Online Dermatologist > Surge in Sexually Transmitted Infections Across Europe

Surge in Sexually Transmitted Infections Across Europe

by | May 19, 2024 | Blog, Sexual Health

sti testing at home

Key Takeaways

 

  • Europe is experiencing a significant rise in sexually transmitted infections (STIs) like gonorrhea, syphilis, and chlamydia, posing a major public health challenge.
  • Young heterosexual individuals, especially young women, are notably affected by this surge, with changing sexual behaviors and antimicrobial resistance exacerbating the situation.
  • Untreated STIs can lead to severe health complications, including infertility, chronic pain, and risks to pregnancy, highlighting the need for prompt diagnosis and treatment.
  • A multi-faceted approach involving enhanced public awareness, targeted interventions, and the promotion of safer sex practices is essential to combat the rise in STIs.
  • Individual responsibility, including regular STI testing and open communication about sexual health, plays a crucial role in reversing the increasing trend of STIs.

 

In recent years, Europe has witnessed an alarming surge in sexually transmitted infections (STIs), with significant increases in gonorrhea, syphilis, and chlamydia cases reported by the European Centre for Disease Prevention and Control (ECDC). While sexually transmitted infections such as chlamydia, gonorrhoea and syphilis, are treatable, they can still lead to serious health complications if left untreated.

These include, amongst others, pelvic inflammatory disease or chronic pain. Additionally, chlamydia and gonorrhoea can lead to infertility while syphilis can cause neurological and cardiovascular issues. Untreated syphilis infection during pregnancy can lead to serious adverse outcomes in children. This article will delve into the alarming data, the factors contributing to the surge, the impact on public health, and potential strategies to address the rise in STIs.

Surge in Sexually Transmitted Infections Across Europe: Alarming Data

 

Overview of the Surge

According to the latest annual data reports of the European Centre for Disease Prevention and Control (ECDC), a dramatic surge of STIs in Europe has been revealed. Gonorrhea cases increased by 89% among women and 36% among men in 15 European countries in 2023.[1] Syphilis cases increased by 34% and chlamydia cases increased by 16% compared to the previous year. Moreover, there were over 70,000 cases of gonorrhea, 35,000 cases of syphilis and 216,000 cases of chlamydia in 2022 across Europe.[2]

 

Factors Fueling the Surge:

  1. Antimicrobial resistance: This is particularly in relation to gonorrhea. The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) illustrates a rise in resistance to two specific antibiotics; azithromycin and ciprofloxacin, underscoring the importance of continuous surveillance and strong response methods.
  2. Shifts in sexual behavior: A significant increase in STIs among young heterosexuals, particularly young women have been documented, indicating a change in sexual behavior after the pandemic. In 2021, the number of gonorrhea cases among men who have sex with men (MSM) climbed beyond pre-pandemic levels, indicating a concerning trend.
  3. Pandemic-Related Disruptions: The temporary halting of STI cases caused by social isolation measures during the COVID-19 pandemic, and the subsequent rebound effect when restrictions are released lead to a resurgence in STI cases. And also the pandemic made the matter worse by interrupting the STI testing and treatment facilities.

This study emphasizes how urgent it is to address the rise in STI cases in Europe by comprehending the statistical patterns, figuring out the main causes, and realizing the various impacts on populations who are more susceptible.

 

 

Innovations and Interventions

 

Promising Developments in STI Prevention and Care

The rise in STIs in Europe has been recently addressed with an emphasis on gonorrhea vaccine development and the investigation of doxycycline-based post-exposure prophylaxis (PEP) methods. Nearly 2 million cases of gonorrhea, chlamydia and primary and secondary syphilis were reported to the Centers for Disease Control and Prevention (CDC) in 2021. The bacterium gonorrhea is becoming more resistant to drugs; therefore, researchers are developing vaccines to prevent it. Early testing on a number of potential gonorrhea vaccine candidates has shown promising results.

Doxycycline’s benefits and drawbacks as a PEP have also been investigated, mostly in relation to various gender and sexual orientation groups. According to a recent study, transwomen, gay, bisexual and other males who have sex with men are considerably less likely to be infected with gonorrhea, syphilis or chlamydia if they take doxycycline within 72 hours after condom-free sex.[3] Research indicates that doxy-PEP can lower the incidence of gonorrhea by around 55-60% and lower the risk of syphilis and chlamydia by 80% or more.    

 

The Role of Testing and Diagnosis

In order to stop the spread of STIs and enable prompt treatment, early screening-based detection is essential. With a move towards less intrusive screening procedures, testing method advancements have centered on enhancing accessibility and accuracy. With better precision and dependability in identifying diseases like gonorrhea and chlamydia, vaginal swabs have become popular and a less invasive option to standard urine samples for STI testing. This approach makes testing more easy and comfortable for patients, which may increase screening and early detection rates.

