School of Science, RMIT University, Melbourne, Victoria, Australia.
From the Melbourne Sexual Health Centre, Alfred Health.
Sex Transm Dis. 2023 Jul 1;50(7):395-401. doi: 10.1097/OLQ.0000000000001777. Epub 2023 Feb 3.
Tongue kissing is a poorly studied risk factor for sexually transmitted infections (STIs). We undertook the first systematic review to assess whether kissing is a risk factor for gonorrhea or chlamydia of the oropharynx.
Online databases (MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane) and reference lists were searched until September 30, 2022. The eligibility criteria for studies included: any peer-reviewed study design in the English language; gonorrhea or chlamydia diagnosed by nucleic acid amplification test, or an infection self-reported by a patient; tongue kissing or its equivalent measured as an exposure. Studies were appraised using a quality scoring tool and qualitatively synthesized.
Of 8248 studies screened, 6 were eligible for review. All were conducted among men who have sex with men in Australia, including 3 prospective cohort studies, 2 cross-sectional studies, and 1 age-matched case-control study. In summary, all 5 studies examining gonorrhea found an unadjusted association between kissing and oropharyngeal gonorrhea. Two cross-sectional studies found that tongue kissing was an independent risk factor for oropharyngeal gonorrhea after adjusting for other confounders, such as participant demographic characteristics and other sexual practices. In contrast, a single eligible prospective cohort study found no association between kissing and oropharyngeal chlamydia.
This systematic review summarized the existing evidence that suggests that tongue kissing may be a risk factor for oropharyngeal gonorrhea but not chlamydia. Reinforcing the message that oropharyngeal gonorrhea could be transmitted through kissing may inform the development of novel approaches to prevent and treat gonorrhea.
舌吻是一种研究甚少的性传播感染（STIs）风险因素。我们进行了首次系统评价，以评估接吻是否是口咽淋病或衣原体感染的风险因素。
在线数据库（MEDLINE、EMBASE、CINAHL、Web of Science、Cochrane）和参考文献列表进行了检索，检索截至 2022 年 9 月 30 日。纳入研究的标准包括：任何同行评议的英语研究设计；通过核酸扩增试验诊断的淋病或衣原体，或患者自述的感染；舌吻或其等效物作为暴露因素进行测量。使用质量评分工具评估研究，并进行定性综合。
在筛选的 8248 项研究中，有 6 项符合审查条件。所有研究均在澳大利亚男男性行为者中进行，包括 3 项前瞻性队列研究、2 项横断面研究和 1 项年龄匹配的病例对照研究。总之，所有 5 项研究都发现接吻与口咽淋病之间存在未经调整的关联。两项横断面研究发现，在调整了参与者的人口统计学特征和其他性行为等其他混杂因素后，舌吻是口咽淋病的独立危险因素。相比之下，唯一一项合格的前瞻性队列研究发现接吻与口咽衣原体之间没有关联。
本系统评价总结了现有的证据，表明舌吻可能是口咽淋病的一个风险因素，但不是衣原体的风险因素。强化口咽淋病可能通过接吻传播的信息，可能有助于制定预防和治疗淋病的新方法。
