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Super Bug: Is Gonorrhea Becoming The New AIDS?

Time was, if you came down with gonorrhea, you got a shot or took a pill. It was an annoyance more than anything else—so benign that they gave it a cute little nickname, “the clap.”

But now, all those millions of shots and pills later, more antibiotic-resistant strains of gonorrhea are emerging and edging the disease dangerously close to becoming untreatable.

On Thursday the Centers for Disease Control and Prevention issued new guidelines on how medical professionals should treat the 700,000 Americans who get gonorrhea each year. The new rules aren’t about better treatments or curbing outbreaks, though—they’re about keeping current treatment effective.

Back in the day, you could zap the clap with penicillin, tetracycline and other common antibiotics. But over the years gonorrhea has mutated to resist those drugs. And the frequency at which patients are given antibiotics for a host of other illnesses makes them less and less effective.

“A lot of this is occurring not because of treatment for gonorrhea but overuse for other infections, such as urinary tract infections, upper respiratory tract infections and so forth,” researcher Jonathan Zenilman told NPR.

There’s now essentially one drug left that scientists feel is an effective treatment: ceftriaxone. And its’ only a matter of time before it ceases to work, too. Cases of untreatable gonorrhea have already been found in Europe and Asia.

Unlike AIDS, though, gonorrhea is passed just as easily through vaginal sex as it is through anal sex. (Well, at least it’ll be an equal-opportunity epidemic.) In fact, since its most serious complications are life-threatening ectopic pregnancies and infertility, gay men would be the least devastated.

That’s not to minimize the seriousness of the situation—we just wonder how the religious right will paint the new strains of gonorrhea as God’s judgment on the gays.

Ironically, though, the AIDS epidemic is what might help us prevent a catastrophe:

Before AIDS, if you got a STD, your doctor gave you the cure and told you to tell your partners (wink, wink). But as AIDS cut a swath through society, learning how to tracking disease vectors became a life-or-death issue.

Before AIDS, no one used condoms (at least if our uncle is to believed). Now we’re all conditioned to wrap that pocket rocket in a jimmy hat.

Before AIDS, medical professionals were not always diligent about sterility—and nobody bothered putting on gloves unless you were getting a prostate exam. Now, the importance placed on antibacterial soap, latex protection and other tools will help control the spread of gonorrhea, which can transfer from a patient’s genitals to a nurse’s hands to her eye.

That’s where some experts say we’re headed: working to control the spread of gonorrhea instead of administering a simple cure. Sound familiar?

If there’s a takeaway from the CDC pulling the alarm bell, its that we have to remember that AIDS is not the only sexually-transmitted infection out there. And just because something can be taken care of with a shot—or a drug cocktail—today, doesn’t mean it won’t become a serious problem tomorrow.

 

By:           Dan Avery
On:           Aug 10, 2012
Tagged: , , , , ,

  • 28 Comments
    • QJ201
      QJ201

      Inaccurate comparison.

      HIV -> AIDS = DEATH

      The Clap = It burns when I pee

      A more apt comparison would be Herpes.

      Aug 10, 2012 at 6:38 am · @ReplyReply to this comment ·
    • YesBut
      YesBut

      QJ201 – thats about it, IF it isn’t left to do its dirty work for years and years. If you don’t or can’t cure it, eventually it can cause all kinds of serious issues (such as, for example, impotence). Check with your doctor.

      Aug 10, 2012 at 7:48 am · @ReplyReply to this comment ·
    • MikeE
      MikeE

      @YesBut: impotence < death

      at least, it would seem to me.
      so I'll agree with QJ201 that it's an inaccurate comparison.

      Aug 10, 2012 at 7:58 am · @ReplyReply to this comment ·
    • The Real Mike in Asheville
      The Real Mike in Asheville

      So, is this “Lets just be stupid” day at Queerty?

      You wrote:

      “Super Bug: Is Gonorrhea becoming the New AIDS?” and

      “Unlike AIDS, though, gonorrhea is passed just as easily through vaginal sex as it is through anal sex. (Well, at least it’ll be an equal-opportunity epidemic.) In fact, since its most serious complications are life-threatening ectopic pregnancies and infertility, gay men would be the least devastated.”

