The odds of getting gonorrhea
In this chapter, we’ll talk about statistics—specifically, what statistics tell us about the likelihood that a person will contract gonorrhea. Statistics are a vital part of clinical medicine. They allow us to predict the chance of getting the infection:
- In a particular geographic area;
- From different kinds of contact; and
- If you’re a male or a female.
Statistics are another tool in doctor’s arsenal that helps them go in the right direction when it comes to testing and treatment. In this section, we summarize the available information about gonorrhea based on statistics, including the following:
- Gonorrhea’s general prevalence in the United States and in New York City;
- The chance of acquiring gonorrhea from different types of contact: oral, rectal, vaginal, etc.; and
- The chance of getting gonorrhea with and without protection.
General gonorrhea statistics for the US and NYC
In this table, we summarize general statistics about the prevalence of gonorrhea prevalence in the United States and New York City (where Dr. Fuzayloff practices).
These statistics are irrespective of gender. They tell us how common the condition is and whether it’s becoming more common. As you can see, gonorrhea is on the rise. From 2009 to 2018, the number of cases has increased by more than 90% in the United States and by 119% in New York City.
| US | NYC |
|---|
- Total gonorrhea cases in 2018
- Total gonorrhea cases in 2009
| | |
The chance of contracting gonorrhea with different types of contact
This table summarizes the chance of getting gonorrhea through different types of contact in a one-time sexual encounter. Pay attention to the differences, in oral and rectal contact, between the chances of contracting gonorrhea via “giving” and “receiving”.
| Genital | Oral | Rectal |
|---|
| Per-intercourse chance of getting gonorrhea | - From male to female: 60%–90%
- From female to male: 20%–30%
| - Receiving oral sex (from genitals to pharynx): 63%
- Giving oral sex (from pharynx to genitals): 9%
| - When you’re “top”(from penis to rectum—receptive anal sex): 84%
- When you’re “bottom” (from rectum to penis—insertive anal sex): 2%
|
The chance of contracting gonorrhea with and without protection
This table summarizes the chance of getting gonorrhea with and without protection. Multiple studies from 1966 to 2004 have shown that condom use reduces the risk of gonorrhea acquisition by 13%–100%.
| Unprotected contact | Protected contact |
|---|
| Per-intercourse chance of getting gonorrhea | - Transmission from male to female: 60%–90%
- Transmission from female to male: 20%–30%
| - Transmission from male to female: up to 78.3%
- Transmission from female to male: up to 26.1 %
|
Frequently Asked Questions
Here we summarize real patients’ questions, grouped by topic, and Dr. Fuzayloff’s answers to them. “Dr. F” (his patients’ name for him) has been an STD doctor for over two decades in Midtown Manhattan, NYC.
What’s the likelihood of a male giving gonorrhea to a female? 
Without protection
The chance of gonorrhea transmission from one time contact from an infected male to a susceptible female during vaginal intercourse without protection is around 60%–90%. This is three times higher than the 20%–30% chance of a female passing gonorrhea to a male. Here are the factors that explain this big difference:
- Neisseria gonorrhoeae (gonorrhea bacteria) enter the body through mucosal epithelial cells, and the genitals of females have more area lined with mucosa (the vagina and urethra) than men’s genitals do (the urethra).
- Infected semen pools in the vagina, significantly exposing the vaginal mucosa to the infection.
- Vaginal tissue is at greater risk of local trauma (microscopic damage) during intercourse than male tissue is.
With protection
Condoms reduce the chance of gonorrhea transmission by 13%–100%. So, the chance of an infected male wearing a condom transmitting gonorrhea to a susceptible female via one-time sexual contact ranges from 0% (complete protection) to 87%.
What’s the likelihood of a female giving gonorrhea to a male?
Without protection
When an infected female has unprotected vaginal sex with a susceptible man, the chance of passing gonorrhea through this one-time contact is 20%–30%.
With protection
With protection, the chance of an infected female passing gonorrhea to a male via one-time contact ranges from 0% to 26%.
What’s the likelihood of getting gonorrhea rectally (through anal sex)?
The chance of contracting gonorrhea anally per sexual encounter is about 2% for the insertive partner (or “top”) and 84% for the receiving partner (“bottom”). These are general statistics for anal sex irrespective of gender or sexual orientation.
We found no gender-specific statistics on rectal transmission of gonorrhea. What is known is the prevalence (how often the disease is diagnosed) in MSM (2.3%) and females (4.2%) rectally.
How does transmission occur?
Most commonly, anal gonorrhea is transmitted with direct penis-to-rectum contact. However, transmission can also occur in these ways:
- Using sex toys
- Rimming
- Fingering
Gonorrhea bacteria can survive on a hard surface for a while (from 10 minutes to 24 hours depending on what the surface is made of, the temperature, and the humidity level—learn more in the “how to protect your partner” section) and be transmitted by coming into contact with the mucous membrane of the anus.
The likelihood of contracting anal gonorrhea can be reduced by proper lubrication, which reduces the risk of local traumas during sex.
What’s the likelihood of getting gonorrhea orally?
There are no gender-specific studies of oral acquisition of gonorrhea per act, but we know the prevalence (frequency of diagnosis) of oral gonorrhea for males and females. As you can see in the table below, males’ and females’ chances of contracting oral gonorrhea are more or less the same.
| Gender | Prevalence of oral gonorrhea |
|---|
| Male | Heterosexual male: 2–11%
Homosexual male: 3%–7% |
| Female | 2%–10% |
Oral gonorrhea can be contracted via different types of sexual contact:
- Oral-to-oral contact (kissing)
- Oral-to-vaginal contact
- Oral-to-penile contact
- Oral-to-anal contact
The likelihood of acquiring oral gonorrhea is greater in some circumstances:
- Frequent oral exposure to vaginal and penile fluids makes it more likely. The risk will be even greater for people who swallow penile and vaginal fluids.
- The number of sexual partners makes a difference as well: there’s a greater chance of getting it if you have more than five sexual partners in a lifetime.
How contagious is gonorrhea—and when?
- A person can pass gonorrhea as soon as they become infected.
- Gonorrhea patients are infectious whether they have symptoms of it or not.
- Gonorrhea patients continue to transmit the infection until they’re cured (seven days after finishing the treatment) regardless of the presence or absence of symptoms and signs.
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