THERE HAS BEEN a 70% increase in the number of gonorrhoea cases in Ireland, according to the latest figures from the Health Protection Surveillance Centre (HPSC).

Some 6,748 cases of gonorrhoea were reported in Ireland up to 23 December 2023, compared with 3,976 cases in 2022.

There was an increase in the number of several sexually transmitted infections (STIs) reported last year including chlamydia, herpes and syphilis, but the biggest jump by far was in gonorrhoea cases.

In 2023 gonorrhoea was most commonly reported among people aged 20-24 years (1,914 cases), 25-29 (1,287 cases) and 30-34 (1,155 cases).

The majority of cases reported in Ireland last year (5,200) were among men, in particular among gay and bisexual males.

Some 13,541 cases of chlamydia were reported in 2023, up from 10,839 in 2022.

The number of chlamydia and gonorrhoea notifications last year include notifications of cases confirmed through the online STI testing service SH24.

HPSC HPSC

The rate of STIs being reported is on the rise throughout Europe, according to the European Centre for Disease Prevention and Control.

In many countries including Ireland there was a decrease in reported cases in 2020 – largely due to social distancing and a lack of data collection during the early stages of the Covid-19 pandemic.

However, the ECDC last month said its 2021 reports, the most recent Europe-wide figures available, revealed a “concerning rise” in STIs across the continent.

Ireland has one of the highest incidence rates of gonorrhoea in Europe.

In total, there were 46,728 confirmed cases of gonorrhoea in Europe in 2021 – a rate of 13.7 per 100,000 population. In Ireland, there were 2,108 confirmed cases of gonorrhoea in 2021 – a rate of 42.1 per 100,000 population.

Taking the more recent HPSC figures – 6,748 cases in 2023 – that’s a rate of 135 per 100,000 population.

Lack of condom use

When asked about the large increase in gonorrhoea cases in particular, a spokesperson for the HSE noted the overall increase in STI cases across Europe post-pandemic.

“Before the pandemic, many STIs were increasing and the figures in 2023 to date reflect ongoing increasing trends evident in advance of the Covid-19 pandemic which resumed in 2022.”

The spokesperson told The Journal that high-risk behaviours like “not using condoms consistently, particularly when changing partners, are relatively common”.

Better access to testing

Another reason behind the spike in reported cases is better access to testing, including the availability of at-home test kits.

A national STI home-testing service, integrated with public STI clinics, was launched on a pilot basis in 2021, before expanding to cover all counties by October 2022.

During the week it was confirmed that about 10,000 free at-home STI test kits are being ordered by Irish households every month.

Minister for Public Health Hildegarde Naughton on Thursday said the HSE received more than 100,000 orders for the kits between January 2023 and the end of November, while 91,000 were ordered in 2022.

Last year the ECDC said an increase in gonorrhoea notifications in young heterosexuals across Europe was “indicative of intensified transmission rather than changes in testing policies”.

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However, the HSE’s spokesperson said that the improved testing capacity in Ireland means the higher number of infection cases here “may represent in some part, better ascertainment of infection, which for STIs can often be asymptomatic”.

“We know that in 2023, availability of the national home testing service has increased access to testing and affected numbers of cases notified, with 20% of gonorrhoea notifications and 36% of chlamydia notifications in 2023 first being identified via the home testing service,” they said.

File photo of a cotton swab and test tube Shutterstock / Bits And Splits Shutterstock / Bits And Splits / Bits And Splits

In general, to test for chlamydia and gonorrhoea a person needs to provide a genital sample – usually via a swab or a urine sample. 

In response to the large increase in STIs, particularly chlamydia and gonorrhoea, the HSE has increased its messaging to key target groups, especially to people aged 17 to 30, on STI prevention including condom use and regular testing.

Mpox

One STI that saw a large decrease in reported cases in 2023 was Mpox. After a surge in cases in 2022 in Ireland and abroad, a vaccine was introduced.

Mpox primarily impacts men who have sex with men. There were 227 cases of the infection in Ireland in 2022, down to just 15 cases last year.

The HSE spokesperson said the dramatic reduction in cases is due to “increasing immunity in the most affected population group due to a combination of natural immunity and vaccination of those most at risk of exposure”.

A nationwide information campaign also helped to reduce cases.

“Risk communication and community engagement in the key affected population (gay bisexual and other men who have sex with men) have contributed to raising awareness of symptoms, what to do if symptomatic and advising about the benefits of vaccination and how to access it for gbMSM at risk of Mpox infection,” the spokesperson said.

Advice on sexual wellbeing can be read here, specific information for gbMSM can be read here. People can order at-home STI kits here.