Investigating factors for increased gonorrhoea re-infection in men who have sex with men attending a genitourinary clinic: a qualitative study

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.

Sexualised drug taking among men who have sex with men: a systematic review

“…The most frequent STIs recorded were gonorrhoea (23 citations; prevalence reported in chemsex-related drug users was 3.9%–100% 12,14–17,20,22,26,29,32,56,77,78,80,82,84,86,87,92,98,103–105 ) and syphilis (16 citations; prevalence reported in chemsex users was 3.6%–100% 12,14–16,23,24,26,51,61,77,80,85,86,98,103,106 ). In a systematic review, Rajasingham et al 86 identified HIV-infected MSM who had used crystal methamphetamines in the prior 3 months to have a significantly higher chance of being diagnosed with an STI (gonorrhoea, chlamydia or syphilis) in the past year, compared to HIV-infected MSM who had not used crystal methamphetamine (OR = 3.37, 95% CI: 1.67–6.81).…”

Diminishing Perceived Threat of AIDS and Increasing Sexual Risks of HIV Among Men Who Have Sex with Men, 1997–2015

“…Of particular importance are local genital tract inflammatory processes that increase HIV shedding in semen rendering an individual more infectious than is apparent from his blood plasma viral load (Kalichman, Diberto, & Eaton, 2008;Pilcher et al, 2006). Thus, increases in condomless anal sex and exposure to STI will ultimately diminish the prevention benefits of HIV treatments (Jansen, Schmidt, Drewes, Bremer, & Marcus, 2016;Katz, Dombrowski, Bell, Kerani, & Golden, 2016;Payne, Lawrence, Soni, Llewellyn, & Dean, 2016;Sood, Wagner, Jaycocks, Drabo, & Vardavas, 2013). …”

“Slam Sex” - Sexualized Injecting Drug Use (“SIDU”) Amongst Men Who Have Sex with Men (MSM)—A Scoping Review

“…Twelve review papers which did not provide any new data were excluded. Two further papers 2018Commentary Netherlands Bourne et al (2015) In-depth interviews England Bourne et al (2014) In-depth interviews UK Bjerno 2017Semi-structured interviews Denmark Bracchi et al 2015Commentary United Kingdom Chung et al (2015) Case Report United Kingdom Dolengevich-Segal et al, 2016Case report Spain Deimel et al (2016) In-depth interviews Germany Dávila (2016) Ethnographic study Spain Elliot et al 2017Prospective opt out United Kingdom Frankis et al, 2018 Cross-sectional online survey Scotland Frankis and Clutterbuck (2017) Commentary United Kingdom Frederick (2016) Ethnography/critical discourse analysis England Gilbart and Gobin (2013) Semistructured in-depth quantitative interviews England Giraudon et al 2018 2018Case Study Australia Page and Nelson (2016) Commentary England Payne et al, (2017) In-depth semistructured interviews Ausralia Power et al 2018Cross-sectional survey Australia Pufall et al 2018Cross-sectional survey England Ralphs, Gray, and Norton 2017 meeting the inclusion criteria were identified through a hand search, yielding a total of 53 papers for critical appraisal (See Figure 1). Specific information including author, year of publication, methodology, and study location were noted (See Table 2).…”

“…In a French cross-sectional survey, chronic HCV prevalence of 10.6% was reported in a population of MSM engaging in SIDU (Vaux et al, 2019). Further harms that may appear include abscesses; phlebitis; track marks and muscle damage (Knoops et al, 2015;Payne et al, 2017). Prolonged use may lead to delusional thoughts; paranoid ideation; hallucinations and suicidal ideation (Dolengevich-Segal et al, 2016) which can be exasperated by long sessions with little sleep and poor nutrition (Bourne et al, 2014).…”