]. National Institutes of Health, “Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention.”
[4]. National Institutes of Health, “Workshop Summary.”
[5]. D.T. Fleming and J.N. Wasserheit, “From Epidemiological Synergy to Public Health Policy and Practice: The Contribution of Other Sexually Transmitted Diseases to Sexual Transmission of HIV Infection,” Sexually Transmitted Infections 75 (1999), 3–17.
[6]. D. S. Michaud, et al., “Gonorrhoea and Male Bladder Cancer in a Prospective Study,” British Journal of Cancer 96 (2007), 169–171.
[7]. National Institutes of Health, “Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention.”
[8]. Rob Stein, “Drugs Losing Efficacy Against Gonorrhea,” Washington Post (April 13, 2007), A03.
[9]. “Trends in Reportable Sexually Transmitted Diseases,” 4.
[10]. National Institutes of Health, “Workshop Summary,” 16.
[11]. Ahmed S, et al., “HIV Incidence and Sexually Transmitted Disease Prevalence Associated with Condom Use: A Population Study in Rakai, Uganda,” AIDS 15:16 (2001), 2171–2179; J. Baeten, et al., “Hormonal Contraception and Risk of Sexually Transmitted Disease Acquisition: Results from a Prospective Study,” American Journal of Obstetrics & Gynecology 185:2 (2001), 380–385.
[12]. Ahmed, et al., 2177.
[13]. T.K. Young, et al., “Factors Associated with Human Papillomavirus Infection Detected by Polymerase Chain Reaction Among Urban Canadian Aboriginal and Non-Aboriginal Women,” Sexually Transmitted Diseases 24:5 (May 1997), 293–298; L. Manhart, L. Koutsky, “Do Condoms Prevent Genital HPV Infection, External Genital Warts, or Cervical Neoplasia? A Meta-Analysis,” Sexually Transmitted Diseases 29:11 (2002): 725–735.
[14]. Robert E. Rector, Heritage Foundation, in Avram Goldstein, “District to Offer Condoms for Free,” Washington Post (December 2, 2003), B01.

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