Gonorrhea Transmission: Risk Factors & Prevention
Neisseria gonorrhoeae infects mucosal surfaces of the reproductive tract, rectum, pharynx, and eyes. Transmission occurs via:
- Unprotected sexual contact: Vaginal, anal, oral sex (giving/receiving).
- Perinatal: Mother to neonate during vaginal delivery → ophthalmia neonatorum.
- Autoinoculation: Genital to eye (rare).
Risk Factors
- Multiple or new partners.
- Inconsistent condom use.
- Prior STI (marker for risk behavior).
- Age 15–24 (highest incidence).
- MSM (men who have sex with men): Higher rectal/pharyngeal rates.
- Substance use (impaired judgment).
Prevention
- Condoms (latex/polyurethane) for all penetrative/oral sex.
- Regular screening (NAAT urine/swab) per CDC guidelines.
- Partner notification/treatment (expedited partner therapy where legal).
- Doxycycline PEP (200 mg within 72 hrs post-exposure) emerging for high-risk MSM.
Asymptomatic infection is common (especially pharyngeal/rectal/female genital)—screening detects silent carriers.
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