The latest sexually transmitted infections (STI) surveillance report from Public Health England (PHE) confirms that cases of the bacterial STIs gonorrhoea and syphilis have continued to rise in England.

More gonorrhoea cases were diagnosed last year than in any year since 1987 – and more cases of syphilis than in any year since 1949, soon after it became curable with penicillin.

Although the overall number of STI cases stayed roughly the same, cases of gonorrhoea increased by 22% and of syphilis by 20%. In gay men and other men who have sex with men (MSM), the increases in these two infections were of the same order, but chlamydia also increased by 17%. In the general population, chlamydia diagnoses stayed static, but this may partly be due to fewer chlamydia tests being done by the NHS.

Syphilis is overwhelmingly concentrated amongst MSM: 78% of the 7137 cases of primary and secondary syphilis and 852 cases of late syphilis were among gay men, even though only 12% of first attendances at STI clinics were MSM. This means syphilis is 6.5 times as common in MSM clinic attendees as it is in other attendees.

One slightly more positive fact, however, was that MSM were more likely to have syphilis diagnosed early, in primary, secondary or early latent infection, when it is more easily cured and less likely to have caused serious disease. The proportion of syphilis diagnosed in late stage, which needs longer and stronger treatment, was 23% in all clinic attendees but only 13% in MSM. Of more concern is that although only 12% of syphilis diagnoses were in women, 62% of those were diagnosed in late stage. Given that late syphilis may have been acquired years ago early diagnosis is a better guide to current incidence, as is the case with HIV.

Women are in the majority when it comes to overall sexual health service attendances: 55% of new patient appointments were in women and 62% of follow-up appointments. This is partly due to chlamydia screening since chlamydia is by some way the most common STI. Chlamydia in women was 4.5 times more likely to be diagnosed than the next most-common female STI, genital warts, and chlamydia in men 2.6 times as common as gonorrhoea or genital warts, which came second-equal for men. Read more via AIDSmap