{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:48:52Z","timestamp":1791283732831,"version":"4.1.0"},"reference-count":23,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":2265,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,13]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since 2014 there has been an increase in gonorrhoea among heterosexuals in Australia. Sex with a partner from a country with high gonorrhoea prevalence has been identified as a risk factor for gonorrhoea in heterosexual females, but risk factors for heterosexual males remain unclear. This study determined risk factors for gonorrhoea among heterosexual males. Methods: Retrospective analysis was performed among heterosexual males attending Melbourne Sexual Health Centre (MSHC) between 1 January 2007 and 31 December 2017. Countries for overseas sexual partners were stratified as high-prevalence countries (HPC) or low-prevalence countries (LPC) based on the incidence of gonorrhoea. Results: The annual gonorrhoea positivity increased from 0.72% in 2007 to 1.33% in 2017 (Ptrend &amp;lt;0.001). Males attending MSHC as a contact of gonorrhoea had the highest odds of testing positive (adjusted odds ratio (aOR) 7.46; 95% confidence interval (CI) 4.46\u201312.49), followed by males identifying as Aboriginal and Torres Strait Islander (aOR 2.57; 95% CI 1.30\u20135.09), males who had injected drugs in the past 12 months (aOR 2.44; 95% CI 1.39\u20134.30) and males who had sex with a female from an HPC (aOR 2.18; 95% CI 1.77\u20132.68). Males aged \u226535 were at higher risk than those aged \u226424 years (aOR 1.44; 95% CI 1.14\u20131.82). Gonorrhoea positivity increased among males who had sex with females from an LPC (from 0.60% to 1.33%; Ptrend = 0.004) but remained the same over time among males who had sex with females from an HPC (2.14%; Ptrend = 0.143). Conclusions: There was an 80% increase in urethral gonorrhoea among heterosexual males between 2007 and 2017. Having sex with a female from an HPC is a significant risk factor for gonorrhoea. Gonorrhoea positivity among men having sex with a female from an HPC did not change over time, suggesting this risk factor has become less important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh19027","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T02:23:45Z","timestamp":1560738225000},"page":"508-513","source":"Crossref","is-referenced-by-count":22,"title":["Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007\u201317"],"prefix":"10.1071","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6920-7710","authenticated-orcid":true,"given":"Tiffany R.","family":"Phillips","sequence":"first","affiliation":[{"name":"AMelbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Vic. 3053, Australia."},{"name":"BCentral Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia."},{"name":"CCorresponding author. Email: TPhillips@mshc.org.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Fairley","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Vic. 3053, Australia."},{"name":"BCentral Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Vic. 3053, Australia."},{"name":"BCentral Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona S.","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Vic. 3053, Australia."},{"name":"BCentral Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":true,"given":"Eric P. F.","family":"Chow","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Melbourne, Vic. 3053, Australia."},{"name":"BCentral Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2019,6,17]]},"reference":[{"key":"2025102617162945200_R1","doi-asserted-by":"publisher","DOI":"10.1071\/SH18097","article-title":"Gonorrhoea gone wild: rising incidence of gonorrhoea and associated risk factors among gay and bisexual men attending Australian sexual health clinics.","author":"Callander","year":"2018","journal-title":"Sex Health"},{"issue":"3","key":"2025102617162945200_R2","doi-asserted-by":"crossref","first-page":"E212","DOI":"10.33321\/cdi.2017.41.31","article-title":"Sexually transmitted infections in Melbourne, Australia from 1918 to 2016: nearly a century of data.","volume":"41","author":"Jasek","year":"2017","journal-title":"Commun Dis Intell Q Rep"},{"issue":"8","key":"2025102617162945200_R3","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1136\/sextrans-2015-052246","article-title":"Trends in gonorrhoea positivity by nucleic acid amplification test versus culture among Australian heterosexual men with a low prevalence of gonorrhoea, 2007\u20132014.","volume":"92","author":"Mannion","year":"2016","journal-title":"Sex Transm Infect"},{"key":"2025102617162945200_R4"},{"key":"2025102617162945200_R5","article-title":"Trends in gonorrhoea infection and overseas sexual contacts among females attending a sexual health centre in Melbourne, Australia, 2008\u20132015.","volume":"42","author":"Misson","year":"2018","journal-title":"Commun Dis Intell (2018)"},{"key":"2025102617162945200_R6","doi-asserted-by":"publisher","DOI":"10.1071\/SH17182","article-title":"Access to sexual health services after the rapid roll out of the launch of pre-exposure prophylaxis for HIV in Melbourne, Australia: a retrospective cross-sectional analysis.","author":"Needleman","year":"2018","journal-title":"Sex Health"},{"key":"2025102617162945200_R7","doi-asserted-by":"publisher","DOI":"10.1071\/SH18024","article-title":"Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia.","author":"Chow","year":"2018","journal-title":"Sex Health"},{"issue":"12","key":"2025102617162945200_R8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143304","article-title":"Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting.","volume":"10","author":"Newman","year":"2015","journal-title":"PLoS One"},{"issue":"5","key":"2025102617162945200_R9","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1136\/sextrans-2014-051850","article-title":"Confirmatory assays are essential when using molecular testing for Neisseria gonorrhoeae in low-prevalence settings: insights from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).","volume":"91","author":"Field","year":"2015","journal-title":"Sex Transm Infect"},{"key":"2025102617162945200_R10","unstructured":"Australasian Sexual Health Alliance. Australian STI management guidelines for use in primary care. 2018. Available online at: http:\/\/www.sti.guidelines.org.au [verified 15 March 2019]."},{"issue":"2","key":"2025102617162945200_R11","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1097\/OLQ.0000000000000232","article-title":"Substantial increases in chlamydia and gonorrhea positivity unexplained by changes in individual-level sexual behaviors among men who have sex with men in an Australian sexual health service from 2007 to 2013.","volume":"42","author":"Chow","year":"2015","journal-title":"Sex Transm Dis"},{"issue":"10","key":"2025102617162945200_R12","doi-asserted-by":"publisher","first-page":"e842","DOI":"10.1016\/j.ijid.2010.02.2251","article-title":"Foreign travel, casual sex, and sexually transmitted infections: systematic review and meta-analysis.","volume":"14","author":"Vivancos","year":"2010","journal-title":"Int J Infect Dis"},{"issue":"5","key":"2025102617162945200_R13","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1136\/sextrans-2014-051918","article-title":"Was an epidemic of gonorrhoea among heterosexuals attending an Adelaide sexual health services associated with variations in sex work policing policy?","volume":"92","author":"Li","year":"2016","journal-title":"Sex Transm Infect"},{"issue":"5","key":"2025102617162945200_R14","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1136\/sextrans-2015-052303","article-title":"How to do it: lessons identified from investigating and trying to control an outbreak of gonorrhoea in young heterosexual adults.","volume":"92","author":"Foster","year":"2016","journal-title":"Sex Transm Infect"},{"issue":"5","key":"2025102617162945200_R15","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1136\/sextrans-2015-052235","article-title":"Epidemics of STIs; 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