Background/introduction Gonorrhoea is a public health problem due to rising incidence and antimicrobial resistance. Understanding drivers of infection locally is important for planning public health interventions.

Aim(s)/objectives Describe demographics, lifestyle factors and antimicrobial resistance of gonorrhoea infections in Brighton.

Methods A prospective study recruited 121 individuals with gonorrhoea. Participants completed a questionnaire and cultures underwent whole genome sequencing. Data from questionnaires and electronic records were anonymised and analysed.

Results Average age was 33.6 years, 7.4% were female, 91.3% were white, 80% were MSM, 6.3% bisexual males. 35.9% of MSM were HIV-positive. In MSM, multisite infection was common. MSM had on average 8 partners in 3 months before diagnosis, compared to 4 for heterosexuals. 71.6% reported visiting a sauna, sex party or the internet to find partners. Sex under the influence of drugs occurred in 39.1% of HIV-positive MSM, 36.4% of HIV-negative MSM and 27.3% of heterosexuals. Most commonly used drugs were mephedrone by MSM and cocaine by heterosexuals. Condom use was lowest in HIV-positive MSM. Previous STIs were more frequent in HIV-positive MSM, particularly syphilis (55% vs 9.1%). 66.9% were culture-positive. Resistance to >1 antibiotic occurred in 34.8% of HIV-positive MSM, 9.1% of HIV-negative MSM and 9.1% of heterosexuals.

Discussion/conclusion Condom avoidance, frequent partner change and sex under the influence of drugs are common in both HIV-positive and HIV-negative MSM, raising concerns about HIV transmission. Antibiotic resistance is more common in HIV-positive MSM, concurring with the national surveillance programme. Effective interventions targeting this group are needed.