Europe is registering an unprecedented level of gonorrhea infections, which mostly affect men who have sex with men; but increasingly women, and they are concentrated in young age groups, the European Center for Disease Prevention and Control (ECDC) has reported. Two more sexually transmitted infections (STIs) that are recording contagion records in Spain are chlamydia and syphilis, which have the highest incidence figures in Catalonia, with the vast majority of cases diagnosed in Barcelona and the metropolitan area .
“There is a clear trend towards more contagions and in younger people”, declares Oriol Mitjà, head of the community-transmitted infections section at Germans Trias i Pujol hospital in Badalona.
The phenomenon is attributed to the evolution of sexual behavior towards relationships that favor the transmission of STIs. Changes in sexual behavior patterns include the use of condoms, which is lower than in the years when there was more fear of contracting HIV or unwanted pregnancies and also a higher 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 intercourse without a condom, the recreational use of drugs associated with sex and having contacted partners on the Internet.
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 no correct diagnosis and proper treatment. Some cases are asymptomatic, so infected people can spread others without knowing it, reports Martí Vall, specialist in STIs at Germans Trias i Pujol hospital.
In the case of gonorrhea, 62% of 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 because of 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 highlights that “there is little awareness about STIs”.
According to the data provided by CeeisCat to La Vanguardia, 9,396 cases of gonorrhea were diagnosed in Catalonia in 2022, which represents a 66% increase compared to the 5,665 diagnosed in 2019, the year before the pandemic. Four out of ten cases were registered in people aged between 20 and 29, the most affected age group.
There has also been an increase in chlamydia infections, with 12,472 cases diagnosed in Catalonia in 2022, half of which in people aged 20 to 29, which makes 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 have increased progressively over the last decade – except for a break in 2020 coinciding with the pandemic – and have reached the highest levels on record.
The trend is different for STIs caused by viruses, thanks to the introduction of vaccines against the papilloma virus and hepatitis B in the adolescent population. Vaccines have caused a decrease in infections in the age groups already immunized.
In the case of the AIDS virus (HIV), infections also do not increase 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 where they are no longer contagious. Paradoxically, the lower risk of HIV infection has led to a relaxation in the use of condoms which has favored the transmission of other STIs.
In the United Kingdom, the Public Health Agency (UKHSA, for its initials in English) published a statement in September addressed to 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 “gonorrhea diagnoses have increased; in 2022 there is an increase of more than 50% compared to 2021”.
The same trend is observed in other European countries, points out 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, there has been a 46% increase in infections in heterosexual relationships. And in Finland the increase in cases for the population as a whole has been 90%.
“The situation in Spain does not seem to be any better”, observes Oriol Mitjà. In Catalonia, according to CeeisCat data, gonorrhea diagnoses have increased by 52% from 2021 to 2022.
In men, in whom the majority of diagnoses are concentrated, the increase has been 45%. In women, who started from lower figures, the rise is faster, with an increase of 82% in the last year.
To curb these trends, sexual health specialists advocate for improved prevention and early diagnosis.
