{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T01:50:36Z","timestamp":1774489836582,"version":"3.50.1"},"reference-count":33,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,4,13]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>There is limited evidence about the prevalence of oropharyngeal gonorrhoea (OPNG) in heterosexuals. To test the hypothesis that the oropharynx acts as a reservoir for gonorrhoea, potentially contributing to high rates of infection, we assessed OPNG positivity in self-sampling individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From November 2023 to March 2024, SH:24, an online postal self-sampling service, expanded gonorrhoea (NG) nucleic acid amplification testing to include oropharyngeal swabs for heterosexual individuals aged 17\u201324 years in Northern Ireland and Ireland. Participants were included if they identified as heterosexual with no same or both-gender sexual partners. Positivity was compared by sex and infection site, with \u03c7<jats:sup>2<\/jats:sup> tests. Island-of-Ireland weighted positivity with 95% CI was estimated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>OPNG was detected in 92% (208\/226) of NG cases, representing 2.9% (95% CI 2.6 to 3.4) of the tested population. Single-site OPNG infections accounted for 63% (143\/226) of cases, corresponding to an overall single-site oropharyngeal positivity of 1.9% (95% CI 1.7 to 2.4). Genital-only infections occurred in 8% (18\/226) of cases, while concurrent oral and genital (multisite) infections were identified in 29% (65\/226). Overall NG positivity (across all anatomical sites) was 3.2% (226\/7009; 95% CI 2.8 to 3.7). Of 12\u2009011 individuals who requested a self-sampling kit, 7036 (58.6%) returned both oropharyngeal and genital swabs suitable for analysis, with valid test results available for 7009 individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings suggest the oropharynx is a common NG infection site among young heterosexuals, often occurring independently of genital infection. Most OPNG cases (63%) did not coincide with genital infection and would have been missed by testing protocols limited to urogenital sites. These results suggest a potential risk for onward transmission, the need to consider a review of testing guidelines in this population and further research to better understand behavioural risk factors associated with OPNG positivity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056487","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T13:20:26Z","timestamp":1747142426000},"page":"436-440","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Oropharyngeal gonorrhoea infections among young heterosexual users of online sexual health services across the island of Ireland"],"prefix":"10.1136","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7435-9994","authenticated-orcid":false,"given":"Abbie","family":"Harrison","sequence":"first","affiliation":[{"name":"Public Health Agency Northern Ireland, Belfast, UK"},{"name":"UK Health Security Agency, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Harbottle","sequence":"additional","affiliation":[{"name":"SH:24 CIC, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2821-5280","authenticated-orcid":false,"given":"Mark","family":"Campbell","sequence":"additional","affiliation":[{"name":"Health Protection Surveillance Centre, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Health Protection Surveillance Centre, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Perry","sequence":"additional","affiliation":[{"name":"HSC Western Health and Social Care Trust, Londonderry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Sykes","sequence":"additional","affiliation":[{"name":"UK Field Epidemiology Training Programme (UKFETP), UK Health Security Agency, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Nugent","sequence":"additional","affiliation":[{"name":"Public Health Agency Northern Ireland, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Declan T","family":"Bradley","sequence":"additional","affiliation":[{"name":"Public Health Agency Northern Ireland, Belfast, UK"},{"name":"Centre for Public Health, Queen\u2019s University Belfast, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Baraitser","sequence":"additional","affiliation":[{"name":"SH:24 CIC, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derval","family":"Igoe","sequence":"additional","affiliation":[{"name":"Health Service Executive, National Health Protection Office, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fionae","family":"Lyons","sequence":"additional","affiliation":[{"name":"Sexual Health Programme, HSE, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Coyle","sequence":"additional","affiliation":[{"name":"Public Health Agency Northern Ireland, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"2025101602151358000_101.7.436.1","unstructured":"ECDC . Annual Epidemiological Report for 2022. Stockholm: European Centre for Disease Prevention and Control, 2023."},{"key":"2025101602151358000_101.7.436.2","unstructured":"PHA . Sexually Transmitted Infections in Northern Ireland, 2022. Belfast: HSC Public Health Agency, 2022."},{"key":"2025101602151358000_101.7.436.3","unstructured":"HPSC . Sexually Transmitted Infections (STIs) in Ireland. 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Disseminated gonococcal infection in england, 2019 to 2023: data from voluntary reporting. 2023."},{"key":"2025101602151358000_101.7.436.9","doi-asserted-by":"publisher","DOI":"10.1177\/0956462413491238"},{"key":"2025101602151358000_101.7.436.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30777-5"},{"key":"2025101602151358000_101.7.436.11","doi-asserted-by":"publisher","DOI":"10.1086\/508460"},{"key":"2025101602151358000_101.7.436.12","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001626"},{"key":"2025101602151358000_101.7.436.13","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3579-6"},{"key":"2025101602151358000_101.7.436.14","doi-asserted-by":"publisher","DOI":"10.1071\/SH17196"},{"key":"2025101602151358000_101.7.436.15","doi-asserted-by":"crossref","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","volume":"95","author":"Chow","year":"2015","journal-title":"Sex Transm Infect"},{"key":"2025101602151358000_101.7.436.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12982-015-0034-7","article-title":"Sexually transmitted infections among female sex workers tested at STI clinics in the Netherlands, 2006-2013","volume":"12","author":"Verscheijden","year":"2015","journal-title":"Emerg Themes Epidemiol"},{"key":"2025101602151358000_101.7.436.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.03.033"},{"key":"2025101602151358000_101.7.436.18","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001068"},{"key":"2025101602151358000_101.7.436.19","article-title":"Pharyngeal Gonorrhoea in Women: An Important Reservoir for Increasing Neisseria gonorrhoea Prevalence in Urban Australian Heterosexuals?","volume":"2013","author":"Lusk","year":"2013","journal-title":"J Sex Transm Dis"},{"key":"2025101602151358000_101.7.436.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0071394","article-title":"Sexually transmitted infections among heterosexual male clients of female sex workers in China: a systematic review and meta-analysis","volume":"8","author":"McLaughlin","year":"2013","journal-title":"PLoS One"},{"key":"2025101602151358000_101.7.436.21","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30594-6"},{"key":"2025101602151358000_101.7.436.22","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2014-051760"},{"key":"2025101602151358000_101.7.436.23","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001760"},{"key":"2025101602151358000_101.7.436.24","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1097\/OLQ.0000000000001777","article-title":"A Systematic Review of Kissing as a Risk Factor for Oropharyngeal Gonorrhea or Chlamydia","volume":"50","author":"Charleson","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2025101602151358000_101.7.436.25","doi-asserted-by":"publisher","DOI":"10.3201\/eid2507.181561"},{"key":"2025101602151358000_101.7.436.26","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053381"},{"key":"2025101602151358000_101.7.436.27","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30306-8"},{"key":"2025101602151358000_101.7.436.28","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001540"},{"key":"2025101602151358000_101.7.436.29","doi-asserted-by":"publisher","DOI":"10.2353\/jmoldx.2006.050045"},{"key":"2025101602151358000_101.7.436.30","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01217-11"},{"key":"2025101602151358000_101.7.436.31","doi-asserted-by":"publisher","DOI":"10.5694\/mja14.00780"},{"key":"2025101602151358000_101.7.436.32","unstructured":"HSPC . Medical Officer of Health: Role and Legal Basis. HPSC, 2023. 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