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Surveillance Open Access
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Abstract

Background

Diagnoses of bacterial sexually transmitted infections (STIs) have increased in France since the 2000s. The main strategy to control STI transmission is recommending/facilitating access to condom use, testing, and antibiotic treatments.

Aim

This study analyses the evolution of STI testing in the private sector in France from 2006 to 2020.

Methods

National health insurance reimbursement data were used to determine numbers and rates of individuals aged ≥ 15 years tested for diagnoses of chlamydia, gonorrhoea and syphilis in the private sector in France and to describe their evolution from 2006 to 2020.

Results

Upward tendencies in testing were observed from 2006 to 2019 for all three STIs. The highest testing rates were identified in people aged 25‒29-years old. The observed testing-increase from 2017 to 2019 was twice as high in young people (< 25 years old) as in older people. In 2019, chlamydia, gonorrhoea and syphilis testing rates were respectively 45.4 (+ 21% since 2017), 41.3 (+ 60%), and 47.2 (+ 22%) per 1,000 inhabitants. For all STIs combined, the number of tested individuals decreased by 37% between March and April 2020 during the first COVID-19 epidemic wave and lockdown in France.

Conclusion

Improvements found in STI testing rates may have resulted from better awareness, especially among young people and health professionals, of the importance of testing, following prevention campaigns. Nevertheless, testing levels remain insufficient considering increasing diagnoses. In 2020, the COVID-19 pandemic had a considerable impact on STI testing. Partner notification and offering diverse testing opportunities including self-sampling are essential to control STI epidemics particularly in exposed populations.

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/content/10.2807/1560-7917.ES.2022.27.39.2100618
2022-09-29
2022-11-30
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2022.27.39.2100618
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References

