Table 4 Univariate and multilevel multivariable regression model for factors associated with self-reported diagnosis of gonorrhea (overall and symptomatic) in 68 countries¹

Region

Central-West Europe (AT, CH, DE, LI, LU)

ref.

West Europe (BE, FR, IE, NL, MC, UK)

2.08

1.31–3.30

0.002

1.06

0.86–1.31

0.586

1.56

1.02–2.38

0.038

1.26

0.88–1.80

0.207

Southwest Europe (AD, ES, IT, MT, PT, SM)

1.02

0.62–1.68

0.925

1.20

0.89–1.62

0.241

0.91

0.57–1.45

0.693

0.72

0.48–1.07

0.103

Northwest Europe (DK, FI, IS, NO, SE)

0.97

0.60–1.58

0.913

0.77

0.58–1.02

0.064

0.89

0.56–1.41

0.616

0.89

0.60–1.32

0.561

Northeast Europe (EE, LT, LV)

0.18

0.07–0.45

< 0.001

0.55

0.13–2.34

0.414

0.17

0.04–0.74

0.018

0.17

0.04–0.71

0.015

Central-East Europe (CZ, HU, PL, SK, SL)

0.57

0.35–0.92

0.021

0.95

0.69–1.32

0.780

0.62

0.39–1.00

0.050

0.55

0.36–0.83

0.004

Southeast Europe (AL, BA, BU, CY, HR, GR, HR, ME, MK, RO, RS, TR, XK)

0.53

0.34–0.82

0.004

0.95

0.68–1.33

0.768

0.46

0.29–0.72

0.001

0.34

0.22–0.51

< 0.001

East Europe (BY, MD, RU, UA)

0.44

0.26–0.74

0.002

0.56

0.40–0.78

0.001

0.69

0.41–1.16

0.159

0.46

0.29–0.73

0.001

Middle East (IL, LB)

1.31

0.69–2.48

0.416

2.43

1.58–3.75

< 0.001

1.17

0.59–2.31

0.649

0.78

0.42–1.43

0.417

Philippines

0.76

0.36–1.62

0.479

0.78

0.48–1.24

0.291

1.07

0.54–2.14

0.841

0.87

0.48–1.56

0.629

Canada

1.66

0.79–3.48

0.181

0.96

0.69–1.33

0.793

1.20

0.62–2.32

0.592

0.89

0.51–1.54

0.666

Mexico

0.74

0.35–1.56

0.431

0.64

0.41–0.99

0.045

0.58

0.30–1.11

0.099

0.39

0.22–0.67

0.001

Central America (CR, GT, HN, NI, PA, SV)

0.74

0.46–1.19

0.219

0.74

0.52–1.05

0.095

0.78

0.48–1.27

0.322

0.62

0.40–0.96

0.033

Andean region (BO, EC, CO, PE, VE, SR)

0.78

0.49–1.24

0.290

0.81

0.56–1.18

0.276

0.83

0.53–1.29

0.400

0.58

0.40–0.86

0.007

Southern Cone (AR, CL, UY, PY)

0.68

0.41–1.13

0.140

0.64

0.44–0.94

0.023

0.77

0.48–1.26

0.299

0.55

0.36–0.84

0.005

Brazil

0.96

0.46–2.01

0.912

0.69

0.45–1.04

0.074

0.60

0.31–1.15

0.124

0.34

0.20–0.58

< 0.001

Survey artefacts

French translation

no

ref.

yes

1.62

1.41–1.87

< 0.001

1.59

1.38–1.83

< 0.001

1.03

0.78–1.37

0.822

0.89

0.68–1.15

0.368

Major data discrepancies

no

ref.

yes

1.28

1.20–1.36

< 0.001

1.20

1.12–1.28

< 0.001

1.06

0.94–1.20

0.320

0.98

0.86–1.11

0.710

Sample composition

Age group

< 25 years

ref.

25–29 years

1.47

1.38–1.57

< 0.001

1.18

1.10–1.27

< 0.001

1.26

1.12–1.42

< 0.001

1.06

0.94–1.19

0.375

30–39 years

1.44

1.35–1.53

< 0.001

1.01

0.94–1.08

0.777

1.20

1.07–1.34

0.001

0.91

0.81–1.02

0.101

40–49 years

1.04

0.97–1.11

0.287

0.67

0.62–0.73

< 0.001

0.83

0.73–0.95

0.005

0.57

0.50–0.66

< 0.001

50 + years

0.57

0.53–0.62

< 0.001

0.42

0.38–0.46

< 0.001

0.48

0.40–0.56

< 0.001

0.36

0.30–0.42

< 0.001

Settlement size (inhabitants)

village/countryside (< 10,000)

ref.

small town (10,000–99,999)

1.24

1.12–1.38

< 0.001

1.16

1.04–1.29

0.010

1.48

1.20–1.82

< 0.001

1.38

1.12–1.70

0.003

medium town (100,000–499,999)

1.71

1.55–1.88

< 0.001

1.38

1.24–1.53

< 0.001

1.84

1.51–2.24

< 0.001

1.61

1.31–1.96

< 0.001

big city (500,000–999,999)

2.17

1.96–2.40

< 0.001

1.50

1.35–1.67

< 0.001

2.54

2.08–3.10

< 0.001

2.06

1.68–2.52

< 0.001

very big city (≥ 1 million)

2.72

2.48–2.99

< 0.001

1.66

1.50–1.84

< 0.001

2.94

2.44–3.55

< 0.001

2.28

1.88–2.76

< 0.001

Diagnosed HIV

no

ref.

yes

2.06

1.96–2.17

< 0.001

1.36

1.27–1.45

< 0.001

1.38

1.23–1.54

< 0.001

1.03

0.91–1.16

0.672

Financial coping

comfortable

ref.

neither struggling nor comfortable

0.99

0.95–1.04

0.702

0.99

0.94–1.04

0.748

0.98

0.89–1.07

0.600

0.97

0.89–1.07

0.574

struggling

1.00

0.94–1.06

0.886

0.96

0.89–1.02

0.173

0.94

0.84–1.05

0.281

0.91

0.81–1.02

0.116

Testing behavior

Last STI screen

no screening

ref.

