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Risky sexual behaviour and STIs on the rise despite the pandemic

Presented by
Dr Marco Cusini
EADV 2020
Despite the COVID-19 lockdown restrictions, an Italian study with data from 2 centres for sexually transmitted infections in Milan revealed an increase in sexually transmitted infections (STIs), including gonorrhoea, secondary syphilis, and Mycoplasma genitalium in 2020 compared with 2019.

Data for the study was collected in 2 main centres for STIs, which together account for about 80% of STI diagnoses in the Lombardy region in Italy [1]. Both centres limited their access but stayed open during the lockdown that started on 8 March 2020 in Italy. The total attendance of the centres decreased by 70% from 1,696 patients in 2019 to 534 in 2020. In 2019, 86% of patients were male compared with 76% male in 2020. The prevalence of men who have sex with men (MSM) was 31% in 2019 and 35% in 2020. The median age was 37 years in 2019 and 33 in 2020.

In 2019, 233 confirmed STI cases were diagnosed. In the same period in 2020, 147 persons were diagnosed with STIs, a drop of 37%. Yet, this drop was noticed in the non-acute cases, such as genital warts and Molluscum, whereas the number of acute bacterial infections associated with MSM increased: in 2020, more cases of secondary syphilis, gonorrhoea, and M. genitalium were diagnosed.

The authors concluded that the COVID-19 pandemic, despite lockdown and advice on social/physical distancing, did not inhibit risky behaviours and that acute STIs even increased. “It was assumed that the lockdown would reduce the opportunity for sexual encounters and STIs. However, I was surprised by the number of new acute infections diagnosed in this short period of time. Gonorrhoea and syphilis are typically more prevalent in people in their 30s, so infections may have increased because the concentration of COVID-19 morbidity and mortality in the elderly made the younger, more active, cohort feel protected and so less risk-averse,” concluded Dr Marco Cusini (Policlinico of Milan, Italy).

Although it is unrealistic to prevent people from having sex, close contact during sexual intercourse inevitably involves an increased risk of SARS-CoV-2 infection. Dr Cusini concluded that these findings highlight the importance of ongoing screening for STIs and the importance of having these types of services open and available during pandemic restrictions.


    1. Cusini M, et al. COVID-19 and STIs. P1534, EADV 2020 Virtual Congress, 29-31 Oct.


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