title: 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).
abstract: BACKGROUND
  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.
  
  
  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 sexually-experienced 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.
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. p.sonnenberg@ucl.ac.uk
authors.forename: Pam
authors.initials: P
authors.lastname: Sonnenberg
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Ison
authors.forename: Soazig
authors.initials: S
authors.lastname: Clifton
authors.forename: Nigel
authors.initials: N
authors.lastname: Field
authors.forename: Clare
authors.initials: C
authors.lastname: Tanton
authors.forename: Kate
authors.initials: K
authors.lastname: Soldan
authors.forename: Simon
authors.initials: S
authors.lastname: Beddows
authors.forename: Sarah
authors.initials: S
authors.lastname: Alexander
authors.forename: Rumena
authors.initials: R
authors.lastname: Khanom
authors.forename: Pamela
authors.initials: P
authors.lastname: Saunders
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Copas
authors.forename: Kaye
authors.initials: K
authors.lastname: Wellings
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D008297:Male; D009175:Mycoplasma Infections / Q000453:epidemiology* / Q000208:ethnology / Q000382:microbiology; D045704:Mycoplasma genitalium; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology; D014247:Trichomonas Vaginitis / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014526:Urethritis / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult