What’s driving soaring gonorrhoea rates?
Kissing could be a factor driving the soaring rates of gonorrhoea as more and more young Australians have oral sex, sexual and infectious disease experts say.
Data has revealed gonorrhoea notifications have increased by 63 per cent in the past five years, particularly among young city-dwelling heterosexual men and women.
Between 2012-2016, rates mong men rose by 72 per cent and 43 per cent in women.
Increased testing, antibiotic resistance and a lack of condom wearing were all largely ruled out as a cause for the concerning prevalence of the STI, leaving infectious disease physicians perplexed.
Associate Professor of Medicine at ANU, Dr Sanjaya Senanayake says it is a real mystery.
“There is a drug called azithromycin; we are seeing some resistance to that, but the dangerous (gonorrhoea) strain that’s resistant to an antibiotic called ceftriaxone we don’t really have at the moment in Australia; it’s not really a big problem,” Dr Senanayake said.
Dr Senanayake says some experts are now investigating whether gonorrhoea can be transmitted through kissing.
“Through oral sex it can end up in the throat and it could potentially be transmitted that way.”
Some small studies have supported the theory, but it is yet to be proven, Dr Senanayake said.
Professor of Sexual Health at the Kirby Institute, Basil Donovan, says there is a “very real” chance that kissing has become an issue for the spread of the STI.
“There’s some evidence coming out of Melbourne that’s certainly pointing that way; I’d like to see it replicated but I wouldn’t call it undeniable,” Prof Donovan said.
There is little doubt, though, the increasing numbers of young Australians having oral sex is one likely factor behind the rise in gonorrhoea notifications, he says.
“We’ve had two rounds of the national sexual behaviour survey, one in 2002 and one in 2012, and what was clear, was that amongst heterosexuals … the proportion reporting oral sex was going up quite substantially,” Prof Donovan said.
“These days, more often than not, people have oral sex before they have vaginal sex.
“Certainly the rise (in gonorrhoea) is driven by a mixture of behaviour and the fact the newest tests are much more sensitive than the old tests; we are probably diagnosing cases now that you wouldn’t have diagnosed before.”
The sexual behaviour expert says oral sex has become “the new black” and new strategies are needed to combat the public health issue.
“The most common cause of genital herpes now is type 1 herpes which comes from the mouth, whereas it used to be type 2,” he said.
According to Prof Donovan, a randomised control trial is being conducted out of the Melbourne Sexual Health Centre (MSHC) to test the effectiveness of Listerine mouthwash.
He has also advised young women to request a throat swab as well as a vaginal swab from their doctor when testing for STIs.