★ Improve and increase the number of screening tests, which play a key role in identifying asymptomatic STIs.

Over the past two decades, the incidence of sexually transmitted infections (STIs) has increased significantly. According to the report “Epidemiological Surveillance of Sexually Transmitted Infections in Spain 2022”, which was published in 2024 by the National Center of Epidemiology (CNE) and the Cyber ​​Infectious Diseases of the Carlos III Institute of Health, the incidence does not stop increasing and the incidence of some of them, such as gonorrhea and syphilis, has been growing for more than 20 years. The incidence of the former has increased 25-fold over these two decades, and the latter by 10. Since 2016, the number of cases of chlamydia has sharply increased by 245%.

Tools for early detection, management and risk management practices are some of the issues related to these pathologies discussed at the 51st Congress of the Spanish Academy of Dermatology and Venereology (AEDV), which takes place in Madrid from 22 to 25 May. .

One of the main factors justifying such a high increase in STI diagnoses is the increase in the number of screenings and the improvement in the accuracy of the methods we use. “The infection data that is transmitted to the Carlos III Health Institute are the cases that we diagnose. Most STIs are asymptomatic, which means many go undetected unless you look for them. By improving these tests and increasing the number of screenings, more infections can be diagnosed.” This is guaranteed Dr. Irene Fuertes de Vegacoordinator of the AEDV STI and HIV research group.

Another factor that has determined the upward trend in the incidence of STIs is the weakening of protective measures in sexual relations. This is a general trend across the population, but is more important for some groups, such as HIV prevention or PrEP users. According to Dr. Fuertes, these consumers tend to use less barrier protection in relationships and, in addition, they undergo comprehensive STI screening every three months, which makes diagnosing their infections much easier. “There is evidence that PrEP users have more bacterial STIs, such as gonorrhea, chlamydia and syphilis,” the doctor says.

Another relatively recent phenomenon is chemsex, which involves the use of drugs to facilitate or enhance sexual activity. “Chemsex has increased, especially in larger cities, and is also associated with an increase in STIs among other possible substance use problems.”

HIV infection is now a treatable disease, although not curable, and patients living with this infection have a life expectancy and quality of life very similar to that of the general population. It has ceased to be a serious public health problem, and with it, there has been a sharp decline in institutional and media interest in providing the public with adequate information and healthy sexuality education, which is absolutely necessary for the youngest. Dr. Fuertes believes that “getting to this point with HIV in terms of prevention and treatment is a great achievement, but we need institutions that will be involved in preventing other STIs and in educating the youngest people about sexual health, since it is among people under 25 years of age that the incidence of STIs has most clearly increased,” he notes.

“There is a change in understanding of sexuality. You have more sexual partners and more sex with anonymous partners. In addition, the perception of risk that some practices may pose is very low, so the use of protective methods is also low,” notes the doctor.

AEDV has launched a project to educate teenagers about healthy sex in secondary schools. “In the STI and HIV research group, we are trying to connect and train both the youngest dermatologists and the oldest, who have a greater interest in STIs. Our role as dermatologists is to try to control these infections in our population and promote the sexual health of our patients,” he notes.

Fountain: BERBES