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The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis

BACKGROUND: Gonorrhea is the second most commonly reported identifiable disease in the United States (U.S.). Importantly, more than 25% of gonorrheal infections demonstrate antibiotic resistance, leading the Centers for Disease Control and Prevention (CDC) to classify gonorrhea as an “urgent threat”...

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Autores principales: Andreatos, Nikolaos, Grigoras, Christos, Shehadeh, Fadi, Pliakos, Elina Eleftheria, Stoukides, Georgianna, Port, Jenna, Flokas, Myrto Eleni, Mylonakis, Eleftherios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580927/
https://www.ncbi.nlm.nih.gov/pubmed/28863154
http://dx.doi.org/10.1371/journal.pone.0183938
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author Andreatos, Nikolaos
Grigoras, Christos
Shehadeh, Fadi
Pliakos, Elina Eleftheria
Stoukides, Georgianna
Port, Jenna
Flokas, Myrto Eleni
Mylonakis, Eleftherios
author_facet Andreatos, Nikolaos
Grigoras, Christos
Shehadeh, Fadi
Pliakos, Elina Eleftheria
Stoukides, Georgianna
Port, Jenna
Flokas, Myrto Eleni
Mylonakis, Eleftherios
author_sort Andreatos, Nikolaos
collection PubMed
description BACKGROUND: Gonorrhea is the second most commonly reported identifiable disease in the United States (U.S.). Importantly, more than 25% of gonorrheal infections demonstrate antibiotic resistance, leading the Centers for Disease Control and Prevention (CDC) to classify gonorrhea as an “urgent threat”. METHODS: We examined the association of gonorrhea infection rates with the incidence of HIV and socioeconomic factors. A county-level multivariable model was then constructed. RESULTS: Multivariable analysis demonstrated that HIV incidence [Coefficient (Coeff): 1.26, 95% Confidence Interval (CI): 0.86, 1.66, P<0.001] exhibited the most powerful independent association with the incidence of gonorrhea and predicted 40% of the observed variation in gonorrhea infection rates. Sociodemographic factors like county urban ranking (Coeff: 0.12, 95% CI: 0.03, 0.20, P = 0.005), percentage of women (Coeff: 0.41, 95% CI: 0.28, 0.53, P<0.001) and percentage of individuals under the poverty line (Coeff: 0.45, 95% CI: 0.32, 0.57, P<0.001) exerted a secondary impact. A regression model that incorporated these variables predicted 56% of the observed variation in gonorrhea incidence (Pmodel<0.001, R(2) model = 0.56). CONCLUSIONS: Gonorrhea and HIV infection exhibited a powerful correlation thus emphasizing the benefits of comprehensive screening for sexually transmitted infections (STIs) and the value of pre-exposure prophylaxis for HIV among patients visiting an STI clinic. Furthermore, sociodemographic factors also impacted gonorrhea incidence, thus suggesting another possible focus for public health initiatives.
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spelling pubmed-55809272017-09-15 The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis Andreatos, Nikolaos Grigoras, Christos Shehadeh, Fadi Pliakos, Elina Eleftheria Stoukides, Georgianna Port, Jenna Flokas, Myrto Eleni Mylonakis, Eleftherios PLoS One Research Article BACKGROUND: Gonorrhea is the second most commonly reported identifiable disease in the United States (U.S.). Importantly, more than 25% of gonorrheal infections demonstrate antibiotic resistance, leading the Centers for Disease Control and Prevention (CDC) to classify gonorrhea as an “urgent threat”. METHODS: We examined the association of gonorrhea infection rates with the incidence of HIV and socioeconomic factors. A county-level multivariable model was then constructed. RESULTS: Multivariable analysis demonstrated that HIV incidence [Coefficient (Coeff): 1.26, 95% Confidence Interval (CI): 0.86, 1.66, P<0.001] exhibited the most powerful independent association with the incidence of gonorrhea and predicted 40% of the observed variation in gonorrhea infection rates. Sociodemographic factors like county urban ranking (Coeff: 0.12, 95% CI: 0.03, 0.20, P = 0.005), percentage of women (Coeff: 0.41, 95% CI: 0.28, 0.53, P<0.001) and percentage of individuals under the poverty line (Coeff: 0.45, 95% CI: 0.32, 0.57, P<0.001) exerted a secondary impact. A regression model that incorporated these variables predicted 56% of the observed variation in gonorrhea incidence (Pmodel<0.001, R(2) model = 0.56). CONCLUSIONS: Gonorrhea and HIV infection exhibited a powerful correlation thus emphasizing the benefits of comprehensive screening for sexually transmitted infections (STIs) and the value of pre-exposure prophylaxis for HIV among patients visiting an STI clinic. Furthermore, sociodemographic factors also impacted gonorrhea incidence, thus suggesting another possible focus for public health initiatives. Public Library of Science 2017-09-01 /pmc/articles/PMC5580927/ /pubmed/28863154 http://dx.doi.org/10.1371/journal.pone.0183938 Text en © 2017 Andreatos et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Andreatos, Nikolaos
Grigoras, Christos
Shehadeh, Fadi
Pliakos, Elina Eleftheria
Stoukides, Georgianna
Port, Jenna
Flokas, Myrto Eleni
Mylonakis, Eleftherios
The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
title The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
title_full The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
title_fullStr The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
title_full_unstemmed The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
title_short The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
title_sort impact of hiv infection and socioeconomic factors on the incidence of gonorrhea: a county-level, us-wide analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580927/
https://www.ncbi.nlm.nih.gov/pubmed/28863154
http://dx.doi.org/10.1371/journal.pone.0183938
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