      HIV is a virus, gonorrhea is a bacteria. BIG FUCKING DIFFERENCE! The HIV virus needs a tear in skin to access the circulatory system, hence a higher incidence of transmission through anal sex than vagina sex.

      Gonorrhea, as a bacteria, just needs to be passed to a body where it will find its own way to the circulatory system, hence, the equal chance of transmission through anal or vaginal sex.

      And this leads you to “not to minimize the seriousness…” So, which are you making light of? That HIV/AIDS is a life threatening disease to the 90% who become infected and a big ongoing medical issue for all HIV+s, or, that a new version of gonorrhea could cause health issues to the up to 3% of women and 1% of men were treatment is a problem?

      ********

      Lets leave the concept of “not to minimize the seriousness” to issues involving cute Olympic athletes, digs at wingnuts, poking fun at red silk dress wearing Cardinals and Popes who want to tell the rest of us how to live.

      How about keeping serious when writing about serious health issues affecting the gay community. We take enough shit from the haters, we don’t need it from you.

      Aug 10, 2012 at 8:32 am · @ReplyReply to this comment ·
    • Louie
      Louie

      No glove…no love…

      Aug 10, 2012 at 10:12 am · @ReplyReply to this comment ·
    • the other Greg
      the other Greg

      @QJ201: There are now around two dozen effective treatments for HIV that when successful, allow the patient to live a long healthy life, and also render the virus almost incapable of being passed on to sexual partners. The main problem with HIV now is those who have it and don’t know it (or don’t want to know).

      The point here is that complacency set in about gonorrhea and the treatments haven’t kept up with it, mostly because people in general nowadays tend to overuse antibiotics for trivial things.

      I’ll leave it to those who’ve experienced it to say how painful gonorrhea is when you pee, but from what I’ve heard I’m guessing if it happens to you and it’s untreatable, you might wish you had treatable HIV instead!

      Aug 10, 2012 at 10:36 am · @ReplyReply to this comment ·
    • MikeE
      MikeE

      @the other Greg: No, wrong.
      there are medications that control the replication of HIV in the human body, for a limited amount of time, and which have seriously damaging effects on the human body’s various systems, notably the liver (most HIV meds have significant liver toxicity).

      Sure, you’re not producing tons of HIV in your body.

      Meanwhile, you’re on a liver transplant list, being treated for diabetes brought on by the liver failure.

      or you could be suffering from the various forms of (sometimes extremely painful) lipid disorders that accompany the use of those “effective treatments” you so loudly trumpet.

      Stop with the myth that HIV is now a benign, treatable, chronic infection with modern medication. It’s not.

      If HIV doesn’t ravage your body, the meds will, and faster than you think. Most cannot be taken for more than 3-4 years. Which means a change in medication every 3-4 years.

      Aug 10, 2012 at 10:58 am · @ReplyReply to this comment ·
    • brad
      brad

      Reason #243 I won’t use Grindr.

      Aug 10, 2012 at 11:02 am · @ReplyReply to this comment ·
    • The Real Mike in Asheville
      The Real Mike in Asheville

      @MikeE: Not to mention, that idiots who think undetectable viral load = freedom to lose the condom, is seriously and dangerously false. Undetectable viral loads sample the viral load in blood; however, low and undetectable viral loads DO NOT MEASURE THE VIRAL LOAD IN SEMEN — that is, the viral load in semen can be hundreds of times greater than the viral load in blood, making unsafe sex VERY unsafe.

      Aug 10, 2012 at 11:35 am · @ReplyReply to this comment ·
    • the other Greg
      the other Greg

      @MikeE: All that IS possible, of course.

      “there are medications that control the replication of HIV in the human body, for a limited amount of time…” Well, wrong – in many patients, for years and years with no complications at all. I’ve talked to many, many HIV patients who’ve been on the same med combos for much longer than 3-4 years. But sure, the dire complications you describe ARE possible.

      I should have added that HIV- guys should avoid barebacking, particularly with new sex partners who CLAIM to be HIV-.

