It is more common in urban blacks of low socioeconomic status. This is somewhat interesting. We see a lot more gonorrhea in people in lower socioeconomic groups and more chlamydia in people of upper socioeconomic groups - college students, for example. Females who develop gonorrhea are usually asymptomatic and males are usually symptomatic. Twenty percent of male homosexuals who practice anal receptive intercourse develop gonorrhea.
Rectal infection is usually asymptomatic.
Pharyngeal infection is usually asymptomatic. They can produce symptomatic infection, but it serves as a mucosal site from which dissemination can occur and certainly from which spread of infection can occur to another individual. Females are less effective transmitters of gonorrhea than male.