Chlamydia, gonococcus, syphilis … Sexually transmitted infections (STIs) are not limited to HIV alone. The virus is worrying more and more rightly. But the lack of protection, by not wearing the condom, has a less media consequence: the explosion of other STIs. The Bulletin Epidémiologique Hebdomadaire (BEH) of Public Health France testifies this November 29th. This last issue is dedicated to World AIDS Day, which is held on December 1st. He recalled that co-infections are common among people with HIV.
81,000 cases diagnosed in 2015. Chlamydia are by far the most common sexually transmitted diseases in France. They continue their growth at a cruising pace: between 2013 and 2015, the number of infections increased by 10%. As with HIV, men are most affected by this progression. But over the year 2015, the majority of diagnoses covered a female population and rather young – from 15 to 29 years.
The chlamydial epidemic is silent, and this is the main source of concern. 45% of patients have no symptoms of the disease. In the absence of management, contamination continues. But the sequelae can also be lasting: infertility can occur.
One form of infection may be particularly severe, rectal venereal lymphogranuloma, due to an invasive strain of chlamydia. It is experiencing a real explosion (47%). The other rectal infections by this bacterium have almost doubled. The profile is unique: almost all patients are male and co-infections with HIV are present in three out of four cases.
But it is indeed the gonorrhea that has seen the biggest increase since 2013. Infections have increased by 100% among men who have sex with men (MSM). It is also the first population affected by HIV. Heterosexual women also incur a significant increase (32%). Co-infections with HIV remain marginal (11%) but antibiotic resistance is progressing. The future looks bleak in this respect.
The epidemic of syphilis, for its part, no longer affects only MSM. A very strong progression is observed in heterosexual men (75%) and females (85%). The numbers remain “relatively low”, nevertheless emphasizes the BEH. The population of MSM, on the other hand, is charged with the active dissemination of the pale treponema. They account for 84% of diagnoses of early forms. The women reported are rather young. “The level of co-infections with HIV remains very high,” says the BEH. In fact, a quarter of patients have been infected with both the immunodeficiency virus and the treponema.
Faced with these disastrous figures, the conclusion of Public Health France is simple: they reveal that the condom is far from being enough in MSM, and the transmission is fast. The same is true for young heterosexuals, where the different STIs have a major progression. Efforts should therefore not be relaxed. With the introduction of pre-exposure prophylaxis (PrEP) – which avoids the transmission of HIV with an antiretroviral drug – an upsurge is to be expected.