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Gonorrhoea in MSM: Is kissing a major means of transmission?
- Significantly higher rates of gonorrhoea in MSM compared to heterosexual men => Why?
- Much higher incidence of of pharyngeal gonorrhoea in MSM compared to rectal infections & urethral (urethral = lowest)
- Prevalence of pharyngeal gonorrhoea in MSM is ~ 11% => ??why so high compared to other sites, especially when anal sex &/or oral-penile, oral-anal sex is reported to be LOW
- Working hypothesis: pharyngeal gonorrhoea is most likely transmitted through kissing, ?related to high rates of MSM kissing multiple partners in e.g. clubs & pubs
Personal reflection on personal practice => I remember a patient who was married (to a woman) who frequently engaged in MSM sex. This patient was Dx'd with pharyngeal gonorrhoea & stringently denied any sex with his wife for a very long time but had kissed her. His wife was admitted to hospital with Reactive Arthritis related to gonorrhoea infection. Based on patient report: the only possible means of gonorrhoea transmission to his wife could be through kissing