1887
  1. Home
  2. Eurosurveillance
  3. Volume 31, Issue 21, 28/May/2026
  4. Article
Euroroundup Open Access
Like 0
Download

SDG 3: STI

Abstract

Over the last decade, bacterial sexually transmitted infection notifications have increased across the European Union/European Economic Area (EU/EEA) and England. However, six EU/EEA countries — Denmark, Finland, Ireland, the Netherlands, Norway and Sweden — and England, reported declines in chlamydia notifications from 2023 to 2024. To explore potential drivers of these decreases, the European Centre for Disease Prevention and Control, together with experts from the seven countries, analysed national surveillance data from 2015 to 2024 and contextualised findings with information on testing practices, policies and public health interventions. Chlamydia notifications in 2024 were compared with expected counts based on trends before the COVID-19 pandemic (2015–2019) using a negative binomial model. Across countries, decreases between 2023 and 2024 ranged from 13% to 19%, primarily affecting 15–24-year-olds. Case numbers fell below the 95% prediction interval in three countries. Five countries reported reduced testing volumes among young people, and all observed lower positivity rates. Some countries implemented online testing and targeted sexual health promotion campaigns. Although reduced testing, changes in behaviour during the COVID-19 pandemic and the risk profile of those accessing testing may have contributed to the declines, further investigation into underlying drivers is necessary to inform sexual health strategies in Europe.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2026.31.21.2500846
2026-05-28
2026-06-10
/content/10.2807/1560-7917.ES.2026.31.21.2500846
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/31/21/eurosurv-31-21-2.html?itemId=/content/10.2807/1560-7917.ES.2026.31.21.2500846&mimeType=html&fmt=ahah

