{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:48:49Z","timestamp":1791283729228,"version":"4.1.0"},"reference-count":38,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"\n Background<\/jats:title>\n Gonorrhoea notifications among women have increased, but the determinants of this trend are unclear. We aimed to examine temporal trends in gonorrhoea positivity and associated clinical characteristics among women attending a major sexual health clinic in Melbourne, Australia between 2015 and 2024.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n We conducted a retrospective analysis of women diagnosed with gonorrhoea between 2015 and 2024. Demographic, behavioural and clinical data were extracted from routine clinical records, including sexual practices, sex work status and condom use. A chart review of a subset of positive cases was performed to obtain symptom characteristics and microscopy findings.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Over the study period, we included a total of 91,332 consultations (47,013 women), with a gonorrhoea test performed on the day. Overall, the gonorrhoea positivity was 1.9% (1693\/91,332), and it increased from 1.3% (61\/4711) in 2015 to 2.3% (243\/10,497) in 2024 (Ptrend\u00a0&lt;\u00a00.001), representing a 78.9% relative increase. Oropharyngeal gonorrhoea increased from 4.4% (21\/482) to 5.8% (96\/1653; Ptrend\u00a0&lt;\u00a00.001), and urogenital gonorrhoea increased from 1.0% (49\/4673) to 1.7% (181\/10,435; Ptrend\u00a0&lt;\u00a00.001), whereas anorectal gonorrhoea remained stable. Of the 1693 women who were diagnosed with gonorrhoea, most were born overseas (52.9%, n\u00a0=\u00a0896), and resided in high socioeconomic areas (76.1%, n\u00a0=\u00a01289). Co-infection with bacterial vaginosis (14.9%) and chlamydia (13.6%) was frequent. Among symptomatic women who underwent chart review, vaginal discharge was the most common symptom (59.5%), but only 8.7% reported a \u2018typical\u2019 yellow, green or pus-like discharge.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Gonorrhoea positivity among women increased over the past decade, particularly at the oropharyngeal site, suggesting broader transmission within the general population. As many women did not present with a typical gonorrhoea discharge, general practitioners and other healthcare providers should consider gonorrhoea in women presenting with genital symptoms and offer testing, including at extragenital sites where clinically indicated.<\/jats:p>\n <\/jats:sec>","DOI":"10.1071\/sh26100","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:03:46Z","timestamp":1789394626000},"source":"Crossref","is-referenced-by-count":2,"title":["Increasing urogenital and oropharyngeal gonorrhoea positivity in women attending a sexual health service in Melbourne, Australia, 2015\u20132024"],"prefix":"10.1071","volume":"23","author":[{"given":"Hannah","family":"Kelly","sequence":"first","affiliation":[{"name":"AMelbourne Sexual Health Centre, Bayside Health, Melbourne, Vic, Australia. Email: hannah.kelly2@health.nsw.gov.au, Nyinyi.soe@monash.edu, mchen@mshc.org.au, Christopher.fairley@monash.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyi Nyi","family":"Soe","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Bayside Health, Melbourne, Vic, Australia. Email: hannah.kelly2@health.nsw.gov.au, Nyinyi.soe@monash.edu, mchen@mshc.org.au, Christopher.fairley@monash.edu"},{"name":"BSchool of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Bayside Health, Melbourne, Vic, Australia. Email: hannah.kelly2@health.nsw.gov.au, Nyinyi.soe@monash.edu, mchen@mshc.org.au, Christopher.fairley@monash.edu"},{"name":"BSchool of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-1664","authenticated-orcid":true,"given":"Christopher K.","family":"Fairley","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Bayside Health, Melbourne, Vic, Australia. Email: hannah.kelly2@health.nsw.gov.au, Nyinyi.soe@monash.edu, mchen@mshc.org.au, Christopher.fairley@monash.edu"},{"name":"BSchool of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-5731","authenticated-orcid":true,"given":"Phyu Mon","family":"Latt","sequence":"additional","affiliation":[{"name":"AMelbourne Sexual Health Centre, Bayside Health, Melbourne, Vic, Australia. Email: hannah.kelly2@health.nsw.gov.au, Nyinyi.soe@monash.edu, mchen@mshc.org.au, Christopher.fairley@monash.edu"},{"name":"BSchool of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, 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, Bayside Health, Melbourne, Vic, Australia. Email: hannah.kelly2@health.nsw.gov.au, Nyinyi.soe@monash.edu, mchen@mshc.org.au, Christopher.fairley@monash.edu"},{"name":"BSchool of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia."