Recovery of the increasing pattern of sexually transmitted infections (STI) after the COVID-19 pandemic: The case of gonorrhea in Catalonia, Spain

Introduction

Sexually transmitted infections (STI) have shown a sustained increase in recent years. Changes in epidemiological patterns highlight the need to adapt public health strategies for their prevention and control. The objective of this study is to describe the trend of reported gonorrhea cases in Catalonia (Spain) from 2017 to 2023 and to compare the epidemiological pattern of reported cases before, during, and after the COVID-19 pandemic.

Methods

Descriptive analysis of reported gonorrhea cases in Catalonia among individuals aged ≥ 14 years between 2017 and 2023. Incidence rates (IR) were calculated overall and by sex, age, and origin. A descriptive analysis was conducted to compare reported cases across the pre-pandemic (2017−2019), pandemic (2020), and post-pandemic (2021−2023) periods.

Results

The IR of gonorrhea showed an average increase of 32.9% between 2017−2019 and 37.9% between 2021−2023, reaching 164.0 cases per 100,000 inhabitants in 2023. During the pandemic, there was an increase in the proportion of cases among MSM (13.3%), alcohol use (40.0%), having ≥ 6 sexual partners (30.5%), and new sexual partners (74.3%). In the post-pandemic period, the highest percentage increase was observed in women (115.7%), Spanish nationals (124.9%), cases reported in sexual and reproductive health units (30.9%), symptomatic cases (58.0%), and reinfections (33.0%). Additionally, there was a decrease in the average age, particularly among women, in contact tracing studies (13.1%), and in antibiotic resistance.

Conclusions

Gonorrhea continues to rise, especially among young people and women. Strengthening its visibility and prioritizing it in STI prevention and control programs is crucial to mitigate its impact on public health.