Objectives Infection with Neisseria gonorrhoeae represents a serious public health problem. According to the national reported incidence surveillance system in Slovenia, gonorrhoea is disproportionately more common in the MSM population. However, estimates of the prevalence of N. gonorrhoeae infection in the general MSM population in Slovenia are lacking. Herein, we present the prevalence of N. gonorrhoeae in two distinct MSM populations in Slovenia in 2012.

Methods Culture-based screening for N. gonorrhoeae infection was performed in two MSM population settings. In the first one (population (a), pharyngeal swab cultures were offered to attendees of two gay clubs and one Non-Governmental Organization based anonymous STI testing point. In the second one (population (b), asymptomatic MSM seeking for preventive STI screening at the specialised MSM clinic were comprehensively examined with pharyngeal, urethral and rectoscopy-guided rectal swab cultures. A short behavioural questionnaire was obtained in both settings.

Results A total of 306 MSM were investigated. The overall prevalence of N. gonorrhoeae infection from any site was 4.3% (95% CI; 2.5–7.1%). The overall prevalence of pharyngeal infection was 2.3% (95% CI; 1.1–4.7%). In population A (n = 239), aged 16–60 years (mean age: 29 years), the prevalence of pharyngeal gonorrhoea was 2.5% (95% CI; 1.2–7.3%). In population B (n = 67), aged 19–62 years (mean age: 35 years), the prevalence of pharyngeal, rectal and genital gonorrhoea was 1.7% (95% CI; 0.3–8.9%), 9.2% (95% CI; 4.3–18.7%) and 0% (95% CI; 0–6.6%), respectively.

Conclusion In two Slovenian MSM populations a relatively high prevalence (4.3%) of pharyngeal and rectal gonococcal infections, which are usually known to be asymptomatic, was identified. This prevalence may also be underestimated, since the culture diagnostics being used is known to display a suboptimal sensitivity compared to NAAT diagnostics, particularly for pharyngeal and rectal specimens. These results might warrant a 3-site testing (urogenital, pharyngeal and rectal) of all MSM in Slovenia.