The increase in sexually transmitted infections (STIs) in adolescents is related to the advance in the age of initiation of sexual relations and the normalization of risk practices. The data indicates a significant increase in the diagnosis of these infections, with the majority of new cases being in the 15 to 24 year age group. This is indicated by the Spanish Association of Pediatrics (AEP), which has described this situation as an “urgent public health issue.”
The availability of digital content and the lack of comprehensive sexuality education are factors that aggravate the situation. Added to this is a difficulty in accessing the health system that limits effective diagnosis and treatment.
In an article published in Annals of Pediatricsthe scientific expression body of the AEP, referred to by EFE Healthexperts from the HIV and STI working group of the Spanish Society of Pediatric Infectious Diseases (SEIP) analyzed the situation, as well as the main challenges in prevention, diagnosis and treatment.
In it, they point out a series of factors that contribute to the sustained increase in STIs, such as the advance in the age of sexual relations, which stands at 16.5 years on average, the increase in the number of couples, the normalization of risk practices and the lack of comprehensive emotional-sexual education.
Statistics in Europe and Spain
In Europe, there has been a significant increase in cases of gonorrhea and syphilis. In Spain, cases of gonorrhea have tripled since 2014, highlighting an alarming trend similar to that observed in the rest of Europe.
Specifically, in 2023 gonorrhea cases increased by 31%; and 13% for syphilis compared to the previous year, with a cumulative increase of 300% and 200% respectively compared to 2014.
That same year, approximately 230,000 cases of chlamydia infection, which is the most commonly diagnosed bacterial STI, were also reported.
Situation in the United States
STIs in the US remain a significant public health problem, although recent data indicate a possible slowdown in rates. In 2023, more than 2.4 million cases were reported, with notable declines in gonorrhea and syphilis.
Key data for 2023
- Gonorrhea cases decreased by 7% compared to 2022, returning to pre-pandemic levels.
- Primary and secondary syphilis fell 10%, the first significant drop in decades, especially 13% among gay and bisexual men.
- Overall, STIs disproportionately affect young people under 25 and minorities.
Historical trends
- From 2017 to 2021, overall cases rose 7%, with gonorrhea +28% and syphilis +74%, including a 203% increase in congenital syphilis.
- In 2021, more than 2.5 million cases of chlamydia, gonorrhea and syphilis were reported.
- The COVID-19 pandemic reduced testing, inflating initial perceptions of casualties.
Strategies to stop the increase
The Spanish Society of Pediatric Infectology proposes a decalogue of measures that includes comprehensive sexual education, training for professionals in the health sector and facilitating access to condoms. These recommendations are designed to effectively address the current crisis and curb the rise of STIs among adolescents.
Comprehensive education. Introduction of sexual education programs from childhood, adapted to age, that address not only the prevention of STIs, but also affection, consent, diversity and healthy relationships.
Training for professionals. Training of pediatricians in sexual health, with an updated, comprehensive and stigma-free approach that facilitates adequate support for adolescents.
Access to health services. Ensuring confidential care adapted to adolescents, with the offer of specific and close care, respecting their autonomy and maturity.
Access to prevention methods. Facilitate the free distribution of condoms and lubricants.
Strengthen vaccination against preventable STIssuch as human papillomavirus or hepatitis.
Promote screening in sexually active adolescents. Establishment of protocols for the detection of STIs, with accessible sampling strategies to improve early detection.
Monitoring and timely treatment of STIswith simple and adapted guidelines that promote adherence.
Carry out contact study to identify asymptomatic cases and cut the chain of transmission.
Facilitate access to biomedical prevention strategiessuch as pre- and post-exposure prophylaxis against HIV, in adolescents at higher risk.
Address the emotional and social impact of STIs to reduce stigma and promote psychosocial health and promote a healthy experience of sexuality.
The proposed approach aims not only to reduce the incidence of STIs, but also to address the associated stigma and promote a healthy experience of sexuality among young people.
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