Sexually transmitted infections: stay vigilant whilst on holiday and get a check-up when you return

The report published on 21 May by the ECDC (European Centre for Disease Prevention and Control) highlights a record increase in sexually transmitted infections (STIs) for 2024. Chlamydia is the most common, with over 200,000 cases in a year, gonorrhoea has more than tripled compared with ten years ago, raising the spectre of resistance to first-line antibiotic treatment, whilst syphilis has more than doubled, with a sharp rise in cases of transmission from mother to newborn during pregnancy (congenital syphilis).

This figure is, at least in part, due to the increased use of diagnostic tools and the systematic reporting of test results. A prime example of this is PrEP, pre-exposure prophylaxis for HIV: people who follow the PrEP programme, designed to prevent HIV infection, undergo regular check-ups and tests not only for HIV but also for other STIs. This enables the detection and appropriate treatment of STIs that in the past would have gone unreported and been managed inadequately, as well as contact tracing and the breaking of the chain of transmission.

It is not just a technical reason, however. There is no doubt, in fact, that the low rate of condom use and the rise in casual sex are the two factors that contribute most to the transmission of STIs. In addition, these infections are often asymptomatic and are therefore sometimes underestimated by the person affected or, particularly in the case of young men and women, involve symptoms that are difficult and embarrassing to discuss, even with their own doctor. However, a lack of diagnosis and treatment not only prolongs the infection and facilitates its transmission, but can also lead to long-term complications, including chronic pelvic pain and infertility.

Where is there room for improvement? Awareness of the risks, correct and consistent use of condoms, vaccinations, pharmacological prevention in certain cases, and early diagnosis – made more widely accessible wherever possible, thanks both to a specific exemption from the patient contribution (available only in some regions) and to the widespread availability of rapid tests that can be carried out in non-hospital settings – so-called ‘community-based’ tests. Anyone who is sexually active should consider their own exposure to the risk of STIs and act accordingly. Using a condom when having sex with partners whose sexual health is uncertain is the safest option. Some STIs, such as hepatitis A, hepatitis B and human papillomavirus (HPV), can also be prevented through vaccination: it is advisable to discuss this with your doctor or with the Prevention Department of your local health authority (ASL). In addition to PrEP, which protects against HIV, there are also ‘post-exposure’ drug treatments involving antibiotics – such as Doxy-PEP, which is effective against syphilis and chlamydia – or antivirals – such as PEP for HIV – which should ideally be started within twenty-four hours of unprotected sex.

We must not let our guard down, therefore, especially in summer when, whilst on holiday, our perception of risk tends to diminish and there is an increase in casual sex or sexual encounters with people we do not usually see. Against this backdrop, Anlaids – the National Association for the Fight against AIDS (ETS) – emphasises that prevention and information are a form of care for oneself and others, and provides free, accessible and reliable resources for anyone wishing to find out more, get tested or receive support. These range from telephone counselling to free rapid tests for HIV, syphilis, hepatitis C and hepatitis B, offered in a non-hospital setting. Contact details and further information can be found on the Anlaids website and on our social media channels. Why not schedule an ‘STI prevention check-up’ when you return from your holidays?