Gonorrhoea during COVID-19 in London, UK

It is unclear how the COVID-19 pandemic has affected sexual behaviour and the transmission of STIs. Reports suggest a decline in STIs during the first COVID-19 lockdown attributed variously to fewer sexual encounters1 and decreased testing or case reporting.2 However, in some settings, diagnoses of symptomatic STIs appeared to remain unchanged.3

Neisseria gonorrhoeae (NG) infection of the male urethra causes symptoms in >90% of individuals but is mostly asymptomatic at other sites. As symptoms usually present within 5 days of exposure and unpleasant enough to seek assistance, urethral NG is a potential marker of recent sexual behaviour.4 First-line NG treatment is a single-dose ceftriaxone injection administered at medical services, whereas other STIs are standardly treated using oral antibiotics which can be sent by post or purchased online.

On 23 March 2020, following instructions to avoid unnecessary travel and non-essential contact with others, the UK…

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