On the rise

Syphilis and gonorrhoea in Italy. Women under 25 are particularly affected. New vaccines and do-it-yourself Syphilis tests are being studied. Alarm from STD Test experts: in the last year in Europe, syphilis has increased by 15 per cent and gonorrhoea by 40%. The trend has continued for some time. There was a physiological decline in 2020, the year of the lockdowns due to Covid-19. The growth also includes Italy. The causes of STIs include high transmissibility of viruses and bacteria and poor prevention. They discussed it at the IX National Congress of the Interdisciplinary Society for the Study of STDs (Simast) in Turin on 3-4 November. Over 200 HPV Test infectious disease specialists, epidemiologists, dermatologists, gynaecologists, and urologists attended.

GROWING

“The alarm over the spread of Sexually Transmitted Infections (STIs) concerns, first of all, syphilis and gonorrhoea,” says Dr Marco Cusini, president of Simast. Syphilis is one of the most widespread STDs in Italy. Its rate is constantly increasing, especially among males who have sex with males (MSM). Gonococcal infection (or gonorrhoea or menorrhagia) ranks as the second most common STD in the world after chlamydia. Recent data show a 40% increase in STDs in many European countries such as Denmark, Sweden, Ireland, and Holland. This trend is also comparable to Italy. What is especially striking is the increase in women under 25. It demonstrates how it is expanding even outside the population most at risk, the MSM. In this sense, the role of oral sex is increasingly relevant in broadcasting.

“MONKEYPOX” STILL PRESENT

Dr Cusini continues: «Among the growing trends, there is also monkeypox. After peaking in spring 2022, reports of cases of the so-called monkeypox in several European countries, including Italy, indicate that the epidemic is ongoing. President Simast highlights, “In addition to the vaccinations already available for some time for Papillomavirus (HPV) and monkeypox, whose effectiveness and safety are recognised.” There are other vaccinations in various experimental phases. For gonorrhoea, we could have a vaccine in one or two years. The time is expected to be longer for syphilis, chlamydia, and herpes.” To combat HPV, some forms of prevention are available, while early diagnosis remains fundamental in the case of risky relationships.

THE DO-IT-YOURSELF WITHDRAWAL

Doctor Cusini continues, “Other forms of HPV prevention, such as screening, can identify risky relationships. Even if those at risk are often not easily reachable, self-sampling has spread in Italy since the pandemic. This method involves sending a do-it-yourself sample by post to specialist centres. However, to achieve an effective result, a network needs to monitor the correct execution of the test and initiate therapy if an infection is present.

Inadequate Sexual Education Among Italian Youth

Young people move mainly online. The information they have on sexuality is often partial, if not completely incorrect. This portrait of Italian young people emerges from the preliminary results of the “National HPV Fertility Study” project. It was coordinated by the Istituto Superiore di Sanità and conducted between 2016 and 2018. The collaboration came from the Sapienza Universities of Rome, the Alma Mater of Bologna, and the International Evangelical Hospital of Genoa.

Lack of Awareness of Risks

Researchers surveyed over sixteen thousand secondary school children (16-17 years old) from all over Italy. The results revealed approximate information useful for avoiding infections and unwanted pregnancies. They also proposed several useful ideas for ensuring that health protection messages reach the greatest number of adolescents.

Young people still know little about the risks related to STDs and STIs. If contracted and neglected at a young age, these diseases can compromise fertility. The same goes for consultants. These are the local offices to turn to for information, anonymously, on contraception, early diagnosis of female cancers, and voluntary termination of pregnancy. These are often unknown realities.

Unsafe Sexual Practices Among Youth

Almost one in three boys, with a prevalence among males, appears to have had full intercourse at 16 years of age. But suppose it is true that the condom is the most used contraceptive method. In that case, one boy in ten does not take any precautions, while over one in three resorts to coitus interruptus or calculating the fertile days to have unprotected intercourse. Both are unsafe choices, both to avoid unwanted pregnancies and to avoid recurring STDs.

Lack of Awareness Among Adults

Doctors from the “Sistema Passi” network asked over twenty-one thousand people aged between 18 and 49. They collected responses to gauge how far adequate knowledge about sexuality has spread among the population. This network collaborates with the Istituto Superiore di Sanità to collect HPV Information on public health among Italians. Their answers demonstrate a lack of full awareness regarding the role of age in female and male biological fertility.

Of the women interviewed, only five per cent seemed aware of the reduction in their ability to have children starting at age 30. For more than one in four women, this decline occurs between the ages of 40 and 44. Even more worrying was the scenario regarding the male population. Nine out of ten men were convinced that the decline in fertility occurred only after age 45.

Limited Role of Adults in Sexual Education

Consequently, the almost nil contribution made by adults to the education of young people should not surprise us. Only in ten per cent of the interviews conducted among the youngest did parents have a role in providing HPV  information on sexual development, aspects of reproduction, and STIs.

University Students and SH

The Syphilis situation regarding university students was slightly better. Nearly fourteen thousand individuals participated in interviews conducted across eighteen universities nationwide. Widespread knowledge emerged about the repercussions of alcohol and cigarettes. However, data on alcohol abuse don’t bode well. Similarly, there needs to be an overestimation of knowledge among respondents. This HPV overestimation needs to be confirmed when asking about habits. Furthermore, considering the age difference, the poor approach with specialists regarding children is worrying. While almost 75% of female students have had a gynaecological examination, only one boy in four has been to the andrologist.