World Sexual Health Day 2024 - Actions needed to limit the spread of sexually transmitted infections in Europe

The study provides evidence-based prevalence estimates for sexually transmitted infections (STIs) in Europe and identifies population groups at greatest risk of contracting these infections.

STIs, which are among the most commonly reported infections globally, remain a significant public health challenge in the European Union and European Economic Area (EU/EEA) where around 300 000 new diagnoses of bacterial STIs are reported annually by the Member States.

Yet this number is an underestimate of the real dimension of STI epidemics in the EU/EEA due to differences in national surveillance system coverage, and variations in testing practices and reporting.

The review, which collected prevalence estimates of chlamydia, gonorrhoea, syphilis and trichomoniasis in EU/EEA countries, identified the disproportionate impact that STI epidemics have on certain groups, such as young people, men who have sex with men (MSM), and sex workers. For example, young people aged 15 to 24 years have a considerably higher prevalence of chlamydia and gonorrhoea than the general population. Young women, in particular, have nearly double the prevalence rates for chlamydia and gonorrhoea when compared to women of all ages.

Similarly, MSM in the EU/EEA show considerably high prevalence rates for various STIs, emphasising the need for targeted prevention efforts. Among MSM, those living with HIV and those taking pre-exposure prophylaxis (PrEP) for HIV have a higher prevalence of bacterial STIs, indicating their vulnerability to poor sexual health outcomes and the need for easy access to testing and treatment.

Despite the above, this review has established that there is a lack of recent and methodologically robust estimates on STI prevalence in many European countries. This data gap hampers the ability to fully understand the extent of STI spread and ascertain vulnerabilities in certain populations. It also hinders the development of effective and targeted public health prevention strategies. The review also reveals that certain populations at risk, such as sex workers and people who inject drugs, are severely understudied, further limiting the ability to address their specific sexual health needs.

To address these challenges, ECDC recommends that European countries strengthen their capacity to understand and document the patterns, transmission dynamics, and effects of STIs within a population. ECDC advises countries to use prevalence estimates and other data to implement evidence-based STI prevention and control measures.

ECDC recommends that Member States create national strategies for STI control, either as a separate plan or part of a broader sexual health or HIV/STI strategy. These strategies should include sexual health education, safe sex campaigns, and condom promotion and ensure accessible testing, treatment, and sexual health care, supported by evidence-based guidelines and effective partner notification. Collaboration with community organisations offering services to at-risk populations is important for targeted and effective control efforts.

Addressing the gaps in STI surveillance and prevention is crucial for reducing the spread of infections and ultimately eliminating them as a public health threat in Europe. Enhanced data collection and targeted prevention strategies are essential steps towards achieving this goal.