(P92) Census tract-level social vulnerability and gonorrhea in Ohio: results from the STD Surveillance Network 2020-2021

Background

Gonorrhea cases have been rising steadily in the greater Columbus, Ohio (OH) area since 2018. We aim to describe trends in gonorrhea from 2020-2021 in this region and identify patterns by census tract-level social vulnerability.



Methods

We used data from 2020-2021 from the Centers for Disease Control and Prevention (CDC)’s STD Surveillance Network (SSuN) to examine cases of gonorrhea per 100,000 population in the greater Columbus area. We used the 2020 CDC/ Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) to categorize each reported case of gonorrhea into tertiles of vulnerability based on their census tract of residence: low vulnerability (0-0.33 on the SVI), moderate vulnerability (0.34-0.66), and high vulnerability (0.67-1.0). We computed gonorrhea prevalence and the frequency and proportion of cases by sex, race, and age group for each SVI category. We created maps showing changes in gonorrhea case rates from 2020 to 2021 for each census tract by SVI category.



Results

A total of 10,415 cases of gonorrhea among 9,582 unique individuals with complete census tract data were reported during the two-year study period. Demographic characteristics by sex and age were similar between the 2020 and 2021 cases, with a higher proportion of males and a younger average age among gonorrhea cases in high vulnerability communities. Case rates increased with category of social vulnerability. In 2020, we observed mean case rates of 256, 716, and 947 per 100,000 for low, moderate, and high vulnerability census tracts, respectively. Findings were similar in 2021. A higher proportion of high-vulnerability census tracts saw an increase in gonorrhea cases between 2020-2021. Whereas in 2021, 59 (44%) high vulnerability census tracts showed an increase in gonorrhea, 23 (26%) moderate vulnerability census tract and only 9 (11%) low vulnerability census tracts saw increases in the same time period.



Conclusions

Cases of gonorrhea in the greater Columbus area increased between 2020 and 2021. A disproportionate burden of gonococcal infection is experienced by highly vulnerable communities. Public health interventions must assess social vulnerability factors at the community level and use these measures to best target and implement limited STD resources.