ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

Day 2: Pharyngeal gonorrhoea: the Holy Grail? Presentation by Christopher Fairley

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Gonorrhoea in MSM: Is kissing a major means of transmission?

Main Points:

  • 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

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