Oropharyngeal gonorrhoea was detected in 92% of gonorrhoea cases among young heterosexuals using an online self-sampling service, with 63% of cases occurring as single-site oropharyngeal infections that would have been missed by urogenital-only testing protocols.
Oropharyngeal gonorrhoea was detected in 92% of all gonorrhoea cases among young heterosexual self-sampling individuals.
Oropharyngeal gonorrhoea positivity was 2.9% of the tested population.
The majority of oropharyngeal gonorrhoea cases (63%) occurred as single-site infections without concurrent genital infection.
Concurrent oral and genital (multisite) gonorrhoea infections were identified in 29% of cases.
The study suggests the oropharynx acts as a common and often independent gonorrhoea infection site among young heterosexuals, with implications for current testing guidelines.
This research suggests that gonorrhoea infections in the throat (oropharyngeal gonorrhoea) are surprisingly common among young heterosexual people, based on a study of over 7,000 individuals aged 17-24 in Ireland and Northern Ireland who used an online home-testing service. Nearly 3% of those tested had a throat gonorrhoea infection, and remarkably, 92% of all gonorrhoea cases detected involved the throat. Most strikingly, 63% of throat infections occurred without any genital infection at the same time — meaning these cases involved only the throat. This matters because standard gonorrhoea testing in heterosexual people typically focuses only on genital sites. This research suggests that if throat testing is not included, the large majority of throat infections in this group would go completely undetected and untreated. Undetected infections could potentially allow the bacteria to spread further within sexual networks. The findings raise important questions about current sexual health testing guidelines, which generally do not recommend routine throat swabs for heterosexual individuals. The authors suggest that guidelines may need to be reviewed for young heterosexual people, and that more research is needed to understand what sexual behaviors are associated with throat gonorrhoea in this population.
Harrison A, Harbottle J, Campbell M, O'Donnell K, Perry M, Sykes A, et al.. (2025). Oropharyngeal gonorrhoea infections among young heterosexual users of online sexual health services across the island of Ireland.. Sexually transmitted infections. https://doi.org/10.1136/sextrans-2025-056487