Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015-2017: Need for oropharyngeal testing

Eric P.F. Chow, Deborah A. Williamson, Ria Fortune, Catriona S. Bradshaw, Marcus Y. Chen, Glenda Fehler, Vesna De Petra, Benjamin P. Howden, Christopher K. Fairley

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: The Victorian legislation requires sex workers to have quarterly screening for genital chlamydia and gonorrhoea, but screening for oropharyngeal infection is not mandatory in Victoria, Australia. In 2017, oropharyngeal screening for gonorrhoea and chlamydia was added as part of the routine quarterly screening for sex workers attending the Melbourne Sexual Health Centre (MSHC). The aim of this study was to examine the prevalence of oropharyngeal gonorrhoea and chlamydia among female sex workers (FSW). Methods: We included females who (1) self-identified as sex workers or were attended MSHC for a sex work certificate and (2) had tested for any STI or HIV, between March 2015 and December 2017. The prevalence of HIV, syphilis, chlamydia and gonorrhoea was calculated. Results: There were 8538 FSW consultations among 2780 individuals during the study period. There was a twofold increase in genital gonorrhoea (from 0.5% (95% CI 0.3% to 0.9%) to 1.1% (95% CI 0.8% to 1.5%); ptrend=0.047) and a 1.5-fold increase in genital chlamydia (from 2.2% (95% CI 1.6% to 2.8%) to 3.2% (95% CI 2.6% to 3.8%); ptrend=0.031) during the period. Overall, the prevalence of HIV (0.2% (95% CI 0.1% to 0.3%)) and syphilis (0.1% (95% CI 0.0% to 0.2%)) remained low and did not change over time. In 2017, the prevalence of oropharyngeal gonorrhoea was 2.0% (95% CI 1.6% to 2.6%) and oropharyngeal chlamydia was 2.1% (95% CI 1.6% to 2.7%). Among FSW who were tested positive for gonorrhoea and chlamydia, 55% (n=41) and 34% (n=45) only tested positive in the oropharynx but not genital for gonorrhoea and chlamydia, respectively. Conclusion: The prevalence of oropharyngeal gonorrhoea and chlamydia is similar to the prevalence at genital sites and is often independent of genital infection. It is important to test the oropharynx and genital site for chlamydia and gonorrhoea among FSW.

Original languageEnglish
Number of pages4
JournalSexually Transmitted Infections
DOIs
Publication statusAccepted/In press - 17 Apr 2019

Keywords

  • Chlamydia trachomatis
  • commercial sex
  • epidemiology (clinical)
  • Neisseria gonorrhoeae
  • screening
  • sex work

Cite this

@article{0b061b414b43431e97ead0f3a0043300,
title = "Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015-2017: Need for oropharyngeal testing",
abstract = "Objective: The Victorian legislation requires sex workers to have quarterly screening for genital chlamydia and gonorrhoea, but screening for oropharyngeal infection is not mandatory in Victoria, Australia. In 2017, oropharyngeal screening for gonorrhoea and chlamydia was added as part of the routine quarterly screening for sex workers attending the Melbourne Sexual Health Centre (MSHC). The aim of this study was to examine the prevalence of oropharyngeal gonorrhoea and chlamydia among female sex workers (FSW). Methods: We included females who (1) self-identified as sex workers or were attended MSHC for a sex work certificate and (2) had tested for any STI or HIV, between March 2015 and December 2017. The prevalence of HIV, syphilis, chlamydia and gonorrhoea was calculated. Results: There were 8538 FSW consultations among 2780 individuals during the study period. There was a twofold increase in genital gonorrhoea (from 0.5{\%} (95{\%} CI 0.3{\%} to 0.9{\%}) to 1.1{\%} (95{\%} CI 0.8{\%} to 1.5{\%}); ptrend=0.047) and a 1.5-fold increase in genital chlamydia (from 2.2{\%} (95{\%} CI 1.6{\%} to 2.8{\%}) to 3.2{\%} (95{\%} CI 2.6{\%} to 3.8{\%}); ptrend=0.031) during the period. Overall, the prevalence of HIV (0.2{\%} (95{\%} CI 0.1{\%} to 0.3{\%})) and syphilis (0.1{\%} (95{\%} CI 0.0{\%} to 0.2{\%})) remained low and did not change over time. In 2017, the prevalence of oropharyngeal gonorrhoea was 2.0{\%} (95{\%} CI 1.6{\%} to 2.6{\%}) and oropharyngeal chlamydia was 2.1{\%} (95{\%} CI 1.6{\%} to 2.7{\%}). Among FSW who were tested positive for gonorrhoea and chlamydia, 55{\%} (n=41) and 34{\%} (n=45) only tested positive in the oropharynx but not genital for gonorrhoea and chlamydia, respectively. Conclusion: The prevalence of oropharyngeal gonorrhoea and chlamydia is similar to the prevalence at genital sites and is often independent of genital infection. It is important to test the oropharynx and genital site for chlamydia and gonorrhoea among FSW.",
keywords = "Chlamydia trachomatis, commercial sex, epidemiology (clinical), Neisseria gonorrhoeae, screening, sex work",
author = "Chow, {Eric P.F.} and Williamson, {Deborah A.} and Ria Fortune and Bradshaw, {Catriona S.} and Chen, {Marcus Y.} and Glenda Fehler and {De Petra}, Vesna and Howden, {Benjamin P.} and Fairley, {Christopher K.}",
year = "2019",
month = "4",
day = "17",
doi = "10.1136/sextrans-2018-053957",
language = "English",
journal = "Sexually Transmitted Infections",
issn = "1368-4973",
publisher = "BMJ Group",

}

Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015-2017 : Need for oropharyngeal testing. / Chow, Eric P.F.; Williamson, Deborah A.; Fortune, Ria; Bradshaw, Catriona S.; Chen, Marcus Y.; Fehler, Glenda; De Petra, Vesna; Howden, Benjamin P.; Fairley, Christopher K.

