Risk of gonococcus gonorrhea infection among women who report sex with women: a prospective study

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American Journal of BioMedicine  Volume 2, Issue 5, pages 598–607, May 2014

Steve R Cudeck;  Matthew Platt; Xiang-Sheng Song; Allan Nielsen; Moritz Walker; Slocum Rothschild; Rueda Bennett; Ezcurra Huggett; Phillips J Drancourt; Bin Lee


Infections caused by Neisseria gonorrhoeae (GC) are major public health problems globally. The objective of this study is to assessed risks for GC acquisition in lesbian women in a prospective study. We used comprehensive computer-assisted self-interview (CASI) to assess behavioral risks. Women were followed for 18-months with interval examinations for genital symptoms at any time. PCR for GC-associated bacteria (GCAB) were applied to vaginal fluid obtained at enrollment. Of 467 participants, 134 women (28.7%) had GC at enrollment and were excluded from the longitudinal analysis of risks for GC acquisition, which thus included 333 participants. These 333 women who not have GC at the enrollment visited 277returned for at least one follow-up visit. Median duration of follow-up for these 277 women was 18 months and 95 episodes of GC occurred among these 277 women. Furthermore; analysis the sexual behavioral data which revealed a direct dose-response relationship with increasing numbers of reported episodes of receptive oral-vulvo-vaginal sex. The corresponding estimated relative risk (RR) of 1.02 per act translates to a 31% increase in risk of GC for each additional 10 such acts in the last three months. A similar association with receptive oral-anal sex did not reach statistical significance. Furthermore, the multivariate model of risks for acquisition of GC included a composite variable that was based on detection of any positive PCR assay for the bacteria that were significantly associated with subsequent GC.

Keywords: Neisseria gonorrhoeae; PCR; Oral-vulvo-vaginal sex; Lesbian


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