Gonorrhoea phylogenetic analysis and clinical notes review

  • Research type

    Research Study

  • Full title

    Investigate the degree of agreement between using whole genome sequencing (WGS) to identify heterosexual identifying men (HM) within higher-risk sexual networks of gay, bisexual, and other men who have sex with men (GBMSM), compared to clinical assessment.



  • Contact name

    John Saunders

  • Contact email


  • Sponsor organisation

    United Kingdom Health Security Agency

  • Duration of Study in the UK

    0 years, 7 months, 31 days

  • Research summary

    Gonorrhoea is a sexually transmitted infection (STI). Gonorrhoea diagnoses in England are increasing annually, especially in men. People with gonorrhoea are at risk of acquiring HIV and hepatitis viruses, which can be prevented by taking HIV medication before sex (HIV PrEP) and using hepatitis vaccines. However, use is low among heterosexual men (HM) with gonorrhoea as many healthcare professionals wouldn’t consider them to be at risk unless reporting sex with men.

    Gonorrhoea whole genome sequencing (WGS) can infer infection clusters, which are likely to be linked as part of transmission networks. Therefore, genetically similar gonorrhoea infections are likely to be found in people who are part of the same transmission network, where other STIs are also likely to be transmitted. My thesis is founded on the idea that it might be possible to infer someone's risk of HIV or hepatitis from the characteristics of their sexual network as determined by gonorrhoea sequencing. Indeed, it has been shown that some HM have gonorrhoea infections that cluster with men who have sex with men (MSM), including MSM living with HIV. This suggests that such HM might not have disclosed their full sexual history, or might be linked to high-risk networks in ways that they aren’t aware, or incorrect coding of their sexual orientation. This is important because it might be possible to use WGS data to enhance risk assessment to influence clinical management. For example, someone presenting as a HM but clustering with MSM and people living with HIV could be offered HIV PrEP and hepatitis vaccination, and advice about their potential level of risk. This study is designed to investigate this question further by comparing WGS network analyses with clinical coding to understand whether WGS could ever be used as part of clinical management to help determine risk and management strategies.

  • REC name

    Wales REC 6

  • REC reference


  • Date of REC Opinion

    20 Dec 2023

  • REC opinion

    Favourable Opinion