No abstract

Investigating factors for increased gonorrhoea re-infection in men who have sex with men attending a genitourinary clinic: a qualitative study Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Aims/objectivesThe aim of this study was to explore reasons for repeat gonorrhoea infections among MSM. Methods:We interviewed 16 MSM about knowledge and awareness of gonorrhoea, antibiotic resistance and attitudes towards safe sex. We used qualitative methods to investigate the potential causes for the rise in gonorrhoea reinfection. Results:Mobile applications were used to meet casual sex partners and arrange impromptu group-sex parties with partner anonymity making contact tracing difficult. The use of recreational drugs was widespread. It was suggested that new technologies could also be used to increase awareness of STI trends and services for at-risk individuals. Participants were concerned about global antibiotic resistance, but felt that behaviour would not change unless there was local evidence of this. Despite knowing gonorrhoea prevalence was high, participants felt their behaviour was unlikely to change and frequently felt resigned to repeat infections. Conclusion:The use of geosocial networking applications to arrange sexual encounters may be contributing to a rise in STIs, as well as recreational drugs, alcohol and sex parties. Networking applications could increase awareness and advertise testing opportunities. In some cases risk-taking behaviours are unlikely to change and for these men regular sexual health screens should be encouraged to detect and treat infections earlier and reduce onward spread.

The traditionally accepted specimen for the laboratory diagnosis of genital Chlamydia trachomatis infection is either a cervical swab from female patients or a urethral swab from male patients. Since the initial report by Adger and colleagues' on the use of urine samples from male patients for the diagnosis of this sexually transmitted disease (STD), this less invasive sampling method has attracted much interest.'" These reports compared the use of urine samples in one test system (for example enzyme immunoassay (EIA) or immunofluorescence) with the corresponding urethral swab tested in another system, such as in cell cultures. The sensitivities of these urine tests ranged from 38%2 to 88%,5 when compared with the urethral specimen.

Background/introduction In 2013, 63% of gonorrhoea infections in England were in men who have sex with men (MSM), in whom the annual incidence increased by 26% (PHE). In our clinic, annual incidence increased by 28.8% (2013) and re-infection (a second infection within 1-year of initial infection) rose from 6.7% as a proportion of total infections (2009) to 19.4% (2013). This is concerning given increasing reports of antibiotic resistant gonorrhoea. Aim(s)/objectives The aim of this study was to explore reasons for repeat gonorrhoea infections among MSM. Methods We interviewed 16 MSM about knowledge of gonorrhoea, attitudes to safe sex and antibiotic resistance. Results Mobile applications were used to meet casual sex partners and arrange impromptu group-sex parties with partner anonymity making contact tracing difficult. The use of recreational drugs was widespread and could result in unsafe sexual practices. Participants felt their behaviour was unlikely to change despite knowing there was increased gonorrhoea prevalence and frequently felt resigned to repeat infections. Participants thought global antibiotic resistance was concerning, but felt behaviour would change only if there was local evidence of this. It was highlighted that new technologies could increase awareness around local STI trends and services for those at risk. Discussion/conclusion MSM's use of geosocial networking applications to arrange sex could also be harnessed to increase awareness and advertise testing opportunities. Enhanced interventions at initial diagnosis may also be beneficial. In some cases risk-taking behaviours are unlikely to change and for these men regular sexual health screens should be encouraged.