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Sexual exposure and sexual behaviour in the interval between gonorrhoea treatment and test of cure: a cross-sectional cohort study
  1. Oluseyi Ayinde,
  2. Jonathan D C Ross
  1. Sexual Health and HIV, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Oluseyi Ayinde, Sexual Health and HIV, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK; oluseyi.ayinde{at}


Objectives We explored sexual contact in the interval between the treatment for gonorrhoea and attending for a test of cure (ToC) and identified factors associated with sexual contact in this period.

Methods Multivariable analysis of demographic, behavioural and clinical data with self-reported sexual contact prior to attending for a gonorrhoea ToC evaluation among participants recruited into the ‘Gentamicin for the Treatment of Gonorrhoea’ trial in England, between October 2014 and November 2016. Associations with sexual contact were expressed as prevalence ratios (PR) and their corresponding 95% CI.

Results The median time to ToC was 15 days (interquartile range 14–20 days). 197/540 (37%) participants reported sexual contact in the time between treatment and ToC. Of these, 173/197 (88%) participants reported inconsistent condom use, including with previous partners (133/197 (68%)). A history of gonorrhoea (adjusted PR (aPR) 1.32 (1.03 to 1.69)) or syphilis (aPR 1.19 (1.08 to 1.32)), being in regular (aPR 1.71 (1.41 to 2.09)) sexual relationships, high number of partners in the last 3 months (aPR 1.77 (1.25 to 2.51))—‘more than 5 partners’ vs ‘0 to 1 partner’, and attending for a ToC more than 14 days after treatment (aPR 1.40 (1.08 to 1. 81)) were associated with reporting sexual contact before the ToC appointment. However, age (aPR (1.00 (0.99 to 1.01)) and presenting with specific symptoms at baseline (aPR 1.17 (0.95 to 1.44)) were not associated with sexual contact by the ToC attendance.

Conclusion Sexual activity after receiving treatment for gonorrhoea and prior to a ToC evaluation was common. This was associated with previous infection history and specific behavioural characteristics. Knowledge of these factors can help guide safe sex counselling at the time of treatment.

  • treatment
  • gonorrhoea
  • sexual behavior
  • disease transmission
  • infectious

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Handling editor Jamie Scott Frankis

  • Contributors JDCR and OA conceived the study. OA and JDCR contributed to the design of the study. OA carried out the statistical analyses. OA and JDCR drafted the manuscript. All authors assisted with interpretation of the data, reviewed and approved the final manuscript. JDCR is the guarantor of this study.

  • Funding The GToG study was funded by the National Institute for Health Research (NIHR) Health Technology Assessment and registered prior to start of recruitment (ISRCTN51783227).

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

  • Competing interests JDCR reports personal fees from GSK Pharma as well as ownership of shares in GSK Pharma and AstraZeneca Pharma; and is author of the UK and European Guidelines on Pelvic Inflammatory Disease; is a Member of the European Sexually Transmitted Infections Guidelines Editorial Board and is a Member of the National Institute for Health Research Funding Committee (Health Technology Assessment programme). He is an NIHR Journals Library Editor and associate editor of Sexually Transmitted Infections journal. He is an officer of the International Union against Sexually Transmitted Infections (treasurer) and a charity trustee of the Sexually Transmitted Infections Research Foundation (chair). OA declares no competing interests or funding.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.