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Cited by 17Reproductive tract infections researchSexual Assault and Victimization StudiesHIV/AIDS Research and Interventions

Follow up of patients who have been recently sexually assaulted.

Open access
Parekh, V, Beaumont Brown, C·2003·Sexually Transmitted Infections
DOI 10.1136/sti.79.4.349-aPMC PMC1744715
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Abstract

Pharyngeal gonorrhoea: the forgotten reservoirUrethral gonorrhoea (UG) dramatically decreased in Paris between 1986 and 1997 as a consequence of safer sexual behaviour.Thus, only 43 cases of gonorrhoea have been collected in our clinic in 1997, the lowest number since the early 1970s.Since 1998, an increase has been observed, as in other STD clinics in France and in the Renago laboratory network.[1][2][3] Men who have sex with men (MSMs) represent an increasing number of men with UG.Many of them are HIV seropositive and recognise unprotected oral sex as the only risk factor for gonorrhoea.This finding prompted us to study pharyngeal carriage of Neisseria gonorrhoeae (NG) and Neisseria meningitidis (NM) in this population.From January 1999 to May 2001, 200 consecutive cases of male UG were observed in our clinic; a pharyngeal smear for culture of NG and NM was suggested as well as a standardised questionnaire aimed at sexual behaviour; 178 gave informed consent.Results are presented in table 1, comparing MSMs and men who also have sex with women (MSWs).Interestingly, MSMs represent more than 50% of patients with UG (compared to 10% in 1986 and 20% in 1995).One third of them are HIV seropositive (a minimal figure because of a high rate, 9%, of test refusal).Fifty eight per cent admitted unprotected oral sex as the sole risk factor for gonorrhoea.Moreover, 98% of the gonococci cultured in MSMs are serogroup W-2-3 (v 73 % in MSWs) and only 1/92 produce penicillinase (v 26 % in MSWs), suggesting a homogeneous cluster of strains circulating in the Paris gay community (study ongoing).Finally, pharyngeal carriage of both NG (14%) and NM (20%) is high.Data concerning MSWs are heterogeneous, UG affects mainly male patients from north (35%) and central (31%) Africa, with oral sex as the only risk factor for gonorrhoea (10%), and pharyngeal carriage of NG and NM (6%) is much lower, but not inconsistent.Pharyngeal gonorrhoea is mostly asymptomatic (all our cases were) and bacteriological diagnosis is uncertain, but we believe that the pharynx acts as an important reservoir accounting for the recent increase in UG, particularly in MSMs using unprotected oral sex as an alleged safer sex act.The high proportion of HIV infected patients is a major cause of concern and information about the hazards of unprotected oral sex is warranted.

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  • Compliance with follow-up visits is typically poor among survivors of sexual assault.

    “Although collection of specimens at initial examination for laboratory STI diagnosis gives the survivor and clinician the option of deferring empiric prophylactic antimicrobial treatment, compliance with follow-up visits is typically poor (1423–1425).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1424]

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Research works printed but not linked: 10

  1. Spenatto N, Viraben R. Substantial increase in gonorrhoea among homosexual men attending an STD centre in Toulouse, France. Sex Transm Infect 2001;77:391-2.
  2. Dupin N, Jdid R, N'Guyen Y-T, et al. Syphilis and gonorrhea in Paris: the return. AIDS 2001;15:814-15.
  3. Goulet V, Sednaoui P, Laporte A, et al. Augmentation du nombre de gonococcies identifiées par le réseau RENAGO. Bull Epidemiol Hebdomadaire 1999;26:109-11. Accepted for publication 29 November 2002 References
  4. Macleod J, Rowsell R, Horner P, et al. Postal urine specimens: are they a feasible method for genital chlamydia infection screening? Br J Gen Pract 1999;49:455-8. Accepted for publication 15 January 2003 References
  5. Taylor-Robinson D, Munday PE. Chlamydia infections. In: Oriel JD, Waugh M, eds. Anglo-Scandinavian Conference on sexually transmitted diseases. Royal Society of Medicine Services International Congress and Symposium Series No 135. London: RSM, 1988:3-12.
  6. Antilla T, Saikku P, Koskela P, et al. Serotypes of Chlamydia trachomatis and risk for development of cervical squamous cell carcinoma. JAMA 2001;285:47-51.
  7. Taylor-Robinson D. Mycoplasm genitalium-an up-date. Int J STD AIDS 2002;13:145-51. Accepted for publication 27 February 2003 References
  8. Moulignier A, Moulonguet A, Pialoux G, et al. Reversible ALS-like disorder in HIV infection. Neurology 2001;57:995-1001.
  9. Karpati G, Dalakas MC. Viral-hide-and-seek in sporadic ALS. A new challenge. Neurology 2000;54:6-7.
  10. Hughes G, Randall S, Hopwood J, et al. Incidence and re-infection rates of genital chlamydial infection in young women attending health care settings in Portsmouth and Wirral, UK: The chlamydia recall study. Poster. Xth International Symposium on Human Chlamydial Infections, Antalya, Turkey, June 2002.

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Authors
Parekh, V, & Beaumont Brown, C.
Affiliations
Canberra Hospital (AU)
Corresponding author
Parekh, V
ORCID
Parekh, V
Venue
Sexually Transmitted Infections
Publisher
BMJ
Published
2003-08-01
Volume
79
Issue
4
Pages
349-349
ISSN
  • 0007-134X (ISSN-L)
  • 1368-4973
DOI
10.1136/sti.79.4.349-a
PMC
PMC1744715
OpenAlex
W2146998419
Cited by
17
References
34
Citations by year
2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2017: 1 · 2016: 2 · 2015: 2 · 2013: 1 · 2012: 1
FWCI
0.52
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Sexually Transmitted Infections (publishedVersion, other-oa)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
pharyngeal gonorrhea, Neisseria gonorrhoeae, Neisseria meningitidis, pharyngeal carriage, men who have sex with men, HIV seropositivity, penicillinase production
MeSH terms
Counseling, Female, United Kingdom, Health Promotion, Humans, Pregnancy, Pregnancy Tests, Rape, Referral and Consultation, Sexually Transmitted Diseases

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