What you need to know
- Reported gonorrhea infections across Europe are at an all-time high according to the European Centre for Disease Prevention and Control (ECDC)
- Condom use is declining, making it easier for sexually transmitted infections (STIs) to spread
continue to rise across European nations, according to annual data released by the European Centre for Disease Prevention and Control.
The most recent release (February 10, 2025) covers data from 2023. It shows rates of bacterial infections, such as gonorrhea and syphilis, rose again, across the European Union and European Economic Area (EU/EEA).
Almost 100,000 new cases of gonorrhea were reported — a record high — up from about 74,000 in 2022. It is more than four times the number of annual cases reported 10 years earlier.
cases were highest among women aged 20-24 years and men aged 25-34 years. Cases among men who have sex with men (MSM) account for more than half of all infections.
Rates of also rose — up 13% on 2022 levels — to more than 40,000 reported cases. About half were reported as MSM cases.
remains the most frequently reported STI in Europe. With particularly high prevalence in women and men aged 20-24 years(577 cases in every 100,000).
It’s not about sex, but how you are having it
Experts are concerned. But they also know there is a simple explanation.
“People are having sex,” Maria Wessman, section head of blood-borne and sexually transmitted infections at the Statens Serum Institut in Denmark, told DW. Wessman was not involved in compiling the ECDC data.
Her’s is a matter-of-fact statement, and obvious, too. But Wessman’s point is about how people are having sex.
Wessman, and other experts that DW spoke to, said a reduction in condom use is the probable driver of bacterial STIs in Europe, especially among young people.
In a , one in five boys and one in seven girls aged 15 years reported being sexually active. Altogether, 30% of them reported using no contraception.
“Something has changed in condom use, or people have more partners, maybe different types of partners or more partners at the same time,” Lina Nerlander, the ECDC’s principal expert on STIs, told DW.
But it may also be due to ongoing improvements in testing and surveillance — that is, the monitoring and reporting of disease is better and, therefore, more cases are being identified.
Men who have sex with men account for the majority of bacterial STI cases. But, at the same time, MSM have been the most likely people to get tested for STIs regularly and seek treatment.
“Men who have sex with men, when they’re treated with HIV medication [to prevent infection], they are required to have a STI check every three months,” Wessman said.
“But I think young heterosexual men and women are getting better at being tested. There’s more consciousness about STIs, I think, more than just a few years ago,” she said.
Possible genetic changes driving gonorrhea rates
Gonorrhea, syphilis and chlamydia are all caused by and are, mostly, transmitted by unprotected vaginal, oral and anal sex.
But while gonorrhea and syphilis rates are rising, chlamydia rates appear to be on the way down. Scientists cannot explain these contrasting trends, given they are transmitted similarly.
“We need more analysis to see if we can find an explanation why this [chlamydia] decline is suddenly happening,” said Wessman.
Whole genome sequencing is being used across Europe to identify genetic changes in bacterial species and learn which ones might be driving the trends.
“We have a big sample of gonorrhea strains from all around the EU, and we’re doing genetic sequencing on those to see what strains are spreading in which populations? But there are no clear answers as of today,” said Nerlander.
Detailed understanding of sexual behaviors could also help pinpoint whether certain types of sex make STI transmission easier — but the EU does not have this kind of information available yet.
Needed: More talk (and action) on safe sex
The experts DW spoke to said sexually active people should continue to use condoms to prevent the spread of STIs in Europe. But they also said there needs to a more open conversation about sex and an effort to destigmatize STIs.
Mojca Matičič, who heads an outpatient STI service at the University Medical Centre Ljubljana, Slovenia, said risky sexual behavior may be driving a rise in infections, and that “healthcare practitioners, as well as policy-makers, need to be aware of that.”
” of these diseases is one of the most important reasons [people don’t] go to a medical doctor, don’t seek help. Then, of course, we need to change sexual behavior.”
Matičič doesn’t want to change behaviors to stop people having sex, but to make it safer. She points to “chem sex” and cellphone dating apps as creating environments that make it easier for casual encounters to occur, and also heighten the risk of STI transmission.
What does safe sex look like in Europe today?
Matičič said safe sex is defined as occurring either between two permanent, uninfected, and monogamous partners without the use of a condom.
In all other cases, partners should use a condom for safe sex, she said.
All the experts DW spoke to emphasized the importance of taking an STI test after unprotected sex with a new partner.
“If you’re going to have sex with a new partner without a condom, then it’s a good idea to get tested before,” said Nerlander.
“But if you don’t manage to get tested before, get tested after having unprotected sex,” Nerlander said. And especially get tested if you have any symptoms, like pain when you pee, discharge, rash around the genitals and/or mouth.”
Edited by: Zulfikar Abbany
Sources:
Gonorrhoea – Annual Epidemiological Report for 2023, ECDC, February 10, 2025 https://www.ecdc.europa.eu/en/publications-data/gonorrhoea-annual-epidemiological-report-2023
Chlamidyia – Annual Epidemiological Report for 2023, ECDC, February 10, 2025 https://www.ecdc.europa.eu/en/publications-data/chlamydia-annual-epidemiological-report-2023
Syphilis – Annual Epidemiological Report for 2023, ECDC, February 10, 2025 https://www.ecdc.europa.eu/en/publications-data/syphilis-annual-epidemiological-report-2023
Congenital syphilis – Annual Epidemiological Report for 2023, ECDC, February 10, 2025 https://www.ecdc.europa.eu/en/publications-data/congenital-syphilis-annual-epidemiological-report-2023
The post STIs in Europe: Gonorrhea and syphilis hit record highs appeared first on Deutsche Welle.
