STIs in 2022: emerging and re-emerging outbreaks

During the COVID-19 pandemic, many countries had reported low coverage for preventive, testing and treatment services related to sexually transmitted infections (STIs), which has led to a resurgence of STIs and the emergence of non-classical STIs globally.

Countries with good STI surveillance such as the United States and Canada have reported an increase in at least 3 STIs: syphilis, gonorrhea and chlamydia. Recent reports from different regions of the world have also reported increase in cases of congenital syphilis and syphilis especially among key populations. Outbreaks of non-classical STIs spread by sexual contact such as Shigella sonnei, hepatitis A, Neisseria meningitidis, Zika and Ebola have been on the rise. There were also reports on re-emergence of neglected STIs such as lymphogranuloma venereum (LGV) among key populations and increasing Mycoplasma genitalium.

Since 1 January 2022, cases of monkeypox have increased exponentially in countries that are not endemic of the disease. Most reported cases have a history of sexual contact and the majority are identified in sexual health or STI clinics and have involved mainly, but not exclusively, men who have sex with men.

And lastly, antimicrobial resistance in Neisseria gonorrhoea and Mycoplasma genitalium are increasing and concerns of imminent limited and more complicated treatment options.

Key shifts are required to end STIs as a public health concern by 2030. New models of STIs services need to be resilient and adaptive to current and future threats. Recent scientific advances in STIs treatment and technologies, and innovative service delivery methods, provide an important opportunity to end STIs as a public health concern by 2030. However, large variations in investment, maturity and performance of STI surveillance systems between countries continues to be a challenge.

In light of these emerging outbreaks, WHO calls on countries to increase funding for STI services and focused efforts to scale-up STI prevention, testing and treatment services, and urges against stigmatization, blaming, or shaming. Stigma makes it harder to end outbreaks and can stop people from accessing services. WHO calls for flexible approaches to addressing changing epidemics, with reinvigorated primary prevention efforts, identified and optimized opportunities to use differentiated service delivery models to meet the diverse needs of specific populations.

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