Risk factors for oropharyngeal gonorrhoea in men who have sex with men: An age-matched case-control study

Vincent Cornelisse, Sandra Walker, Tiffany Phillips, Jane Hocking, Catriona Bradshaw, David Lewis, Garrett P. Prestage, Andrew E Grulich, Christopher K Fairley, Eric Pui Fung Chow

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Objectives Oropharyngeal gonorrhoea is common among men who have sex with men (MSM). We aimed to clarify which oral sex practices were independent risk factors for oropharyngeal gonorrhoea: tongue kissing, receptive oro-penile sex (fellatio) or insertive oro-anal sex (rimming), and whether daily use of mouthwash and recent antibiotic use was protective. Methods In 2015, we conducted an age-matched case-control study of MSM who attended the Melbourne Sexual Health Centre. Cases had tested positive for oropharyngeal gonorrhoea by nucleic acid amplification testing, and controls had tested negative. Questionnaire items included tongue kissing, oral sex practices, condom use, recent antibiotic use, mouthwash use and alcohol consumption. Results We identified 177 cases, age matched to 354 controls. In univariable analyses, cases were 1.90 times (95% CI 1.13 to 3.20) more likely than controls to have had casual sexual partners (CSP) in the preceding 3 months, were 2.17 times (95% CI 1.31 to 3.59) more likely to have kissed CSP and were 2.04 times (95% CI 1.26 to 3.30) more likely to have had receptive oro-penile sex with CSP. Oropharyngeal gonorrhoea was not associated with insertive oro-anal sex or mouthwash use. The number of CSP for tongue kissing and receptive oral sex and total CSP were highly correlated, and in multivariable analysis neither kissing nor receptive oro-penile sex was significantly associated with having oropharyngeal gonorrhoea, after adjusting for total number of CSP. Conclusions The finding that oropharyngeal gonorrhoea was associated with a higher number of sexual partners but not specific sexual practices highlights the need for further research in the area of gonorrhoea transmission to define the probability of transmission from specific sex acts.

Original languageEnglish
Pages (from-to)359-364
Number of pages6
JournalSexually Transmitted Infections
Volume94
Issue number5
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • gay men
  • homosexuality
  • neisseria gonorrhoea
  • oral sex

Cite this

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title = "Risk factors for oropharyngeal gonorrhoea in men who have sex with men: An age-matched case-control study",
abstract = "Objectives Oropharyngeal gonorrhoea is common among men who have sex with men (MSM). We aimed to clarify which oral sex practices were independent risk factors for oropharyngeal gonorrhoea: tongue kissing, receptive oro-penile sex (fellatio) or insertive oro-anal sex (rimming), and whether daily use of mouthwash and recent antibiotic use was protective. Methods In 2015, we conducted an age-matched case-control study of MSM who attended the Melbourne Sexual Health Centre. Cases had tested positive for oropharyngeal gonorrhoea by nucleic acid amplification testing, and controls had tested negative. Questionnaire items included tongue kissing, oral sex practices, condom use, recent antibiotic use, mouthwash use and alcohol consumption. Results We identified 177 cases, age matched to 354 controls. In univariable analyses, cases were 1.90 times (95{\%} CI 1.13 to 3.20) more likely than controls to have had casual sexual partners (CSP) in the preceding 3 months, were 2.17 times (95{\%} CI 1.31 to 3.59) more likely to have kissed CSP and were 2.04 times (95{\%} CI 1.26 to 3.30) more likely to have had receptive oro-penile sex with CSP. Oropharyngeal gonorrhoea was not associated with insertive oro-anal sex or mouthwash use. The number of CSP for tongue kissing and receptive oral sex and total CSP were highly correlated, and in multivariable analysis neither kissing nor receptive oro-penile sex was significantly associated with having oropharyngeal gonorrhoea, after adjusting for total number of CSP. Conclusions The finding that oropharyngeal gonorrhoea was associated with a higher number of sexual partners but not specific sexual practices highlights the need for further research in the area of gonorrhoea transmission to define the probability of transmission from specific sex acts.",
keywords = "gay men, homosexuality, neisseria gonorrhoea, oral sex",
author = "Vincent Cornelisse and Sandra Walker and Tiffany Phillips and Jane Hocking and Catriona Bradshaw and David Lewis and Prestage, {Garrett P.} and Grulich, {Andrew E} and Fairley, {Christopher K} and Chow, {Eric Pui Fung}",
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Risk factors for oropharyngeal gonorrhoea in men who have sex with men : An age-matched case-control study. / Cornelisse, Vincent; Walker, Sandra; Phillips, Tiffany; Hocking, Jane; Bradshaw, Catriona; Lewis, David; Prestage, Garrett P.; Grulich, Andrew E; Fairley, Christopher K; Chow, Eric Pui Fung.

