In recent weeks, there has been much discussion of regional and national initiatives directed toward offering free condoms and other contraceptives to youth and disadvantaged populations. As is often the case when it comes to sexuality, the proposed measures have elicited divided opinions, based more on ideological considerations and political expediency than public health protection, underestimating the seriousness of the situation.
Epidemiological reality says that among Italian under-25s. sexually transmitted diseases (STDs) are clearly on the rise, creating not only serious discomfort for those who experience them, but also entailing non-negligible risks to fertility and reproductive health (especially women’s) and an additional cost to the National Health Service (NHS), which has to bear the burden of their treatment.
The most recent data on STDs published by theNational Institute of Health indicate that:
- Between 2010 and 2015, the number of people with a confirmed STD increased, while the number of foreigners in Italy with a confirmed STD has stabilized over the past decade (in essence, new infections mainly affect Italians);
- Between 2004 and 2015, reports of ano-genital condylomas (caused by Human Papilloma virus, HPV, against which an effective vaccine has been available for a decade) increased by 153 percent;
- Since 2008, cases of Chlamydia trachomatis infection have steadily increased, especially among adolescent girls and young women (15-24 years old);
- Since 2000, stage I-II syphilis cases have increased by 350% since the 1990s (meaning they have more than tripled);
- Between 2010 and 2015, cases of latent syphilis (i.e., without obvious symptoms) and gonorrhea also increased slightly;
- Between 2008 and 2015, the proportion of HIV+ people among people with a confirmed STD increased (it should be remembered that the presence of an STD facilitates further HIV infection during risky relationships);
- In 2015, the prevalence of HIV infection among people with a confirmed STD was about sixty times higher than that estimated in the general Italian population.
Additional data collected by the AIDS Operations Center (AOC) of ISS related to HIV infection, updated in 2017, report that:
- 3,443 new diagnoses of HIV infection were reported in 2017, representing an incidence of 5.7 new cases per 100,000 residents (similar to other European countries);
- The incidence of new HIV+ diagnoses declined slightly between 2012 and 2015, stabilizing thereafter for all modes of transmission;
- In 2017, the highest incidence of HIV infection involved young adults (25-29 years old);
- In general, new HIV+ diagnoses were mainly related to transmission of the virus during heterosexual intercourse, while new infections during homosexual intercourse prevailed in the male population;
- In recent years, the number of women newly diagnosed with HIV+ has remained constant, as did the number of new diagnoses among foreign persons between 2012 and 2017.
What do these data tell us as a whole? First, that some severe STDs that had become “niche” infections in the late twentieth century (syphilis, chlamydia, gonorrhea, etc.) have once again become a serious public health problem, especially among young people. Second: that information/education about STDs and associated risks coupled with active prevention interventions, such as promoting condom use during all types of sexual intercourse, can substantially reduce their prevalence, as the case of HIV infection shows.
Reliable information on STDs and prevention can be obtained from the websites of the Ministry of Health (http://www.salute.gov.it/portale/news/p3_2_6_1_1.jsp?lingua=italiano&menu=campagne&p=dacampagne&id=120), COA-ISS (http://old.iss.it/ccoa/index.php?lang=1) and EpiCentro (http://www.epicentro.iss.it/temi/ist/aggiornamenti.asp).
Sources
- Salfa MC et al. Sexually Transmitted Infections: update of data from the two Sentinel Surveillance Systems active in Italy as of December 31, 2015. Not Ist Super Health 2017;30(7-8):3-27
- Istisan Newsletter 2018; Vol. 31(9):Supplement 1
- Suligoi B, Salfa MC. Sexually transmitted infections. How to recognize and prevent them. Editorial Pathways by Carocci publisher, Rome – 2018).
