Chlamydia trachomatis and Neisseria gonorrhoeae Transmission from the Oropharynx to the Urethra among Men Who Have Sex with Men

Bernstein, Kyle T.; Stephens, Sally C.; Barry, Pennan M.; Kohn, Robert; Philip, Susan S.; Liska, Sally; Klausner, Jeffrey D.

doi:10.1086/648427

Cited by 111Reproductive tract infections researchHIV/AIDS Research and InterventionsCervical Cancer and HPV Research

Chlamydia trachomatis and Neisseria gonorrhoeae Transmission from the Oropharynx to the Urethra among Men Who Have Sex with Men

Bernstein, Kyle T., Stephens, Sally C., Barry, Pennan M., Kohn, Robert, Philip, Susan S., Liska, Sally, Klausner, Jeffrey D.·2009·Clinical Infectious Diseases

DOI 10.1086/648427

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Abstract

BACKGROUND: Limited data exist on the risk of Chlamydia trachomatis and Neisseria gonorrhoeae transmission from oropharynx to urethra. We examined urethral C. trachomatis and N. gonorrhoeae positivity among men who have sex with men (MSM) seen at San Francisco City Clinic (San Francisco, CA) during 2007. METHODS: All patients who sought care at the San Francisco City Clinic (the only municipal sexually transmitted disease clinic in San Francisco) received a standardized interview conducted by clinicians. We estimated urethral C. trachomatis and N. gonorrhoeae positivity for 2 groups of visits by MSM who visited during 2007: (1) men who reported their only urethral exposure was receiving fellatio in the previous 3 months and (2) men who reported unprotected insertive anal sex in the previous 3 months. Additionally, urethral C. trachomatis and N. gonorrhoeae positivity was estimated, stratified by human immunodeficiency virus infection status, urogenital symptom history, and whether the patient had been a contact to a sex partner with either chlamydia or gonorrhea. RESULTS: Among MSM who reported only receiving fellatio, urethral C. trachomatis and N. gonorrhoeae positivity were 4.8% and 4.1%, respectively. These positivity estimates were similar to positivity found among MSM who reported unprotected insertive anal sex. CONCLUSIONS: A more complete understanding of the risks of transmission of C. trachomatis and N. gonorrhoeae from oropharynx to urethra will help inform prevention and screening programs.

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Pharyngeal infections with gonorrhea or chlamydia might be a principal source of urethral infections.
“Pharyngeal infections with gonorrhea or chlamydia might be a principal source of urethral infections (209–211).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [211]
The Discussion (page unavailable) reports urethral chlamydia and gonorrhea among men whose only reported urethral exposure was receiving oral sex, and describes this route as potentially important. It does not establish that pharyngeal infection is a principal source of urethral infection; the study was limited to men who have sex with men attending an STD clinic. (LLM, conf=0.86)
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Transmission from the Oropharynx to the Urethra among Men who have Sex with Men
Klausner, J. D. (2015)
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Prevalence of pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae among heterosexual men in Japan
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Authors: Bernstein, K. T., Stephens, S. C., Barry, P. M., Kohn, R., Philip, S. S., Liska, S., & Klausner, J. D.
Affiliations: San Francisco Department of Public Health (US)
University of California, San Francisco (US)
Corresponding author: Bernstein, Kyle T.
ORCID: Bernstein, Kyle T.
Barry, Pennan M.
Philip, Susan S.
Klausner, Jeffrey D.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2009-12-15
Volume: 49
Issue: 12
Pages: 1793-1797
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1086/648427
OpenAlex: W2098720698
Cited by: 111
References: 18
Citations by year: 2026: 3 · 2025: 1 · 2024: 1 · 2023: 7 · 2022: 2 · 2021: 9 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 13 · 2016: 7 · 2015: 11 · 2014: 4 · 2013: 11 · 2012: 12
FWCI: 7.99
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
Funders: Council of State and Territorial Epidemiologists
Centers for Disease Control and Prevention (1h25ps001354-01)
National Institute of Allergy and Infectious Diseases (T32AI007641)
Topics: Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
Keywords: Chlamydia trachomatis, Neisseria gonorrhoeae, urethral infection, men who have sex with men, fellatio, unprotected anal intercourse, HIV infection, sexually transmitted infections
MeSH terms: Chlamydia trachomatis, Humans, Male, Neisseria gonorrhoeae, Oropharynx, Urethra, Homosexuality, Male

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Chlamydia trachomatis and Neisseria gonorrhoeae Transmission from the Oropharynx to the Urethra among Men Who Have Sex with Men

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