HERS was a case-control study that aimed to identify risk factors for oropharyngeal gonorrhoea among female sex workers. We specifically recruited female sex workers attending our Centre who tested positive for oropharyngeal gonorrhoea. We recruited study participants from different cultural backgrounds. We asked study participants to complete a survey. We asked about:
- mouthwash use
- sexual practices with clients
- sexual practices with non-work partners
- condom use
HERS was a mixed-methods study that looked at what increases the risk of throat gonorrhoea in female and gender-diverse sex workers. Researchers studied 664 sex workers in Australia who were attending either Melbourne or Sydney Sexual Health Centre between 2018 and 2020, comparing 83 who had throat gonorrhoea with 581 who did not. They also interviewed 19 sex workers about their experiences.
The key finding was that giving oral sex to clients without a condom was the main risk factor for throat gonorrhoea. Those who did this were 3.6 times more likely to have the infection. Most sex workers used condoms for oral sex, but some followed client preferences. Kissing clients was common, but it wasn't linked to higher risk (but this could be because kissing is not often the only sexual act being performed so its difficult to tell if it’s a risk factor by itself).
The study highlights the need for new ways to prevent throat gonorrhoea, beyond just condoms, since oral transmission remains a concern.
You can read the published paper here:
Publications
Understanding Risk Factors for Oropharyngeal Gonorrhea Among Sex Workers Attending Sexual Health Clinics in 2 Australian Cities: Mixed Methods Study
Phillips TR, Fairley CK, Maddaford K, McNulty A, Donovan B, Guy R, McIver R, Wigan R, Varma R, Ong JJ, Callander D, Skelsey G, Pony M, O'Hara D, Bilardi JE, Chow EP
(2024), JMIR Public Health Surveill,
DOI: 10.2196/46845