Europe's Sexually Transmitted Infections Hit Record Highs – And Condom Use Is Becoming "Increasingly Rare"

Bacterial sexually transmitted infections, including syphilis and gonorrhoea, are reaching record levels across Europe, according to new data published by the European Centre for Disease Prevention and Control (ECDC) on Thursday. "Sexually transmitted infections have been on the rise for 10 years and reached record high levels in 2024," said Bruno Ciancio, Head of Unit for Directly Transmitted and Vaccine-Preventable Diseases at the ECDC. "Untreated, these infections can cause severe complications, such as chronic pain and infertility, and, in the case of syphilis, problems with the heart or nervous system."

The latest data from 2024 show that notifications of gonorrhoea and syphilis, alongside congenital syphilis, reached their highest levels in over a decade, reflecting sustained transmission across multiple countries. Gonorrhoea cases reached 106,331 – a 303 percent increase since 2015. Syphilis cases more than doubled over the same period to 45,577. Chlamydia remains the most frequently reported STI, with 213,443 cases.

The gonorrhoea notification rate in 2024 is the highest recorded since the ECDC began STI surveillance in 2009. Gonorrhoea is caused by the Neisseria gonorrhoeae bacterium. Many infections are asymptomatic, especially among women, which can result in delayed diagnosis, complications, and uninterrupted transmission. Between 2023 and 2024, overall rates increased by 4.3 percent. Among men, there was a 7.9 percent increase, with the highest rates among those aged 25 to 34. More than half of the cases in 2024 were in men who have sex with men. Among women, however, overall rates decreased by 8.6 percent. The most reported cases were in the 20-24 age group. "While a proportion of these cases may be due to increased awareness and testing, high rates of gonorrhoea among women of reproductive age are of concern due to the potential risk of reproductive tract complications," the ECDC warned. Overall, the highest rates in 2024 were in Ireland, Malta, Iceland, Luxembourg, Denmark, and Spain.

The ECDC found a steep rise in congenital syphilis, with the number reaching its highest point since 2009 and nearly doubling from 2023. Congenital syphilis occurs when the infection is passed from an infected pregnant person to the foetus during pregnancy. The ECDC notes that transmission can occur at any stage of the infection and at any stage of pregnancy; however, the risk is greatest in pregnant people with untreated early syphilis. Between 2015 and 2024, Bulgaria reported the highest number of cases (195), followed by Portugal (96) and Hungary (91). "Congenital syphilis is a preventable condition, and elimination across the EU/EEA is achievable," the report noted. The World Health Organization Europe has set a 2030 elimination target of fewer than one case per 100,000 live births. The report recommends strengthening prevention among heterosexual populations, increasing screening programmes, and considering universal third-trimester retesting of pregnant women.

Possible reasons behind high rates among heterosexual men and women in recent years include changes in sexual behaviour involving a higher risk of STI transmission. "Condom use has become increasingly rare; it is used less and less," said Josep Mallolas, head of the HIV/AIDS unit at Hospital Clínic Barcelona, who did not participate in the report. "Secondly, there has been an increase in the number of sexual partners, not in the number of sexual encounters, which would be less relevant, and this is particularly notable among younger populations, starting from puberty through adolescence and into people in their twenties," he added.

However, it is not all bad news. The ECDC noted that increased screening and testing, as well as better reporting systems, can also contribute to an extent to the higher numbers. The report found that, in response to recent increases in cases, some countries have implemented changes to testing policies and enhanced access to free testing and self-sampling. Still, the ECDC warns that more data are needed to better understand the trends across different countries and population groups.

So Europe is facing a sexually transmitted infection crisis: gonorrhoea up 303 percent since 2015, syphilis more than doubled, and congenital syphilis nearly doubled in just one year while condom use becomes increasingly rare – especially among younger populations who are also having more partners. Improved testing explains some of the rise, but not all of it, and the highest gonorrhoea rates are in Ireland, Malta, Iceland, Luxembourg, Denmark, and Spain, while congenital syphilis is most prevalent in Bulgaria, Portugal, and Hungary. The WHO has set a 2030 elimination target for congenital syphilis, but at the current rate that goal looks optimistic, and the ECDC's recommendations for more screening and better prevention will only work if anyone actually follows them. Europe has a sexual health problem, the solutions are known, the data is clear, and yet the bacteria keep winning – because knowing what to do and actually doing it have never been the same thing, and until that changes, the records will keep being broken, just not the kind anyone wants to set.

Written by Christiane Hofreiter