TABLE 3.
Frequencies and Odds of Selected Characteristics of Gonorrhea Cases With Completed SSuN Patient Interviews* During Compared With Pre–COVID-19 Pandemic†, Baltimore City, MD
| Prepandemic (n = 512) | During Pandemic (n = 448) | (A) Unadjusted OR | (B) Models Adjusted for Diagnosing Provider Type‡ | (C) Models Adjusted for Diagnosing Provider Type and Age§ | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | OR | 95% CI | aOR | 95% CI | aOR | 95% CI | |
| Symptomatic¶ | 336 | 65.6% | 293 | 65.4% | 0.99 | 0.76–1.29 | 1.11 | 0.84–1.47 | 1.12 | 0.85–1.49 |
| Anatomic site of infection | ||||||||||
| Males, any urethral∥ | 225 | 43.9% | 109 | 24.3% | 0.29 | 0.19–0.44** | 0.36 | 0.23–0.56** | 0.36 | 0.23–0.56** |
| Males, extragenital only | 51 | 10.0% | 85 | 19.0% | Reference | Reference | Reference | |||
| Males, unknown site | 33 | 6.5% | 80 | 17.9% | 1.45 | 0.85–2.48 | 1.25 | 0.69–2.24 | 1.22 | 0.68–2.20 |
| Female, all sites | 203 | 39.6% | 174 | 38.8% | 0.51 | 0.34–0.77†† | 0.53 | 0.35–0.81†† | 0.53 | 0.34–0.83†† |
| Same-day/empiric treatment‡‡ | 272 | 53.1% | 167 | 37.3% | 0.52 | 0.40–0.68** | 0.66 | 0.50–0.87†† | 0.67 | 0.50–0.89†† |
| Age, years | ||||||||||
| <18 | 27 | 5.3% | 29 | 6.5% | 1.20 | 0.68–2.11 | 1.17 | 0.65–2.10 | ||
| 18–24 | 181 | 35.4% | 145 | 32.4% | 0.89 | 0.66–1.21 | 0.89 | 0.65–1.21 | ||
| 25–34 | 183 | 35.7% | 164 | 36.6% | Reference | Reference | ||||
| 35–44 | 63 | 12.3% | 71 | 15.8% | 1.26 | 0.84–1.87 | 1.38 | 0.90–2.09 | ||
| 45+ | 58 | 11.3% | 39 | 8.7% | 0.75 | 0.47–1.19 | 0.84 | 0.52–1.35 | ||
| Female sex at birth | 203 | 39.6% | 174 | 38.8% | 0.97 | 0.75–1.25 | 0.90 | 0.68–1.18 | 0.91 | 0.68–1.22 |
| Race/ethnicity | ||||||||||
| Non-Hispanic Black | 437 | 85.4% | 372 | 83.0% | 0.85 | 0.60–1.20 | 0.97 | 0.68–1.39 | 1.01 | 0.70–1.46 |
| Hispanic, or other race§§ | 75 | 14.6% | 76 | 17.0% | Reference | Reference | Reference | |||
| Diagnosing provider type | ||||||||||
| Sexual health clinic | 94 | 18.4% | 41 | 9.2% | Reference | |||||
| Emergency department/urgent care center | 78 | 15.2% | 109 | 24.3% | 3.20 | 2.01–5.12** | ||||
| Hospital | 141 | 27.5% | 56 | 12.5% | 0.91 | 0.56–1.47 | ||||
| FQHC¶¶ | 61 | 11.9% | 89 | 19.9% | 3.35 | 2.05–5.46** | ||||
| Private health care provider | 88 | 17.2% | 90 | 20.1% | 2.34 | 1.47–3.75** | ||||
| Other∥∥ | 50 | 9.8% | 63 | 14.1% | 2.89 | 1.71–4.87** | ||||
| Living with HIV*** | 39 | 7.6% | 64 | 14.3% | 2.02 | 1.33–3.08** | 1.95 | 1.26–3.03†† | 1.91 | 1.22–3.00†† |
| Previous gonorrhea diagnosis, past 12 mo | 67 | 13.1% | 86 | 19.2% | 1.58 | 1.11–2.24†† | 1.55 | 1.08–2.23††† | 1.56 | 1.09–2.25††† |
| Insurance | ||||||||||
| Insured | 428 | 83.6% | 413 | 92.2% | 2.32 | 1.48–3.62 | 1.89 | 1.18–3.03†† | 1.90 | 1.18–3.05†† |
| Uninsured | 72 | 14.1% | 30 | 6.7% | Reference | Reference | Reference | |||
| Unknown | 12 | 2.3% | 5 | 1.1% | 1.00 | 0.32–3.09** | 0.91 | 0.28–2.93 | 0.90 | 0.28–2.93 |
| MSM‡‡‡ | 104 | 20.3% | 129 | 28.8% | 1.59 | 1.18–2.13†† | 1.51 | 1.10–2.07†† | 1.50 | 1.08–2.08††† |
| In care | ||||||||||
| HIV care§§§ | 36 | 7.0% | 56 | 12.5% | 2.10 | 1.35–3.28** | 2.07 | 1.30–3.31†† | 2.07 | 1.28–3.35†† |
| PrEP care¶¶¶ | 50 | 9.8% | 77 | 17.2% | 2.08 | 1.42–3.06** | 2.21 | 1.47–3.32** | 2.23 | 1.48–3.35** |
| None documented | 426 | 83.2% | 315 | 70.3% | Reference | Reference | Reference | |||
*SSuN-enhanced surveillance activities, which include a survey completed by the diagnosing provider and a patient interview, are conducted on a random sample of the total reported gonorrhea diagnoses.
†During pandemic: March 1, 2020 to September 30, 2021; prepandemic: March 1, 2018 to September 30, 2019.
‡Values shown are odds ratios for each characteristic adjusted for diagnosing provider type.
§Values shown are odds ratios for each characteristic adjusted for diagnosing provider type and age.
¶Symptomatic patients were those that providers documented as having urethritis, proctitis, epididymitis, PID, discharge, or other STD-related findings during the examination or patients that self-reported discharge/oozing from the penis/vagina, painful/burning urination, or symptoms/pains believed to be caused by an STD.
∥Cases with reported positive laboratory tests from urine/urethral specimens.
**P < 0.001.
††P < 0.01.
‡‡Cases with documentation of receipt of CDC-recommended antimicrobial regimens for gonorrhea treatment or other microbial commonly used to treat symptoms consistent with gonorrhea on or before the date a specimen collected for laboratory testing.
§§Other race includes White, Asian, American Indian/Alaska Native, Hawaiian/Pacific Islander, multirace or other; 4 individuals with unknown race were collapsed into this category.
¶¶Federally qualified health center.
∥∥Includes outreach, schools, correctional facilities, laboratories, and reproductive health facilities.
***Documented HIV diagnosis reported to Maryland electronic HIV/AIDS reporting system on or before the gonorrhea diagnosis date.
†††P < 0.05.
‡‡‡Cases reporting male sex at birth and male gender identity, as well as either gay/homosexual or bisexual identity OR male sex partners.
§§§Cases living with HIV who self-report taking antiretroviral treatment (ART).
¶¶¶Cases reporting not living with HIV and self-report taking HIV PrEP treatment.