Rate of sexually transmitted infections falls amid Covid-19 pandemic

Nightclub closures and fall in dating app use may be factors but HSE warns on reading too much into data

A computer illustration of a cell infected with chlamydia. There have been significant reductions in reported new cases of chlamydia

A computer illustration of a cell infected with chlamydia. There have been significant reductions in reported new cases of chlamydia

 

The transmission rate of sexually transmitted infections has fallen dramatically in an era when Covid-19 restrictions have cut the opportunity for intimate contact.

Latest available data from health authorities for the year to May 23rd shows significant reductions in reported new cases of chlamydia, gonorrhoea, genital herpes and syphilis among other common infections.

However, the data comes with a health warning: the downward trend may have as much to do the closure of clinics and delays in reporting results as it has to do with social distancing.

The closure of pubs and nightclubs, an anecdotal reduction in dating app meet-ups, and a fall-off in tourist numbers are also suspected to be contributing factors.

Statistics from the Health Protection Surveillance Centre (HPSC) found that compared with the same period last year, chlamydia infections have reduced by 21 per cent, gonorrhoea by 18 per cent, genital herpes by 31 per cent and syphilis by 25 per cent.

HIV rates are an outlier, rising by 17 per cent, with 224 reported cases.

Of a total of nine listed diseases recorded under the CIDR system (Computerised Infectious Disease Reporting) on a weekly basis, 4,705 new cases have been reported so far this year compared to 5,956 for the same period in 2019, a decline of 21 per cent, or one fifth.

Dr Derek Freedman, a specialist in STI treatment for 50 years, is hopeful the current pandemic might have a positive long-term effect on sexual behaviour.

“I think one of the overall side-effects of Covid-19 is that people are going to be much more careful about their personal risk-taking, particularly in the context of virus contraction,” he said. “We are all going to be much more health-conscious.”

Take risks

He said that during the phase of social lock down there remains a “hard core” of people who will take risks; he has continued to be contacted by people looking for Prep, a preventative drug taken to reduce the chance of contracting HIV.

However, at his testing, consultation and counselling service, Dr Freedman says he has seen appointments halve during the pandemic and has heard anecdotally that activity on social networks such as Grindr and Tinder, where people seek out partners, has decreased.

One user of the Grindr service, which is aimed at members of the gay community, told The Irish Times that civic-minded people in his social circle had all stopped using it to meet partners.

“Of course, we would have a collective memory in our time of a virus that no one took seriously,” he said of the HIV/Aids crisis that tore through the gay community in the 1980s. “So we would be more responsibly minded about pandemic situations.”

However, the Health Service Executive (HSE) said there was a need for some caution around the reasons behind the latest data.

As well as decreased exposure to infections because of physical distancing, it might also be explained by less attendance at STI clinics and at GPs, and by delays in the reporting of new cases where health staff have been reallocated to Covid-19 activities.

“It is most likely that it may be a combination of the above, but we cannot confirm at this point,” it said in a statement. “As the data is provisional at this time, we will continue to monitor the situation to determine whether it reflects a true indication of declines in STIs or delayed diagnosis.”

Clinical staff

In comprehensive advice on its website, HIV Ireland said many of the clinical staff who operate sexual health services have been responding to the Covid-19 crisis, resulting in major scaling-back of services.

“The ‘surge’ of Covid-19 diagnoses . . . will mean that the services which have been able to continue offering testing and treatment are likely to close completely too,” it said. “That adds extra risk if you continue to have sex during the Covid-19 emergency.”

Dr Freedman said that in Milan, based on conversations with a colleague, while there was a decrease in chronic conditions such as genital warts, acute conditions such as gonorrhoea and syphilis had remained steady.

He also noted official health guidance in Amsterdam that people seek out a regular and local “seksbuddy” or “sex buddy” for the duration of the Covid-19 pandemic.

The advice from the Dutch National Institute for Public Health and the Environment (RIVM) appears to be aimed more at safely accommodating some kind of sexual intimacy among single people during strict lockdown conditions.

It suggests meeting “with the same person to have physical or sexual contact (for example, a cuddle buddy or ‘sex buddy’), provided you are free of illness. Make good arrangements with this person about how many other people you both see. The more people you see, the greater the chance of [spreading] the coronavirus.”