Not claptrap: kissing as the strongest route for oral gonorrhoea
Simon Collins, HIV i-Base
Understanding how infections are transmitted is essential if information about prevention is be accurate, and an interesting study challenged common assumptions about both kissing and oral sex.
Eric Chow from the Melbourne Sexual Health Centre, Australia, provided data from a cohort of gay men to support the importance of the link between kissing and oral gonorrhoea. 
This was based on results from a sexual activity survey completed by 3769 gay men between March 2016 and February 2017, who were tested for oropharyngeal gonorrhoea on the same day. The survey asked about sexual activity during the previous three months, with categories of (i) kissing only, (ii) oral and/or anal sex without kissing or (iii) both.
Median age was 30 (IQR: 25 to 37) and 235 men (6.2%) tested positive for oral gonorrhoea.
Although the majority of men did not have sex-only partners, participants who reported ≥4 kissing-only partners was significantly associated with oropharyngeal gonorrhoea compared to no kissing-only partners (62.5%; aOR=1.6; 95% CI: 1.1 to 2.33; p=0.012). This analysis adjusted for potential confounders such as demographic characteristics, HIV status, contact of gonorrhoea and urethra and anorectum gonorrhoea infection.
As the association for the kiss-and-sex group was not significant in the multivariate analysis (aOR = 1.53, p=0.067) the results showed that kissing was the strongest risk factor and that in this group of gay men, sex was not the principal route for acquiring oropharyngeal gonorrhoea.
The same research group is also leading an ongoing study on whether antibacterial mouthwash prevents gonorrhea in the throat. [2. 3]
When told about the results, the majority of participants said that this wouldn’t stop them form kissing.
When asked about whether there should be a public health message from these results, the presenter was just as clear: “Oh no, we all love kissing”.
This study is one of the highly commended posters that was selected for a short oral presentation.
- Chow EPF et al. Kissing but not sex is the strongest risk factor for oropharyngeal gonorrhoea in men who have sex with men: a cross-sectional survey. 4th BHIVA/BASHH, 17 – 20 April 2018, Edinburgh. Poster abstract P103. HIV Medicine, 19 (Suppl. 2), s21–s152.
- Chow EPF et al. A multicentre double-blind randomised controlled trial evaluating the efficacy of daily use of antibacterial mouthwash against oropharyngeal gonorrhoea among men who have sex with men: the OMEGA (Oral Mouthwash use to Eradicate GonorrhoeA) study protocol. BMC Infectious Diseases 201717:456 doi: 0.1186/s12879-017-2541-3. (28 June 2017).
- OMEGA study website.