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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”...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
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. |
format | Online Article Text |
id | pubmed-5580927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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