Gonorrhea

It usually starts with a tingling or burning sensation when you take a piss, and then can take a nasty turn towards a yellowish, milky discharge from your dick or even anus (depending on how you get down). But either way, these are the tell-tell signs that you’ve been infected with gonorrhea. It’s also known as “the clap” because, legend says, that’s the sound your hand makes against your forehead once you realize that you have contracted an STD.

Either way, gonorrhea is a very common sexually transmitted disease, along with its sister chlamydia. They often travel in pairs, which can make detection and treatment a bit more complicated, but we’ll deal with that part later. For the vast majority of people, gonorrhea is a very treatable illness and (almost always) can be cured.

Yes, there’s been lots of fear being spread about the new super gonorrhea and its resistance to medication. But, resistance doesn’t mean it cannot be cured. Rather that it might take a different set of medications or for a longer period of time. This is not the time to panic. Keep calm and get your learn on!

What is Gonorrhea?

Caused by the Neisseria gonorrhoeae bacterium, gonococcal infection is transmitted via some form of unprotected sexual intercourse or contact. The effects vary: the infection may take hold in your mouth, throat, urethra or anus with symptoms appearing between 2-10 days after infection, with some studies suggesting a possible longer incubation period lasting up to 30 days.

Oral sex, is known to produce more minor symptoms in the . . . let’s say, “dick suckers” throat, associated more with soreness for the estimated 10% of the population that will produce symptoms at all. Without proper medical testing, these symptoms may be mistaken or misdiagnosed as a cold, allergies or a basic sore throat. But this also means 90% of dudes infected with an oral clap infection are essentially asymptomatic. So proper and consistent testing is key! If you are sexually active, testing for gonorrhea, as well as syphilis, chlamydia, herpes and HIV should be conducted at least three times a year (yes, 3) whether you think you need it or not.

The two main reasons why gonorrhea is so common are:
1. carriers may be asymptomatic no matter where they were infected
2. it is a skin-to-skin, contact infection

No amount of bodily fluid transfer is needed to contract this illness. This might account for the estimated 7,000 new cases each year. So proper hand washing (for the duration of the “Happy Birthday” song) is a great first line of defense. Washing your cock wouldn’t hurt either.

Like some other STDs, gonorrhea is a major traveler and likes to get around. Sucking an infected guy’s dick can give you oral gonorrhea. And putting your cock inside of an infected mouth can give a penile infection. This also goes for anal sex, so when you are tested by your doctor, make sure that he/she is testing every portion of your body that is sexually active. Better safe than sorry, as the long term effects of not being treated are pretty gross. These include inflammation of the pelvis, joint and heart valve disorders, painful, swollen nuts and even sterility.

Saliva as a mode of Transmission

A report from May 2019, published on AIDSMAP, shed new light on the possiblity of saliva (spit) being a mode of transmitting gonorrhea. The report is very clear. “The throat is a major source of gonorrhoea transmission among men who have sex with men (MSM), according to Australian research published in Sexually Transmitted Infections. The study involved 60 male couples and showed a high prevalence of gonorrhoea infection in the throat and/or anus in the absence of urethral infection. The investigators suggest that transmission is occurring due to kissing, oral sex, rimming, or the use of saliva as lubricant for anal sex”.   

They add: “Our data are not consistent with the conventional paradigm of gonorrhoea transmission between men, in which most gonorrhoea    transmission is from the urethra to the throat and anus, and vice versa. Instead, our data are consistent with a new paradigm of gonorrhoea transmission in which the throat plays a central role in transmission to the partner’s throat, anus an d urethra, presumably through infected saliva”.

The investigators also highlight that when one man in a couple had throat gonorrhoea, there was a high chance that both men in the couple would have the infection at this site. They therefore suggest that transmission was occurring directly from throat to throat via kissing.

A second study from the same research group provides further evidence to support the hypothesis. A total of 3677 MSM attending the Melbourne clinic completed surveys, reporting on numbers of sexual partners in the past three months:

• mean 4.3 partners who they had kissed but not had oral or anal sex with
• mean 5.0 partners they had kissed and had sex with
• mean 1.4 partners they had had oral or anal sex with, but not kissed.

Kissing-only and kissing-with-sex were associated with gonorrhoea in the throat, but sex-only was not. The adjusted odds for gonorrhoea in the throat were 1.46-fold for men with more than four kissing-only partners and 1.81-fold for men with more than four kissing-with-sex partners.

What does this mean?

