Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 1;51(3):146-155.
doi: 10.1097/OLQ.0000000000001917. Epub 2023 Dec 19.

Factors Associated With Delays in Presentation and Treatment of Gonorrhea, Massachusetts 2015-2019

Heather Elder  1 , Laura Platt, Dylan Leach  1 , Cordelia Sheetoh  1 , Victor M Ramirez  1 , Lauren Molotnikov  1 , Brenda Hernandez  1 , Kathleen Roosevelt  1 , Katherine K Hsu
Affiliations

Factors Associated With Delays in Presentation and Treatment of Gonorrhea, Massachusetts 2015-2019

Heather Elder et al. Sex Transm Dis. .

Abstract

Background: Rates of gonorrhea are increasing across the United States. Understanding and addressing contributing factors associated with longer time to diagnosis and treatment may shorten the duration of infectiousness, which in turn may limit transmission.

Methods: We used Massachusetts data from the US Centers for Disease Control and Prevention Sexually Transmitted Disease Surveillance Network collected between July 2015 and September 2019, along with routinely reported surveillance data, to assess time from gonorrhea symptom onset to presentation to care, and time from presentation to care to receipt of treatment. Factors associated with longer time to presentation (TTP) and time to treatment (TTT) were assessed using Cox proportional hazard models with a constant time variable.

Results: Among symptomatic patients (n = 672), 31% did not receive medical care within 7 days of symptom onset. Longer TTP was associated with younger age, female gender, reporting cost as a barrier to care, and provider report of proctitis. Among patients with symptoms and/or known contact to gonorrhea (n = 827), 42% did not receive presumptive treatment. Longer TTT was associated with female gender, non-Hispanic other race/ethnicity, and clinics with less gonorrhea treatment experience. Among asymptomatic patients without known exposure to STI (n = 235), 26% did not receive treatment within 7 days. Longer TTT was associated with sexually transmitted disease clinic/family planning/reproductive health clinics and a test turnaround time of ≥3 days.

Conclusions: Delays in presentation to care and receipt of treatment for gonorrhea are common. Factors associated with longer TTP and TTT highlight multiple opportunities for reducing the infectious period of patients with gonorrhea.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest and Sources of Funding: There are no conflicts of interest to report.

References

    1. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2019. (CDC Publication; ). Available at: https://www.cdc.gov/std/statistics/2019/std-surveillance-2019.pdf. Accessed January 26, 2023.
    1. Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory, Sciences. 2019. Integrated HIV/AIDS, STD and Viral Hepatitis Surveillance Report (MDPH Web site). Available at: https://archives.lib.state.ma.us/bitstream/handle/2452/841748/on10019601.... Accessed January 26, 2023.
    1. Unemo M, Seifert HS, Hook EW, et al. Gonorrhoea. Nat Rev Dis Primers. 2019; 5(1):1–23. - PubMed
    1. Garnett GP, Mertz KJ, Finelli L, et al. The transmission dynamics of gonorrhoea: modelling the reported behaviour of infected patients from Newark, New Jersey. Philosophical Transactions of the Royal Society of London Series B: Biological Sciences. 1999; 354(1384):787–97. - PMC - PubMed
    1. Center for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep., 2015; 64(RR-03):1. - PMC - PubMed