condom packets on yellow background

Let's talk about sex

We don’t need a return to the doom-and-gloom advertising campaigns of the 1980s, but a UQ Centre for Clinical Research scientist is urging the community to prioritise safe sex once again.

UQ microbiologist Associate Professor David Whiley and his team have played a key role in developing a new test for gonorrhoea, a sexually transmitted disease with potentially devastating consequences.

Prevalence of gonorrhoea has risen in Australia in recent years, despite the wide availability of education and effective treatment.

“Even though gonorrhoea is currently very treatable, for whatever reason the rates of infection have absolutely surged across Australia and elsewhere,” Dr Whiley says.

“In Australia rates of gonorrhoea have dramatically increased in urban heterosexuals, something which we really haven’t seen since before the 1980s.

“If you go by the numbers then, as a nation, we do not appear to be doing a very good job of managing gonorrhoea. We really need to understand why.

“There’s no need to bring back scare campaigns like the HIV/AIDS adverts, but now that people see these conditions as manageable, sexual health is no longer in the limelight.

“People have almost certainly become complacent about safe sex.”

Infertility, blindness in babies, ectopic pregnancies and premature birth can all be potentially caused by gonorrhoea, a condition that not only affects the genital area, but also the throat and anus.

It is often spread without any warning signs as infections can be asymptomatic, particularly in the throat.

Making the situation more volatile is the threat of strains that are antibiotic resistant.

The infection has developed resistance to six antibiotics during the past few decades and doctors have identified cases which have failed to respond to standard treatment.

Gonorrhoea bacteria
condom packets
man leaning on handrail

Professor David Whiley is leading the charge against gonorrhoea.

Professor David Whiley is leading the charge against gonorrhoea.

laboratory test
colourful packet of condoms

“Ceftriaxone is the key drug used to treat infection, and we have now documented international transmission of gonorrhoea strains that are resistant to ceftriaxone, including a few cases in Australia,” Dr Whiley says.

“While the cases have so far been few, it is still a very worrying development.

“If we get to a point where our antibiotics are no longer effective in treating gonorrhoea, even if in just a small percentage of the population, then it will be totally out of control.

“It’s going to be difficult to ever win the battle against gonorrhoea if you have increased prevalence and reduced effectiveness of treatment.

“The first thing we really need to do is make sure that those with gonorrhoea are detected.

“We need those at risk to be tested.

“Then using our new resistance tests we want to ensure that we give the right treatment to the right people.”

Treatment of gonorrhoea need not be complex if diagnosed early and correctly.

Using a test his team developed in partnership with SpeeDx Pty Ltd, Dr Whiley says that up to 60 per cent of gonorrhoea cases in Australia could potentially be treated with a single oral dose of ciprofloxacin.

“The availability of these new tests can change the way we treat patients, by allowing us to reuse older drugs like ciprofloxacin so we are not just relying on ceftriaxone,” Dr Whiley says.

“I didn’t originally intend on gonorrhoea becoming my area of focus, although I always had an interest in clinical microbiology.

“A stint working in the laboratory at Brisbane Sexual Health Clinic in the 1990s connected me with that path of research.

“Originally, I thought of gonorrhoea as a disease from the 1960s that was long gone, but my eyes were soon opened to the realities.

“I realised the diagnostic challenges that we were facing and I guess the challenging aspects of the condition are what sustained my interest.”

Although prevalence of gonorrhoea peaks in younger age brackets where greater sexual activity is common, the condition is reported across the full spectrum of age groups.

Declining condom usage and technology that facilitates a greater number of sexual partners are two likely contributors to the re-emergence of gonorrhoea as a threat to public health

This story is featured in the Winter 2019 edition of UQMedicine Magazine. View the latest edition here. Or to listen, watch, or read more stories from UQ’s Faculty of Medicine visit our blog, MayneStream.