ABSTRACT
BACKGROUND: Sexual health service disruptions due to COVID-19 mitigation measures may have decreased gonorrhea screening and biased case-ascertainment towards symptomatic individuals. We assessed changes in reported symptoms and other characteristics among reported gonorrhea cases during- vs. pre-pandemic periods in one city with persistent gonorrhea transmission. METHODS: Enhanced surveillance data collected on a random sample of gonorrhea cases reported to the Baltimore City Health Department between March 2018-September 2021 was used. Logistic regression assessed differences in case characteristics by diagnosis period (during-pandemic: March 2020-September 2021; pre-pandemic: March 2018-September 2019). RESULTS: Analyses included 2,750 (1,090 during-pandemic, 1,660 pre-pandemic) gonorrhea cases, representing 11,904 reported cases. During- vs. pre-pandemic, proportionally fewer cases were reported by sexual health clinics (8.8% vs. 23.2%), and more frequently reported by emergency departments/urgent care centers (23.3% vs. 11.9%). Adjusting for diagnosing provider, fewer cases who were males with urethral infections [aOR: 0.65, 95% CI: (0.55-0.77)], aged <18 [aOR: 0.64, (0.47-0.89)], and females [aOR: 0.84, (0.71-0.99)] were reported, and cases with insurance [aOR: 1.85, (1.40-2.45)], living with HIV [aOR: 1.43, (1.12-1.83)], or recent (≤12 months) gonorrhea history [aOR: 1.25, (1.02-1.53)] were more frequently reported during- vs. pre-pandemic. Reported symptoms and same-day/empiric treatment did not differ across periods. CONCLUSIONS: We observed no changes in reported symptoms among cases diagnosed during- vs. pre-pandemic. Increased frequency of reported diagnoses who were insured, living with HIV, or with recent gonorrhea history are suggestive of differences in care access and/or care seeking behaviors among populations with high gonorrhea transmission during the pandemic.
ABSTRACT
The Baltimore City Health Department (Baltimore, MD) promoted IWantTheKit for chlamydia, gonorrhea, and HIV testing to city residents and clinic patients when COVID-19 restricted in-person clinic services. From April to October 2020, monthly online IWantTheKit orders increased by 645%. A high prevalence of chlamydia and gonorrhea was detected, and 96% of users who tested positive for chlamydia and gonorrhea were successfully contacted for treatment. Uptake by Baltimore City Health Department priority populations and excellent treatment linkage demonstrated how a public health-academic partnership successfully addressed a service gap during the pandemic. (Am J Public Health. 2022;112(7):985-989. https://doi.org/10.2105/AJPH.2022.306835).