Europe is registering an unprecedented level of gonorrhea infections, which mostly affect men who have sex with men but increasingly women, and which are concentrated in young age groups, the European Center for Prevention and Prevention has reported. Disease Control (ECDC). Two other sexually transmitted infections (STIs) that are recording infection records in Spain are chlamydia and syphilis, which have their highest incidence figures in Catalonia, with the vast majority of cases diagnosed in Barcelona and its metropolitan area.
“There is a clear trend towards more infections and in younger people,” declares Oriol Mitjà, head of the community-transmitted infections section at the Germans Trias i Pujol hospital in Badalona.
The phenomenon is attributed to the evolution of sexual behaviors towards relationships that favor greater transmission of STIs. Among the changes in sexual behavior patterns, there is a lower use of condoms than in the years when there was more fear of contracting HIV or unwanted pregnancies, as well as a greater number of sporadic relationships.
The risk factors for contagion identified in scientific studies, reports Mitjà, include precisely having had multiple sexual partners in the last six months, more sex without a condom, the consumption of drugs associated with sex and having contacted partners online.
Gonorrhea and chlamydia, both caused by bacteria, stand out as the most common STIs, both in Spain and in Europe as a whole. Although they can be treated with antibiotics, they can cause infertility and other health problems if there is not a correct diagnosis and proper treatment. Some cases are asymptomatic, so infected people can infect others without suspecting it, reports Martí Vall, STI specialist at the Germans Trias i Pujol hospital.
In the case of gonorrhea, 62% of the infections reported in 2021 in Europe correspond to men who have sex with men, 20% to homosexual men and 18% to women. But “the increase among women is worrying due to the risk of complications in the reproductive system,” warns the ECDC in its latest epidemiological report on the infection.
“STIs are more transversal than a few years ago, when they were more concentrated in certain groups”, observes Jordi Casabona, scientific director of the Center for Epidemiological Studies on Sexually Transmitted Infections and AIDS in Catalonia (CeeisCat), who emphasizes that ” there is little awareness about STIs”.
According to the data that CeeisCat has provided to La Vanguardia, in 2022, 9,396 cases of gonorrhea were diagnosed in Catalonia, which represents an increase of 66% compared to the 5,665 diagnosed in 2019, the year before the pandemic. Four out of ten cases were recorded in people between 20 and 29 years old, the most affected age group.
An increase in chlamydia infections has also been recorded, with 12,472 cases diagnosed in Catalonia in 2022, half of them in people between 20 and 29 years old, making it the most common STI.
Catalonia stands out as the community in Spain with the highest incidence of STIs, according to the latest report Epidemiological surveillance of sexually transmitted infections in Spain, which collects data until 2021. The report, published by the Ministry of Health, indicates that STIs They have increased progressively over the last decade – with a parenthesis in 2020 coinciding with the pandemic – and have reached the highest levels ever recorded.
The trend is different for STIs caused by viruses thanks to the introduction of vaccines against papillomavirus and hepatitis B in adolescents, which have caused a decrease in infections in age groups already vaccinated.
In the case of HIV, infections do not increase either thanks to antiretroviral drugs, which have two complementary positive effects. On the one hand, they prevent infection if taken before a risky relationship. On the other hand, they control the virus in affected people to the point that they are no longer contagious. Paradoxically, the lower risk of HIV infection has caused a relaxation in condom use, which has favored the spread of other STIs.
In the United Kingdom, the Public Health Agency (UKHSA) published a statement this September aimed at university students in which it warns that “there is a very real risk of contracting sexually transmitted infections if you have sex without a condom.” For this reason, he urges students to “use condoms with any new or sporadic partner and get tested regularly,” since “diagnoses of gonorrhea have skyrocketed; In 2022 there is an increase of more than 50% compared to 2021.”
The same trend is observed in other European countries, notes the ECDC in its latest epidemiological report on gonorrhea. In the Netherlands, for example, cases of gonorrhea have increased by 75% in women from 2021 to 2022. In Denmark, an increase in infections of 46% has been recorded in heterosexual relationships. And in Finland the increase in cases for the entire population has been 90%.
“The situation in Spain does not seem to be better”, observes Oriol Mitjà. In Catalonia, according to CeeisCat data, gonorrhea diagnoses have increased by 52% from 2021 to 2022.
In men, where the majority of diagnoses are concentrated, the increase has been 45%. In women, who started from lower figures, the rise is being faster, with an increase of 82% in the last year. To curb these trends, sexual health specialists advocate improving prevention and early diagnosis.
Stopping these trends requires improving prevention and early diagnosis, says Jordi Casabona, who is also spokesperson for the STI group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). For prevention, the main recommendation is to use a condom. Early detection ensures that those affected receive appropriate treatment and stop transmitting the infection. “The fewer people are infected, and they are infected for less time, the fewer infections there will be,” says Casabona.
“Early detection is not only recommended for people who suspect they have contracted an STI,” says Oriol Mitjà. Given that some gonorrhea and chlamydia infections are asymptomatic, “screening tests are also convenient for those people who have been exposed to situations in which they may have contracted an STI even if they do not have symptoms.”
The tests performed depend on the type of sexual activity that has been had. They always include urine in men and a vaginal sample in women, and can be complemented with analysis of samples from the rectum and pharynx, if there is suspicion of transmission of an STI through oral or anal sex.
