Trends in gonorrhoea infection and overseas sexual contacts among females in Melbourne, Australia, 2008-2015
J, M1; Chow, EPF1; Chen, MY1; Read, TRH1; Bradshaw, CS1; Fairley, CK1
1: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
Objectives: There has been a steady increase in gonorrhoea among females in Australia recently. The aim of this study was to examine the risk factors for gonorrhoea among females attending a sexual health service in Melbourne to determine if there was evidence of emerging endemic heterosexual transmission.
Material and Methods: Analysis of retrospective electronic patient records of females aged 16 to 80 years old attending the Melbourne Sexual Health Centre, Australia between 1st January 2008 and 20th March 2015. East and South-East Asian countries were considered as higher-prevalence countries for gonorrhoea (i.e. East and Southeast Asian countries).
Results: Gonorrhoea positivity by culture in females increased from 0.3% in 2008 to 1.2% in 2015 (ptrend=0.004). The rise in positivity was greatest in females reporting sex in a higher-prevalence country (0% to 7.4%, ptrend=0.026) but only moderate (0.2 to 0.4%, ptrend=0.49) in those reporting sex in Australia and/or in lower-prevalence countries. There was no association between gonorrhoea positivity and age, country of birth, number of male partners or injecting drug use behaviours. Gonorrhoea positivity was significantly associated with presenting as a contact of gonorrhoea (aOR: 74.79; 95% CI: 44.07-126.93) or having sex with someone from a higher-prevalence country (aOR: 2.46; 95% CI: 1.15-5.25).
Conclusions: There has been a recent four-fold increase in gonorrhoea among females attending a sexual health service in Melbourne. The association between female gonorrhoea infection and sex with a partner from a country with higher gonorrhoea and lack of association with traditional risk factors argues against substantial endemic heterosexual transmission within Australia.
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