PASS Announces Updated Mgen Guidance, Requiring Testing by Oct 1

The statement from PASS is quoted in its entirety below and is available on the PASS website, as well.

“The PASS Medical Advisory Board met last month in part to discuss the current impact of Mycoplasma genitalium, “Mgen”, on the adult industry. The science on Mgen is not settled, research is ongoing with new developments regularly occurring. Here’s what we do know:

• Many cases of Mgen are asymptomatic. The current evidence suggests that potential complications from asymptomatic infections are rare, however, it is still possible to transmit cases that could cause symptoms in other people.
• Some cases of Mgen cases will resolve on their own but studies have shown wide ranges of timeframes for natural clearance (could be several weeks to months).
• The bacteria is slow to grow, which makes transmission and testing timelines difficult to know. Testing may identify infections that are no longer active, and are no longer a threat, for weeks or even months later.

This presents a challenge because it means that testing alone is not the answer. If we test everyone for Mgen with the same frequency as other infections, we’re likely to identify a significant percentage of those who test positive may not have needed any or additional treatment. And if we treat all of those people, there may be a significant risk of creating a drug-resistant strain of Mgen in our community. There is no current evidence that frequent testing will result in better health outcomes.

This is a complex problem that needs coordinated solutions that go beyond testing. While it will not be easy, the PASS is already working with testing centers, infectious disease specialists, laboratory diagnosticians, public health experts and people within the community to effectively address the issue. In the coming weeks, we’ll continue to adapt solutions and be transparent about the process. In the meantime, we are implementing the following actions:

To be eligible for clearance in PASS, we will request everyone be tested by October 1, 2023. All tests during the month of September will be eligible.

PASS is working to implement a volunteer contact tracing program to help identify, isolate, and treat the spread of Mgen infections within our community which we will be rolling out within the next week.

Helping people get appropriate treatment through programs and educational campaigns. Successful treatment, including taking all medicine as prescribed by your clinician, is essential to preventing drug resistance. Current CDC treatment guidelines for Mgen is Doxycycline 100 mg orally 2 times/day for 7 days, followed by moxifloxacin 400 mg orally once daily for 7 days.

PASS strongly advises against requiring Mgen testing as part of regular 14-day work clearance. We wish the solution were as simple as adding an additional test. Unfortunately, in the case of Mgen, the harms may outweigh the benefits — both individually and as a community. Our goal with the plan we have laid out is to reduce the prevalence of Mgen within our community while minimizing the development of antimicrobial resistance and unnecessary financial impact to talent.

However, anyone who is experiencing symptoms or who has had sex with someone who has tested positive for Mgen should get tested. Mgen testing is currently available at all PASS Certified testing partners.

We know many of you are frustrated and scared. It is our responsibility as an organization, as health experts, to provide a clear head in times of fear and confusion. We don’t know all the answers, but no one does — especially not about our community. We will be in contact in the coming days and weeks to share what we know and update any guidance.”