ReviewThe Lancet. Infectious diseases2019
Models of gonorrhoea transmission from the mouth and saliva.
Review in The Lancet. Infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 82 citations in OpenAlex.
- The Impact of Mouthwash on the Oropharyngeal Microbiota of Men Who Have Sex with Men: a Substudy of the OMEGA Trial.Microbiology spectrum · 2022Trial
- An open-label, parallel-group, randomised controlled trial of antiseptic mouthwash versus antibiotics for oropharyngeal gonorrhoea treatment (OMEGA2).Scientific reports · 2020Trial
- Evidence-Based Assessment of the Role of Pharyngeal Gonorrhea and Commensal Neisseria Species in the Emergence of Antimicrobial Resistance in Neisseria Gonorrhoeae: Data Gaps and Future Research.The Journal of infectious diseases · 2026Review
- Exploring community and expert perceptions of the acceptability of an oropharyngeal gonorrhoea controlled human infection model in Australia.Scientific reports · 2025Article
- Chlamydia and gonorrhoea screening and diagnosis by anatomical site among individuals with opposite-sex partners: a rapid review.Sexually transmitted infections · 2025Article
- Chlamydia and Gonorrhea Infections in Genital and Extragenital Samples Among Men and Women.Sexually transmitted diseases · 2025Article
- Tetracycline-resistantJAC-antimicrobial resistance · 2025Review
- Switching From Dual to Monotherapy for Gonorrhea is Associated With a Halving of Gonococcal Resistance to Azithromycin-A Modelling Study of MSM in Belgium.Open forum infectious diseases · 2025Article
- Rationale and Ethical Assessment of an Oropharyngeal Gonorrhea Controlled Human Infection Model.The Journal of infectious diseases · 2025Article
- An oropharyngeal gonorrhoea controlled human infection model: a provisional protocol using a novelWellcome open research · 2025Article
- The incubation for urethral gonorrhoea among men who have sex with men with and without oropharyngeal gonorrhoea.Epidemiology and infection · 2024Article
- Understanding Risk Factors for Oropharyngeal Gonorrhea Among Sex Workers Attending Sexual Health Clinics in 2 Australian Cities: Mixed Methods Study.JMIR public health and surveillance · 2024Article
- Review
- Inadequate performance of a risk score to predict asymptomaticSexually transmitted infections · 2023Article
- Optimisation of treatments for oralBMJ open · 2022Article
- Kissing, fellatio, and analingus as risk factors for oropharyngeal gonorrhoea in men who have sex with men: A cross-sectional study.EClinicalMedicine · 2022Article
- Anatomic Site-Specific Gonorrhea and Chlamydia Testing and Incidence Among People With HIV Engaged in Care at 4 US Clinical Centers, 2014-2018.Open forum infectious diseases · 2022Article
- Inhibitory Activity of Antibacterial Mouthwashes and Antiseptic Substances against Neisseria gonorrhoeae.Antimicrobial agents and chemotherapy · 2022Article
- Time to Clearance of Neisseria gonorrhoeae RNA at the Pharynx following Treatment.Journal of clinical microbiology · 2022Article
- Non-conventional interventions to prevent gonorrhea or syphilis among men who have sex with men: A scoping review.Frontiers in medicine · 2022Article
Corrections and comments
- Commented on by
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This Personal View argues for a new framework of gonorrhoea transmission in men who have sex with men in which the oropharynx plays a major role in transmitting gonorrhoea to, or acquiring gonorrhoea from, their partner's oropharynx, penis, or anorectum through either direct contact or via saliva. To avoid preconceived notions of transmission dynamics, we ask readers to imagine that they are investigating a new sexually transmitted infection. On the basis of the existing clinical and epidemiological data for gonorrhoea at the penis, oropharynx, and anorectum site, we develop two models for transmission: the so-called penile model and the so-called oropharyngeal model. We argue that the existing epidemiological data and behavioural data best fit the oropharyngeal model. Our argument rests on the observation that, at the population level, the prevalence of urethral gonorrhoea is too rare to explain the high incidence of oropharynx and anorectum infection. We describe studies of gonorrhoea detection in saliva, saliva use during sex, epidemiological studies of kissing and oropharyngeal gonorrhoea, as well as studies aided by mathematical models. Finally, we argue that the correlation between sexual acts (eg, kissing, oral sex, anal sex, and saliva use) is so high that any epidemiological study that does not measure these factors will be prone to confounding.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.