Trends in gonorrhoea testing and incidence among gay and bisexual men in Australia during PrEP implementation: an analysis of surveillance data (2012–2023)
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Le résumé fourni par la source
OBJECTIVES: Gonorrhoea incidence is increasing globally, with gay and bisexual men (GBM) over-represented in notifications. Changes in behaviour, sexual networks and screening practices associated with HIV pre-exposure prophylaxis (PrEP) uptake and treatment-as-prevention may influence gonorrhoea transmission. We describe trends in gonorrhoea testing and incidence among GBM over 12 years spanning PrEP implementation in Australia. METHODS: We conducted a retrospective study using surveillance data from 67 sexual health and general practice clinics between 1 January 2012 and 31 December 2023. For testing analyses, we included GBM with ≥1 visit and calculated annual test uptake (proportion of attendees tested at least once). For incidence analyses, we included GBM with ≥2 tests and calculated annual gonorrhoea incidence per 100 person-years (py). Test uptake and incidence were stratified by HIV status and PrEP use (ever vs never prescribed PrEP). Poisson regression explored factors associated with incident gonorrhoea, adjusted for calendar year and age. RESULTS: A total of 193 053 GBM attended a clinic during the study period, of which 176 244 (91.3%) had ≥1 test. Annual test uptake increased from 58.7% in 2012 to 75.2% in 2023, largely driven by increased testing among ever-PrEP-users. Among 119 741 GBM in incidence analyses, there were 61 896 gonorrhoea infections over 542 949 py (incidence rate=11.4/100 py). From 2012 to 2023, incidence among HIV-negative ever-PrEP users increased from 6.2 to 19.6/100 py (p<0.001), and among GBM with HIV increased from 8.6 to 18.8/100 py (p<0.001). GBM with recurrent infections (n=13 620; 11.4%) accounted for 69.1% of all diagnoses. Ever being prescribed PrEP (adjusted incidence rate ratio (aIRR)=2.40, 95% CI: 2.35 to 2.45) and living with HIV (aIRR=3.05, 95% CI: 2.97 to 3.13) were associated with incident gonorrhoea. CONCLUSIONS: In this large cohort of GBM, gonorrhoea incidence significantly increased during PrEP implementation, although incidence was already rising before large-scale PrEP roll-out in 2016. GBM with HIV, PrEP users or those previously diagnosed with gonorrhoea should be prioritised for testing and prevention strategies.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Trends in gonorrhoea testing and incidence among gay and bisexual men in Australia during PrEP implementation: an analysis of surveillance data (2012–2023)
- Date Crossref
- 21/09/2026
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Burnet Institute pays non établi dans la noticeOrganisation à but non lucratif
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The University of Melbourne Centre of Epidemiology and Biostatistics pays non établi dans la noticeUniversité ou école supérieure
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UNSW Sydney pays non établi dans la noticeUniversité ou école supérieure
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Monash University Department of Infectious Diseases pays non établi dans la noticeUniversité ou école supérieure
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Melbourne Sexual Health Centre pays non établi dans la noticeÉtablissement de santé
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Alfred Health pays non établi dans la noticeÉtablissement de santé
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Sydney Sexual Health Centre pays non établi dans la noticeÉtablissement de santé
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Gold Coast Health pays non établi dans la noticeÉtablissement de santé
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The University of Sydney pays non établi dans la noticeUniversité ou école supérieure
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NSW Health Pathology pays non établi dans la noticeÉtablissement de santé
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Sydney Local Health District pays non établi dans la noticeOrganisme public
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Peter Doherty Institute pays non établi dans la noticeStructure de recherche
Burnet Institute, Centre of Epidemiology and Biostatistics — The University of Melbourne et UNSW Sydney, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.