A routine testing of high-risk populations is required to prevent the proliferation of STIs. According to World Health Organization (WHO), anyone who participate in high-risk sexual practices, like having several partners or having unprotected sex, should have regular STI screenings. With the advent of home-testing kits, people now have an easy way to test for STIs in the comfort of their own homes, which may lead to a higher percentage of high-risk populations getting tested.[4]

Health Complications and Concerns

Untreated sexually transmitted infections (STIs) can lead to severe health complications, highlighting the critical importance of timely diagnosis and treatment.

STIs such as syphilis, gonorrhea, and chlamydia, if left untreated, can result in a range of health issues. For instance, untreated syphilis can progress through several stages, leading to serious complications such as neurological damage, cardiovascular problems, and even death in severe cases.[6] Gonorrhea and chlamydia, if untreated, can cause pelvic inflammatory disease (PID) in women, which may result in chronic pelvic pain, ectopic pregnancy, and infertility.[7]

One particularly concerning aspect is the rise in congenital syphilis cases, which has significant implications for maternal and child health. Congenital syphilis occurs when a pregnant woman with syphilis passes the infection to her unborn child. If left untreated, the severe phase of syphilis may lead to complications decades after infection, affecting multiple organs and systems, including the brain, nerves, eyes, liver, heart, blood vessels, bones, and joints.[8] Severe syphilis can also cause death.Congenital syphilis can cause premature delivery, and it is essential to perform serological tests during the third trimester, particularly for women who have immigrated from regions with high syphilis prevalence. The CDC reported over 3700 cases of newborn syphilis in the United States in 2022, a more than ten-fold increase since 2012, highlighting the urgency of addressing this issue.[9]

 

Addressing the Surge

Data from the European Centre for Disease Prevention and Control (ECDC) indicates a pressing need for comprehensive public health interventions aimed at tackling the surge in STIs. In 2022, there were over 500,000 reported cases of gonorrhea alone in the European Union/European Economic Area (EU/EEA), underscoring the urgency for increased testing, treatment, and prevention efforts.[10]

Scaling up accessibility to STI testing services, particularly in high-risk populations and underserved communities, is crucial for early detection and prompt treatment.

Moreover, promoting safer sex practices, such as consistent and correct condom use, remains vital. According to the World Health Organization (WHO), condoms can reduce the risk of acquiring STIs, including HIV, by up to 80% when used consistently and correctly . Additionally, while Pre-exposure prophylaxis (PrEP) has been successful in HIV prevention.Pre-exposure prophylaxis (PrEP) is highly effective, reducing the risk of HIV transmission by about 99% during sex and at least 74% during injection drug use when taken as prescribed.[11] Also it is important to acknowledge its limitations in preventing other STIs.

References
  1. Simmons BJ. Management of Bartholin’s duct cyst and gland abscess. American family physician. 2023;68 1:135-140. doi: https://doi.org/%22,
  2. Apoorvi Bharat Shah, Suresh Vasant Phatak, Pratap Singh Parihar, Lakshmi Bisnoi, Sai G. Infected Bartholin Cyst – Ultrasonography Doppler, Magnetic Resonance Evaluation. Journal of evolution of medical and dental sciences. 2021;10(18):1369-1371. doi: https://doi.org/10.14260/jemds/2021/289
  3. Daugherty JE. Bartholin Gland Cysts and Abscesses. Springer eBooks. Published online January 1, 2010:219-235. doi: https://doi.org/10.1007/978-0-387-76604-1_17
  4. Anozie OB, C. U. O. Esike, Anozie RO, E. Mamah, Eze JN, Onoh RC. Incidence, Presentation and Management of Bartholin’s Gland Cysts/Abscesses: A Four-Year Review in Federal Teaching Hospital, Abakaliki, South-East Nigeria. Open Journal of Obstetrics and Gynecology. 2016;06(05):299-305. doi: https://doi.org/10.4236/ojog.2016.65038
  5. Lee MY, Dalpiaz A, Schwamb R, Miao Y, Waltzer W, Khan A. Clinical Pathology of Bartholin’s Glands: A Review of the Literature. Current Urology. 2015;8(1):22-25. doi: https://doi.org/10.1159/000365683
  6. J. Pundir, Auld BJ. A review of the management of diseases of the Bartholin’s gland. Journal of Obstetrics and Gynaecology. 2008;28(2):161-165. doi: https://doi.org/10.1080/01443610801912865
  7. McNair R. Risks and prevention of sexually transmissible infections among women who have sex with women. Sexual Health. 2005;2(4):209-209. doi: https://doi.org/10.1071/sh04046

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