In: Sexually Transmitted Infections, Vol. 94, No. 5, 01.08.2018, p. 359-364.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Risk factors for oropharyngeal gonorrhoea in men who have sex with men

T2 - An age-matched case-control study

AU - Cornelisse, Vincent

AU - Walker, Sandra

AU - Phillips, Tiffany

AU - Hocking, Jane

AU - Bradshaw, Catriona

AU - Lewis, David

AU - Prestage, Garrett P.

AU - Grulich, Andrew E

AU - Fairley, Christopher K

AU - Chow, Eric Pui Fung

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Objectives Oropharyngeal gonorrhoea is common among men who have sex with men (MSM). We aimed to clarify which oral sex practices were independent risk factors for oropharyngeal gonorrhoea: tongue kissing, receptive oro-penile sex (fellatio) or insertive oro-anal sex (rimming), and whether daily use of mouthwash and recent antibiotic use was protective. Methods In 2015, we conducted an age-matched case-control study of MSM who attended the Melbourne Sexual Health Centre. Cases had tested positive for oropharyngeal gonorrhoea by nucleic acid amplification testing, and controls had tested negative. Questionnaire items included tongue kissing, oral sex practices, condom use, recent antibiotic use, mouthwash use and alcohol consumption. Results We identified 177 cases, age matched to 354 controls. In univariable analyses, cases were 1.90 times (95% CI 1.13 to 3.20) more likely than controls to have had casual sexual partners (CSP) in the preceding 3 months, were 2.17 times (95% CI 1.31 to 3.59) more likely to have kissed CSP and were 2.04 times (95% CI 1.26 to 3.30) more likely to have had receptive oro-penile sex with CSP. Oropharyngeal gonorrhoea was not associated with insertive oro-anal sex or mouthwash use. The number of CSP for tongue kissing and receptive oral sex and total CSP were highly correlated, and in multivariable analysis neither kissing nor receptive oro-penile sex was significantly associated with having oropharyngeal gonorrhoea, after adjusting for total number of CSP. Conclusions The finding that oropharyngeal gonorrhoea was associated with a higher number of sexual partners but not specific sexual practices highlights the need for further research in the area of gonorrhoea transmission to define the probability of transmission from specific sex acts.

AB - Objectives Oropharyngeal gonorrhoea is common among men who have sex with men (MSM). We aimed to clarify which oral sex practices were independent risk factors for oropharyngeal gonorrhoea: tongue kissing, receptive oro-penile sex (fellatio) or insertive oro-anal sex (rimming), and whether daily use of mouthwash and recent antibiotic use was protective. Methods In 2015, we conducted an age-matched case-control study of MSM who attended the Melbourne Sexual Health Centre. Cases had tested positive for oropharyngeal gonorrhoea by nucleic acid amplification testing, and controls had tested negative. Questionnaire items included tongue kissing, oral sex practices, condom use, recent antibiotic use, mouthwash use and alcohol consumption. Results We identified 177 cases, age matched to 354 controls. In univariable analyses, cases were 1.90 times (95% CI 1.13 to 3.20) more likely than controls to have had casual sexual partners (CSP) in the preceding 3 months, were 2.17 times (95% CI 1.31 to 3.59) more likely to have kissed CSP and were 2.04 times (95% CI 1.26 to 3.30) more likely to have had receptive oro-penile sex with CSP. Oropharyngeal gonorrhoea was not associated with insertive oro-anal sex or mouthwash use. The number of CSP for tongue kissing and receptive oral sex and total CSP were highly correlated, and in multivariable analysis neither kissing nor receptive oro-penile sex was significantly associated with having oropharyngeal gonorrhoea, after adjusting for total number of CSP. Conclusions The finding that oropharyngeal gonorrhoea was associated with a higher number of sexual partners but not specific sexual practices highlights the need for further research in the area of gonorrhoea transmission to define the probability of transmission from specific sex acts.

KW - gay men

KW - homosexuality

KW - neisseria gonorrhoea

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