Gonorrhea and Rectal Infections in Men Who Have Sex with Men

Q: Gonorrhea and Rectal Infections in Men Who Have Sex with Men

Hello： I had unprotected intercourse for the first time and tested positive, while my partner has more sexual experience but shows no symptoms. <br>Should I consider DNA testing for more detailed accuracy? -- DNA testing may not be as effective as directly observing the pathogen

Gonococcal rectal infection in men who have sex with men?

Hello Dr.
Du, I have currently contracted gonorrhea, and both parties have undergone bacterial culture tests.
I am the infected party (Subject 1), while my partner (Subject 0) is uninfected.
I contracted the infection during unprotected intercourse for the first time, while my partner has more sexual experience but shows no symptoms.
Should we consider using DNA testing for more detailed accuracy? Additionally, could you explain what a rectal infection is? Is it possible for both parties to have no history of gonorrhea, yet the gonorrhea bacteria could have originated from rectal bacteria? If the follow-up DNA test for gonorrhea shows no reaction, does that indicate that I have recovered?

Niming, 20~29 year old female. Ask Date: 2021/07/21

Dr. Du Shixi reply Urology

Hello: I had unprotected intercourse for the first time and tested positive, while my partner has more sexual experience but shows no symptoms.
Should I consider DNA testing for more detailed accuracy? -- DNA testing may not be as effective as directly observing the pathogen or isolating the strain from the specimen.
Please refer to https://www.cdc.gov.tw/File/Get/lh6TyjM85hwqWMfnOLbT8Q.
Additionally, I would like to ask the doctor what a rectal infection is.
-- Gonorrhea can manifest in the rectum and increase in number; is it possible for both partners to have no history of gonorrhea and for the gonorrhea bacteria to derive from rectal bacteria? -- If a subsequent DNA test for gonorrhea shows no reaction, does that indicate recovery? -- There is a chance of false negatives in testing, so it should only be considered as a reference.
Wishing you good health.

Reply Date: 2021/07/21

More Info

Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, is a sexually transmitted infection (STI) that can affect various parts of the body, including the urethra, throat, and rectum. In men who have sex with men (MSM), rectal infections are particularly common due to the nature of anal intercourse. Understanding the dynamics of gonorrhea transmission and infection is crucial for effective prevention and treatment.

In your case, it appears that you have tested positive for gonorrhea while your partner has tested negative. This situation raises several important points regarding the nature of gonorrhea transmission and the implications of rectal infections.

1. Transmission Dynamics: Gonorrhea can be transmitted through direct contact with infected bodily fluids. If you engaged in unprotected anal intercourse, it is possible to contract the infection from an infected partner. However, it is also important to note that asymptomatic infections are common. Your partner may have been exposed to gonorrhea in the past but is currently not showing symptoms or may have cleared the infection without treatment.

2. Rectal Infections: A rectal infection occurs when the bacteria infect the rectum, which can happen through anal intercourse. Symptoms may include discharge, pain, or discomfort, but many individuals remain asymptomatic. This is particularly concerning because asymptomatic individuals can still transmit the infection to others.

3. DNA Testing: DNA testing, such as nucleic acid amplification tests (NAATs), is highly sensitive and specific for detecting gonorrhea. If you have already tested positive and are considering further testing, a DNA test can provide confirmation of the presence of the bacteria. However, if you have completed treatment, a follow-up test is typically recommended to ensure that the infection has been cleared.

4. Reinfection and Treatment: If you have been treated for gonorrhea, a follow-up test is essential to confirm that the infection has been successfully eradicated. A negative result after treatment generally indicates that you are no longer infected. However, it is crucial to consider the possibility of reinfection, especially if your partner has not been treated or if you engage in sexual activities with other partners.

5. Bacterial Origin: Regarding your question about whether rectal bacteria could lead to the development of gonorrhea, it is important to clarify that gonorrhea is caused specifically by Neisseria gonorrhoeae. While the rectum can harbor various bacteria, the presence of other bacteria does not cause gonorrhea. Instead, gonorrhea must be transmitted from an infected individual.

6. Prevention: To reduce the risk of gonorrhea and other STIs, it is advisable to use condoms consistently during anal and oral sex. Regular STI screenings are also recommended, especially for individuals with multiple partners or those in high-risk categories.

In summary, understanding gonorrhea and its transmission is vital for maintaining sexual health. If you have tested positive, it is essential to follow up with your healthcare provider for appropriate treatment and further testing. Additionally, open communication with your partner about STI testing and safe sex practices can help prevent future infections. If you have any further questions or concerns, do not hesitate to reach out to a healthcare professional for guidance.

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