      More importantly, it’s not even possible to get HIV from GETTING a bj, but gonorrhea can be gotten that way. Maybe it’s best to concentrate on combating the new gonorrhea problem without sensational analogies to it being “the new HIV” or anything like that, because there are important differences and it just confuses the issue.

      Aug 10, 2012 at 11:36 am · @ReplyReply to this comment ·
    • the other Greg
      the other Greg

      @The Real Mike in Asheville: Barebacking should be avoided, always. (It’s a mystery to me why people seem to be always looking for some inane, idiotic excuse to do it.)

      However, gonorrhea can be transmitted easily by oral sex! Which is fortunately NOT the case with HIV.

      Aug 10, 2012 at 11:41 am · @ReplyReply to this comment ·
    • Cory
      Cory

      Agreed QJ101. Yes you can get gonorrhea from oral sex. I’ve never gotten it but a younger GWM friend of mine did from oral sex.

      Aug 10, 2012 at 3:04 pm · @ReplyReply to this comment ·
    • Cory
      Cory

      Agreed QJ101. Yes you can get gonorrhea from oral. I’ve never gotten it but a younger GWM friend of mine did from oral.

      Aug 10, 2012 at 3:08 pm · @ReplyReply to this comment ·
    • Cory
      Cory [Different person #1 using similar name]

      Agreed QJ101. Yes you can get gonorrhea from oral sex. I’ve never gotten it but a younger GWM friend of mine did from oral sex. This guy was convinced that you can’t get STDs from oral sex and that the ones you could get were not that big of a deal. He also was into barebacking at times.

      Aug 10, 2012 at 3:09 pm · @ReplyReply to this comment ·
    • The Real Mike in Asheville
      The Real Mike in Asheville

      @the other Greg: Greg — while it is true that HIV is not easily transmitted orally, that is not the same as not being transmittable orally.

      HIV levels in semen do not correspond with viral loads in blood. While the viral load in blood drops to undetectable with successful therapy, drug therapy attacks the virus in blood but not semen. Viral levels in semen are at their height during the acute infection stage (first month) and in advanced infection.

      Here is where the problem with oral sex and transmission — HIV+ has sufficient viral load in semen, and the person performing oral sex has bleeding gums (say, they showered and brushed and flossed before a hook-up). Since viral load in semen is not part of therapy review, one does not know whether they are at higher risk of transmitting the virus.

      *******

      Regarding MikeE’s comment about medications, I think MikeE was informing those who don’t know, that drug therapy only works while the patient is actively on the therapy. As soon as one goes off their meds, the virus returns to full strength within 2-3 weeks — I have taken 4 drug holidays (on 3-4 years, off 6 months), and each time my undetectable viral load jumped to over 50,000 copies in less than 1 month.

      Aug 10, 2012 at 3:17 pm · @ReplyReply to this comment ·
    • cam
      cam

      Gee,

      This must be God’s punishment for Straight people. This disease is extremely communicable between hetros.

      So since nutjobs all said AIDS was our punishment because gays were getting it in large numbers, the reverse must be true here.

      So now we have natural disasters crushing states like Texas, Mississippi etc… and STD’s effecting straights….guess God is PISSED at the Hetros!

      Aug 10, 2012 at 4:49 pm · @ReplyReply to this comment ·
    • phishy2
      phishy2

      @QJ201:
      It is clear that whoever wrote this title did not live thru the 1980’s and early 90’s.
      It really is sad how quickly the population has forgotten just how severe HIV was then and just how severe it can become if you become resistant to therapy.

      Aug 11, 2012 at 12:01 am · @ReplyReply to this comment ·
    • Eddie
      Eddie

      “Untreatable gonorrhea” …the way things are coming the only way to stop/treat this is to do like the islamics do: Cutting penises and hands ( to not scretch there… ) of those who are infected. Sounds stupid and naive to you? But what do you want me to say if the article told that this is ” untreatable ” ? When AIDS ” began ” there where people that went to hospitals to visit terminal “friends” that went to the facilities and did the flush with the foot…

      Aug 11, 2012 at 1:11 am · @ReplyReply to this comment ·
    • Dagrlzrd
      Dagrlzrd

