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Why is gonorrhea treatment different for gay men and straight men?

Great question!  There are 2 different courses of treatment available for gonorrhea:

  • a single dose oral antibiotic plus an injection (both given at the same time)
  • 2 separate antibiotics pills used to treat gonorrhea.

There are a couple of factors that determine which treatment will be the most effective.  Though generally the two oral antibiotics are effective to treat gonorrhea, there are 2 instances in which a pill plus injection combination treatment is necessary.

In Canada there has been an increase in treatment-resistant gonorrhea reportedly among men who have sex with men.  In order to ensure the treatment works against these strains and to delay further resistance, men who have sex with men receive the pill plus injection treatment.  Also anyone diagnosed with gonorrhea in their throat (pharyngeal gonorrhea) will also receive the pill plus injection treatment.  This can be found in people of any gender or sexuality.

If this sounds complicated, don’t worry.  You can always ask questions at a testing appointment.  The clinician will help you understand the tests and results.  Being open about your sexual activity can help the clinician get a better idea of what to test for, where to test for it and what treatment is going to be the most effective.

You’ll also notice that the difference is not between gay or straight people.  During an STI assessment the clinician focuses on the type of sex you engage in and not who you engage with.  There are men who have sex with men who wouldn’t identify as gay, and STI testing professionals keep an open mind and ask open ended questions to assess the right course of action.