Reported cases of gonorrhea infections in Iowa are up more than 75 percent in the last three years, according to preliminary data from the Iowa Department of Public Health. The department says while Iowa's overall infection rate isn't unusual, the sudden increase in infections from 2013 is unique.
IDPH STD program manager George Walton says part of the reason for this increase is that providers are conducting more comprehensive testing, which has identified cases that would have otherwise gone undetected.
"[Gonorrhea] can infect multiple different anatomic sites," he says. "We've really been trying to promote taking good sexual history. If somebody has been exposed at sites other than the genital region, they’re also tested there. So throat and rectal are places where people can become infected."
In particular, gay men in Iowa are experiencing increased rates of infection. Of the more than 1,300 gonorrhea infections confirmed in Iowa men in 2016, a quarter were detected in men who have sex with other men. That's a five percent increase from the previous year.
Walton says the higher rate can partially be attributed to the fact that Iowa's gay community is relatively small compared to the state's total population.
"It's not necessary an increase in high-risk behaviors or anything like that," he says. "It's just since it’s a smaller network the infection can spread more quickly within that network."
Most states don’t report on the sexuality of people infected with gonorrhea, though data from the Centers for Disease Control and Prevention indicates that gay men contracting gonorrhea at higher rates is likely a nationwide occurrence. Iowa has very limited historical data to determine if the 2016 stats are part of an ongoing trend.
However Walton notes that neither the testing or the higher infection rates in gay men can totally account for why Iowa's increase in gonorrhea cases is so significant.