LAUSR

W e appreciate Dr Fullilove continuing the work that his father started in the 1940s to bring attention to the limitations of using reported race and Hispanic ethnicity to identify the risk for sexually transmitted diseases (STDs).We agree that race and Hispanic ethnicity are social attributes of groups of people, not biological attributes of individuals in those social groups; therefore, the observed disparities in gonorrhea case rates by race and Hispanic ethnicity are unlikely to be caused by biological differences linked to race or Hispanic ethnicity. Those disparities are associated with a range of other social factors, including differential access to quality sexual health care and prevalence of disease in sexual networks. Measuring disparities in STDs can help direct limited prevention resources toward populations at greatest need. However, when reporting disparities in STDs, it is important to ensure that the underlying drivers of observed disparities are identified to avoid stigmatizing the affected groups and to inform the design and implementation of effective interventions to reduce or eliminate disparities.