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Published: June 24, 2025
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Dr. Jay Varma explores new evidence that gonorrhea may spread not only through oral sex but also through kissing, highlighting why more people should consider throat testing for sexually transmitted infections.
An Overlooked Risk in the Fight Against Gonorrhea
Gonorrhea has long been considered one of the most common sexually transmitted infections (STIs). Traditionally, prevention efforts have focused on genital infections and, more recently, anal infections. But a growing body of evidence suggests that the throat may be an underrecognized reservoir for the disease—one that can spread silently, without symptoms, and possibly through kissing.
Dr. Jay Varma explains why gonorrhea in the throat deserves more attention, particularly as rates of antibiotic resistance climb and transmission continues in communities where access to comprehensive testing is limited.
A Real-World Outbreak That Raises Questions
Earlier this year, Dr. Varma was asked to advise on a gonorrhea outbreak traced to a sex party in the Midwest. At this event, condoms were used for vaginal and anal sex, but not for oral sex. When attendees were tested within five days, half of the participants tested positive for gonorrhea—in both their urine and their throats—despite reporting no symptoms.
The results pointed to a likely culprit: transmission through oral contact, either during oral sex or possibly through kissing.
How Gonorrhea Testing Works
Standard gonorrhea screening usually involves a urine test, which reliably detects genital infections. However, the bacteria can also colonize the throat and anus. Testing these sites requires swabs, which patients can safely and accurately collect themselves.
Currently, the CDC only recommends three-site testing (genitals, anus, and throat) for men who have sex with men (MSM) and transgender women who have sex with men—groups with higher rates of oral and anal infections. Straight men and women are rarely tested outside the genitals, based on assumptions about their sexual practices.
But as this outbreak illustrates, those assumptions may underestimate risk.
Can Kissing Transmit Gonorrhea?
While oral sex is a well-documented route for throat gonorrhea, new research suggests that kissing alone may also spread the infection. Studies among gay men in Australia found that kissing was one of the strongest predictors of throat gonorrhea, independent of oral sex.
The possibility of throat-to-throat transmission matters because throat infections are usually asymptomatic. People may carry gonorrhea for months without knowing, spreading it through kissing or subsequently passing it genitally through oral sex.
Why Throat Infections Matter
Unlike genital gonorrhea, where untreated infections can cause infertility and pelvic inflammatory disease, the long-term effects of throat gonorrhea on an individual’s health remain unclear. What is clear is that throat infections act as silent reservoirs, enabling the bacteria to spread widely in communities.
They also pose another danger: the throat is a site where gonorrhea may more easily develop antibiotic resistance, since bacteria encounter low levels of antibiotics prescribed for other illnesses, such as sore throats or dental infections.
Should Everyone Get Throat Testing?
From a public health perspective, decisions about screening balance benefits with costs. Routine three-site testing for the entire population would increase early detection but also raise healthcare costs and resource demands. For now, broad recommendations remain limited.
At the individual level, however, more thorough testing may make sense—especially for people who:
- Engage in oral sex with multiple or new partners
- Participate in group sex
- Have partners who also have other partners
- Belong to communities with high STI prevalence
Dr. Varma recommends that sexually active adults advocate for three-site testing—throat, genitals, and anus—rather than relying on urine tests alone.
Gonorrhea in the throat is a growing concern, and kissing may be an overlooked route of transmission. Because these infections often go undetected, they quietly fuel ongoing spread. Regular, comprehensive STI testing is essential—not only for individual health but also for preventing community outbreaks.
“Gonorrhea infections in the throat can linger for months without symptoms—making kissing a hidden route of transmission we can’t ignore.” —Dr. Jay Varma
📅 Publication Date & Outlet
June 24, 2025 | Psychology Today
