Rates of new gonorrhea diagnoses among Australians rose 63% in just five years, reveals a new report on the nation’s sexual health.
Australian health experts highlighted the alarming rise — from 62 to 101 infections per 100,000 people — and the need for people to be more aware of the infection as the reasons behind the trend are not yet fully understood.
There were more than 23,800 new cases of gonorrhea diagnosed in 2016, and about 75% of them were among men, according to the Annual Surveillance Report on HIV, viral hepatitis and sexually transmissible infections in Australia, published Monday.
In males, rates of gonorrhea infection were highest in 20- to 29-year-olds last year, while in women they were highest in 15- to 24-year-olds. But older age groups also saw increased numbers.
Infection rates also rose significantly in major cities, which saw a 99% increase between 2012 and 2016, while remote areas saw a decline, the report shows. For example, among women, there was a 126% increase in major cities compared with a 43% rise among all Australian women.
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“The increase was most pronounced in the past two years,” said Rebecca Guy, program head with the Surveillance Evaluation and Research Program in The Kirby Institute for Infection and Immunity in Society at the University of New South Wales, who compiled the report.
The reason behind the rise is not fully understood, Guy said. “What we do know is that more testing doesn’t explain this trend,” she said, adding that factors such as changes in sexual behavior, differences in screening and treatment practices, or differences in a particular strain in urban centers could be possible explanations.
“The data really highlight the need for greater awareness among clinicians, young people and adults about gonorrhea,” said Guy, stressing that the condition is largely asymptomatic: Eighty percent of women and 50% of men won’t have symptoms. “Therefore, regular testing is important.”
In the United States, rates of gonorrhea infection have also been rising since 2009, according to the US Centers for Disease Control and Prevention, and are higher than rates in Australia, though the rise in recent years has been more modest.
“Australia is seeing some of the same trends of increasing (sexually transmitted disease) rates that we are in the United States,” said David Harvey, executive director of the National Coalition of STD Directors, who was not involved in the report. “There are many factors at play here, but we have to acknowledge that as HIV becomes a more treatable and medically preventable disease, and condom use may be decreasing for some, we must continue to ensure that STD testing and treatment is prioritized, particularly in populations at increased risk for all STDs.”
“Left untreated, gonorrhea is associated with serious long-term adverse health effects, including pelvic inflammatory disease, ectopic pregnancy and infertility.,” said Matthew Chico, assistant professor of public health at the London School of Hygiene & Tropical Medicine in response to the findings.
“Particularly concerning is that we are rapidly facing the day when gonorrhea is no longer treatable due to antimicrobial resistance,” he said.
The infections seen in Australia had reduced susceptibility to drugs, meaning they are moving toward resistance, Guy said. But she doesn’t believe this is causing the rise in infections.
