Sexually Transmitted Infections: A Silent Threat

published on Saturday, October 15, 2022 at 05:53

They often go unnoticed but are potentially dangerous: some sexually transmitted infections continue to increase, especially among young people, pushing the government to expand access to screening after the Covid low.

“We are going to pay the price for the Covid pandemic”: it has “delayed screenings” and thus favored “the circulation of strains and infections”, explains to AFP Professor Cécile Bébéar, head of the National Reference Center on bacterial sexually transmitted infections (STIs) and head of department at Bordeaux University Hospital.

Chlamydia infections mainly affect young women. Those with gonococcal strike mainly men — more those having homosexual relations.

In France, the number of chlamydia infections jumped by 29% between 2017 and 2019, that of gonorrhea by 21%, according to Public Health France. Even more marked increases for those under 30 (chlamydia +41% for women aged 15-24, +45% for men aged 15-29).

In 2020, the first year of the Covid pandemic, cases fell, mainly because testing dropped.

“We do not yet have the figures for 2021, but we do not expect a decrease. At best, a stabilization”, indicates Cécile Bébéar.

Since the early 2000s, bacterial STIs have started to increase again in Western countries, after a decline over the previous 20 years in the wake of the AIDS epidemic.

– Condoms –

“As AIDS is less scary, because it can be treated – without curing it – and that Prep (preventive treatment) is effective and reimbursed, many young people no longer protect themselves during sexual intercourse”, notes the Pr Béatrice Berçot, head of service at the Saint-Louis hospital in Paris and director of a laboratory associated with the CNR of bacterial STIs for gonococci.

Result, “the gonococcus has become very present again”, even if it is “contained”, below the peak of the 1980s.

These STIs are sometimes manifested by genital damage, but you can be a carrier of the bacteria without symptoms. And pass it on without knowing it.

“In the past, gonococcus was the + hot piss +, very painful. Urinary tract infections in humans with gonococcus are however less frequent and the bacterium is now often found in the throat or anus, among many other bacteria. It does not cause pain” and goes unnoticed, observes Béatrice Berçot.

Why worry? Without treatment, these diseases sometimes have serious repercussions. The most serious sequelae is infertility, more often in women but also in men.

To reduce the risk of complications and limit spread in the population, doctors are calling for increased efforts.

“Used correctly and consistently, condoms are one of the most effective methods of protection against STIs,” says the WHO.

“Male and female condoms, dental dams (in the case of oral sex)”, lists Cécile Bébéar, who insists on “education in sexual health, from college”.

– Without a prescription –

Another bulwark: screening.

The doctor perceives “still taboos among some and a lot of ignorance” but underlines the importance of “regular screening, to avoid more serious infections”.

In its prevention section, the 2023 Social Security budget plans to expand access to non-prescription screening for other STIs than AIDS, for which it is already possible. For those under 26, the refund will be full.

To reach more people, Cécile Bébéar talks about a project for 2023 to request, online and free of charge, a screening kit for chlamydia and gonococcal infections, to be returned to health insurance.

When detected, these STIs can be treated with antibiotics. For gonococcus, the response is limited to one molecule, due to the growing resistance to antibiotics. In question: “more resistant strains imported from Southeast Asia” via sex tourism, according to Béatrice Berçot.

Taking antibiotics preventively is also sometimes possible to reduce transmission during a sexual act. “Sailors or soldiers protected themselves from gonococcus like that in the past,” notes the specialist.

And a vaccine is hoped for, within five years, according to Cécile Bébéar. “Several studies show that the meningococcal vaccine reduces the prevalence of gonococcus by 30% in men who have sex with men. Therapeutic trials are underway in the USA, Australia, France”, she specifies. .


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