STIs – trends and epidemiology
M.J.W. van de Laar (RIVM) and the European Surveillance of Sexually Transmitted Infections (ESSTI) Network
Bilthoven, The Netherlands
Sexually transmitted infections (STIs) are a major public health problem in Europe. Their substantial morbidity and disproportionate burden upon women, marginalized communities, and those with high-risk sexual lifestyles continue to drive their prioritisation in European public health. Behavioural changes in response to the HIV/AIDS pandemic resulted in initial reductions in the incidence of STIs. However, these have not been maintained and STI rates are on the rise again in many countries. Specific population sub-groups are disproportionately affected: Homosexual men and young people (aged less than 24 years) contribute highly to the rising trends of acute STIs in Europe and are at high risk for infection and re-infection. The prevalence of genital chlamydial infection is high in young females; and gonorrhoea remains fairly concentrated among those with high rates of partner change or the economically deprived in many EU states. In the past 5 years, many previously low incidence European countries have reported outbreaks of STIs, suggesting a changing epidemiology and deterioration in sexual health. Gains in STI control may be achieved though greater European collaboration in laboratory diagnosis, harmonising treatment protocols and strengthening disease surveillance. Recent trends in, and the epidemiology of, acute STIs will be discussed.