The annual sexually transmitted infection (STI) reports presenting data for 2017 on infectious syphilis, Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhoea) diagnoses in Scotland were published on 31 July 2018 by Health Protection Scotland (HPS), along with a report on antimicrobial resistance monitoring in gonorrhoea infection published jointly with the Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL).
Genital chlamydia remains the most frequently diagnosed STI in Scotland with 15,685 diagnoses reported in 2017, a 4% increase compared to 2016. This STI predominates in women (59% of all diagnoses) and in young people (67% of all diagnoses were made in those aged less than 25 years), which mirrors patterns observed over the past decade.
In 2017, 2,610 diagnoses of gonorrhoea were reported, a 10% increase compared to the previous year and, using the data from clinical recording, the largest annual total recorded since the late 1980s. In contrast to genital chlamydia, three-quarters of gonorrhoea diagnoses were among men, 62% of whom were aged 25 and over. Over the past five years, a 64% increase has been observed in gonorrhoea diagnoses which is considered to be due, largely, to an increase in transmission among men who have sex with men (MSM). Rectal gonorrhoea, a marker of condomless anal intercourse (CAI), remained high in 2017.
In addition, the number of infectious syphilis diagnoses increased from 356 in 2016 to 397 in 2017. This is the highest annual total in nearly 70 years. While infection among heterosexual men and women remains stable, the burden of infection is among MSM (84%) and the number of diagnoses has increased threefold in the last few years. The rise in infectious syphilis and gonorrhoea diagnoses mirrors the epidemiological picture in England, where increases of 20% and 22% respectively have also been reported.
Among heterosexual men and women, rates of STIs remain stable and diagnoses of gonorrhoea and syphilis remain relatively uncommon. However, these reports highlight that the numbers of diagnoses of STIs (particularly chlamydia and infectious syphilis) among MSM continue to increase and gonorrhoea infection remains high.