> 6–12 months ago

0.50

0.45–0.55

< 0.001

0.32

0.29–0.36

< 0.001

1–6 months ago

1.24

1.17–1.30

< 0.001

0.50

0.47–0.53

< 0.001

within the previous 4 weeks

2.28

2.15–2.42

< 0.001

0.68

0.63–0.73

< 0.001

Anal swab in the previous 12 months

no

ref.

yes

7.07

6.73–7.42

< 0.001

5.06

4.76–5.37

< 0.001

Sexual behavior

Number of sex partners, previous 12 months

none or one

ref.

2–4

1.55

1.41–1.70

< 0.001

1.37

1.20–1.58

< 0.001

1.66

1.40–1.98

< 0.001

1.52

1.19–1.95

0.001

5–7

2.70

2.46–2.96

< 0.001

2.09

1.80–2.42

< 0.001

3.14

2.65–3.72

< 0.001

2.65

2.04–3.44

< 0.001

8–10

3.51

3.18–3.89

< 0.001

2.46

2.11–2.86

< 0.001

3.79

3.15–4.56

< 0.001

3.01

2.29–3.96

< 0.001

11–20

5.27

4.85–5.74

< 0.001

3.38

2.93–3.91

< 0.001

4.86

4.15–5.69

< 0.001

3.70

2.85–4.80

< 0.001

> 20

10.34

9.53–11.21

< 0.001

5.01

4.34–5.79

< 0.001

8.40

7.21–9.78

< 0.001

5.79

4.47–7.51

< 0.001

Anal intercourse, condom use with last nonsteady partner (NSP)

no anal intercourse with NSP

ref.

never condom with NSP

3.80

3.41–4.23

< 0.001

1.44

1.23–1.69

< 0.001

3.40

2.78–4.17

< 0.001

1.54

1.16–2.03

0.003

seldom condom with NSP

7.67

6.98–8.42

< 0.001

1.78

1.52–2.07

< 0.001

5.59

4.67–6.69

< 0.001

1.77

1.35–2.33

< 0.001

sometimes condom with NSP

6.71

6.13–7.34

< 0.001

1.66

1.43–1.92

< 0.001

5.48

4.63–6.49

< 0.001

1.73

1.32–2.25

< 0.001

mostly condom with NSP

4.90

4.51–5.32

< 0.001

1.39

1.21–1.60

< 0.001

4.61

3.96–5.36

< 0.001

1.42

1.11–1.83

0.006

always condom with NSP

2.26

2.07–2.47

< 0.001

0.90

0.78–1.04

0.146

2.33

1.99–2.73

< 0.001

0.90

0.70–1.16

0.400

no answer condom with NSP

1.30

1.15–1.47

< 0.001

0.84

0.71–0.98

0.030

1.22

0.97–1.54

0.088

0.72

0.54–0.96

0.024

PrEP use

never/ don’t know

ref.

when needed

4.68

4.13–5.30

< 0.001

1.63

1.41–1.89

< 0.001

3.58

2.80–4.58

< 0.001

1.95

1.51–2.51

< 0.001

former daily use

3.83

3.10–4.74

< 0.001

1.70

1.33–2.17

< 0.001

3.10

2.03–4.72

< 0.001

1.81

1.18–2.78

0.007

current daily use

5.99

5.50–6.51

< 0.001

1.75

1.58–1.94

< 0.001

2.80

2.28–3.43

< 0.001

1.25

1.01–1.55

0.040

Multipartner sex during last NSP sex

no

ref.

yes

2.31

2.19–2.43

< 0.001

1.11

1.04–1.18

0.001

1.94

1.75–2.15

< 0.001

1.07

0.96–1.19

0.244

Country level rates

Country-level screening rates (quartiles)

0.81%–

ref.

1.92–

0.85

0.60–1.19

0.340

0.87

0.72–1.04

0.116

4.28–

1.07

0.72–1.59

0.728

1.29

1.02–1.62

0.031

7.63–35.96%

2.04

1.42–2.92

< 0.001

1.62

1.13–2.33

0.009

Country-level partner notification rates (quartiles)

25.00%–

ref.

61.29%–

0.81

0.55–1.20

0.292

0.49

0.39–0.63

< 0.001

73.08%–

0.93

0.62–1.41

0.741

0.48

0.37–0.62

< 0.001

83.33–100%

1.04

0.68–1.59

0.864

0.46

0.35–0.61

< 0.001

cons.

0.02

0.01–0.02

< 0.001

0.00

0.00–0.01

< 0.001

Random part

68 countries¹

random intercept

0.01

0.00–0.03

0.05

0.02–0.10