Concern at rise in STIs as lack of condom use cited as one reason

There has been a concerning rise in STIs in young people in Ireland with the non use of condoms a contributory factor. 

Preliminary data for 2023 to date (week 38 ending 23/09/2023) shows an increase nationally in notifications for chlamydia, up 43%, and gonorrhoea, up 95%, when compared to data up to week 38 2022.

The groups most affected by STIs continue to be young people aged 15 to 24 years and gay, bisexual and other men who have sex with men (gbMSM).

Preliminary data for 2023 shows that 52% of chlamydia and 39% of gonorrhoea notifications occur in those aged 15-24 years.

Information on mode of transmission is very preliminary and subject to change; to date, where mode of transmission is known, 26% of chlamydia notifications and 59% of gonorrhoea notifications have occurred in those who identify as gbMSM. Where known, 33% of gonorrhoea notifications have been in heterosexual women.

The Health Protection Surveillance Centre say they cannot definitively say why STIs have increased in 2023 compared to previous years but it is likely to be due to a combination of contributory factors.

Prior to the pandemic, many STIs were increasing and the figures in 2023 to date reflect ongoing increasing trends evident in advance of the COVID-19 pandemic and which resumed in 2022.The introduction of a national HSE STI home testing service, integrated with public STI clinics, initially on a pilot basis in 2021, but progressively expanding over time to cover all counties by October 2022, has provided more testing capacity, and so the figures may represent in some part, better ascertainment of infection, which for STIs can often be asymptomatic.

Behaviours that increase the risk of acquiring an STI, including not using condoms consistently, particularly when changing partners, are relatively common.

Increases in gonorrhoea have also been seen internationally. In June 2023, ECDC reported on increases in gonorrhoea notifications in young heterosexuals in EU/EEA reporting countries in 2022 and 2023, and said they were “indicative of intensified transmission rather than changes in testing policies”. ECDC Communicable Disease Threats report – week 25 2023

However, in Ireland, it is known that in 2023, availability of the national home testing service has increased access to testing and affected numbers of cases notified, with 20% of gonorrhoea notifications and 36% of chlamydia notifications in 2023 first being identified via the home testing service.

Whilst STIs are usually easily treatable, some STIs can cause serious health issues such as infertility and pelvic inflammatory disease. Many people are unaware that they have an STI as they are often asymptomatic.

The key prevention messages are to use condoms for vaginal, oral and anal sex, and to get tested for STIs if people have symptoms of an STI, change their sexual partner, have multiple or overlapping partners or their partner has an STI.

An ongoing nationwide Sexual Wellbeing campaign, developed by SHCPP for the 18-30 year age group, promotes condom use, free home STI testing and raises awareness of Sexualwellbeing.ie as a source of information. The campaign reaches the target audience across a variety of channels and also delivers messages on the ground to students in colleges around the country.

The Man2Man campaign for gbMSM aged 18+ promotes safer sex (including condoms) and STI testing among gbMSM and promotes Man2Man.ie as a source of information on safe sex. Messages are promoted on an ongoing basis across the platforms.

HSE SHCPP and partners continue to work on implementation of the Sexual Health Strategy and are working with the Department of Health on development of a new Sexual Health Strategy.