{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:57:31Z","timestamp":1789088251035,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"crossref","award":["xjh012019055"],"award-info":[{"award-number":["xjh012019055"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Australian NHMRC early career fellowship","award":["APP1104781"],"award-info":[{"award-number":["APP1104781"]}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2018M631134"],"award-info":[{"award-number":["2018M631134"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["8191101420"],"award-info":[{"award-number":["8191101420"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["11801435 (MS)"],"award-info":[{"award-number":["11801435 (MS)"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian National Health and Medical Research Council (NHMRC) Leadership Investigator Grant","award":["GNT1172900"],"award-info":[{"award-number":["GNT1172900"]}]},{"name":"Australian NHMRC Emerging Leadership Investigator Grant","award":["GNT1172873"],"award-info":[{"award-number":["GNT1172873"]}]},{"name":"Australian NHMRC Emerging Leadership Investigator Grant","award":["GNT1174555"],"award-info":[{"award-number":["GNT1174555"]}]},{"name":"Xi\u2019an Jiaotong University Basic Research and Profession Grant","award":["xtr022019003"],"award-info":[{"award-number":["xtr022019003"]}]},{"name":"Xi'an Jiaotong University Young Talent Support Program"},{"name":"Thousand Talents Plan Professorship for Young Scholars","award":["3111500001"],"award-info":[{"award-number":["3111500001"]}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"crossref","award":["xzy032020026"],"award-info":[{"award-number":["xzy032020026"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100017596","name":"Natural Science Basic Research Program of Shaanxi Province","doi-asserted-by":"crossref","award":["2019JQ-187"],"award-info":[{"award-number":["2019JQ-187"]}],"id":[{"id":"10.13039\/501100017596","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,10,3]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>\nThe spectrum of sexual practices that transmit\n<jats:italic>Neisseria gonorrhoeae<\/jats:italic>\nin men who have sex with men (MSM) is controversial. No studies have modelled potential\n<jats:italic>Neisseria gonorrhoeae<\/jats:italic>\ntransmission when one sexual practice follows another in the same sexual encounter (\u2018sequential sexual practices\u2019). Our aim was to test what sequential practices were necessary to replicate the high proportion of MSM who have more than one anatomical site infected with gonorrhoea (\u2018multisite infection\u2019).\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>To test our aim, we developed eight compartmental models. We first used a baseline model (model 1) that included no sequential sexual practices. We then added three possible sequential transmission routes to model 1: (1) oral sex followed by anal sex (or vice versa) (model 2); (2) using saliva as a lubricant for penile\u2013anal sex (model 3) and (3) oral sex followed by oral\u2013anal sex (rimming) or vice versa (model 4). The next four models (models 5\u20138) used combinations of the three transmission routes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The baseline model could only replicate infection at the single anatomical site and underestimated multisite infection. When we added the three transmission routes to the baseline model, oral sex, followed by anal sex or vice versa, could replicate the prevalence of multisite infection. The other two transmission routes alone or together could not replicate multisite infection without the inclusion of oral sex followed by anal sex or vice versa.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our gonorrhoea model suggests sexual practices that involve oral followed by anal sex (or vice versa) may be important for explaining the high proportion of multisite infection.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/sextrans-2020-054565","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T22:34:50Z","timestamp":1605738890000},"page":"183-189","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Modelling the contribution that different sexual practices involving the oropharynx and saliva have on\n<i>Neisseria gonorrhoeae<\/i>\ninfections at multiple anatomical sites in men who have sex with men"],"prefix":"10.1136","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-4734","authenticated-orcid":false,"given":"Xianglong","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason J","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J P A","family":"Hoebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7363-6665","authenticated-orcid":false,"given":"Deborah","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingwang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian Yuh Shiong","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S","family":"Hocking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-1664","authenticated-orcid":false,"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,18]]},"reference":[{"key":"2024092304150575000_97.3.183.1","doi-asserted-by":"crossref","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":"2024092304150575000_97.3.183.2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.228486"},{"key":"2024092304150575000_97.3.183.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0208107","article-title":"Incidence of sexually transmitted infections in men who have sex with men and who are at substantial risk of HIV infection - 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