Gonorrhoea as an Indicator of Altered Sexual Behaviour and as a Surrogate Marker of HIV Concern: A 13-Year Analysis in Newcastle

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Abstract
Summary: It has been proposed that changes in sexual behaviour arising out of concerns regarding HIV infection can be inferred by changes in the incidence of gonorrhoea. We have reviewed data on gonococcal isolates in Newcastle over the last 13 years and looked at changes in relation to HIV test requests, new cases of HIV infection and media campaigns. HIV testing has been available in the clinic since late 1985. There was a steady decline in cases of gonorrhoea from 1985–1991 and then as in other areas an increase in incidence was seen among homosexual and bisexual men. The majority of this recent increase was due to pharyngeal infection. Sexual behaviour may have changed but this cannot be purely attributed to HIV concerns. HIV testing began after the incidence of gonorrhoea in England was already falling and we found no relationship between trends in gonorrhoea, HIV test requests and new cases of HIV infection.