Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea

Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men

Chow EPFCornelisse VJWilliamson DA, et al

Abstract:

Objectives A mathematical model suggested that a significant proportion of oropharyngeal gonorrhoea cases are acquired via oropharynx-to-oropharynx transmission (ie, tongue-kissing), but to date, no empirical study has investigated this. This study aimed to examine the association between kissing and oropharyngeal gonorrhoea among gay and bisexual men who have sex with men (MSM).

Methods MSM attending a public sexual health centre in Melbourne, Australia, between March 2016 and February 2017 were invited to participate in a brief survey that collected data on their number of male partners in the last 3 months, in three distinct categories: kissing-only (ie, no sex including no oral and/or anal sex), sex-only (ie, any sex without kissing), and kissing-with-sex (ie, kissing with any sex). Univariable and multivariable logistic regression analyses were performed to examine associations between oropharyngeal gonorrhoea positivity by nucleic acid amplification tests and the three distinct partner categories.

Results A total of 3677 men completed the survey and were tested for oropharyngeal gonorrhoea. Their median age was 30 (IQR 25–37) and 6.2% (n=229) had oropharyngeal gonorrhoea. Men had a mean number of 4.3 kissing-only, 1.4 sex-only, and 5.0 kissing-with-sex partners in the last 3 months. Kissing-only and kissing-with-sex were associated with oropharyngeal gonorrhoea, but sex-only was not. The adjusted odds for having oropharyngeal gonorrhoea were 1.46-fold (95% CI 1.04 to 2.06) for men with ≥4 kissing-only partners and 1.81-fold (95% CI 1.17 to 2.79) for men with ≥4 kissing-with-sex partners.

Conclusions These data suggest that kissing may be associated with transmission of oropharyngeal gonorrhoea in MSM, irrespective of whether sex also occurs.

Experts debate whether kissing is to blame for gonorrhoea spread

Sydney Morning Herald, July 18, 2019 — 2.00am

The long-held position of sexual health experts is that gonorrhoea is transmitted by the penis, but an Australian researcher is studying the possibility the infection can be spread by kissing.

At the STI and HIV World Conference in Vancouver on Thursday, Professor Kit Fairley from Monash University will be arguing his case in a debate with Professor Emeritus H. Hunter Handsfield from the University of Washington.

Gonorrhoea: Drug Resistance in Australia

Australian Federation of AIDS Organisations (AFAO), 26 June 2018

There has long been concern globally about the potential emergence of drug resistant STIs. In response, the World Health Organisation released new treatment guidelines for three common STIs – chlamydia, gonorrhoea and syphilis – in 2016.

At present, strains resistant to first line treatment of syphilis and chlamydia are not common and not a concern in Australia. There is, however, a growing level of concern about gonorrhoea. This paper therefore focuses on the likelihood and implications of the emergence of drug resistant cases of gonorrhoea in Australia. It also highlights treatment options in Australia and current and emerging strategies for preventing drug resistant gonorrhoea.

Download paper: AFAO Brief – Gonorrhoea – Drug Resistance in Australia – 26 June 2018

Can you get gonorrhoea from kissing?

ABC Radio (Hack), 8th November 2017

In a troubling development, Melbourne researchers suspect gonorrhoea is being spread by kissing, overturning years of conventional wisdom.

Although it’s early days and not cause for alarm, there is evidence to suggest ‘throat-to-throat transmission’ may be driving the spread of gonorrhea in inner-city Australia.

It’s been generally understood you could only get gonorrhea by having vaginal, anal or oral sex with someone who has gonorrhea. Dr Vincent J Cornelisse, a sexual health physician and PhD candidate at Monash University, has been conducting research that challenges this idea.

Professor Basil Donovan, head of the Sexual Health Program at the Kirby Institute, told Hack the finding was “highly tenuous”. “You’ll need a lot more science before you put out a warning,” he said.

