The overall burden of gonorrhea in the US is not equally distributed across the population; there are marked disparities in terms of the geographical distribution of cases, as well as the reported race/ethnicity and sexual orientation of cases. There is significant geographic heterogeneity in affected population groups across the US that a national-level model is not able to capture. In particular, some regions in the country are experiencing primarily black heterosexual outbreaks, others predominantly MSM outbreaks, and others a mixture of the two.
Given this regional variation, the types of interventions used and the success of screening programs might be expected to differ by region, depending on the affected populations and epidemic profile. To take account of this, models will need to describe current trends in gonorrhea incidence in regions with different epidemic characteristics, as defined by the relative distribution of cases across different ethnic/racial and sexual orientation groups.
To better understand how demographic differences in the distribution of gonorrhea cases will influence the effectiveness of screening interventions, we propose re-parameterizing a meta-population model to describe outbreaks in different regions with distinct epidemic characteristics. We will use these local-level models that reproduce regional trends to evaluate the effect of current and novel approaches to screening and treatment in the face of different outbreak characteristics. This approach may help local public health practitioners better tailor approaches to screening based on local gonorrhea epidemiology.