},{"name":"CCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026091410034263500_R1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-026-01232-6","article-title":"Mechanisms, management and prevention of anorectal sexually transmitted infections.","author":"Latt","year":"2026","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"8","key":"2026091410034263500_R2","doi-asserted-by":"publisher","first-page":"e235","DOI":"10.1016\/S1473-3099(17)30310-9","article-title":"Sexually transmitted infections: challenges ahead.","volume":"17","author":"Unemo","year":"2017","journal-title":"Lancet Infect Dis"},{"issue":"6","key":"2026091410034263500_R3","doi-asserted-by":"publisher","first-page":"e396","DOI":"10.1016\/s2352-3018(19)30043-8","article-title":"Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV.","volume":"6","author":"Chow","year":"2019","journal-title":"Lancet HIV"},{"key":"2026091410034263500_R4","unstructured":"King J, Kwon J, Gray R, McManus H, McGregor S. HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2025. The Kirby Institute, UNSW Sydney; 2025."},{"key":"2026091410034263500_R5","unstructured":"Department of Health. Local government areas surveillance report. Victorian Government; 2025. 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MSHC annual report 2024. Melbourne Sexual Health Centre; 2025. Available at https:\/\/www.mshc.org.au\/images\/downloads\/AnnualReports\/MSHC_AnnualReport_2024.pdf\u00a0[accessed 6 January 2026]"},{"issue":"1","key":"2026091410034263500_R11","doi-asserted-by":"publisher","DOI":"10.1071\/SH25119","article-title":"Evaluating completion rates between kiosk and smartphone computer-assisted self-interviewing at a sexual health clinic in Melbourne: a before-and-after implementation study.","volume":"23","author":"Wijekoon","year":"2026","journal-title":"Sex Health"},{"issue":"2","key":"2026091410034263500_R12","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1097\/OLQ.0000000000000553","article-title":"Increased detection of pharyngeal and rectal gonorrhea in men who have sex with men after transition from culture to nucleic acid amplification testing.","volume":"44","author":"Cornelisse","year":"2017","journal-title":"Sex Transm Dis"},{"key":"2026091410034263500_R13","unstructured":"Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). Gonorrhoea 2024. Available at https:\/\/sti.guidelines.org.au\/sexually-transmissible-infections\/gonorrhoea\/"},{"issue":"6","key":"2026091410034263500_R14","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1136\/sextrans-2018-053957","article-title":"Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015-2017: need for oropharyngeal testing.","volume":"95","author":"Chow","year":"2019","journal-title":"Sex Transm Infect"},{"issue":"11","key":"2026091410034263500_R15","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1097\/OLQ.0000000000001068","article-title":"Oropharyngeal and genital gonorrhea infections among women and heterosexual men reporting sexual contact with partners with gonorrhea: implication for oropharyngeal testing of heterosexual gonorrhea contacts.","volume":"46","author":"Chow","year":"2019","journal-title":"Sex Transm Dis"},{"key":"2026091410034263500_R16","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268820002265","article-title":"Clinical presentation of asymptomatic and symptomatic women who tested positive for genital gonorrhoea at a sexual health service in Melbourne, Australia.","volume":"148","author":"Martin-Sanchez","year":"2020","journal-title":"Epidemiol Infect"},{"issue":"1","key":"2026091410034263500_R17","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1186\/s12879-020-05197-y","article-title":"Clinical presentation of asymptomatic and symptomatic heterosexual men who tested positive for urethral gonorrhoea at a sexual health clinic in Melbourne, Australia.","volume":"20","author":"Mart\u00edn-S\u00e1nchez","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2026091410034263500_R18","unstructured":"Australian Bureau of Statistics. 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