As if carrying the burden of fueling a resurgence in gonorrhea and syphilis isn't troubling enough, gay men now face this: Gonorrhea is becoming resistant to antibiotics and the problem is worse among men who have sex with men.
The Centers for Disease Control & Prevention sounded the alarm on Thursday about the threat of antibiotic-resistant gonorrhea and how the problem is more acute among gay and bisexual men.
"The confluence of emerging drug resistance and very limited alternative options for treatment creates a perfect storm for future gonorrhea treatment failure in the U.S.,” Jonathan Mermin (photo), director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD & Tuberculosis Prevention said in a prepared statement.
“History shows us that bacteria will find a way to outlast the antibiotics we’re using to treat it. We are running just one step ahead in order to preserve the remaining treatment option for as long as possible," Mermin added.
The combination therapy still works – an oral dose of azithromycin and single shot of ceftriaxone – but the CDC is taking note of signs of emerging resistant to azithromycin. The sexually transmitted disease, one of the most common in the U.S., is already resistant to penicillin, tetracycline and fluoroquinolones.
“It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persist,” said Gail Bolan, director of CDC’s Division of STD Prevention. “We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”
More troubling for gay men, according to the new CDC report, is that the antibiotic resistance to gonorrhea was greatest among gay and bisexual men – a population that experiences gonorrhea infections in greater numbers than other populations.
The CDC says about 56 percent of gonorrhea cases in the U.S. are among men and of those, 48 percent are estimated to be gay men. Put another way, men who have sex men face a gonorrhea incidence 17 times greater that seen in heterosexual men and nearly 14 times that seen in women, based on the 2014 STD Surveillance Report.
That antibiotic resistance comes in the wake of a CDC report that shows gay men are helping to spike numbers for gonorrhea and syphilis infections. The CDC isn't quite sure why gay and bisexual men are driving the increases.
Gay and bisexual men face a combination of social, epidemiologic, and individual risk factors that can fuel high levels of STDs. Higher prevalence of infection within sexual networks increases the likelihood of acquiring an STD with each sexual encounter.
Additionally, barriers to receiving STD services such as lack of access to quality health care, homophobia, or stigma may all contribute to greater risk for this population. CDC recommends screening at least once a year for syphilis, chlamydia, and gonorrhea for all sexually active MSM.