      @MikeE: Hey Dude! Are you a Doctor? I have had HIV since 1984 and have been on the same medication since 1995. Sustiva and combivir to start then Atripla when it became available. And while it is true that HIV infection does accelerate certain ailments such as arthritis and may effect hereditary disorders.My viral load is undetectable,my liver enzymes are within normal levels,and my T-Cell count remains around the 700 to 800 range, my CD-4 is over 50% 52.3% to be precise.However there are mutated strains of the HIV virus that are resistant to treatment largely due to the fact that people were irresponsible with taking their medication.By exposing HIV to drugs alcohol and antiviral and retro-viral agents.The same can be said for Hep-C,Syphilis,and Gonorrhea.Viruses have developed different more aggressive genotypes and bacteria becomes resistant.Super staff or M.R.S.A. is a very good example of this.I never miss my HIV medication and I always finish antibiotics on the rare occasion that they are needed.On a more positive note I feel great,I eat right exercise and take Geritol everyday.I also do my homework before I make broad statements about anything.

      Aug 11, 2012 at 9:59 am · @ReplyReply to this comment ·
    • Mitch
      Mitch

      @The Real Mike in Asheville: Mike, until you can scare up a single medically documented example of a stable undetectable transmitting HIV, please kindly refrain from your fearmongering and half-assed assumptions about how much virus is in the body or anecdotes that it can be detected in semen. It does, quite literally, appear as though undetectable plasma load equates uninfectious. The how and the why is beside the point and too much information to go into. The important thing is that after decades of examination, dozens of studies and tens of thousands of people studied, we’ve yet to produce a single undetectable monogamous couple that seroconverted. The last thing we need is some self-appointed “prevention activist” running around scaring people with lies and misinformation.

      Aug 11, 2012 at 1:20 pm · @ReplyReply to this comment ·
    • Rob McGee
      Rob McGee

      One thing that’s not made clear in the story: Are the rising gonorrhea rates accounted for by oral transmission, or by anal transmission, or both, or is this unknown?

      Why this is important: Although gonorrhea affects the whole body, the lesions are often localized to the site of the initial infection. And in the earliest years of AIDS — even before HIV had been identified — doctors treating gay male patients noticed something interesting:

      MSMs with AIDS symptoms very often had gonorrhea lesions in the rectum (and, sometimes, also in the mouth/throat and/or on the genitals). However, men who had oral gonorrhea lesions but NO rectal lesions were often free from AIDS symptoms. So this provided a significant early clue that AIDS was easily spread by anal sex, but did not spread very easily by oral sex.

      And what this means in the present context is that if *rectal* gonorrhea is on the rise, it’s quite likely that anal barebacking is a significant factor. But if oral gonorrhea is on the rise, it doesn’t necessarily mean that MSMs are having unsafe anal sex more often; it could mean, instead, that there’s a new strain of gonorrhea that spreads even more easily by oral transmission.

      Aug 11, 2012 at 3:13 pm · @ReplyReply to this comment ·
    • hf2hvit
      hf2hvit

      As an RN, it just amazes me the ignorance and stupidity I still read about HIV

      MIKE!

      Aug 11, 2012 at 11:52 pm · @ReplyReply to this comment ·
    • the other Greg
      the other Greg

      @The Real Mike in Asheville: No, MikeE (Fake Mike?) was saying exactly the opposite: “If HIV doesn’t ravage your body, the meds will, and faster than you think.” He says that’s the inevitable outcome, which is not even close to being true. This after commenter #1 said “HIV -> AIDS = DEATH,” a wild exaggeration even in the ’80s before HAART therapy. Sensationalism like this has no other motive than to demonize the HIV-positive like yourself, so I’m a little puzzled why you don’t see it for what it is.

      Also I wonder why you’ve taken so many “drug holidays” – isn’t that a long-discredited concept?

      @Mitch: Once in awhile you encounter a guy who thinks cum is icky!

      @hf2hvit: Yeah, any mention of HIV on Queerty devolves into a b*tch-fest by the “HIV- guys are good, poz guys are evil sluts” crowd. One poster even used the term “pure and wholesome” several times to describe himself! Months later this still sends my (sero-discordant) household into uncontrollable giggling.

