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Gonorrhea rates rise among Ontario gay, bisexual men

Casual hook-ups, lack of awareness of STI, credited for increase

The very nature of gonorrhea transmission makes it hard to detect and easy to get. Credit: Dtkytoo / iStock / ThinkStock

Gonorrhea is on the rise amongst men who have sex with men in Ontario.

Just under 1,300 men who have sex with men (MSM) reported gonorrhea infections in 2014, compared to 800 in 2012, according to a new report released by Public Health Ontario.

When shown as a percentage, the numbers seem fairly steady — MSM fluctuate as between 40 percent and 45 percent of all gonorrhea cases in men over the last three years. But Dr Vanessa Allen, the chief of medical microbiology at Public Health Ontario, expressed concern about the rising number. “The overall number is striking in terms of increase,” she says.

“We’ve never seen this before in terms of the [overall spectrum] of cases. It really is an opportunity to remind people to protect themselves.”

For men, the highest risk age group is 20 to 29, while for women it’s about 20 to 24. “But we are seeing gonorrhea in the full age range,” she says. “So it’s highest in those age ranges but it’s certainly not exclusive.”

In Toronto, the increase of men who have sex with men who had reported cases of gonorrhea was smaller than reported in heterosexual people, according to Dr Rita Shahin at Toronto Public Health. “It’s hard to say exactly what’s going on,” Shahin says, noting that the rates have raised right across the board. However, the predominant risk factor for both gay and straight people is not using a condom.

Global News first reported the rise, noting that the infection has become more resistant to traditional treatments, causing concern that it may eventually become untreatable.

Shahin says that currently the most effective treatment for gonorrhea is an injectable antibiotic. “Not all doctors have switched over to that and not all people want the injection,” she says, noting that some people are more comfortable taking oral antibiotics.

A variety of factors play into the increase that public health organizations have seen across the board — the popularity of dating apps like Grindr and Tinder have, for example, made it easier for people to have casual and anonymous sex, but harder to have awkward conversations.

“If you don’t know your partner well, you might not be comfortable discussing things like, ‘when have you been tested for an STI?’” Shahin says.

The very nature of gonorrhea transmission makes it hard to detect and easy to get. The infection can be transmitted through oral, anal or vaginal sex. However, it is almost always asymptomatic when transmitted orally, according to Allen — which means it’s possible to have it and pass it to other partners without ever knowing you had an infection.

As well, only about 10 percent of women with gonorrhea show symptoms, compared to 50 percent of men, according to Shahin.

Allen says that there also remains a worry that people simply don’t know how to protect themselves — or simply choose not to do so. Many people, for example, choose not to use protection when performing oral sex. That’s why the use of condoms or dental dams are always advised.

“Then the only other thing to do is to get tested,” Shahin says. She adds that people should be tested at least once a year — more regularly if they have new partners — and should ask their doctors to examine everywhere there is potential to contract an STI.