In Italy, infections of syphilis, gonorrhea and chlamydia are increasing. While waiting for the publication of the official newsletter of the Higher Institute of Health, the first data from the sentinel surveillance systems, coordinated by the ISS AIDS Operations Center, reveal significant increases in the spread of sexually transmitted infections. The data were analyzed during the 16th edition of Icar – Italian Conference on Aids and Antiviral Research.
“The 2022 data show an increase in STIs especially among young people – underlines Barbara Suligoi, Coa director of the ISS – For gonorrhea, around 1,200 cases were reported to the sentinel system, which compared to the 820 in 2021 implies a 50% increase . For syphilis, we went from 580 cases in 2021 to 700, therefore +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 (+100%) , while those of syphilis were 470 (+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% – he underlines – while over 40 years of age 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.”
The consequences of sexually transmitted infections are numerous, experts point out: 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; 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. Above 5% resistance is considered severe.
“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”, underlines Andrea Antinori, director of the Clinical and Research Department of the Spallanzani Institute in Rome, where a Prep Clinic is active which permanently follows more than a thousand people at risk. “The incidence of new STI diagnoses in Prep users ranges from 16% to 24% and Prep confirms itself as a tool to increase access to early diagnosis of sexually transmitted infections, and to include people at risk in prevention programs combined, in order to reduce both the circulation of these infections and the related morbidity”.
“In addition to a lack of information on STIs widespread in the general population, there are some specific causes that involve the youth population – highlights 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 go regularly from a specialist as happens in adulthood with the gynecologist and andrologist. Furthermore, they often get information on the web, with approximate if not misleading sources. These elements start a circuit of unawareness, which increases exponentially in moments of sociality which lowers the threshold of prudence, with the loss of inhibitions and protections. Furthermore, some young people use drugs or chemsex, but, considering these activities as occasional, they mistakenly do not consider them to be risky situations information, emotional education at school level, clear routes in the area for those who need timely advice in case of suspicion of having contracted an STI”.
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