Sexual transmission of infections across Europe: appraising the present, scoping the future

Abstract

Objectives: Our journal partnered with the Europe section of the International Union against STI (IUSTI) at a workshop held at the 18th European AIDS Conference in London on 30 October 2021. The workshop reviewed epidemiological trends and discussed STI care provision within HIV services across Europe. Methods and Results: We started by highlighting trends in bacterial STIs reported to the European Centre for Disease Prevention and Control from countries in the European Union/European Economic Area. This showed that notifications of bacterial STIs reached an all-time high in 2019, but are expected to be impacted by the COVID-19 pandemic in 2020–2021. We then reviewed the evolving relationship between STIs and HIV and pointed out how antiretroviral treatment and pre-exposure prophylaxis remain highly effective against HIV transmission despite the rising incidence of STIs. Within emerging concepts in STIs, we appraised the benefits and risks of asymptomatic screening for chlamydia, and also considered the potential perils of routinely testing for agents that lack a defined role in disease. Finally, we discussed standards of STI care for people living with HIV, informed by a brief survey of IUSTI Europe country representatives and members of the Euroguidelines in Central and Eastern Europe network. Conclusions: The survey indicated substantial variability and identified key improvement targets: fighting barriers to effective service provision and access, increasing diagnostic capability and taking leadership in driving up the quality of care. We must not forget the STI-related needs of the many people who will be living with HIV for decades into the future.

Prevalence ofMycoplasma genitaliuminfection among HIV PrEP users: a systematic review and meta-analysis

“…The high proportion of MG infection and its antibiotic resistance among PrEP users might also be related to the high frequency of routine STI screening and, therefore, frequent diagnosis and use of antimicrobials 5 9. For this reason, some guidelines recommend that screening and treatment for MG should be performed only for symptomatic patients or those with specific indications 55 56. Screening for MG in asymptomatic patients may induce unnecessary prescription of antimicrobials, contributing to the increase in bacterial resistance 55–57.…”

“…For this reason, some guidelines recommend that screening and treatment for MG should be performed only for symptomatic patients or those with specific indications 55 56. Screening for MG in asymptomatic patients may induce unnecessary prescription of antimicrobials, contributing to the increase in bacterial resistance 55–57. It is also highly recommended evaluating the macrolide resistance of positive MG samples, whenever possible, to avoid prescribing inappropriate antibiotics 55.…”

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices

“…However, the focus on COVID-19 may have led to a decrease in the number of conducted, and thus documented, disease burden studies for other infectious diseases, such as sexually transmitted infections. The low number of burden of studies estimating the burden of sexually transmitted infections may be explained by heterogeneity in the coverage, completeness and repetitiveness of such data, previously reported across national reporting systems of most of the European countries [40,41].…”

Increased clonality among Neisseria gonorrhoeae isolates during the COVID-19 pandemic in Amsterdam, the Netherlands

“…Gonorrhoea, caused by the sexually transmitted pathogen Neisseria gonorrhoeae ( Ng ) , is one of the most prevalent bacterial STIs worldwide and its prevalence is globally on the rise [3]. This rising trend has also been reported in Europe, including the Netherlands, where before the pandemic the prevalence of gonorrhoea and other bacterial STIs increased, especially among men who have sex with men (MSM) [4–6]. However, interpreting the number of STI cases during the COVID-19 pandemic has been challenging, since social measures and large scale COVID-19 testing temporarily restricted STI testing at Centres for Sexual Health (CSH) [4, 7].…”