A Study of the Prevalence of Gonorrhea among High Risk Population in Hyderabad, A.P

Background: Gonorrhea is now mainly seen in homosexual men and sexually active individuals, who are more vulnerable to STIs and HIV. High prevalence among them is due to presence of large reservoirs of asymptomatic carriers. Early detection and treatment of STIs has been advocated as HIV prevention strategy. This study was carried out to detect the prevalence of gonorrhea among the risk groups.

Methods: MSM and FSW attending sentinel STI clinics for regular checkups or symptoms were screened for study eligibility. Heterosexual men attending STD OP at Gandhi Hospital with urethritis were also included. A behavioral questionnaire was administered, clinical examination performed and laboratory samples were collected. We also determined the proportion of asymptomatic infections among sexual workers. Culture and NAAT was performed on all specimens.

Results: During a period of 1 year, 183 MSM were tested for pharyngeal and rectal gonorrhea and positive percentages were 1.09 % and 11% respectively. Among 125 FSW, 18.4% were positive and among 50 heterosexual males, 40% were positive for urethral gonorrhea. Younger age, number of sexual partners in past month, irregular condom usage and rectal, urethral symptoms were associated significantly with the infection. Sensitivity, specificity, PPV and NPV of culture compared to NAAT were 31%, 99.6%, 95% and 86% respectively.

Conclusion: Prevalence of infection, sexual behavior and the asymptomatic nature among sexual workers are alarming, serving them as reservoirs for gonorrhea. So screening them at anatomical sites based on exposure history should be considered.