Iceberg Ahead: Drug-Resistant Gonorrhea
In January 2023, Massachusetts became the vanguard of a long-feared national public health threat: drug-resistant gonorrhea.
This is the first time that gonorrhea, one of the most widespread sexually transmitted infections (STIs), has shown reduced or full resistance to five classes of antibiotics. Any reduction in response to antibiotics is bad news because it means that one of our most important modern medicines is failing.
Antibiotic-resistance is a natural occurrence that develops over time but is exacerbated by healthcare providers over-prescribing and by patients not adhering to prescription guidelines — this includes stopping your antibiotics earlier than your doctor advised!
Antibiotic-resistant gonorrhea has been an issue in Europe and Asia for several years, with the UK identifying nine cases between 2015 and 2021. Another 10 cases appeared in a recent six-month period, which is a sudden and rapid increase that worries public health experts. Data from 77 countries show an increase in gonorrhea antibiotic-resistance. The WHO global surveillance program, which monitors trends in drug-resistant gonorrhea, reported an increased resistance to our final line of defense against this STI.
Gonorrhea is the second most common STI. An estimated 78 million people are infected with gonorrhea globally every year, and across the world the rates of all STIs are constantly on the rise. The Netherlands reported a 33% increase of gonorrhea in 2022, Australia experienced a 64% rise in gonorrhea cases over the past five years, and the United States had a 27% rise in cases from 2017 to 2021.
Gonorrhea can infect the genitals, rectum, and throat. Complications from gonorrhea disproportionally affect women, and include pelvic inflammatory disease, infertility, ectopic pregnancy, and chronic pelvic or abdominal pain. If left untreated, gonorrhea can cause life-threatening blood and joint damage. Gonorrhea is known to not show symptoms in many cases. Sometimes people go undiagnosed for years, which leads to permanent damage.
Gonorrhea requires the correct antibiotic to fully treat the infection. An insufficient antibiotic treatment will allow the infection to remain and potentially worsen.
Studies from France to California are making the case for presumptively treating high-risk patients for STIs with Doxycycline as a post-exposure prophylaxis, called DoxyPEP. This presumptive treatment is given to persons within three days of having sex without a condom. Study trials have been effective in reducing rates of syphilis and chlamydia, but not gonorrhea. Additionally, presumptively treating with antibiotics can be a slippery slope to escalating antibiotic resistance.
AIDS Healthcare Foundation sounded the alarm by posting billboards in major cities across the US, and local news agencies took notice in Baltimore, Seattle, Washington, D.C., New York, and even the UK.
Prevention is the best defense against dangerous strains of gonorrhea. The most effective way to reduce STIs is through safer sex practices. Using condoms, getting tested, and talking to your sexual partners about your health can save your life.
AIDS Healthcare Foundation is the largest provider of HIV/AIDS medical care in the world, providing cutting-edge medicine and advocacy to over 1.7 million people in 45 countries. Find out if there is a location near you for free HIV and STI testing: https://www.freestdcheck.org
