Prevalence of Neisseria gonorrhoeae Among Men Screened for Chlamydia trachomatis in Four United States Cities, 1999–2003

In Brief Objectives: Neisseria gonorrhoeae infections are the second most commonly reported disease in the United States and cause significant morbidity. We describe the prevalence of gonorrhea in a large sample of men tested for gonorrhea and Chlamydia trachomatis in Baltimore, Denver, San Francisco, and Seattle. Methods: Gonorrhea prevalence was measured among 17,712 men tested in a variety of non–sexually transmitted disease (STD) clinic venues using urine-based nucleic acid amplification tests. Results: Among 16,850 asymptomatic men, prevalence ranged from 0% to 1.5% by city (P = 0.20): Baltimore 1.3%, Denver 1.5%, San Francisco 1.5%, and Seattle 0%. Among 862 symptomatic men, the gonorrhea prevalence varied from 0.0% to 28.3% by city (P <0.01). Conclusions: The high prevalence of gonorrhea in symptomatic men supports the importance of testing for symptomatic men. The prevalence of gonorrhea among asymptomatic men is low, and routine screening cannot be recommended when screening is performed for chlamydia, unless a substantial local prevalence of gonorrhea can be documented in specific targeted venues or population groups. Among 17,712 men undergoing urine screening in non-STD clinical and nonclinical settings in Baltimore, Denver, San Francisco, and Seattle, the prevalence of Neisseria gonorrhoeae detected by nucleic acid amplification testing in each city ranged from 0% to 1.5% in 16,850 asymptomatic men and 0.0% to 28.3% in 862 symptomatic men.