STIs – trends and epidemiology

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.

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