What’s on the rise in Sexually Transmitted Infections?

Several factors related to Sexually Transmitted Infections (STIs) transmission and detection are on the rise.As a result, there is an urgent need for a comprehensive understanding of the epidemiology, challenges, and emerging issues in bacterial STIs.Two of the four papers in The Lancet Regional Health-Europe Series on Sexually Transmitted Infections help understand what exactly is on the rise in STIs, by delving into the epidemiology of STIs and the management of asymptomatic STIs in Europe.Notifications of bacterial STIs are on the rise.In one of the Series articles, Oriol Mitjà et al. 1 performed a nonsystematic review of notification data from 49 countries in the WHO European Region, covering 24 European Economic Area countries, 17 Eastern European/Central Asian countries, Switzerland, the UK, and Israel.They provide a comprehensive overview for newly diagnosed syphilis, gonorrhoea, and Chlamydia trachomatis infections spanning a 10-year period from 2012 to 2021.One major finding is high regional variability in bacterial STI notifications.For instance, Northern and Western European countries exhibit higher notification rates per 100,000 population compared to other regions.These differences can be attributed to variations in surveillance performance, STI testing policies (including chlamydia screening programmes targeting young women), and testing accessibility.Therefore, notification data do not provide convincing evidence for major differences regarding infection prevalence and transmission.This view is supported by e.g., Doran et al. who examined STI screening performance specific to MSM over time and across locations and observed an increase in MSM-targeted diagnostic services, a substantial rise in screening for genital and rectal bacterial STIs, with PrEP-using MSM showing 8-times higher odds for syphilis testing and anal swabbing compared to other