‘Marked’ rise in syphilis cases – report

There was a “marked” increase in the number of cases of syphilis in 2021, new figures show.

Data on sexually transmitted infections (STIs), published by the UK Health Security Agency (UKHSA), show that there were 7,506 diagnoses of infectious syphilis reported in 2021, an 8.4% increase compared to 2020 when there were 6,923 new cases.

But overall reported cases of STIs are still below pre-pandemic levels.

In 2021, there were 311,604 diagnoses of new STIs in England, a similar number compared to 2020, and a decrease of 33.2% since 2019, according to the UKHSA report.

But the Terrance Higgins Trust said that STI and HIV testing rates are “still lagging behind pre-Covid levels”.

The new 2021 STI report for England also reveals:

– Chlamydia continues to account for the majority of STI diagnoses made in 2021, some 51% of all STIs.

– Though between 2020 and 2021, there was a small decrease in the number of chlamydia diagnoses.

– Some 159,448 new STI cases in 2021 were gonorrhoea, a small increase from 2020.

– Small increases were also noted in cases of herpes and genital warts.

On syphilis, the authors wrote: “There was a marked increase (8.4%; from 6,923 to 7,506) in the number of diagnoses of infectious syphilis, such that diagnoses of infectious syphilis have nearly returned to pre-pandemic levels and in some regions have exceeded them.

“The increase is particularly driven by asymptomatic diagnoses, but there has also been a notable increase in diagnoses of neurosyphilis.”

Syphilis is an STI which can lad to life-threatening problems if it is not treated.

Meanwhile, the UKHSA said that in 2021 there were more than four million consultations in sexual health services.

There were almost two million diagnostic tests for chlamydia, gonorrhoea, syphilis, and human immunodeficiency virus (HIV), an increase compared to 2020, but 13.2% decrease relative to 2019.

Commenting on the figures, Ian Green, chief executive at Terrence Higgins Trust, said: “Today’s statistics show that STI and HIV testing rates are still lagging behind pre-Covid levels seen in 2019.

“This comes at a time when the already very limited capacity of sexual health services is being swallowed up by leading the country’s monkeypox response, which is displacing HIV and STI testing.

“The Government needs to act with urgency to properly resource the monkeypox response and mitigate the impact on wider sexual health service to avoid an increase in STIs, unwanted pregnancies and people contracting HIV.”

On STI rates, he added: “Levels of syphilis and gonorrhoea remain high while testing levels aren’t back to where they were before Covid.

“That’s why we need the Government to set out its vision for sexual and reproductive health in its long over-due sexual and reproductive health action plan.

“These latest numbers show why the Government must urgently set out what good looks like with the funding attached to achieve that vision.”

Deborah Gold, chief executive of the National Aids Trust, said: “This data is concerning and shows the Government isn’t doing enough to end HIV.

“Women and people from black African and other minority ethnic communities are not getting the access to HIV tests and the HIV prevention drug PrEP that they deserve. Covid-19 has deepened pre-pandemic inequalities, and without action the Government will miss its target of ending HIV by 2030.

“This is worsened as sexual health services are now experiencing another shock to the system in monkeypox, for which they are woefully under-resourced.

“To get us on track to end HIV in this country once and for all, the Government must invest in sexual health services, which are on the front lines of monkeypox and HIV prevention, expand HIV testing in hospitals across the country, and improve access to the HIV prevention drug PrEP.”

Dr Zara Haider, president of the Faculty of Sexual and Reproductive Healthcare (FSRH), said: “Chlamydia continues to account for the majority of STI diagnoses made in 2021. It is the leading preventable cause of infertility in women and people with a womb and ovaries.

“We encourage everyone who is sexually active, including young people, to have a chlamydia test annually and on change of sexual partner.”