{
  "abstract": "Objectives 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.Methods 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 17–24 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 χ 2 tests. Island-of-Ireland weighted positivity with 95% CI was estimated.Results 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 12 011 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.Conclusions 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.",
  "authors": [
    {
      "affiliations": [
        "Public Health Agency Northern Ireland, Belfast, UK",
        "UK Health Security Agency, London, UK"
      ],
      "name": "Abbie Harrison"
    },
    {
      "affiliations": [
        "SH:24 CIC, London, England, UK"
      ],
      "name": "Justin Harbottle"
    },
    {
      "affiliations": [
        "Health Protection Surveillance Centre, Dublin, Ireland"
      ],
      "name": "Mark Campbell"
    },
    {
      "affiliations": [
        "Health Protection Surveillance Centre, Dublin, Ireland"
      ],
      "name": "Kate O’Donnell"
    },
    {
      "affiliations": [
        "HSC Western Health and Social Care Trust, Londonderry, UK"
      ],
      "name": "Melissa Perry"
    },
    {
      "affiliations": [
        "UK Field Epidemiology Training Programme (UKFETP), UK Health Security Agency, London, UK"
      ],
      "name": "Alison Sykes"
    },
    {
      "affiliations": [
        "Public Health Agency Northern Ireland, Belfast, UK"
      ],
      "name": "Chris Nugent"
    },
    {
      "affiliations": [
        "Public Health Agency Northern Ireland, Belfast, UK",
        "Centre for Public Health, Queen’s University Belfast, Belfast, UK"
      ],
      "name": "Declan T Bradley"
    },
    {
      "affiliations": [
        "SH:24 CIC, London, England, UK"
      ],
      "name": "Paula Baraitser"
    },
    {
      "affiliations": [
        "Health Service Executive, National Health Protection Office, Dublin, Ireland"
      ],
      "name": "Derval Igoe"
    },
    {
      "affiliations": [
        "Sexual Health Programme, HSE, Dublin, Ireland"
      ],
      "name": "Fionae Lyons"
    },
    {
      "affiliations": [
        "Public Health Agency Northern Ireland, Belfast, UK"
      ],
      "name": "Rachel Coyle"
    }
  ],
  "title": "Oropharyngeal gonorrhoea infections among young heterosexual users of online sexual health services across the island of Ireland",
  "uid": "7c94d4ad-938b-5951-bb13-21262fe78833"
}