Sexually transmitted infections : A worrying increase
Cases of sexually transmissible infections (STI) are increasing in Europe, according to a report issued by the ECDC (European Centre for Disease Control). That agency, which was established in 2005 and is based in Stockholm recently published detailed figures for Europe for 2022. These reports are part of its mission for the yearly monitoring of infections, with the publication of some 65 reports available on their web-site.
How are STI classified?
According to the web-site of the French health insurance, STI, previously often known as STD (sexually transmissible diseases) are those “infections which may be transmitted during sexual intercourse” and “there exist about thirty of them”.
According to the same source, the most frequent STI are caused by miscellaneous infections:
- bacterial sexually transmissible diseases. The best known being syphilis, gonorrhoea, chlamydiosis and mycoplasma infections, which, when diagnosed, can be cured;
- viral diseases: B hepatitis, genital herpes, HIV and human papillomavirus (HPV) responsible for several types of cancer according to the WHO. These infections may be difficult or impossible to cure depending on the type of virus.
- parasitic sexually transmissible diseases such as trichomoniasis treated by anti-parasite medicines.
What does the European report reveal?
In summary, the ECDC notes that the number of cases reported has increased significantly compared with the previous year: +48% for gonorrhoea, +34% for syphilis, +16% for chlamydiosis. The Agency is also concerned about the increase in the number of cases of syphilis transmitted from the mother to her child. For cases of syphilis, this represents 35,391 cases reported in 2022.
In detail, for syphilis, an emblematic infection, the data show that men are eight times more affected than women, the 25-34-year-old age bracket being the most prevalent. In 74% of cases, the report notes that syphilis concerns men having sexual relations with men (known as MSM). however, for the first time in 10 years, there has also been a notable increase in the number of cases in heterosexual men and women.
The Managing Director has issued a communiqué calling for reinforcement of the fight against such infections. “The fight against the substantial increase in the number of cases of STI requires urgent attention and concerted efforts. The detection, treatment and prevention are at the heart of any long-term strategy. We must prioritise education in sexual health, extend access to detection and treatment services, and combat the stigmatisation associated with STI.”
A global problem
A study published by Cambridge University in 2019 already noted the resurgence of such infections which were thought to have been relegated to the past, from the year 2000s, following their downward trends during the 1980s and 1990s. The authors, some of whom worked for the ECDC, wrote that:
“Since the year 2000s, the syphilis rates have again increased in the developed nations, the rates increasing more rapidly for men having sexual relations with other men (MSM), but also increasing in other population groups. The interaction with co-infection by HIV, the changes in sexual behaviour following the greater availability of an effective antiretroviral treatment against HIV, the evolution of means and the facility for finding sexual partners through the Internet and mobile matchmaker applications have increased the complexity of the epidemiology, and in particular its control.”
In 2022, there were 2.5 million cases of chlamydiosis, gonorrhoea and syphilis identified in the United States. Last year, the American health authorities (CDC) issued an alert on cases of newborns affected by syphilis. Over 3,700 cases were reported in 2022, ten times more than in 2012 (335 cases). The report also alerted on the disparity of situations, babies of Afro-American, Hispanic, and Indian origins were much more affected. The Medical Director of the CDC made the following statement: “The crisis of congenital syphilis in the United States has exploded at a rate which is heart rending.”
It was thought that such infections were a thing of the past. It would appear that Charles Baudelaire died of syphilis. Guy de Maupassant, also. A historian specialist of the 19th century°, Alain Corbin, thus declared “The fear of syphilis haunts literature”. Will the prophylactic measures recommended by the authorities: use of a condom, notification to partners as required by the Higher Authority for Health (HAS) be sufficient ?
In the days of globalisation and matchmaking applications which facilitate contacts between strangers, a more general strategy would appear necessary, incorporating behaviours which go beyond the purely prophylactic approach all too often put forward by the sanitary authorities.
