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Australians are being urged to get regular tests for sexually transmitted infections (STIs) after a significant rise in cases across the country, including an almost 20% increase in New South Wales gonorrhoea cases between 2022 and 2023.
The Royal College of Pathologists (RCPA) issued a warning on Wednesday of a concerning rise in cases of gonorrhoea, syphilis and HIV nationally. The RCPA is the lead body for pathologists who are specialist doctors trained in laboratory techniques used to test for disease.
Dr Christine Selvey, NSW Health’s director of its communicable diseases branch, sent a letter in June warning general practitioners that gonorrhoea cases in the state had increased by almost 20% from 2022 to 2023, and were rising even further this year.
Selvey said a particular concern was that cases resistant to first-line antibiotic treatments azithromycin or ceftriaxone were “increasing rapidly”.
Gonorrhoea cases were diagnosed in heterosexual males and females, sex workers, and men who have sex with men, across a broad age range, Selvey wrote.
The RCPA said the increasing number of gonorrhoea cases with antibiotic-resistant infections “complicates treatment protocols and highlights the urgent the need for regular STI testing”.
Alongside gonorrhoea, RCPA warned that “syphilis rates have also surged, particularly congenital syphilis, where the infection is transmitted to unborn children”.
The college said the rise in cases could be attributed to changing sexual practices, including reduced use of condoms across a range of demographics.
The Kirby Institute’s latest annual surveillance report of sexually transmissible infections in Australia shows diagnoses of gonorrhoea have doubled from 2013 to 2022, while cases of syphilis have tripled.
Associate Prof Caitlin Keighley, a spokesperson for RCPA and medical director of Southern IML Pathology, said: “Despite a concerning rise in cases, we are not seeing a corresponding increase in testing rates.”
“This includes older adults who may not be forthcoming about changes in their sexual practices.
“Low testing levels mean that infections can go undiagnosed and untreated, leading to severe health complications and further transmission,” Keighley said.
“This leaves many individuals unknowingly at risk and is particularly concerning for pregnant women, where untreated STIs can result in congenital infections with devastating outcomes.
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“Regular testing is crucial to early detection, effective treatment and preventing the spread of these infections.”
RCPA highlighted that Aboriginal people and Torres Strait Islanders faced substantially higher rates of STIs compared with non-Indigenous Australians. For example, chlamydia diagnoses among Aboriginal people and Torres Strait Islanders were twice as common as in non-Indigenous individuals, while for gonorrhoea and syphilis, the prevalence was more than five times higher, the college said.
It said these figures highlighted the critical need for culturally sensitive health promotion, testing and treatment initiatives.
The latest Kirby report found there had been a decline in the number of Medicare-rebated tests for chlamydia and gonorrhoea among both men and women between 2019 and 2022, likely due to the ongoing impacts of the Covid-19 pandemic.
“Any rise in STIs is bad news, but rising STIs against a backdrop of decreased testing, and the persistent upward trend over the past decade, is particularly concerning,” Dr Skye McGregor, an epidemiologist who leads the report at the Kirby Institute, said.
“Chlamydia, gonorrhoea, and syphilis are all easily treatable with antibiotics. The key message we want Australians to take away from these data is that for any sexually active person, condoms remain highly effective at preventing STIs, and regular STI testing is crucial,” McGregor said.
“A key part of this is combating stigma around sexual health and notifying sexual partners when someone has tested positive for an STI.”
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