“From 2019 to 2022, Gonorrhea cases doubled; the increase in Syphilis cases is 20%, while those of Chlamydia have grown by 25%. Young people are particularly involved: correct information and awareness of the consequences of risky behavior are needed” underlines Barbara Suligoi of the ISS during the 16th edition of Icar
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“The 2022 data shows an increase in STIs especially among young people. For Gonorrhea, approximately 1200 cases were reported to the sentinel system, which compared to the 820 in 2021, implying an increase of 50%. For Syphilis, we went from 580 cases in 2021 to 700, therefore an increase of 20%. This growth in numbers is not only an effect of the greater socialization that occurred after the most acute phases of the Covid-19 pandemic, as it is also found compared to 2019, when there were 610 cases of Gonorrhea (therefore compared to then increased by 100%), while those of Syphilis were 470, therefore increased by over 50%. The finding on Chlamydia is also similar: from 800 cases in 1919, it reached 993 in 2022, with an increase of 25%. The most relevant aspect is the involvement of young people, in particular girls under 25: the prevalence of Chlamydia among young people in this age group is 7%, while over 40 years old it is just 1%. In 3 out of 4 cases the infection is asymptomatic, so many girls don’t notice it for a long time.”
These are some of the data on Sexually Transmitted Infections anticipated, in view of the official newsletter of the Istituto Superiore di Sanità, from Barbara Suligoi, COA Director of the ISS during the 16th edition of Icar – Italian Conference on Aids and Antiviral Research.
Sterility, childhood diseases, damage to the nervous system are among the consequences. The growing resistance of gonococcus to antibiotics The consequences of STIs are numerous. Syphilis can also affect the central nervous system. Chlamydia can develop pelvic inflammatory disease, which in turn can lead to fertility problems or complications in pregnancy, so much so that a large number of cases of medically assisted procreation can be traced back to this cause; the infection can manifest itself with urethritis and cervicitis, proctitis, pharyngitis. Furthermore, transmission of the infection from mother to baby at the time of birth can lead to the onset of eye problems or pneumonia in the newborn. Gonococcal infection can lead to ectopic pregnancies, infertility, increased transmissibility of other STIs such as HIV, urethritis, proctitis, pharyngitis.
The concern is also given by the growing resistance of the bacterium to antibiotics, reaching 22% in Italy for azithromycin, with a significant increase compared to the lowest percentages of previous years. Considering that resistance above 5% is considered serious, this figure is in line with Italy’s critical position in the fight against antimicrobial resistance.
STIs and HIV pre-exposure prophylaxis (PREP). “Increasing access to HIV pre-exposure prophylaxis (PrEP) represents a fundamental tool for early diagnosis and control of other STIs, which are currently increasing in the sexually active population” highlights Andrea Antinori, Director of the Clinical and Research Department of the National Institute for Infectious Diseases, where a PrEP clinic is active which permanently follows more than a thousand people at risk.
“The PrEP delivery and monitoring protocols – highlights Antinori – include periodic monitoring of even asymptomatic STIs, and this is a way to bring out an undiagnosed hidden population in the population at risk. The incidence of new diagnoses of STIs in PrEP users ranges from 16% to 24% and PrEP is confirmed as a tool to increase access to early diagnosis of STIs, and to include people at risk in combined prevention pathways, at in order to reduce both the circulation of STIs and the related morbidity. Although it must be said, and it was discussed today at ICAR 2024 in a very lively and participatory session of the Congress – continues Antinori – there is an open debate in the scientific community on the cost-benefit of screening people with asymptomatic STIs, even for the risks of antimicrobial resistance in the extensive treatment of these forms in the absence of symptoms. In any case, increasing access to PrEP in key populations not currently involved in prophylaxis programs, such as cisgender and transgender women at risk and sex workers, means not only increasing the accessibility of this important prevention tool in vulnerable populations , but also implement overall prevention programs that also include infections such as syphilis, chlamydia and gonorrhea”.
Young people know very little – “In addition to a lack of information on STIs widespread in the general population, there are some specific causes that involve the young population – highlights Barbara Suligoi -. Young people, in fact, often do not know where to find the information and where to carry out the necessary checks, they do not regularly go to a specialist as happens in adulthood with the gynecologist and andrologist. Furthermore, they often get their information on the web, with approximate if not misleading sources. These elements start a circuit of unawareness, which increases exponentially in moments of sociality, in which the threshold of prudence is lowered, with the loss of inhibitions and protections. Furthermore, some young people use drugs or chemsex, but, considering these activities occasional, they mistakenly do not consider them risky situations. We therefore need more information, emotional education at school level, clear paths in the area for those who need timely advice in case of suspicion of having contracted an STI”.
June 25, 2024
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