Homosexually acquired gonorrhoea in Victoria, 1983-1991.

Abstract

OBJECTIVE: To identify trends in the rate of gonorrhoea, particularly homosexually acquired infection. DESIGN: A retrospective descriptive study of records stored in a relational database. Records contain epidemiological, demographic and microbiological data of laboratory confirmed cases of gonorrhoea. SUBJECTS: Individuals with gonorrhoea diagnosed microbiologically in Victoria and from whom isolates were subsequently forwarded to the Microbiological Diagnostic Unit, University of Melbourne, for further bacteriological work for the years 1983-1991. RESULTS: Overall, gonorrhoea is declining in Victoria in the general population but has risen sharply in recent years in homosexually active men. An increased number of cases of rectal gonorrhoea in men has also been noted. An age cohort effect in homosexually active men is only evident for the final year of the study. These men do not tend to acquire gonorrhoea abroad and beta-lactamase producing gonococci are rarely found in this group. CONCLUSIONS: Gonorrhoea in homosexually active men has increased disproportionately to the rate of infection in heterosexual men in recent years, despite intensive education and counselling aimed at the gay community. Implications for risk of acquisition of other sexually transmitted diseases, including the human immunodeficiency virus, are evident.