Can you get gonorrhea from french kissing

Infectious Disease > STDs

— Higher risk in MSM linked to "tongue kissing," with or without sex

by Staff Writer, MedPage Today May 10, 2019

"Tongue kissing" may be an overlooked risk factor for transmission of oropharyngeal, or throat gonorrhea, among men who have sex with men (MSM), researchers found.

Men with four or more kissing-only partners had a higher risk of having oropharyngeal gonorrhea (adjusted OR 1.46, 95% CI 1.04-2.06), with similar risks seen for men with four or more kissing-and-sex partners (adjusted OR 1.81, 95% CI 1.17-2.79), reported Eric P.F. Chow, MD, of Melbourne Sexual Health Center in Australia, and colleagues.

However, the number of sex-only partners (without kissing) was not a risk factor for oropharyngeal gonorrhea, the authors wrote in Sexually Transmitted Infections.

They noted that while most gonorrhea infections in this population occur through anal sex, recent prior research indicated that transmission of gonorrhea through the oropharynx is more common than previously thought. Neisseria gonorrhoeae was cultured from saliva, with the authors noting that both oro-anal contact (rimming) and saliva use for lubrication during anal sex are risk factors for anal gonorrhea. With "tongue-kissing" involving an exchange of saliva, gonorrhea could potentially be transmitted that way, the authors said.

"It has been proposed that [gonorrhea] can be transmitted through kissing, but kissing has always been neglected as a risk factor for [gonorrhea] transmission," they wrote.

Researchers examined data from MSM attending a public sexual health center in Melbourne from March 2016 to February 2017. Participants were boys and men ages 16 and up who had either kissed or had sex with a male partner in the last 3 months and were tested for oropharyngeal gonorrhea on that day. They were invited to complete a "Kissing" survey, which asked the number of male partners men had for:

  • Kissing-only partners
  • Sex-only partners (specified as oral or anal sex, but without tongue-kissing)
  • Kissing-and-sex partners

Overall, 3,677 responses were included from 3,091 MSM, with a median age of 30. Around 3% had previously been diagnosed with HIV. There were about 6% of men who tested positive for oropharyngeal gonorrhea, about 6% for anorectal gonorrhea, and around 3% for urethral gonorrhea. There were 52 men with kissing-only partners, and 95 men with sex-only partners.

Notably, the authors found that a significantly lower proportion of men who only had sex-only partners tested positive for oropharyngeal gonorrhea than those who only had kissing-only partners (3% vs 6%, respectively, P=0.020).

They noted that "younger men kiss more sexual partners than older men" and added that "potential interventions such as antiseptic mouthwash, if shown to be effective against oropharyngeal [gonorrhea], could provide a non-condom and non-antibiotic-based intervention for [gonorrhea] control." This is particularly important, given "known challenges" in antimicrobial treatment of oropharyngeal gonorrhea, they said.

Limitations to the study include selection bias, due to the fact that it was at a single urban sexual health center, and that about 60% of MSM declined to participate in the "Kissing" survey, which could have had an impact on the results.

Disclosures

Chow disclosed support from the Australian National Health and Medical Research Council.

Co-authors disclosed support from the Australian National Health and Medical Research Council and grants from the NHMRC, an NHMRC practitioner fellowship, and a research training scheme scholarship from the Australian government's Department of Education and Training.

(Reuters Health) - Deep kissing with tongue may be a way that gonorrhea is passed on, even if romantic partners haven’t been otherwise sexually active, according to research from Australia.

Although the study involved only gay and bisexual men, the risk of transmitting gonorrhea orally is likely also present for heterosexuals and particularly sex workers, the study authors write in the journal Sexually Transmitted Infections.

“It’s important to understand that safe sex isn’t a catch-all for gonorrhea, which challenges previous sexual health practices,” said lead study author Eric Chow of the Melbourne Sexual Health Centre and Monash University.

Public health messaging has focused on condom use because most gonorrhea is thought to be transmitted during penile-anal sex among men who have sex with men. However, recent studies have suggested that sex accounts for only part of the documented cases, especially when gonorrhea occurs in the throat.

“Kissing may be riskier than previously thought,” Chow told Reuters Health by email. “This may help people understand how the infection was introduced, particularly if they haven’t been sexually active.”

Chow and colleagues surveyed 3,677 men who have sex with men between March 2016 and February 2017 at the Melbourne Sexual Health Center, which offers free walk-in service. The survey asked about the number of male partners during the past three months in three separate categories: kissing-only, sex-only and kissing-with-sex.

All of the men were tested for sexually transmitted diseases, and 229 men, about six percent, had throat gonorrhea infections. About six percent had anorectal gonorrhea and three percent had urethral gonorrhea. At an average age of 30, almost all of the men had kissing-with-sex partners in the past three months, and 70 percent had kissing-only partners, but just 38 percent had sex-only partners. Less than a third of the men reported having all three types of partner, but most had at least two of the types.

On average, the men had 4.3 kissing-only partners in the previous three months, as well as 1.4 sex-only partners and 5 kissing-with-sex partners. Kissing-only and kissing-with-sex were associated with throat gonorrhea but sex-only was not.

The odds of having throat gonorrhea nearly doubled for those with four or more kissing-only or kissing-with-sex partners. In addition, younger men had greater odds of having throat gonorrhea, which was associated with younger men having more kissing-only partners, the study team notes.

“Gonorrhea rates continue to increase, and although some interventions are bending the curve of the epidemic, we need to continue to encourage screening,” said Dr. Lindley Barbee of the University of Washington in Seattle, who wasn’t involved in the study.

Future studies should investigate the different types of sex that may be related to gonorrhea transmission as well, she added, such as anal or oral sex. In addition, researchers should investigate specific kissing behaviors, including the duration, number of times or number of female partners kissed by bisexual men.

“This can be tough to study because people are not isolated and do all of these behaviors in the same setting,” Barbee told Reuters Health by email. “It’s hard to tease out which encounter or sexual behavior transmitted the infection.”

Chow and colleagues are now conducting a clinical trial that tests whether daily mouthwash use could reduce the risk of infection with the gonorrhea bacteria.

“We know it’s unlikely that people will stop kissing,” Chow said. “If this works, it could be a simple and cheap intervention for everyone.”

In the meantime, Barbee recommends remaining aware and getting tested. Throat gonorrhea can often be asymptomatic but may build resistance to antibiotics, which can make the gonorrhea itself tough to treat and potentially lead to more severe throat infections later.

“Gonococcus is able to scavenge DNA from other bacteria and interchange genetic material that can lead to antimicrobial resistance,” she added. “It’s important to understand what’s going on in our throats and treat it.”

SOURCE: bit.ly/2VF4WLr Sexually Transmitted Infections, online May 9, 2019.

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Can French kissing cause gonorrhea?

Oropharyngeal gonorrhea may be spread via French kissing, according to a new study out of Australia that looked at oropharynx-to-oropharynx transmission of the sexually transmitted infection (STI).

What STDs can you get from French kissing?

There are two STDs that spread easily through mouth-to-mouth kissing: herpes simplex virus 1 (HSV-1) and human papillomavirus (HPV).

Can I get gonorrhea from saliva?

For gonorrhoea, infections at extragenital sites are transmitted through non‐genital contacts such as kissing, rimming and use of saliva in addition to condomless oral or anal sex. For chlamydia, condomless anal sex is the main risk factor.