Epidemiology of Mycoplasma genitalium in British men and women aged 16–44 years: evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
International Journal of Epidemiology
Pam Sonnenberg1,*, Catherine A. Ison2, Soazig Clifton1,3, Nigel Field1, Clare Tanton1, Kate Soldan4, Simon Beddows5, Sarah Alexander2, Rumena Khanom2, Pamela Saunders2, Andrew J. Copas1, Kaye Wellings6, Catherine H. Mercer1 and Anne M. Johnson1
1Research Department of Infection and Population Health, University College London, London, UK
2Sexually Transmitted Bacteria Reference Unit, Public Health England, London, UK
3NatCen Social Research, London, UK
4Centre for Infectious Disease Surveillance and Control (CIDSC)
5Virus Reference Department, Public Health England, London, UK
6Department of Social and Environmental Research, London School of Hygiene and Tropical Medicine, London, UK
*Corresponding author. Reader in Infectious Disease Epidemiology, Research Department of Infection and Population Health, University College London, Mortimer Market Centre, London WC1E 6JB, UK. E-mail: firstname.lastname@example.org
There are currently no large general population epidemiological studies of Mycoplasma genitalium (MG), which include prevalence, risk factors, symptoms and co-infection in men and women across a broad age range.
In 2010-–12, we conducted the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability sample survey in Britain. Urine from 4507 sexually-experienced participants, aged 16–44 years, was tested for MG.
MG prevalence was 1.2% [95% confidence interval (CI): 0.7–1.8%] in men and 1.3% (0.9–1.9%) in women. There were no positive MG tests in men aged 16–19, and prevalence peaked at 2.1% (1.2–3.7%) in men aged 25–34 years. In women, prevalence was highest in 16–19 year olds, at 2.4% (1.2–4.8%), and decreased with age. Men of Black ethnicity were more likely to test positive for MG [adjusted odds ratio (AOR) 12.1; 95% CI: 3.7–39.4). For both men and women, MG was strongly associated with reporting sexual risk behaviours (increasing number of total and new partners, and unsafe sex, in the past year). Women with MG were more likely to report post-coital bleeding (AOR 5.8; 95%CI 1.4–23.3). However, the majority of men (94.4%), and over half of women (56.2%) with MG did not report any sexually transmitted infection (STI) symptoms. Men with MG were more likely to report previously diagnosed gonorrhoea, syphilis or non-specific urethritis, and women previous trichomoniasis.
This study strengthens evidence that MG is an STI. MG was identified in over 1% of the population, including in men with high-risk behaviours in older age groups that are often not included in STI prevention measures.