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)

Pam Sonnenberg*, Catherine Ison, Soazig Clifton, Nigel Field, Clare Tanton, Katherine Soldan, Simon Beddows, Sarah Alexander, Rumena Khanom, Pamela Saunders, Andrew J. Copas, Kaye Wellings, Catherine H. Mercer, Anne M. Johnson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

107 Citations (Scopus)


Background: There are currently no large general population epidemiological studies of Mycoplasma genitalium (MG), which include prevalence, risk factors, symptoms and coinfection in men and women across a broad age range. Methods: 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 sexuallyexperienced participants, aged 16-44 years, was tested for MG. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)1982-1994
Number of pages13
JournalInternational Journal of Epidemiology
Issue number6
Publication statusPublished - 1 Dec 2015

Bibliographical note

Funding Information:
Natsal-3 is a collaboration between University College London, the London School of Hygiene and Tropical Medicine, NatCen Social Research, Public Health England (PHE; formerly the Health Protection Agency) and the University of Manchester. The study was supported by grants from the Medical Research Council [G0701757] and the Wellcome Trust [084840], with contributions from the Economic and Social Research Council and Department of Health. N.F. is supported by an NIHR Academic Clinical Lectureship. We thank: the study participants, the team of interviewers from NatCen Social Research who carried out the interviews, and operations and computing staff from NatCen Social Research ; Chinelo Obi, Rebecca Howell-Jones, David Mesher, Heather Northend, Krishna Gupta and Tracey Cairns (Department of HIV and Sexually Transmitted Infections, PHE) for data linkage, anonymization, and data entry; and Filomeno Coelho da Silva (Virus Reference Department, PHE) for undertaking CT, GC and HPV testing.

Publisher Copyright:
© The Author 2015.


  • Epidemiology
  • Mycoplasma genitalium
  • Population
  • STI
  • Sexual behaviour


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