Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007-17.

UNLABELLED

Background Since 2014 there has been an increase in gonorrhoea among heterosexuals in Australia. Sex with a partner from a country with high gonorrhoea prevalence has been identified as a risk factor for gonorrhoea in heterosexual females, but risk factors for heterosexual males remain unclear. This study determined risk factors for gonorrhoea among heterosexual males.

METHODS

Retrospective analysis was performed among heterosexual males attending Melbourne Sexual Health Centre (MSHC) between 1 January 2007 and 31 December 2017. Countries for overseas sexual partners were stratified as high-prevalence countries (HPC) or low-prevalence countries (LPC) based on the incidence of gonorrhoea.

RESULTS

The annual gonorrhoea positivity increased from 0.72% in 2007 to 1.33% in 2017 (Ptrend <0.001). Males attending MSHC as a contact of gonorrhoea had the highest odds of testing positive (adjusted odds ratio (aOR) 7.46; 95% confidence interval (CI) 4.46-12.49), followed by males identifying as Aboriginal and Torres Strait Islander (aOR 2.57; 95% CI 1.30-5.09), males who had injected drugs in the past 12 months (aOR 2.44; 95% CI 1.39-4.30) and males who had sex with a female from an HPC (aOR 2.18; 95% CI 1.77-2.68). Males aged ≥35 were at higher risk than those aged ≤24 years (aOR 1.44; 95% CI 1.14-1.82). Gonorrhoea positivity increased among males who had sex with females from an LPC (from 0.60% to 1.33%; Ptrend = 0.004) but remained the same over time among males who had sex with females from an HPC (2.14%; Ptrend = 0.143).

CONCLUSIONS

There was an 80% increase in urethral gonorrhoea among heterosexual males between 2007 and 2017. Having sex with a female from an HPC is a significant risk factor for gonorrhoea. Gonorrhoea positivity among men having sex with a female from an HPC did not change over time, suggesting this risk factor has become less important.