Norway: Significant increase in chlamydia and gonorrhea in 2022
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The number of reported cases of chlamydia and gonorrhea increased significantly in the latter half of 2022. The numbers of HIV and syphilis also increased from 2021 to 2022. This is evidenced by figures from STD surveillance reported by the Norwegian Institute for public health in 2022.
Numbers appear in Family Health International Annual Report 2022 on Sexually Transmitted Diseases Reported to the Communicable Disease Reporting System (MSIS).
As of August 2022, the number of reported cases of chlamydia is higher than in previous years. This coincides with a corresponding increase in gonorrhea among infected youth of both sexes, and may be due to increased social contact following the reopening of society. Some changes in reporting and monitoring standards may also have contributed to the increased reporting rate, says FHI’s senior physician Ann Olug Olsen.
Chlamydia numbers are back to where they were before the pandemic
- After a decrease during the epidemic, 29,271 cases of chlamydia were reported in Norway in 2022. There was a clear increase compared to the epidemiological year 2021, when 23,447 cases were reported. The numbers for 2022 are at the same level as for the peak year 2019.
- In 2022, as in previous years, the majority of reported cases are among women (58 per cent).
- The under-25s group accounted for 67 percent of all chlamydia cases in 2022.
- The number of reported cases increased in all counties from 2021 to 2022, with the exception of Agder (where there was an increase in 2021).
- In 2022, as in the previous year, the majority of those who took the test will be women (69 per cent). Over the past two decades, men have made up an increasingly large proportion of those tested.
– Sampling should target the group most vulnerable to infection, that is, young people under the age of 25, says Ann Olug-Olsen.
– If symptoms appear and/or a sexually transmitted infection is suspected, it is now important to be tested for both gonorrhea and chlamydia, she adds.
Increased use of condoms is critical to reducing the spread of chlamydia and gonorrhea. At the same time, it’s very important to have good infection control guidelines and comprehensive infection tracing on each case, says Olsen.
She notes that these measures are extremely important now that gonorrhea infection has been introduced in sexually infected women and men.
Gonorrhea: a strong increase in young man Heterosexual
After a sharp decrease in reported cases of gonorrhea during the pandemic, the number of cases rose sharply again in 2022. Then there were 1,857 cases reported, compared to 555 in 2021. This increase is particularly large among young women compared to the situation before the pandemic. .
An increase in syphilis
After what was likely an epidemic-related decline in syphilis in 2021, the number of reported cases among men who have sex with men and infected heterosexuals increased in 2022.
- There were 192 reported cases (184 men and 8 women) of syphilis in 2022 compared to 163 cases in 2021.
- Of the cases in 2022, 163 (85%) were in men who have sex with men.
- HIV-infected men who have sex with men (MSM) and men who have sex with men of immigrant background are most likely to contract syphilis.
A few cases of syphilis have been detected by tracing the infection. Olsen says that frequent testing and routine screening in particularly high-risk groups is important for detecting infection in people who don’t have symptoms.
HIV numbers have increased
The HIV situation is now characterized by the large number of refugees and migrants living with HIV who come to Norway.
- There were 245 reported cases of HIV infection in 2022 compared to 102 cases of HIV infection in 2021. Of the 245 cases, 192 (78%) were infected prior to their arrival in Norway, of which 97 were from Ukraine.
- The proportion of HIV-infected people in Norway has decreased by about 80 percent over the past 10 years. In 2022, 22 people will be infected with HIV in Norway.
- MSM and heterosexual men who travel abroad, particularly in Southeast Asia, are still at increased risk of contracting HIV.
At least 37,000 refugees from Ukraine came to Norway in 2022, and 97 of them were found to be HIV-positive in connection with the health check provided to everyone coming from middle and high HIV-endemic regions. 82 percent of HIV-positive refugees from Ukraine were known to be HIV-positive and undergoing treatment from their countries of origin. Among the other 95 immigrants infected before their arrival in Norway, the proportion known to be HIV-positive was high (73 percent). Thus these present somewhat infection control challenges in Norway, but like other people living with HIV they must have regular medical follow-up.
Drug prevention strategies (Tasp and PrEP) are thought to be the most important causes of HIV decline among men who have sex with men over the past 10 years. The sharp increase in the same period of gonorrhea and syphilis among MSM shows that it is not a change in behavior such as increased condom use or a decrease in the number of casual sexual partners that explains the decline in confirmed HIV cases.