The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
Identifieur interne : 000133 ( Main/Exploration ); précédent : 000132; suivant : 000134The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis
Auteurs : Nikolaos Andreatos ; Christos Grigoras ; Fadi Shehadeh ; Elina Eleftheria Pliakos ; Georgianna Stoukides ; Jenna Port ; Myrto Eleni Flokas ; Eleftherios MylonakisSource :
- PLoS ONE [ 1932-6203 ] ; 2017.
Abstract
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”.
We examined the association of gonorrhea infection rates with the incidence of HIV and socioeconomic factors. A county-level multivariable model was then constructed.
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, R2 model = 0.56).
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.
Url:
DOI: 10.1371/journal.pone.0183938
PubMed: 28863154
PubMed Central: 5580927
Affiliations:
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis</title>
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<author><name sortKey="Mylonakis, Eleftherios" sort="Mylonakis, Eleftherios" uniqKey="Mylonakis E" first="Eleftherios" last="Mylonakis">Eleftherios Mylonakis</name>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>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”.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>We examined the association of gonorrhea infection rates with the incidence of HIV and socioeconomic factors. A county-level multivariable model was then constructed.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>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<sup>2</sup>
model = 0.56).</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
</front>
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<name sortKey="Flokas, Myrto Eleni" sort="Flokas, Myrto Eleni" uniqKey="Flokas M" first="Myrto Eleni" last="Flokas">Myrto Eleni Flokas</name>
<name sortKey="Grigoras, Christos" sort="Grigoras, Christos" uniqKey="Grigoras C" first="Christos" last="Grigoras">Christos Grigoras</name>
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