STIs Are on the Rise in Europe

Europe is seeing a surge in the number of cases of sexually transmitted infections. According to the European Centre for Disease Prevention and Control (ECDC), this includes gonorrhoea, chlamydia and syphilis. Where the number of reported cases dipped for each STI in 2020, likely due to changes in access to testing and less social mixing during the pandemic, figures have started to climb once more.

According to the ECDC’s Surveillance Atlas of Infectious Diseases database, chlamydia is the most widespread of the three diseases in Europe, with more than 216,000 cases confirmed in 2022 alone. That year, Denmark reported the highest rate of cases (708.9 per 100,000 population), followed by Norway (539.5 per 100,000), Iceland (492.5), Sweden (313.8) and Finland (303.9).

As the following chart shows, the number of syphilis cases also climbed between 2015 and 2022. Malta had the highest rate of the countries with available data at 24.4 cases per 100,000 population in 2022. This was followed by Luxembourg (23.4), Spain (16.6), Ireland (16.6), Lichtenstein (15.3) and Portugal (14.8). However, it's worth noting that a number of other European countries bucked this trend. For example, in Romania, the prevalence of the disease has been falling since its peak of 55.25 cases per 100,000 population in 2002 to just 2.59 cases per 100,000 by 2022. Bulgaria has also dropped from 32.52 cases per 100,000 in 1998 to just 5.28 per 100,000 population in 2022.

Of these three diseases, cases of gonorrhoea have increased most quickly since 2015 across the bloc, reaching 70,881 reported cases in 2022 - up 131 percent. Much of this increase has been driven by Spain in recent years, rising from 10,306 cases in 2020 to 22,932 cases in 2022. The prevalence of the disease was notably high in Ireland (75.3 per 100,000), Luxembourg (73.6), Denmark (66.9) and Spain (48.4).

The EU/EEA average shown in this chart does not include the United Kingdom’s figures, since the site stopped publishing them in 2019. The UK had by far the highest rates of the recorded European countries prior to 2019, with 116.1 confirmed cases per 100,000 population, with Ireland taking second place that year with a still-high 57.3 cases per 100,000 population.

The ECDC highlights how gonorrhoea is a particular cause for concern due to signs of increasing resistance to the antibiotics azithromycin and ciprofloxacin and has called for “vigilant monitoring and robust response strategies" in light of it.

In a series of reports released in December 2023 on 2021 data, the ECDC detailed patterns in groups that have a higher share of infections. For chlamydia, rates were highest among young adult heterosexual women. Analysts add that this could be due to gender disparities in testing and that chlamydia could well be underdiagnosed among men. Meanwhile, for syphilis, men who have sex with men (MSM) made up roughly 77 percent of reported cases in Europe in 2021. For gonorrhoea, MSM accounted for 55 percent in 2021.

The ECDC warns about taking care when drawing comparisons between countries due to differing testing and reporting methods. In addition to many cases remaining undiagnosed or unreported, increases may also be related to factors such as the use of more sensitive tests. Analysts add that these European-wide figures are most likely low estimates, due to non-comprehensive reporting systems in France, Belgium and the Netherlands and a lack of data publishing in Germany, Austria and Lichtenstein.