Medical and psychosocial aspects of gonococcal infection in the adolescent patient: epidemiology, diagnosis, and treatment.

Gonorrhea has reached epidemic proportions and poses a significant health problem for teenagers. The attitudes and behavior of adolescents play a major role in the increase of gonococcal infection, interacting with characteristics of the disease and public health issues. Controlling gonorrhea among teenagers thus requires attending to the medical and psychosocial issues. Accurate diagnosis is dependent, in part, on eliciting a valid sexual history. Selection of a laboratory protocol should reflect not only the sensitivity and specificity of a test but its acceptability to teenagers. Similarly, there is no longer a single "drug of choice" for treatment. Patient acceptability, potential for noncompliance, toxicity, cost, jeopardy to other uses, and possible coexistent infection are factors to be considered in addition to efficacy. Finally, medication is only part of the treatment plan, which includes sexual abstinence, therapy for sexual partners, and returning for a test of cure. Compliance with the entire treatment plan can often be enhanced by maximizing communication and rapport with the adolescent.