STIs grow, syphilis triples in decade: report

According to a new analysis issued by the Kirby Institute at UNSW Sydney, gonorrhoea diagnoses in Australia have doubled over the last decade, while syphilis cases have tripled.

Chlamydia is also on the rise (up 12% since 2013), and poor testing rates caused by the COVID-19 epidemic have researchers concerned that the upward trend will continue.

“Any increase in STIs is bad news, but rising STIs against a backdrop of decreased testing, and the persistent upward trend over the past decade, is particularly concerning,” says Kirby Institute researcher Dr Skye McGregor.

Between 2019 and 2022, the number of Medicare-rebated tests for chlamydia and gonorrhoea among both men and women decreased, which is likely owing to the ongoing effects of the COVID-19 pandemic.

“Antibiotics are effective against Chlamydia, gonorrhoea, and syphilis.” “The key message we want Australians to take away from these data is that condoms remain highly effective at preventing STIs for any sexually active person, and regular STI testing is critical,” says Dr McGregor.

“A critical component of this is combating sexual health stigma and notifying sexual partners when someone tests positive for a STI.” Early detection, diagnosis, and treatment of STIs reduces the risk of catastrophic long-term consequences.”

In 2022, there were 93,777 chlamydia diagnoses, 32,877 gonorrhoea diagnoses, and 6036 infectious syphilis diagnoses.

Concerning rates of syphilis

The number of syphilis cases has more than tripled in the last decade, and while the majority of cases continue to be men, there has been a six-fold increase in the number of women diagnosed with syphilis during the same time period.

“The rise in syphilis among women is extremely concerning because syphilis is completely preventable.” If left untreated during pregnancy, infection can cause miscarriage or stillbirth, as well as congenital syphilis, in which the infection is passed on to unborn offspring. “Congenital syphilis is an extremely serious condition for infants that can have long-term health consequences and, in the most severe cases, can be fatal,” says Dr. McGregor.

According to the report, there would be 15 cases of congenital syphilis in 2022, with eight of them being Aboriginal and Torres Strait Islander peoples. In the last five years, there have been 69 cases of congenital syphilis, 18 of which have resulted in the infant’s death.

“When comparing Aboriginal and Torres Strait Islander infants to non-Indigenous infants, congenital syphilis diagnoses are 14 times higher.” All pregnant women should be checked for STIs as part of prenatal and antenatal health screening, however research has revealed that nearly half of moms with congenital syphilis did not receive antenatal care. “It is critical that comprehensive services are in place to ensure that all pregnant women have access to appropriate care,” says Dr. McGregor.

From 2013 to 2019, the frequency of congenital syphilis diagnoses was low across all communities, and the recent increase in cases has researchers, community groups, and health officials concerned.

“Syphilis can be cured with timely screening, so even one case of congenital syphilis is completely avoidable and unacceptable.” “We are working with our partners to understand and address this breakdown in prenatal screening as soon as possible,” Dr. McGregor explains.

The majority of chlamydia infections go undetected

According to the survey, the majority of chlamydia cases in Australia go undiagnosed and untreated, emphasizing the importance of expanded testing. Chlamydia, if left untreated, can have major long-term health repercussions such as pelvic inflammatory disease in women and infertility in both men and women.

“If you are sexually active, talk to your GP, nurse, or health worker about the risk of STIs; they will recommend anything from quarterly to annual testing.” A simple urine test or a self-collected vaginal swab is used to test for Chlamydia and gonorrhoea. “It’s also recommended to get a syphilis and HIV blood test at the same time,” Dr McGregor explains.

Chlamydia was the most often reported STI in Australia in 2022, with two out of every three diagnoses occurring in those aged 15 to 29.

“We estimate that one in every 27 young females in Australia will have chlamydia by 2022, with less than half being diagnosed.” “That translates to over 91,000 young women,” Dr. McGregor explains.

Men are more prone to gonorrhoea and syphilis.
Gonorrhoea also rose in 2022, with diagnoses in cities five times higher than they were ten years earlier. Men account for the most majority of diagnoses (71%).

“When we look closely at the data, we see that the majority of gonorrhoea diagnoses are among gay and bisexual men.” This motivates us to examine developing prevention options, such as immunization, in addition to recommending frequent testing,” Dr Mc Gregor says.

Syphilis was also most common in men, accounting for 82% of diagnoses

“It is likely that these increases can be explained by more comprehensive screening and increased availability and awareness of highly effective HIV prevention strategies, resulting in a decrease in condom use and greater sexual mixing,” says Professor Andrew Grulich, head of the Kirby Institute’s HIV Epidemiology and Prevention program.

“However, we know how effective health promotion can be in this community, as evidenced by the significant reductions in HIV.” These lessons must be applied to STIs in order to reduce infections in this population.”

Aboriginal and Torres Strait Islander peoples bear a disproportionate share of the burden

Aboriginal and Torres Strait Islander peoples continued to have much higher STI rates than non-Indigenous Australians in 2022.

“Aboriginal and Torres Strait Islander peoples are twice as likely as non-Indigenous people to be diagnosed with chlamydia.” The rate for gonorrhoea and syphilis is more than five times higher. “These disparities are even more pronounced in regional and remote communities,” says Robert Monaghan, a Bundjalung-Gumbaynggir man and the Kirby Institute’s Manager of Aboriginal and Torres Strait Islander Health Research.

“This demonstrates the critical importance of culturally appropriate health promotion, testing, and treatment strategies.” It is critical that these be developed in collaboration with Aboriginal and Torres Strait Islander peoples.

“While these figures are alarming, we know that well-targeted, appropriately funded health interventions work in our communities.” For example, HPV vaccination has been enormously successful, with no diagnoses of genital warts among young Aboriginal men under the age of 21 in 2022.”

Getting rid of some STIs

Because of the impact of the HPV vaccination program, Australia has made overall significant progress in the elimination of genital warts: the proportion of nonIndigenous females aged under 21 years attending sexual health clinics diagnosed with genital warts caused by HPV has decreased from 10.6 percent in 2007 to 0.2 percent in 2022.

“Australia is a leader in the rollout of the HPV vaccine, and it is very encouraging to see that genital warts diagnoses are so low among this population,” says Professor Basil Donovan AO, a sexual health physician and the director of the Kirby Institute’s Sexual Health Program.

Similarly, Australia is thought to have eliminated donovanosis, which was previously a common STI in remote Aboriginal populations. The most recent instance was reported in 2014, and no new cases have been identified since then.

“It is critical that we look to these examples as an encouraging sign of what can be accomplished when sectors work together.” “It is critical that we direct the necessary resources to other STIs in order to improve the health and wellbeing of all Australians,” Prof Donovan says.

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