First in the United States, and then also in Europe. On the subject of sexually transmitted infections (IST) we are traveling on the same wave: cases, both overseas and in our area, are increasing. We are talking in particular about infections of bacterial origin, such as gonorrhea, chlamydia and syphilis, which cause more than 300 thousand infections a year in Europe. An effect certainly partly attributable to the pandemic, similar to what happened to others infections, thanks to the restrictive measures and the attention focused on Covid-19, as the health authorities admit. But some trends, for some of these infections, had been established well before the pandemic, as shown for example by the case of syphilis, especially in the United States. So much so as to justify renewed calls for safe sex and diagnoses.
The ones who launched one in recent days were the European Center for Disease Prevention and Control (ECDC), in view of the beautiful season. The appeal is yes to safe sex understood as protected sex – not only condoms, but also dental dams, gloves and attention to hygiene, including that of sex toys – but it is also an invitation to testing for STIs, especially for who has multiple partners. To try to reverse the trend against infections that are anything but trivial. “Gonorrhea, syphilis and chlamydia infections represent a significant risk to public health for several reasons. On the one hand, these infections, if left untreated, can cause serious complications, such as infertility and organ damage – he tells Wired Italy Valentina Mazzotta, head of the PrEP/IST clinic at Spallanzani in Rome – L’syphilis alarm it is not to be underestimated. Cases of congenital syphilis are also increasing, because reduced access to screening leads women not to notice their positivity even during the pregnancy. Furthermore, both ulcerative and non-ulcerative infections are associated with an increased risk of transmit or acquire other infections, first of all HIV infection. Having an STI in fact facilitates the acquisition of other infections, especially HIV infection: in Italy approximately 8% of people with an STI, tested for HIV, tested positive. For this reason, preventing, diagnosing and treating sexually transmitted infections with the right drugs at the right time is necessary to reduce the HIV transmission and improve sexual and reproductive health.”
Gonorrhea, syphilis and chlamydia: the symptoms
Sexually transmitted infections include, among others and beyond chlamydia, gonorrhea and syphilisme too’herpes simplex, trichonomyasis, HIV, HPV, and monkeypox. They are very common: according to the WHO, looking at curable STIs (which include syphilis, gonorrhea and chlamydia), we are talking about a million cases a day. Going into detail, we discover that – focusing only on Europe and limiting ourselves to the three examined by the ECDC – chlamydia alone is responsible for approximately 216 thousand cases per year (data referring to 2022), syphilis exceeds 35 thousand, and gonorrhea is close to 71 thousand.
Cases which, from a symptomatic point of view, can be very different from each other, explains Mazzotta: “Gonorrhea, syphilis and chlamydia they can present in a rather varied manner, from asymptomatic or paucisymptomatic forms, up to complicated forms. For example, lGonorrhea can manifest as urethritis in men and cervicitis in women, but often has no obvious symptoms in women, which can lead to unrecognized and untreated complications such as pelvic inflammatory disease, ectopic pregnancy, and infertility. Syphilis can progress through different phases, with symptoms ranging from generalized skin and mucosal lesions, to asymptomatic latency periods, up to involvement of the cardiovascular and nervous systems. Chlamydia can cause abnormal vaginal discharge, dysuria (pain and discomfort during urination, ed.) and intermenstrual or post-coital bleeding in women, while in men it can present with urethral discharge and dysuria.”
The leap forward in sexually transmitted infections
Chlamydia, syphilis and gonorrhea, increased respectively by one sixth, one third and almost half compared to the previous year and with a clear leap forward also compared to the pre-pandemic era (here are all the details in the ECDC report). Because Covid-19 has contributed to theirs surgeespecially with the reduction in access to health services during lockdowns, Mazzotta continues, but to explain the trend of these infections it is necessary to broaden our gaze. “The type of epidemics that gradually occur are closely linked to the customs of society. The evolution towards a model of sexual relations more fluid and which recognizes and declares the importance and centrality that the sexual component has in people’s lives, is certainly a more fertile basis for the circulation of infections connected to sexual practices. Exactly how globalization and the ease of reaching the other part of the world in a short time allowed the rapid spread of the SARS-CoV-2 infection in 2020.”
