Background As well as monitoring antimicrobial resistance, the enhanced Gonococcal Resistance to Antimicrobial Surveillance Programme dataset can be used to understand the epidemiology of gonococcal infection.

Objective To explore socio demographic and behavioural characteristics of MSM (HIV positive and negative) and heterosexuals (male and female) infected with gonorrhoea.

Methods Demographic and behavioural data from Gonococcal Resistance to Antimicrobial Surveillance Programme, collected annually between July and September 2005–2010 from 26 sentinel GUM clinics were analysed.

Results Of 9239 gonorrhoea cases, 3089 (36%) were in MSM, of whom 861 (28%) were HIV positive; 5588 in heterosexuals, of whom 3012 (54%) were men. Predominantly of white ethnic background, HIV positive MSM (mean age 36 y) were older than HIV negative MSM (mean age 30 y). A higher proportion of HIV positive than negative MSM were co-infected with another STI (OR=1.6, 95% CI 1.3 to 1.9), mainly chlamydia (18% vs 15%) or syphilis (5% vs 2%). HIV positive MSM were also more likely (OR=1.5, CI 1.3 to 1.8) to report rectal gonococcal infection. Over a quarter of HIV positive MSM reported ≥6 sexual partners in the past 3 months compared to 18% of HIV negative MSM. Within the heterosexual population, higher proportion of women than men were of white ethnic background (74% vs 43%) and <25 y (72% vs 47%). Compared to heterosexual men, women were more likely to be co-infected with another STI (OR=1.5, CI 1.4 to 1.7) primarily chlamydia (41% vs 35%). Nearly two-third of heterosexual men reported ≥2 sexual partners in past 3 months while most women (64%) reported one or no sexual partners.

Conclusion Gonorrhoea is concentrated amongst specific population sub-groups. Our analysis indicates that these groups are at high risk of contracting and transmitting other STIs as well as HIV, and underlines the need for targeted interventions.