Gay male sex is complex but unfortunately, it is not studied as a compete series of contacts and actions. Rather our sex is researched around one singular activity at a time. This creates difficulties in finding out which activity causes some infections verses others.

For the grown folks, here is an example regarding saliva.

• Joe and Dale meet to have sex. Joe is a total top and Dale is a vers/bottom. Joe and Dale begin with kissing and progress to touching and exploring each others naked bodies. At some point, Joe begins to rim Dale, who, in turn, performs oral sex on Joe. Joe returns the favour before inserting his condom covered penis inside of Dale’s rectum.

Traditionally, the above activities would be considered very safe. But now think of the large amounts of saliva and bare physical contact Joe and Dale had. This is how oral, penile and rectal gonorrhoea is spread.

1. Saliva is a major mode of gonorrhoea infection. Spit, when used during rimming, as lubrication for anal sex, exchanged during kissing and even during oral sex is the most likely way oral, anal and penile infections are occurring.
2. Condoms will not stop the spread of gonorrhoea if kissing, rimming and oral sex are involved.
3. Condoms should decrease the risk of infection if the only contact is anal sex, and the condom(s) are used each time and correctly.
4. Kissing is not a new risk factor for gonorrhoea infection…IT ALWAYS HAS BEEN A RISK FACTOR, we just didn’t know it.
5. Regular testing, and treatment for gonorrhoea and all STDs is paramount.
6. It is time we change the conversation around safer sex to include risk factors associated with saliva.
7. PrEP should not be blamed for increases in gonorrhoea infections.

Symptoms

Any good news?

Even as the United States has been seeing a “progressive development” of drug resistant gonorrhea cases, which require higher dosages of traditional antibacterial medications for a cure, more and better medications are being developed to combat this ever tricky bug. “At this time, no drug-immune cases have been identified in the United States,” says Sarah Kidd, a medical epidemiologist at the CDC. This means that the clap is still very treatable but some strains may require higher dosages, combination therapies and longer cure times. Luckily, for now, gonorrhea is still curable.

As we stated above, the rate for gonorrhea in the gay male population around the world is seeing an alarming rise. But this is good news because these facts are being reported in the news and there is a global response both from guys and the medical field. Even these so called resistant strains are being treated in America and Europe, with campaigns and multi-governmental strategies. What we, in our community, need to do, is follow the advice, get tested and don’t let fear force us into making poor decisions.

How do I protect myself from Gonorrhea?

We want you to dig a little deeper into this one and use this STD as a basis for how you approach all sexually transmitted illnesses. It’s very simple to say “wrap it up,” but condoms aren’t always effective in stopping any of these illnesses. We, as gay men, must stop believing that a thin piece of rubber is our greatest protector. It is this mindset—and its failure—which keeps biting us in the ass, literally. Condoms are the most effective way to prevent anal-sex gonorrhea infections but they do nothing for cock suckers.

We hate to use preachy “non-profit speak” but this is an opportunity to think about what is in your STD-prevention tool box. The very first tool should be your brain. Think first, then act. Not re-act, or act-out. So how about we use our big head in this case. Even though you should remain aware of the symptoms of gonorrhea, most guys don’t show them. Because of this, you have to actually do some work. This includes talking to your potential sex partners about possible gonorrhea infection—when was the last time they were tested—and stop believing the only STD you need to think about is HIV. Pissing out fire or green goo dripping from your asshole is not cute.

Communication is key, but so is regular testing, and hand washing. But, if you do contract the clap, at least for now, there is a pretty good chance it will be curable. Relax, go see a medical professional if you believe you have been exposed, take the medication (an antibiotic) fully (no left-over pills) as directed, and try to remember how you were infected, so that you may be more aware the next time.

NOTE: Some people just seem to attract this STD like flies to… well, you know. If you find that you are contracting gonorrhea over and over again, then maybe you should not only think about some lifestyle changes but check with your doctor to see if you are one of those “special magnets”. It seems that a previous history of STDs may make you more likely to contract the clap.

Partner Notification

Remember that part earlier about communication? Well, here is one of the harder parts. Talking to your prior and current sexual partners about your gonorrhea infection is a huge step in reducing the infection incidence rate and also a great way to slow down the progress of this bacteria through our community.

Since most guys don’t show symptoms, if you are the one that got tested or did show symptoms, you can be the “bigger man” and raise the bar for others. Yes, this may seem scary and also feel humiliating but we both know that it is the right thing to do. Not to shame-blame him (or them… all of them), rather to notify and help someone else out and keep them from spreading this illness. Who knows, if you think you cannot get it again, the ass (and dick, and throat) you save may be your own.