Increasing rates of gonorrhoea among services users tested through online STI testing services across England in 2022

22nd June 2023 by Claire Taylor

Sara Day2, Sophie Jones2, Emma Ostridge3, Efejiro Ashano1, Vanessa Apea1,
1Preventx, 2Chelsea and Westminster Hospitals NHS Foundation Trust, 3Lloyds Pharmacy Online Doctor

Background

The UKHSA recently announced a 21% increase in gonorrhoea cases in England in 2022, despite stable rates of chlamydia. We queried the 2022 GC testing data from pan-UK online postal self-sampling services (OPSS) to determine if GC rates had also changed among those testing online.

Methods

We conducted a retrospective analysis of monthly GC testing data obtained from January 2019 to December 2022 and compared positivity rates over time, analysing by age, gender, ethnicity, sexual identity, deprivation decile and symptom status. The cohort included samples from OPSS across 70 NHS services in England (n=2238505 tests; 47% from London). All diagnoses were made by Neisseria gonorrhoeae CT/NG PCR (Roche cobas®), confirmed with the Diagenode S-Diagono PCR assay at the Preventx laboratory in Sheffield, England.

Results

There was an overall increase in GC positivity rates of 1.09% between 2019 and 2022. In April 2020, a significant increase in positivity was detected (0.9%), with a significantly larger increase of 1.09% occurring between July 2021 and November 2022 (p = 0.006566). The 2021–22 GC positivity rates and trend are detailed in Figure 1.

Increased rates of GC were associated with age 18–21 years, male gender, Asian and Latin American ethnicities, gay/bisexual MSM, higher deprivation deciles and asymptomatic status.

Discussion

The recent increase in English GC diagnoses in 2022 is reflected in this large OPSS dataset showing an increased proportion of GC-positive tests from service users. Whilst OPSS use has increased since pre- COVID, these data demonstrate a 55% increase in positivity rates for GC testing across this period (1.28% in 2019 vs. 1.99% in 2022). Health promotion and prevention interventions for GC should include people of Asian and Latin American ethnicities in the UK. These data also demonstrate that early trends in STI epidemiology can be observed from analysis of monthly data obtained by OPSS.