Ariza-MejÃÂa MC, García-García L, Puerta-López T, Menéndez-Prieto B, Vera-García M, Clavo-Escribano P, Ballesteros Martín J, Rodriguez-Martín C, Gil de Miguel A, del Romero-Guerrero J and Gil-Prieto R
Introduction: During the past decade, the incidence of gonorrhoea has increased in Spain, mainly affecting the community of men who have sex with men. The objective of the present study was to describe the cases of gonococcal infection at a referral centre for sexually transmitted diseases in Madrid, as well as the factors associated with co-infection by the human immunodeficiency virus. Methods: A retrospective cross-sectional study was performed of all of the cases of gonococcal infection that were diagnosed in 2010 at the Sandoval Health Centre of Madrid. Clinical histories, diagnostic tests, and sociodemographic and risk-behaviour questionnaires were analysed. Results: Eighty-three per cent of the patients who were diagnosed with gonorrhoea were men who had engaged in sex with men, and 29% tested positive by serological screening for HIV. In the multiple logistic regression model the following factors were associated with the HIV co-infection: having a positive history of one or more sexually transmitted diseases (OR=57.44; 95% CI: 6.78-486.50), having a stable partner who was HIV-positive (OR=23.13; 95% CI: 2.44-219.36), having a concomitant syphilis diagnosis (OR=8.88; 95% CI: 1.90-41.37), having engaged in unprotected, insertive anal intercourse (OR=6.10; 95% CI: 2.52-14.76), and having engaged in high-risk sexual contacts while under the influence of alcohol or other drugs (OR=2.73; 95% CI: 1.13-6.62). Conclusions: In the present study, a greater incidence of gonococcal infection and HIV co-infection was observed in men who had engaged in sex with men. Therefore, greater emphasis should be placed on the routine screening for sexually transmitted diseases and the targeting of education and health-promotion initiatives to highrisk communities
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