In: Sexually Transmitted Infections, 17.04.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015-2017

T2 - Need for oropharyngeal testing

AU - Chow, Eric P.F.

AU - Williamson, Deborah A.

AU - Fortune, Ria

AU - Bradshaw, Catriona S.

AU - Chen, Marcus Y.

AU - Fehler, Glenda

AU - De Petra, Vesna

AU - Howden, Benjamin P.

AU - Fairley, Christopher K.

PY - 2019/4/17

Y1 - 2019/4/17

N2 - Objective: The Victorian legislation requires sex workers to have quarterly screening for genital chlamydia and gonorrhoea, but screening for oropharyngeal infection is not mandatory in Victoria, Australia. In 2017, oropharyngeal screening for gonorrhoea and chlamydia was added as part of the routine quarterly screening for sex workers attending the Melbourne Sexual Health Centre (MSHC). The aim of this study was to examine the prevalence of oropharyngeal gonorrhoea and chlamydia among female sex workers (FSW). Methods: We included females who (1) self-identified as sex workers or were attended MSHC for a sex work certificate and (2) had tested for any STI or HIV, between March 2015 and December 2017. The prevalence of HIV, syphilis, chlamydia and gonorrhoea was calculated. Results: There were 8538 FSW consultations among 2780 individuals during the study period. There was a twofold increase in genital gonorrhoea (from 0.5% (95% CI 0.3% to 0.9%) to 1.1% (95% CI 0.8% to 1.5%); ptrend=0.047) and a 1.5-fold increase in genital chlamydia (from 2.2% (95% CI 1.6% to 2.8%) to 3.2% (95% CI 2.6% to 3.8%); ptrend=0.031) during the period. Overall, the prevalence of HIV (0.2% (95% CI 0.1% to 0.3%)) and syphilis (0.1% (95% CI 0.0% to 0.2%)) remained low and did not change over time. In 2017, the prevalence of oropharyngeal gonorrhoea was 2.0% (95% CI 1.6% to 2.6%) and oropharyngeal chlamydia was 2.1% (95% CI 1.6% to 2.7%). Among FSW who were tested positive for gonorrhoea and chlamydia, 55% (n=41) and 34% (n=45) only tested positive in the oropharynx but not genital for gonorrhoea and chlamydia, respectively. Conclusion: The prevalence of oropharyngeal gonorrhoea and chlamydia is similar to the prevalence at genital sites and is often independent of genital infection. It is important to test the oropharynx and genital site for chlamydia and gonorrhoea among FSW.

AB - Objective: The Victorian legislation requires sex workers to have quarterly screening for genital chlamydia and gonorrhoea, but screening for oropharyngeal infection is not mandatory in Victoria, Australia. In 2017, oropharyngeal screening for gonorrhoea and chlamydia was added as part of the routine quarterly screening for sex workers attending the Melbourne Sexual Health Centre (MSHC). The aim of this study was to examine the prevalence of oropharyngeal gonorrhoea and chlamydia among female sex workers (FSW). Methods: We included females who (1) self-identified as sex workers or were attended MSHC for a sex work certificate and (2) had tested for any STI or HIV, between March 2015 and December 2017. The prevalence of HIV, syphilis, chlamydia and gonorrhoea was calculated. Results: There were 8538 FSW consultations among 2780 individuals during the study period. There was a twofold increase in genital gonorrhoea (from 0.5% (95% CI 0.3% to 0.9%) to 1.1% (95% CI 0.8% to 1.5%); ptrend=0.047) and a 1.5-fold increase in genital chlamydia (from 2.2% (95% CI 1.6% to 2.8%) to 3.2% (95% CI 2.6% to 3.8%); ptrend=0.031) during the period. Overall, the prevalence of HIV (0.2% (95% CI 0.1% to 0.3%)) and syphilis (0.1% (95% CI 0.0% to 0.2%)) remained low and did not change over time. In 2017, the prevalence of oropharyngeal gonorrhoea was 2.0% (95% CI 1.6% to 2.6%) and oropharyngeal chlamydia was 2.1% (95% CI 1.6% to 2.7%). Among FSW who were tested positive for gonorrhoea and chlamydia, 55% (n=41) and 34% (n=45) only tested positive in the oropharynx but not genital for gonorrhoea and chlamydia, respectively. Conclusion: The prevalence of oropharyngeal gonorrhoea and chlamydia is similar to the prevalence at genital sites and is often independent of genital infection. It is important to test the oropharynx and genital site for chlamydia and gonorrhoea among FSW.

KW - Chlamydia trachomatis

KW - commercial sex

KW - epidemiology (clinical)

KW - Neisseria gonorrhoeae

KW - screening

KW - sex work

UR - http://www.scopus.com/inward/record.url?scp=85066106902&partnerID=8YFLogxK

U2 - 10.1136/sextrans-2018-053957

DO - 10.1136/sextrans-2018-053957

M3 - Article

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

ER -