# Exploring community and expert perceptions of the acceptability of an oropharyngeal gonorrhoea controlled human infection model in Australia

## TL;DR

This study explores whether a controlled human infection model for oropharyngeal gonorrhoea is acceptable to potential participants and experts in Australia.

## Contribution

The paper presents novel insights into stakeholder acceptability of a gonorrhoea CHIM, emphasizing ethical design and stigma concerns.

## Key findings

- An oropharyngeal gonorrhoea CHIM is generally acceptable to most participants and experts.
- Financial compensation and participant selection criteria were key areas of debate.
- Stigma associated with gonorrhoea and historical stigma against MSM must be addressed in recruitment strategies.

## Abstract

The development of an oropharyngeal gonorrhoea controlled human infection model (CHIM) could result in important translational outcomes, including accelerated development of new drugs and vaccines. Ethical study design for such a model requires community consultation, including assessment of the acceptability of the proposed CHIM among key stakeholders. This qualitative study involved: (i) semi-structured interviews and focus groups with individuals who would be eligible for participation in the proposed oropharyngeal gonorrhoea CHIM, defined as healthy men who have sex with men (MSM) aged 18–50 years living in Victoria (Australia); and, (ii) semi-structured interviews with gonorrhoea experts. Data were analysed using inductive thematic analysis supported by NVivo. Twenty-seven semi-structured interviews and one focus group were undertaken with 32 individuals between July and November, 2024, comprising 22 potential CHIM participants, and 10 experts. Overall, an oropharyngeal gonorrhoea CHIM was acceptable to most participants. Financial compensation and including only MSM who do not have sex with women were highlighted as key areas of debate. Participants highlighted that recruitment strategies should be sensitive to the stigma associated with gonorrhoea and history of stigma experienced by MSM. An oropharyngeal gonorrhoea CHIM is acceptable to key stakeholders but must be carefully designed to avoid exacerbation of stigma.

The online version contains supplementary material available at 10.1038/s41598-025-30975-6.