Ethnically diverse urban transmission networks of Neisseria gonorrhoeae without evidence of HIV serosorting

Jayshree Dave, John Paul, Thomas Joshua Pasvol, Andy Williams, Fiona Warburton, Kevin Cole, Victoria Fotini Miari, Richard Stabler, David W. Eyre*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective We aimed to characterise gonorrhoea transmission patterns in a diverse urban population by linking genomic, epidemiological and antimicrobial susceptibility data. Methods Neisseria gonorrhoeae isolates from patients attending sexual health clinics at Barts Health NHS Trust, London, UK, during an 11-month period underwent whole-genome sequencing and antimicrobial susceptibility testing. We combined laboratory and patient data to investigate the transmission network structure. Results One hundred and fifty-eight isolates from 158 patients were available with associated descriptive data. One hundred and twenty-nine (82%) patients identified as male and 25 (16%) as female; four (3%) records lacked gender information. Self-described ethnicities were: 51 (32%) English/Welsh/Scottish; 33 (21%) white, other; 23 (15%) black British/black African/black, other; 12 (8%) Caribbean; 9 (6%) South Asian; 6 (4%) mixed ethnicity; and 10 (6%) other; data were missing for 14 (9%). Self-reported sexual orientations were 82 (52%) men who have sex with men (MSM); 49 (31%) heterosexual; 2 (1%) bisexual; data were missing for 25 individuals. Twenty-two (14%) patients were HIV positive. Whole-genome sequence data were generated for 151 isolates, which linked 75 (50%) patients to at least one other case. Using sequencing data, we found no evidence of transmission networks related to specific ethnic groups (p=0.64) or of HIV serosorting (p=0.35). Of 82 MSM/bisexual patients with sequencing data, 45 (55%) belonged to clusters of ≥2 cases, compared with 16/44 (36%) heterosexuals with sequencing data (p=0.06). Conclusion We demonstrate links between 50% of patients in transmission networks using a relatively small sample in a large cosmopolitan city. We found no evidence of HIV serosorting. Our results do not support assortative selectivity as an explanation for differences in gonorrhoea incidence between ethnic groups.

Original languageEnglish
Pages (from-to)106-109
Number of pages4
JournalSexually Transmitted Infections
Issue number2
Publication statusPublished - 1 Mar 2020

Bibliographical note

Funding Information:
Funding the research was funded by the National Institute for health research health protection research Unit (NIhr hprU) in healthcare-associated infections and antimicrobial resistance at the University of oxford in partnership with public health england (phe) (hprU-2012-10041) and the NIhr hprU in Modelling Methodology at Imperial College London (hprU-2012-10080) in partnership with phe. DWe is a Big Data Institute robertson Fellow. Competing interests None declared.


  • epidemiology (molecular)
  • neisseria gonorrhoeae
  • sexual networks


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