Gonorrhea is a relatively common sexually transmitted infection (STI) that can be passed along through oral, vaginal, and anal sex. It was once thought that these were the only sexual activities that posed a significant risk for this particular STI; however, a recent study suggests that gonorrhea can potentially be transmitted through kissing as well, regardless of whether any genital contact occurs.

In this study, researchers looked at 3,677 men who have sex with men who were visiting a sexual health clinic in Melbourne, Australia. All of these men completed a survey about their recent (meaning within the last 3 months) kissing and sexual behaviors. Each participant was tested for the presence of gonorrhea in the throat as well. Researchers then looked for links between people’s sexual behaviors and their odds of contracting this infection.

In total, six percent of the men tested positive for oral gonorrhea. In addition, those who had more kissing-only partners and more kissing-and-sex partners were more likely to test positive; by contrast, having more sex-without-kissing partners was not linked to testing positive.

Specifically, for those with 4+ kissing-only partners, their odds of having oral gonorrhea were 46% higher. For those who had 4+ kissing-and-sex partners, their odds of having oral gonorrhea were 81% higher.

What these results suggest is that, regardless of whether sex occurs, kissing may be a potential risk factor for transmission of gonorrhea. Why is that? The most plausible explanation is that gonorrhea is present in the saliva of infected persons—and we know that saliva transfer occurs during kissing. A few recent studies have confirmed that gonorrhea can be detected in the saliva of persons with oral infections (see here and here), which supports this idea.

Obviously, these findings are limited in that only men who have sex with men were studied. It’s also important to caution that this research is very new and we really should replicate the main findings before drawing too many conclusions.

With that said, we’ve long known that STIs (like herpes) can potentially be spread through kissing, so this doesn’t change anything other than to suggest that perhaps more STIs can be transmitted this way than previously thought. Even so, this isn’t to say that people should stop kissing or anything like that. Rather, what this tells us is that we clearly need more research on how STIs are transmitted and also that we need to encourage more screening for oral gonorrhea infections, especially as this STI becomes more resistant to antibiotics.

Fortunately, there may be a potential (and cheap) solution available: antibacterial mouthwash. Research has found that Listerine inhibits bacterial growth of gonorrhea, suggesting that it could potentially play an important future role in preventing oral transmission of this STI.

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To learn more about this research, see: Chow, E. P., Cornelisse, V. J., Williamson, D. A., Priest, D., Hocking, J. S., Bradshaw, C. S., ... & Fairley, C. K. (2019). Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men. Sexually Transmitted Infections.

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