Gonorrhea is the second most common bacterial sexually transmitted infection in the UK, but despite assumptions it can only be passed on through genital contact, new research suggests throat (oropharyngeal) gonorrhea might be contracted through kissing alone.
According to a study published in the journal Sexually Transmitted Infections, “deep kissing” (aka French kissing or kissing with tongues) might be a neglected route for spreading the infection among gay and bisexual men.
Gonorrhea can be developed in the rectum, throat or eyes and may become increasingly difficult to treat given that certain strains of the infection are resistant to antibiotics.
Traditionally, public health campaigners have always advised people to reduce the risk of contracting gonorrhea through condom use, but the new findings from a team of researchers in Melbourne, Australia suggest this advice might be insufficient.
To analyse whether or not throat gonorrhea can be passed through deep kissing alone, the researchers gathered data from 3,091 men at a major public health service in Melbourne from 2016 to 2017.
All those included were either gay or bisexual, criteria that lead author, associate Professor Eric Chow of the Melbourne Sexual Health Center, tells The Independent was intentional because gonorrhea is more prevalent in this community than in heterosexuals in Australia.
Participants were required to fill in a survey describing their sexual practices with male partners in the last three months and had to state whether they had had partners with whom they had kissed but not had sex with, had sex with but not kissed, and/or kissed and had sex with.
Almost all of the men (95 per cent) reported having experienced the latter at some stage – partners with whom they had kissed and had sex with.
Meanwhile, 70 per cent said they’d had kissing-only partners and 38 per cent reported having had sex-only partners. Roughly one in four of the men involved in the study had had all three categories of partner in the past three months. Only 1.4 per cent had exclusively had kissing-only partners, but the proportion of these men testing positive for throat gonorrhea was higher than for those who had had only sex without kissing.
What are the symptoms of super-gonorrhea and how can it be treated?
After accounting for other possibly influential factors, the odds of testing positive for throat gonorrhea were 46 per cent higher among participants who had had four or more kissing only partners in the last three months, and 81 per cent higher among those with four or more kissing with sex partners compared to men who had only one or no partners in either category.
This led the researchers to conclude that throat gonorrhea can be spread through tongue kissing alone. But they clearly state that the study is only observational and therefore can’t confirm cause and effect.
“It has been proposed that gonorrhea can be transmitted through kissing, but kissing has always been neglected as a risk factor for gonorrhea transmission,” Chow comments, adding that using antiseptic mouthwash could be an effective way of reducing the risk of throat gonorrhea.
“This is particularly relevant in the context of recent reports of highly-resistant Neisseria gonorrhea (aka super-gonorrhea),” he adds, “and known challenges associated with the antimicrobial treatment of oropharyngeal gonorrhea.”
However, Chow explains that further research is needed and his team is currently doing a clinical trial examining whether daily use of mouthwash could prevent gonorrhea. “If it works, it could be a simple and cheap intervention for everyone,” he adds.
The NHS states that symptoms for gonorrhea in women may include pain when urinating, unusual vaginal discharge or bleeding in between periods. For men, symptoms can include inflammation of the foreskin and unusual discharge from the top of the penis.
