Why are gonorrhea diagnoses declining in the US?

Abstract

After a decade of rising cases, the US CDC reported a decline in the rate of gonorrhea diagnoses for two years in a row in 2022 and 2023, especially among young adults. Primary and secondary syphilis rates also declined, yet chlamydia remains steady and STI diagnoses around the world continue to rise. Although declining gonorrhea diagnoses are encouraging, the reasons for the reductions remain unclear. Here, we enumerate potential drivers, the evidence that argues for or against each one, and the data needed to clarify their roles.