We know. When it comes to gay males and sexually transmitted diseases, it seems like when it rains, it pours, then rains some more. If your Twitter Feed has been like ours, you’ve been drowning in the depressing news about this new strain of “drug resistant gonorrhea“, often called super gonorrhea. But, this doesn’t mean what you think it does, or the way it has been reported. Let’s take a look at what these words really mean for you and the future of gonorrhea.

Drug resistance is the reduction in effectiveness of a medication! It does not mean the infection cannot be cured. It does mean that it may take more of those medications or different ones, and/or for longer periods of time.

(read that last sentence again and memorize it)

Since the early 1930’s and the rise of antibiotics, gonorrhea was known to be tricky and gain a quick resistance to medications. What we’re experiencing now is not new or news to those in the medical field. This isn’t to say that gonorrhea or any sexually transmitted disease shouldn’t be taken seriously, rather that context is important when reading about this disease.

The World Health Organization (WHO) reported from Geneva that “The bacteria that causes gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” said Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO.

“Gonorrhoea is a very smart bug,” said Wi, a human reproduction specialist at the Geneva-based UN health agency. “Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it.”Wi also said one of two new studies on gonorrhoea published in the journal Plos Medicine had documented antibiotic-resistant cases in Japan, France and Spain.

Read that above quote one more time please, because many news outlets misquoted or did bad research on what Wi said. Those outlets said in those three (3) countries, gonorrhea was “untreatable”. That is untrue. This is from Forbes Magazine: “In fact the WHO has indicated that strains of untreatable gonorrhea have emerged in three countries: Japan, France and Spain. Just super.”

Here is the quote from the research:

Treatment failure with ESCs

Treatment failures with cefixime have been identified in Japan since the early 2000s [36,37], followed by verified treatment failures in Austria, Canada, France, Norway, South Africa, and the UK [38–44]. Rare treatment failures with ceftriaxone (250–1,000 mg single dose) administered for pharyngeal gonorrhea have been verified in Australia, Japan, Slovenia, and Sweden [45–51]. The first verified treatment failure with the UK-recommended dual therapy (ceftriaxone 500 mg plus azithromycin 1 g) was recently identified [52]. To date, 3 extensively drug-resistant gonococcal strains with high-level resistance to ceftriaxone (“superbugs”) have also been reported—in France, Japan, and Spain [41,45,53].

Words and facts matter. Drug resistant strains, though a major issue, aren’t the same as an infection being untreatable. Doctors still have three (3) medications to use to treat gonorrhea with one known to still work every time. Also, this STD has much greater concerns for women than for gay males, who are known to rarely show symptoms.

As for the the development of new antibiotics to treat gonorrhea, it’s not very attractive for commercial pharmaceutical companies. Treatments are taken only for short periods of time (unlike medicines for chronic diseases) and they become less effective as resistance develops, meaning that the supply of new drugs constantly needs to be replenished “To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline. In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use,” said Dr Manica Balasegaram, GARDP Director. “Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible.”

So, WHO is giving you facts. They are concerned about how traditional antibiotics are administered but also stressing the need, and their work, to get new medications into the pipeline. Now, let’s take a look at what the American Centers for Disease Control (CDC) has to say on this matter.

“Our last line of defense against gonorrhea is weakening,” said Jonathan Mermin, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, in a CDC press release. “If resistance continues to increase and spread, current treatment will ultimately fail and 800,000 Americans a year will be at risk for untreatable gonorrhea.” This statement was related to seven people in Hawaii with a high resistance to current medications. All 7 fully recovered.  “Although all the patients were successfully treated with the combination therapy and no cases have been recorded since May, both the resistance pattern and the fact that the cases involved a cluster are causes of concern”, the CDC said.

The above is what is called a scare tactic. “Our last line of defense is weakening”, “If resistance continues” and “800,00 Americans a year will be at risk”. These are your clues folks. (In my head, I can hear the voice over for a disaster movie) Yes, we are finding that gonorrhea is becoming harder to treat, but scaring guys isn’t going to make things better. We need facts, not fear. Somehow, the message from the CDC concluded with this:

“Using both drugs ensures patients are cured of infection and prevents further transmission, but to preserve this option, providers should treat infections right away with the combination of azithromycin and ceftriaxone,” said Gail Bolan, MD, director of the CDC’s Division of STD Prevention.

“All health care providers should also promptly report any suspected treatment failure to local health officials and CDC to ensure rapid response to cases or clusters of concern.”

In the release, the CDC emphasized that no confirmed failures of the CDC-recommended dual treatment therapy have yet been reported in the United States.

“In Hawaii, the system worked,” said Mermin. “Front-line providers diagnosed and treated infections, public health officials quickly detected resistance, and we were able to use cutting-edge lab technologies to track its spread and treat people who were linked to the cluster.

“A strong STD prevention and control infrastructure is critical to ensure we’re ready to confront drug resistance not just in Hawaii, but nationwide.”

Oh, Ok, then. See how the resistant clap was treated and others linked to the cluster were as well? As you can read, we aren’t on the verge of a new mega infection that cannot be treated and cured. Now, the bigger concern is that news outlets are not distinguishing the different types of gonorrhea that exist. For gay males, there are two (2). Anal and oral. The drug resistant strains seems to revolve around oral. Yup, dick sucking.

Here is the issue. Oral sex can transmit Neisseria gonorrhoeae from someone’s privates to your throat and vice versa. And up to 90% of people with oral gonorrhea have no or minimal symptoms. Many people do not even realize that they have oral gonorrhea. So, unless you are always using a condom when sucking cock, you have some decisions to make. Also, scientists believe the issue is greater with oral gonorrhea because many doctors over prescribe antibiotics for sore throats, suspected cases of gonorrhea and false positives, thus weakening the ability of other medications to work on gonorrhea. Sometimes a cough drop and some lemon tea is a better treatment.

So, what can you do? We at GMJ always stress that your first line of defense is to be checked every three (3) months for any and all STDs as well as communicate with your partners about their STD history. NOT JUST HIV. If you show signs or believe that you may have contracted gonorrhea, see a doctor and have the test done at least twice to ensure that you actually have the clap before taking a medication you don’t need. If you are truly positive for gonorrhea, make sure you take the medication as directed, and see your doctor for a follow-up before going back out to play.

Now, if you want to truly be a gentleman, you can notify your sexual partners of your infection, and assist them in getting checked out as well.

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