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Freshers' Week Warning Over Record Levels of Gonorrhoea

The UK Health Security Agency (UKHSA) reminded students heading to university of the danger of contracting a sexually transmitted infection (STI) as it urged the use of condoms and regular testing. Cases of gonorrhoea remained at record levels, the Agency said.

Young people aged 15 to 24 years remained the most likely to be diagnosed with STIs, and last year there were "over 400 diagnoses of STIs every day" in this age group, the UKSHA warned. "There is a very real danger of catching a sexually transmitted infection if having condomless sex this freshers' week," it alerted. 

Dr Katy Sinka, UKHSA head of sexually transmitted infections, commented that starting university can be an "exciting time", but that STIs can have "serious consequences".

UKHSA data published this year revealed record numbers of cases of gonorrhoea and syphilis diagnosed in 2022. Gonorrhoea infection had the "highest number" of diagnoses since records began in 1918 – the number of cases reaching 82,592 compared with 54,961 in 2021.

Cases of syphilis were the highest they had been since 1948, with diagnoses having increased to 8692 in 2022 – 15.2% higher than 2021 (7543).

Antibiotic Resistance on the Rise

The increase in gonorrhoea diagnoses was in part due to increases in testing, explained the UKHSA. Last year there were almost 2.2 million sexual health screens performed by sexual health services – an increase of 13.4% over 2021 (1.9 million). However, the Agency stressed that the scale of the increase in diagnoses strongly suggested that there was "more transmission" of STIs within the population.

One of the reasons for the increase in gonorrhoea infections is that the bacteria were becoming increasingly resistant to antibiotics, UKHSA said. Resistance of gonorrhoea to antibiotics had been "increasing for years", with ceftriaxone now the standard first-line therapy due to resistance to other antibiotics. However, although ceftriaxone-resistance had been rare in the UK, between December 2015 and September 2021, nine cases of travel-related ceftriaxone-resistant N. gonorrhoeae were detected, with a further 10 cases reported between December 2021 and June 2022.

When asked in a written parliamentary question in March what steps the Government was taking to limit the spread of extensively antibiotic-resistant gonorrhoea, in particular given the fact that the effectiveness of ceftriaxone treatment of gonorrhoea continued to be threatened, health minister Lord Markham explained that the UKHSA's Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) reported annually on drug resistance in N. gonorrhoeae in England and Wales and had "directly influenced changes in treatment guidelines on three occasions".

Testing Appeal

The UKHSA stressed the importance of testing early and diagnosing the infection so transmission could be prevented, and urged all those heading to university to use a condom with any new or casual partners, and to get tested regularly. "Everyone should have an STI screen, including an HIV test, at least once a year, if having condomless sex with new or casual partners," the Agency advised.

"If you're a student going to university for the first time or returning for a new year, it's a good idea to get tested before you start having sex with a new or casual partner," recommended Dr Sinka.

Laura Domegan, head of nursing at Brook, the sexual health and wellbeing charity, stressed that the "STI stats speak for themselves", and said that it had "never been more important" to consider using condoms and getting tested. She highlighted that with most areas having a home testing option, getting tested was "easy".

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