“Nearly half” of all rectal gonorrhea cases may be eliminated if men did not use their partners’ saliva as a lubricant during anal sex, reports a study published recently in Sexually Transmitted Infections. However, the authors note, “It is likely that the public health message from our findings is complicated and involves more than simply recommending that saliva is not used as a lubricant for anal sex.”
The study, which tested participants for gonorrhea and also questioned them about anal sex practices other than penile-anal intercourse, found that receptive partners who used their partners’ saliva as a lubricant were more than 2 times more likely to have rectal gonorrhea—even after adjusting for factors such as condom use, HIV status and gonorrhea infection of the throat.
Other studies have found that using saliva as a lubricant during anal sex is common practice among men who have sex with men, and gonorrhea bacteria can be detected in the saliva of people with pharyngeal (throat) infections. The current study is the first to provide evidence that saliva from a person with a pharyngeal gonorrhea infection may substantially increase risk for rectal infections when that partner’s saliva is used as a lubricant during anal sex.
“This article makes a decent argument for looking into lube saliva as a method of GC [gonorrhea] transmission,” said Pierre-Cédric Crouch, PhD, ANP, the nursing director at Strut. “The study does have many limitations that the author do list out—most notably, it is a very small study and it is all self-report. I wouldn’t change my messaging about GC transmission based on this study, but I think it’s compelling enough for other public health researchers to look more into it.”
Read more on BETA about gonorrhea, how it’s transmitted, and how it’s possible to get rectal gonorrhea even if you’re a top.
The study was conducted at a sexual health clinic in Victoria, Australia, and included 1,312 men. The researchers tested participants for pharyngeal and rectal gonorrhea infections and assessed three different types of anal sex practices including receptive rimming, receptive fingering or penis dipping, and use of a partner’s saliva as a lubricant during sex.
A total of 56 participants (4.3%) tested positive for rectal gonorrhea and 22 (1.7% of those tested) tested positive for pharyngeal gonorrhea. The majority of men reported receptive rimming (70%), receptive fingering or penis dipping (84%) and use of a partner’s saliva as a lube during anal sex (69%) in the preceding three months.
Using a partner’s saliva as a lube for anal sex was associated with a 40% increased risk for rectal gonorrhea even after adjusting for age, condom use during receptive anal intercourse, pharyngeal gonorrhea infection and HIV status. Rimming and receptive fingering/penis dipping was not associated with rectal gonorrhea. The authors speculate that the larger volume of saliva present when used as a lube, compared to the amount present when rimming, may explain this difference.
The authors note that because the study was only conducted at one sexual health clinic, their findings may not be generalizable to men who have sex with men in other communities.
The findings, the authors conclude, “highlight how important the pharynx is in the overall transmission [of gonorrhea] and how important further studies of exploring more complex sexual behaviors and their role in rectal gonorrhea are.”
Larger studies are needed, they say, to verify the association between specific sexual practices involving saliva and rectal gonorrhea.
Source:
Chow, E. P. F. and others. Saliva use as a lubricant for anal sex is a risk factor for rectal gonorrhea among men who have sex with men, a new public health message: A cross-sectional survey. Sexually Transmitted Infections, March 2016.
Gonorrhea is a sexually transmitted infection caused by a bacterium that can live in the mouth and throat, in the rectum and in the reproductive tract. It can be transmitted by touching body parts that are infected. Many times, people don’t realize they have gonorrhea because they don’t have any symptoms. Strut, the health and wellness center of San Francisco AIDS Foundation, offers free gonorrhea testing for gay, bi and trans men. Get additional information at www.strutsf.org.
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