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.
