Oral and anal sex are key to sustaining gonorrhoea at endemic levels in MSM populations: a mathematical model

Hui, Ben B; Fairley, Christopher K.; Chen, Marcus Y; Grulich, Andrew E.; Hocking, Jane S; Prestage, Garrett; Walker, Sandra; Law, Matthew; Regan, David G.

doi:10.1136/sextrans-2014-051760

Cited by 74 publications

(67 citation statements)

References 23 publications

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“…There has been one mathematical model of gonorrhoea transmission that includes sexual activities other than penile/anal sex, and this model (2015) supports our findings 6. The model estimates that the prevalence of rectal gonorrhoea is higher among MSM with rimming (4.6%) compared with 4.1% in those who do not.…”

Section: Discussionsupporting

confidence: 79%

“…It has been widely assumed that rectal gonorrhoea is transmitted by unprotected receptive anal intercourse (RAI) 4 5. However, a recent mathematical model has shown that gonorrhoea would not be eliminated by consistent condom use during penile–anal sex as transmission can occur between other anatomical sites 6. This is consistent with a recent empirical study showing gonorrhoea positivity in MSM is increasing after adjusting for condom use during anal sex 7.…”

Section: Introductionsupporting

confidence: 63%

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Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men, a new public health message: a cross-sectional survey

et al. 2016

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Section: Discussionsupporting

confidence: 79%

Section: Introductionsupporting

confidence: 63%

Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men, a new public health message: a cross-sectional survey

et al. 2016

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“…The model is an extension of a previously published model in which we examined the role of anal and oral sex in the transmission of NG in an Australian MSM population 15. The following is a brief description of the model.…”

Section: Methodsmentioning

confidence: 99%

Identifying factors that lead to the persistence of importedgonorrhoeaestrains: a modelling study

Hui¹,

Whiley

Donovan

et al. 2016

Sex Transm Infect

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The imported NG strain is unlikely to persist as a result of a single importation event. However, the probability of persistence increases if the imported NG strain is resistant to treatment, can form mixed infections with the local NG strain or there are frequent importation events. Identification of the factors that determine the likelihood of persistence of an imported NG strain could contribute to our capacity to respond appropriately and in a timely fashion.

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“…It is important to understand how gonorrhea is transmitted in order to effectively reduce the burden of this epidemic. An Australian-based mathematical model conducted by Hui et al has shown that gonorrhea cannot be eliminated even if 100% condom use is practiced for anal sex among MSM (5), suggesting that gonorrhea has other routes of transmission other than penile-anal sex. Several observational studies have shown that kissing, oroanal (rimming) practices, oral-penile sex, and saliva use as a lubricant for anal sex are all associated with the detection of gonorrhea (6,7).…”

mentioning

confidence: 99%

Neisseria gonorrhoeae Bacterial DNA Load in the Pharynges and Saliva of Men Who Have Sex with Men

et al. 2016

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e Neisseria gonorrhoeae can be cultured in the saliva of individuals with pharyngeal gonorrhea. The aim of this study was to quantify the gonococcal bacterial DNA loads in the pharynges and saliva among men who have sex with men (MSM) with untreated pharyngeal gonorrhea. Untreated MSM who tested positive for pharyngeal gonorrhea by culture and returned for antibiotic treatment within 14 days at the Melbourne Sexual Health Centre between October 2014 and March 2015 were eligible for this study. The gonococcal bacterial DNA load was measured using real-time quantitative PCR. The median gonococcal bacterial DNA loads in the pharynges and saliva were calculated and compared to culture positivity using the Mann-Whitney U test. A total of 33 men were included in this study. The median gonococcal bacterial DNA load did not differ between the pharynges in men who were culture positive (2.5 ؋ 10 5 copies/swab) and culture negative (2.9 ؋ 10 4 copies/swab) (P ‫؍‬ 0.166) and the saliva (culture positive, 2.2 ؋ 10 5 copies/ml; culture negative, 2.7 ؋ 10 5 copies/ml) (P ‫؍‬ 0.499). The bacterial DNA load in the pharynges (P ‫؍‬ 0.695) and saliva (P ‫؍‬ 0.969) did not differ between who men returned for treatment within 7 days and those who returned 8 to 14 days later. Substantial gonococcal bacterial DNA loads were detected in both saliva and pharynges among MSM with pharyngeal gonorrhea. These findings suggest that gonorrhea can be transmitted via sexual practices involving exposure to saliva, such as oroanal practices (rimming) and saliva use as a lubricant for anal sex.T he high prevalence of gonococcal infection among men who have sex with men (MSM) is a public health issue in many developed countries (1-4). It is important to understand how gonorrhea is transmitted in order to effectively reduce the burden of this epidemic. An Australian-based mathematical model conducted by Hui et al. has shown that gonorrhea cannot be eliminated even if 100% condom use is practiced for anal sex among MSM (5), suggesting that gonorrhea has other routes of transmission other than penile-anal sex. Several observational studies have shown that kissing, oroanal (rimming) practices, oral-penile sex, and saliva use as a lubricant for anal sex are all associated with the detection of gonorrhea (6, 7). All of these sexual activities involve the use and transfer of saliva, indicating that saliva could potentially act as a vehicle for the transmission of gonorrhea during sex. There have been three published studies showing that gonorrhea can be cultured from saliva samples (8-10); however, none of these studies examined the gonococcal bacterial DNA load in saliva. If saliva can act as a medium for gonorrhea transmission, it is important to understand the relative concentrations of bacteria at different anatomical sites to provide further understanding on gonorrhea transmission. The aim of this study was to quantify the gonococcal bacterial DNA loads in saliva and the pharynx. MATERIALS AND METHODSThis cross-sectional study was conducted at the M...

show abstract

Oral and anal sex are key to sustaining gonorrhoea at endemic levels in MSM populations: a mathematical model

Cited by 74 publications

References 23 publications

Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men, a new public health message: a cross-sectional survey

Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhoea among men who have sex with men, a new public health message: a cross-sectional survey

Identifying factors that lead to the persistence of importedgonorrhoeaestrains: a modelling study

Neisseria gonorrhoeae Bacterial DNA Load in the Pharynges and Saliva of Men Who Have Sex with Men

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