  1. Santé publique France (SPF). Estimations nationales et régionales du nombre de diagnostics d’infections à Chlamydia et à gonocoque en France en 2016. [National and regional estimates of the number of Chlamydia and Gonnorhoea infections in France in 2016]. Saint-Maurice: SPF; 2018. Available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/infections-sexuellement-transmissibles/chlamydiae/documents/rapport-synthese/estimations-nationales-et-regionales-du-nombre-de-diagnostics-d-infections-a-chlamydia-et-a-gonocoque-en-france-en-2016
  2. Ministère des solidarités et de la santé. Stratégie nationale de santé sexuelle, agenda 2017-2030. [National sexual health strategy, 2017-2030 agenda]. Ministère des solidarités et de la santé; 2017. Available from: https://solidarites-sante.gouv.fr/IMG/pdf/strategie_nationale_sante_sexuelle.pdf
  3. Agence nationale d’accréditation et d’évaluation en santé. Evaluation du dépistage des infections uro-génitales basses à Chlamydia trachomatis en France. [Evaluation of screening for lower urogenital infections due to Chlamydia trachomatis in France]. Agence nationale d’accréditation et d’évaluation en santé; 2003. Available from: https://www.has-sante.fr/jcms/c_464119/fr/evaluation-du-depistage-des-infections-uro-genitales-basses-a-chlamydia-trachomatis-en-france
  4. Haute Autorité de Santé. Réévaluation de la stratégie de dépistage des infections à Chlamydia trachomatis. [Reassessment of Chlamydia trachomatis infection screening strategy]. Haute Autorité de Santé; 2018. Available from: https://www.has-sante.fr/jcms/c_2879401/en/reevaluation-de-la-strategie-de-depistage-des-infections-a-chlamydia-trachomatis
  5. Haute Autorité de Santé. Évaluation a priori du dépistage de la syphilis en France. [A priori evaluation of syphilis screening in France]. Haute Autorité de Santé; 2007. Available from: https://www.has-sante.fr/upload/docs/application/pdf/argumentaire_-_evaluation_a_priori_du_depistage_de_la_syphilis.2.pdf
  6. Haute Autorité de Santé. Dépistage et prise en charge de l'infection à Neisseria gonorrhoeae: état des lieux et propositions. [Screening and management of Neisseria gonorrhoeae infection: current situation and proposals]. Haute Autorité de Santé; 2010. Available from: https://www.has-sante.fr/upload/docs/application/pdf/2011-03/synthese_gonocoque_vf.pdf
  7. Moulis G, Lapeyre-Mestre M, Palmaro A, Pugnet G, Montastruc JL, Sailler L. French health insurance databases: What interest for medical research? Rev Med Interne. 2015;36(6):411-7.  https://doi.org/10.1016/j.revmed.2014.11.009  PMID: 25547954 
  8. Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés. Biologie médicale nomenclature des actes. [Medical biology act nomenclature]. Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés; 2019. Available from: http://www.codage.ext.cnamts.fr/f_mediam/fo/nabm/DOC.pdf
  9. Ndeikoundam Ngangro N, Viriot D, Lucas E, Boussac-Zarebska M, Lot F, Dupin N, et al. Relevance of healthcare reimbursement data to monitor syphilis epidemic: an alternative surveillance through the national health insurance database in France, 2011-2013. BMJ Open. 2018;8(7):e020336.  https://doi.org/10.1136/bmjopen-2017-020336  PMID: 30037863 
  10. Janier M, Unemo M, Dupin N, Tiplica GS, Patel R. 2014 European guideline on the management of syphilis: giving evidence priority. J Eur Acad Dermatol Venereol. 2016;30(10):e78-9.  https://doi.org/10.1111/jdv.13320  PMID: 26372738 
  11. Janier M, Dupin N, Spenatto N, Vernay-Vaisse C, Bertolotti A, Derancourt C, la section MST de la SFD. Syphilis précoce. Ann Dermatol Venereol. 2016;143(11):720-4.  https://doi.org/10.1016/j.annder.2016.09.007  PMID: 27773508 
  12. Cazein F, Sommen C, Moutengou E, Laporal S, Ramus C, Bruyand M, et al. Focus. Dépistage du VIH: état des lieux en 2019 et sur les sept premiers mois de l’année 2020. [Focus. HIV testing: situation in 2019 and in the first seven months of 2020]. Bull Epidemiol Hebd (Paris). 2020;33-34:685-7. Available from: http://beh.santepubliquefrance.fr/beh/2020/33-34/2020_33-34_5.html
  13. Ndeikoundam Ngangro N, Viriot D, Fournet N, Pioche C, De Barbeyrac B, Goubard A, et al. , referents for the regional offices of the French national public health agency. Bacterial sexually transmitted infections in France: recent trends and patients’ characteristics in 2016. Euro Surveill. 2019;24(5).  https://doi.org/10.2807/1560-7917.ES.2019.24.5.1800038  PMID: 30722812 
  14. Ratna N, Sonubi T, Glancy M, Sun S, Harb A, Checchi M, et al. Sexually transmitted infections and screening for chlamydia in England, 2020. London: Public Health England; September 2021. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1015176/STI_NCSP_report_2020.pdf
  15. Kojima N, Davey DJ, Klausner JD. Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men. AIDS. 2016;30(14):2251-2.  https://doi.org/10.1097/QAD.0000000000001185  PMID: 27314179 
  16. Société française de dermatologie. Recommandations diagnostiques et thérapeutiques pour les maladies sexuellement transmissibles. [Diagnostic and therapeutic recommendations for sexually transmitted diseases]. 2016. 23-6 p. Available from: https://www.sfdermato.org/media/image/upload-editor/files/Guidelines%202016(1).pdf
  17. European Centre for Disease Prevention and Control (ECDC). Technical Report: Technologies, strategies and approaches for testing populations at risk of sexually transmitted infections in the EU/EEA. Stockholm: ECDC; 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/technologies-strategies-approaches-testing-populations-at-risk-sti
  18. Public Health England (PHE). Sexually transmitted infections (STIs): annual data tables. London: PHE; 2020. Available from: https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables
  19. Statens Serum Institut (SSI). Chlamydia 2018. Copenhagen: SSI. 2019. Available from: https://en.ssi.dk/surveillance-and-preparedness/surveillance-in-denmark/annual-reports-on-disease-incidence/chlamydia-2018]
  20. Saarentausta K, Ivarsson L, Jacobsson S, Herrmann B, Sundqvist M, Unemo M. Potential impact of the COVID-19 pandemic on the national and regional incidence, epidemiology and diagnostic testing of chlamydia and gonorrhoea in Sweden, 2020. APMIS. 2022;130(1):34-42.  https://doi.org/10.1111/apm.13191  PMID: 34758169 
  21. Public Health England (PHE). Antenatal screening for infectious diseases in England: summary report for 2015. London: PHE; 2017. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/583576/hpr0217_naism.pdf
  22. Simões D, Stengaard AR, Combs L, Raben D, EuroTEST COVID-19 impact assessment consortium of partners. Impact of the COVID-19 pandemic on testing services for HIV, viral hepatitis and sexually transmitted infections in the WHO European Region, March to August 2020. Euro Surveill. 2020;25(47).  https://doi.org/10.2807/1560-7917.ES.2020.25.47.2001943  PMID: 33243354 
  23. Charles H, Ratna N, Thorn L, Sonubi T, Sun S, Mohammed H, et al. COVID-19 impact on bacterial sexually transmitted infections in England between 1 January 2019 and 31 December 2020. Sex Transm Infect. 2021;sextrans-2021-055262.  https://doi.org/10.1136/sextrans-2021-055262  PMID: 34548415 
  24. Pinto CN, Niles JK, Kaufman HW, Marlowe EM, Alagia DP, Chi G, et al. Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S. Am J Prev Med. 2021;61(3):386-93.  https://doi.org/10.1016/j.amepre.2021.03.009  PMID: 34020848 
  25. Apalla Z, Lallas A, Mastraftsi S, Giannoukos A, Noukari D, Goula M, et al. Impact of COVID-19 pandemic on STIs in Greece. Sex Transm Infect. 2022;98(1):70.  https://doi.org/10.1136/sextrans-2021-054965  PMID: 33653880 
  26. Sentís A, Prats-Uribe A, López-Corbeto E, Montoro-Fernandez M, Nomah DK, de Olalla PG, et al. , Catalan HIV and STI Surveillance Group. The impact of the COVID-19 pandemic on Sexually Transmitted Infections surveillance data: incidence drop or artefact? BMC Public Health. 2021;21(1):1637.  https://doi.org/10.1186/s12889-021-11630-x  PMID: 34493244 
  27. Kuitunen I, Ponkilainen V. COVID-19-related nationwide lockdown did not reduce the reported diagnoses of Chlamydia trachomatis and Neisseria gonorrhoeae in Finland. Sex Transm Infect. 2021;97(7):550.  https://doi.org/10.1136/sextrans-2020-054881  PMID: 33397798 
  28. Traeger MW, Schroeder SE, Wright EJ, Hellard ME, Cornelisse VJ, Doyle JS, et al. Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis. Clin Infect Dis. 2018;67(5):676-86.  https://doi.org/10.1093/cid/ciy182  PMID: 29509889 
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