5F2 Mycoplasma Genitalium in British Women and Men Aged 16-44 Years: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Thursday, June 12, 2014: 8:10 AM
Pam Sonnenberg, MB BCh, MSc, PhD1, Catherine Ison, PhD2, Nigel Field, MB PhD3, Soazig Clifton, BSc3, Clare Tanton, PhD3, Kate Soldan, PhD2, Simon Beddows, PhD2, Cath Mercer, BSc, MSc, PhD1 and Anne Johnson, MBBS, MD3, 1Department of Infection and Population Health, University College London, London, United Kingdom, 2National Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom, 3Research Department of Infection and Population Health, University College London, London, United Kingdom

Background:  In clinical studies, Mycoplasma genitalium(MG) is commonly implicated in non-gonoccocal urethritis (NGU) in men and as a putative cause of female genital tract inflammation. Yet prevalence data and associated traits in the general population, which might inform clinical practice and population-based MG screening, are scarce. We present age and gender-specific population prevalence estimates for MG, and describe associated risk factors and symptoms.

Methods:  In 2010-2012, we conducted a probability sample survey in Britain. Urine from 4,696 participants, aged 16-44 years (including 189 sexually-inexperienced participants aged 16-17 and 42 sexually-experienced participants aged 16-44 reporting only oral sex), was tested for MG. Results were linked to detailed demographic and behavioural data.

Results:  MG prevalence in sexually-experienced 16-24 year olds was 1.7% (95%CI:1.1%-2.6%) in women and 0.4% (0.1-1.1) in men, whereas the prevalence in 25-44 year olds was 1.2% (0.4-1.9) and 1.5% (0.9-2.4) respectively. We detected no MG in sexually-inexperienced 16-17 year olds, or in 16-44 year olds reporting only oral sex. MG was significantly associated with younger age at first sex, more sexual partners in the past year, condomless sex, concurrency, same-sex experience ever (women), and black ethnicity (men). Most women (56%) and men (94%) with MG reported no STI symptoms, although MG was associated with post-coital bleeding in women. Women with MG were more likely to have high-risk human papillomavirus detected in urine, and to report previous trichomoniasis. Men with MG were more likely to report previous gonorrhoea, syphilis or NGU.

Conclusions:  We provide the first population-based prevalence estimates for MG in Britain, and in those older than 27 years internationally, and strong evidence for MG being a STI. While the overall prevalence of MG was low, the age distribution, symptom profile, and some risk factors differed in women and men. These findings inform testing, treatment and control measures.