Loss of fear of AIDS due to the effectiveness of pre-exposure prophylaxis; Sexual drug use and an increase in screening tests in specific programs are the main reasons behind the “alarming” increase in sexually transmitted infections (STIs) in Spain, a reality that is central to World Drug Day.
This is reflected in the report on STIs “Sexually transmitted infections in Spain: state of the art” prepared by the Scientific Committee on COVID and Emerging Pathogens of the Official College of Physicians of Madrid (ICOMEM).
This position paper points to an increase in the incidence of STIs such as gonococcus, syphilis and chlamydia, especially among young people aged 15-19 and among men who have sex with men (MSM).
The main purpose of this report is to collect information on the current epidemiological situation and update the diagnosis and treatment of the most common diseases.
These include HIV infection in Spain, which is transmitted sexually in 81.7% of new diagnoses, and monkeypox (Mpox), which now behaves like an STI.
STI data
According to ICOMEM in Spain, of the 7,541 cases of smallpox diagnosed, 98% are men with an average age of 37, registered before March 1 this year in 17 autonomous communities.
In addition, in recent years, there has been a steady increase in the incidence of genital Chlamydia trachomatis infections, with more than 40% of cases occurring in children under 25 years of age.
With regard to genital herpes (HSV), it affects 10-15% of the adult population, while the incidence of syphilis in Spain is 30.81 cases per 100,000 inhabitants among the population aged 20 to 24 years.
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Although the likelihood of contracting HIV infection in uninfected patients is reduced, and its effectiveness in preventing sexual transmission of HIV is estimated at about 99%, “it has been noted that its use can cause patients to relax once they start using a barrier contraceptive” . methods such as condoms,” the document notes.
For this reason, especially in the last 10 years, users of this preventive therapy have seen a steady increase in the incidence of bacterial STIs.
Certain sexual practices, such as the use of certain drugs during sexual relationships, known as chemsex, also place sexual health at the center of attention.
Tests
For this panel of experts, STIs are a “public health problem of the first magnitude”, although the real situation in Spain is “currently little known”.
One of the goals is to improve pathways followed by patients with suspected STIs to “adequate diagnosis and treatment” because “it is little known”.
ICOMEM experts understand that this problem is mainly solved in institutions.
publicly owned health care and that primary care and emergency hospitals, as well as some institutions dealing with this problem, are the recipients of most of these diseases.
Another difficulty with STDs is availability of microbiological tests necessary for its diagnosis, to which is added the increase in the cost of implementing the latest generation of molecular methods and the difficulty of transporting samples.
They also consider it necessary better understand risk groups what to focus on and warn that STIs are also a problem in pediatric age and that their presence may be a sign of sexual abuse, implying assistance but also medico-legal activities.
After the recognition of the creation ministerial area of special focus on STIs and the existence of plans to improve the diagnosis, treatment, and prevention of these problems, they estimate that “the necessary evidence of impact” is still lacking.
“We cannot forget that these are illnesses that transcend the individual and constitute a public health problem,” the document emphasizes.