[Abstract] Investigating factors for increased gonorrhoea re-infection in msm attending a gu clinic: a qualitative study

Background/introduction In 2013, 63% of gonorrhoea infections in England were in men who have sex with men (MSM), in whom the annual incidence increased by 26% (PHE). In our clinic, annual incidence increased by 28.8% (2013) and re-infection (a second infection within 1-year of initial infection) rose from 6.7% as a proportion of total infections (2009) to 19.4% (2013). This is concerning given increasing reports of antibiotic resistant gonorrhoea. Aim(s)/objectives The aim of this study was to explore reasons for repeat gonorrhoea infections among MSM. Methods We interviewed 16 MSM about knowledge of gonorrhoea, attitudes to safe sex and antibiotic resistance. Results Mobile applications were used to meet casual sex partners and arrange impromptu group-sex parties with partner anonymity making contact tracing difficult. The use of recreational drugs was widespread and could result in unsafe sexual practices. Participants felt their behaviour was unlikely to change despite knowing there was increased gonorrhoea prevalence and frequently felt resigned to repeat infections. Participants thought global antibiotic resistance was concerning, but felt behaviour would change only if there was local evidence of this. It was highlighted that new technologies could increase awareness around local STI trends and services for those at risk. Discussion/conclusion MSM’s use of geosocial networking applications to arrange sex could also be harnessed to increase awareness and advertise testing opportunities. Enhanced interventions at initial diagnosis may also be beneficial. In some cases risk-taking behaviours are unlikely to change and for these men regular sexual health screens should be encouraged.