      Aug 12, 2012 at 1:09 pm · @ReplyReply to this comment ·
    • Mitch
      Mitch

      @the other Greg:
      Yeah, you do sometimes meet a guy who thinks cum is icky. That’s his prerogative. For the record, I actually think we should ALL ideally continue to use condoms, poz and neg alike. There are a lot of nasties that float around besides HIV. It’s particularly bizarre that to me that for more than half of this epidemic, we’ve been able to treat HIV succesfully, and yet we still talk about nothing but HIV HIV HIV when we discuss gay sexual health, making people who are infected out to be lepers and ignoring everything else that can fuck you up. This is bizarre. Tell an HIV- with neurosyphillis that they’re “clean”. I’m sure they won’t feel too relieved. Heck, tell someone with untreatable gonnorrhea that it’s “not as bad as HIV” as the infection spreads into sepsis after their dick has been spliced open and irrigated with bleach. That is, by the way, what really will happen to a good chunk of gonorrhea victims in the absence of effective antibiotics. I’ve no doubt that these people will disagree with the sentiment that HIV is the worst thing that can happen to them.

      What offends me…and you’ve already touched on it…is “mike in asheville” and his tendency to exaggerate the consequences of HIV as part of some alleged “HIV prevention at any cost” mentality. You are totally accurate when you say that it demonizes people with HIV. This in turn encourages risky behavior amongst both poz and neg, as the poz people tend to think we have nothing left to lose, and the neg people think that as long as their test keeps coming back neg, they’re fine. I see people like mike as the reason why barebacking is ubiquitous amongst poz men, and increasingly normal amongst idiots who presume their partners to be neg. Mike represents a part of the HIV community that has always bewildered me, the part that doesn’t hesitate to use various “nuclear options” against the virus. Yeah, like nuclear weapons, demonizing poz people and keeping up fear of the virus sounds like it’ll work (we can go into how it doesn’t later), but like nuclear weapons, what we’re left with is a radioactive wasteland. Of what value is a population of HIV- gay men who’ve gone mad from syphillis, who’ve learned to treat their fellow man like shit and who are total hypochondriacs?

      Of particular concern from Mike is his ongoing need to completely fabricate risk of transmission from undetectables, creatively estimating various viral loads and citing irrellevant information to make his point. Who cares that there’s still detectable VL in the semen of undetectable poz men? There’s obvious not enough VL in there to prove infectious either way. Why does he do this? What possible benefit is there? Even if undetectables ARE infectious, we can reasonably assert that we’re no more infectious than the average gay man who thinks he’s negative, as 1/10 of these guys are poz. So really, what benefit is there in scaring off neg men from poz?

      Let’s be clear though, the overwhelming data indicates that undetectables aren’t infectious. The reason medical science hasn’t come out and said it is that ethics prevent us from performing the sort of controlled experiments and comparisons that would allow us to say this. When you have TENS OF THOUSANDS of undetectable cohorts who aren’t seroconverting though, the answer to the question is pretty obvious, regardless of how legalistic you want to get about minor details.

      Aug 12, 2012 at 2:47 pm · @ReplyReply to this comment ·
    • Daez
      Daez

      @the other Greg: My partner and I enjoy barebacking. It gets us both off. Its enjoyable. We are both HIV- and have been together for two years. Who are you to tell us what to avoid?

      Aug 13, 2012 at 10:11 pm · @ReplyReply to this comment ·
    • Daez
      Daez

      @The Real Mike in Asheville: His comment was that you can not get HIV from RECEIVING oral sex. It would be next to impossible unless you have open sores on your penis at the time you are receiving oral sex.

      Aug 13, 2012 at 10:13 pm · @ReplyReply to this comment ·
    • Daez
      Daez

      This is also why you should not run to the doctor and allow them to prescribe you an antibiotic every time your nose runs. Building tolerance to any drug is the worst thing you can possibly do.

      Aug 13, 2012 at 10:20 pm · @ReplyReply to this comment ·
    • the other Greg
      the other Greg

      @Daez: Not sure why you’re bothering to read and comment on an HIV article at all. (To brag?) But okay, you guys are such a rare, rare, rare, rare case that I didn’t bother to mention it!

      Aug 14, 2012 at 11:03 am · @ReplyReply to this comment ·

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