Rising STIs in Europe: report finds critical gaps in testing and prevention policies

The report, 'Monitoring of the responses to sexually transmitted infection epidemics in EU/EEA countries, 2024', provides the first comprehensive overview of how European countries are tackling the rise in STIs. 

Sharp increases among key populations

Notification rates for gonorrhoea increased by nearly 300% between 2014 and 2023 among gay, bisexual and other men who have sex with men. More recent increases have also been seen among young people, in particular women aged 20–24, where gonorrhoea notification rates rose by almost 200% between 2021 and 2023 alone, signalling an urgent need for robust, inclusive national responses..

Ageing strategies lagging behind prevention needs

Eighteen of the 29 reporting countries have a national strategy or policy for STI prevention and control. Most of these strategies specifically target the populations most affected by the current epidemics, including young people aged 15–24 and gay, bisexual, and other men who have sex with men. However, many of these plans are ageing. Only 10 countries have updated their national STI plans within the past five years, meaning many strategies may not account for post-pandemic behavioural changes or the latest epidemiological trends. The lack of updated strategies is compounded by significant hurdles for those seeking care. 

Barriers to testing and care

Testing is the cornerstone of STI control, yet it is reported that in 13 of the 29 reporting countries, individuals still face out-of-pocket costs for basic STI tests. For young people, privacy concerns are also a barrier, as seven countries require individuals under the age of 18 to have parental consent to access testing, potentially discouraging sexually active adolescents from seeking help.

Data and prevention gaps

Few countries collect data on the coverage of prevention and treatment. Despite the severe risks associated with congenital syphilis, only four countries were able to submit data on the proportion of pregnant women screened for the infection. 

Prevention gaps are also evident in vaccination efforts, as many countries have policies for mpox vaccination, but coverage remains low. Data show that the proportion of gay, bisexual and other men who have sex with men who are fully vaccinated against mpox is just 13.2% on average across reporting countries. ECDC urges public health authorities to maintain high vigilance and ensure that vaccination is accessible to those at highest risk in light of ongoing mpox transmission, including the recent detection of locally acquired clade Ib mpox cases among men who have sex with men in Europe. 

Call for action

The findings underscore the need for accessible services and measurable outcomes. To effectively curb these epidemics, countries are encouraged to update their national strategies, remove barriers to testing, and strengthen surveillance data on STIs and data on coverage of interventions to better target and improve prevention efforts.