 

Rising Chlamydia and Gonorrhoea Incidence and Associated Risk Factors Among Female Sex Workers in Australia

Rising Chlamydia and Gonorrhoea Incidence and Associated Risk Factors Among Female Sex Workers in Australia: A Retrospective Cohort Study

Authors

Denton Callander, PhD,*† Hamish McManus, PhD,* Rebecca Guy, PhD,* Margaret Hellard, PhD,‡ Catherine C. O’Connor, DrPH,*§¶ Christopher K. Fairley, PhD,||** Eric P.F. Chow, PhD,||** Anna McNulty, MM,†† David A. Lewis, DA, PhD,‡‡§§ Christopher Carmody, MB, BS,¶¶ Heather-Marie A. Schmidt, PhD,|||| Jules Kim,*** and Basil Donovan, MD*††

From the *The Kirby Institute, †Centre for Social Research in Health,
UNSW Australia, Sydney, NSW; ‡Burnet Institute, Melbourne, VIC;
§RPA Sexual Health Clinic, Community Health, Sydney Local Health
District; ¶Central Clinical School, University of Sydney, Sydney, NSW;
||Melbourne Sexual Health Centre, Alfred Health; **Central Clinical
School, Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, VIC; ††Sydney Sexual Health Centre,
Sydney Hospital, Sydney; ‡‡Western Sydney Sexual Health Centre,
Parramatta; §§Marie Bashir Institute for Infectious Diseases and
Biosecurity & Sydney Medical School-Westmead, University of
Sydney, Sydney; ¶¶Liverpool Sexual Health Centre, Liverpool; ||||
New South Wales Ministry of Health; and ***Scarlet Alliance, Australian
Sex Worker Association, Sydney, NSW, Australia

Abstract:

Background: Female sex workers in Australia have achieved some of the lowest documented prevalences of human immunodeficiency virus (HIV) and other sexually transmissible infections globally but rates overall are increasing in Australia and warrant closer investigation.

Methods: We constructed a retrospective cohort using repeat testing data extracted from a network of 42 sexual health clinics. Poisson and Cox regression were used to determined trends in incidence and risk factors for HIV, chlamydia, gonorrhoea, and infectious syphilis among female sex workers.

Results: From 2009 to 2015, 18,475 women reporting sex work attended a participating service. The overall incidence of urogenital chlamydia was 7.7/100 person years (PY), declining by 38% from 2009 to 2013 before increasing by 43% to 2015 (P < 0.001); anorectal chlamydia incidence was 0.6/100 PY, and pharyngeal was 1.9/100 PY, which increased significantly during the study period (P < 0.001, both). For gonorrhoea, the urogenital incidence was 1.4/100 PY, anorectal incidence was 0.3/100 PY, P < 0.001), and 3.6/100 PY for pharyngeal; urogenital incidence doubled during the study period, anorectal increased fivefold, and pharyngeal more than tripled (P < 0.001, all). Incidence of infectious syphilis was 0.4/100 PY, which remained stable from 2009 to 2015 (P = 0.09). There were seven incident infections of HIV among female sex workers (0.1/100 PY). Inconsistent condom use with private partners, higher number of private partner numbers, recent injecting drug use, younger age, and country of birth variously predicted sexually transmissible infections among female sex workers.

Conclusions: Although infectious syphilis and HIV remain uncommon in female sex workers attending Australian sexual health clinics, the increasing incidence of gonorrhoea across anatomical sites and increasing chlamydia after a period of decline demands enhanced health promotion initiatives.

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New class of antibiotic raises hopes for urgently-needed gonorrhoea drug

The Guardian, Tuesday 8 August 2017 

A new class of antibiotic has been found to work in the lab against the sexually transmitted infection gonorrhoea, which can cause infertility and damage to babies and is fast becoming resistant to all existing drugs.

Although it is early days, because the antibiotic has yet to be tried in animals or humans, researchers say they are excited by its potential.