Know Your STD :: Gonorrhea

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WHAT IS IT?

Gonorrhea is a sexually transmitted disease (STD) caused by the bacterium Neisseria gonorrhoeae. It is a very common STD (also known as "the Clap") and is estimated that there are more than 700,000 new cases each year.

WHY DO GAY/BI MEN NEED TO KNOW ABOUT IT?

Besides being the second-most commonly reported bacterial STD, it has increasingly become resistant to available medications. Quinolone-Resistant N. gonorrhoeae (QRNG) is rising fast in the gay/bi men's community (MMWR 2004).

Gonorrhea can cause serious, long-term damage and sterility. Also, it makes it easier to both get HIV (because of tissue inflammation) and give HIV (there is more HIV in semen and vaginal fluids when a person is infected with gonorrhea).

HOW DO I GET IT?

Gonorrhea is most commonly spread from person to person during unprotected oral, anal, or vaginal sex. Like chlamydia, it is site-specific, so if a person has a gonorrheal infection in their throat, it can be transmitted to a penis during oral sex, and vice versa. If a person has gonorrhea in their penis, it can be transmitted inside of a butt, and vice versa. It is possible to be infected in more than one site at the same time.

The eyes are also susceptible and can be infected if someone with gonorrhea in their penis ejaculates in another person's eye.

A guy does not need to ejaculate (cum) in order for transmission to occur during unprotected sex.

Using a latex or polyurethane condom will help prevent transmission if used correctly, and used every time.

Communicate with your partners about current or previous risks for STDs, and familiarize yourself with the symptoms of gonorrhea.

WHAT ARE THE SYMPTOMS?

Many men do not exhibit symptoms of gonorrhea, especially if infected in the throat or the butt. Symptoms typically develop within 2 to 5 days after initial infection, though symptoms may take as long as 30 days to develop.

Typical, site-specific symptoms (for those men that develop them), may include:

Left untreated, gonorrhea can cause epididymitis, a painful condition of the testicles that can cause sterility. Gonorrhea can also spread to the blood, joints, heart and nervous system, and can sometimes lead to life-threatening conditions.

HOW DO I KNOW IF I HAVE IT?

Gonorrhea can be diagnosed by collecting samples from each site (urine or urethral swab for the penis, anal swab for the butt, and pharyngeal swab for the throat) and examining the sample under a microscope.

If a person has had their penis in someone else's mouth, butt or vagina, the penis needs to be tested.

If a person has had a penis in their throat, the throat needs to be tested.

If a person has had a penis in their butt and/or vagina, the butt and/or vagina needs to be tested.

A person can test negative for gonorrhea in their penis and be positive in their throat and/or butt and not know it unless each site is tested.

HOW IS IT TREATED?

Gonorrhea is no longer easily treated with antibiotics taken by mouth. It is no longer recommended that gay/bi men be treated with penicillin or fluoroquinolones (MMWR 2004).

Cephalosporans are the recommended treatment for gonorrhea infections in gay/bi men and are administered by injection. It is very important to work closely with your medical provider around drug resistance and treatment.

People infected with gonorrhea frequently are co-infected with chlamydia, and often people are routinely treated for both when testing positive for gonorrhea.

It is possible to be re-infected with gonorrhea after treatment if a person is exposed again.

For more specific information about treatment and drug resistance, consult your medical provider. You can also read more in the CDC's 2006 Sexually Transmitted Diseases Treatment Guidelines as well as their April 2007 Update.

WHAT ABOUT SEX PARTNERS?

It is best to wait two weeks after treatment, but at the very least wait at least one week after treatment before having any kind of sex (oral, anal, or vaginal) to avoid infecting others and avoid becoming re-infected.

It is also important that anybody that you have had sex with in the last two months (or your last sex partner if more than two months ago) be notified about your infection.

Each of your sex partners will need to be tested and treated. Do not have sex with anyone you have had sex with that has not been tested and treated.

Click here for information on how to notify your partners through InSPOT.

WAYS TO REDUCE YOUR RISK

• Use latex or polyurethane condoms every time to help prevent transmission
• Use a new condom or latex glove with each new partner in group settings
• Limit the number of people you have sex with
• Get a full STD exam on a regular (at least annual) basis, depending on your risk
• Get your partners tested on a regular basis

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For more information about gonorrhea, check out the CDC's Gonorrhea Fact Sheet.

For more information about QRNG and drug resistance, check out the CDC's Resistance Fact Sheet.

Questions about your risk? About testing? Contact the HIM Program or call us at 612.348.9100.

Content updated: May 08