References

  1. European Centre for Disease Prevention and Control (ECDC). Surveillance atlas of infectious diseases. Stockholm: ECDC; 2025. Available from: https://www.ecdc.europa.eu/en/surveillance-atlas-infectious-diseases
  2. European Centre for Disease Prevention and Control (ECDC). Chlamydia - annual epidemiological report for 2023. Stockholm: ECDC; 2025. Available from: https://www.ecdc.europa.eu/en/publications-data/chlamydia-annual-epidemiological-report-2023
  3. European Centre for Disease Prevention and Control (ECDC). Monitoring of the responses to sexually-transmitted infection epidemics in EU/EEA countries, 2024. Stockholm: ECDC; 2025. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Monitoring-of-responses-to-STIs-in-EU-EEA-2024.pdf
  4. Migchelsen SJ, Daahir U, Macdonald C, Harb AK, Drisdale-Gordon L, Duffell S, et al. Sexually transmitted infections and screening for chlamydia in England: 2024 report. London: United Kingdom Health Security Agency; 2025. Available from: https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2024-report
  5. European Centre for Disease Prevention and Control (ECDC). EpiPulse - the European surveillance portal for infectious diseases. Stockholm: ECDC; 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/epipulse-european-surveillance-portal-infectious-diseases
  6. Bruun T, Børud B, Finbråten A-K, Grenersen MP, Kløvstad H, Olsen AO, et al. Årsrapport 2025: Blod- og seksuelt overførbare infeksjoner i Norge. [Annual Report 2025. Blood and sexually transmitted infections in Norway]. Oslo: Folkehelseinstituttet; 2026. Norwegian. Available from: https://doi.org/10.21349/w0mb-3v68
  7. Folkhälsomyndigheten (Fohm). Klamydia 2024. [Chlamydia 2024]. Stockholm: Fohm; [Accessed: 31 Oct 2025]. Swedish. Available from: https://www.folkhalsomyndigheten.se/statistik-och-data/hitta-statistik-och-data/klamydiainfektion-statistik/?tab=tab-report
  8. Health Protection Surveillance Centre (HPSC). Sexually transmitted infections (STI) in Ireland: trends to the end of 2024. Dublin: HPSC; 2025. Available from: https://www.hpsc.ie/a-z/sexuallytransmittedinfections/stireports
  9. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). Thermometer seksuele gezondheid. [Sexual health thermometer]. Bilthoven: RIVM; 2025. Dutch. Available from: https://www.rivm.nl/soa/rapportages/thermometer
  10. Rijksinstituut voor Volksgezondheid en Milieu (RIVM). Consult seksuele gezondheid. LCI-draaiboek. [Sexual health consultation. LCI protocol]. 2025. Dutch. Available from: https://lci.rivm.nl/draaiboeken/consult-seksuele-gezondheid
  11. Statens Serum Institut (SSI). EPI-NYT. Uge 23/26 - 2025 -Klamydia 2024. 2025. Available at: https://www.ssi.dk/aktuelt/nyhedsbreve/epi-nyt/2025/uge-23-26---2025
  12. Terveyden ja hyvinvoinnin laitos (THL). Klamydian esiintyvyys Suomessa. [Chlamydia prevalence in Finland]. Helsinki: THL; 2025. Finnish. Available from: https://thl.fi/aiheet/infektiotaudit-ja-rokotukset/taudit-ja-torjunta/taudit-ja-taudinaiheuttajat-a-o/klamydia/klamydian-esiintyvyys-suomessa
  13. Pedersen TR, Salado-Rasmussen K, Hoffmann S, Wessman M, Skov Jensen J. Chlamydia trachomatis Infections: A Rapid Decrease in Denmark from 2022 to 2024 is Driven by the Young Population. Acta Derm Venereol. 2025;105:adv43603.  https://doi.org/10.2340/actadv.v105.43603 
  14. United Kingdom Health Security Agency (UKHSA). National STI surveillance data 2024: Table 1, Table 2, Table 4. Sexually transmitted infections (STIs): annual data (data to end of December 2024). London: UKHSA; 2025. Available from: https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables
  15. United Kingdom Health Security Agency (UKHSA). Decreases in chlamydia tests, diagnoses and positivity in young people, England 2023 to 2024. London: UKHSA; 2025. Available from: https://www.gov.uk/government/publications/chlamydia-analyses-to-inform-control-interventions/decreases-in-chlamydia-tests-diagnoses-and-positivity-in-young-people-england-2023-to-2024
  16. United Kingdom Health Security Agency (UKHSA). National chlamydia screening programme trend data tables, 2015 to 2024. National Chlamydia Screening Programme (NCSP): annual data (data to end of December 2024). London: UKHSA; 2025. Available from: https://assets.publishing.service.gov.uk/media/683808cb8ade4d13a632372d/NCSP-trend-tables-2015-to-2024.ods
  17. United Kingdom Health Security Agency. Changes to the National Chlamydia Screening Programme (NCSP). 2021. Available from: https://www.gov.uk/government/publications/changes-to-the-national-chlamydia-screening-programme-ncsp/changes-to-the-national-chlamydia-screening-programme-ncsp
  18. El-Jobouri R, Kayaert L, Visser M, Sarink D, Op de Coul ELM, Alexiou ZW, et al. Sexually transmitted infections in the Netherlands in 2024. Bilthoven: RIVM; 2025. Available from: https://www.rivm.nl/bibliotheek/rapporten/2025-0009.pdf
  19. Bruun T, Caugant D, Kløvstad H, Labberton AS, Nilsen Ø, Olsen AO, et al. Årsrapport 2023. Blod- og seksuelt overførbare infeksjoner i Norge. [Annual report 2023. Blood and sexually transmitted infections in Norway]. Oslo: Folkehelseinstituttet; 2024. Norwegian. Available from: https://www.fhi.no/contentassets/bdfaa30f609b4734850f0eb7746683f7/arsrapport-2023-blod--og-seksuelt-overforbare-infeksjoner.pdf
  20. Regjeringen.no. Regjeringen sikrer gratis kondomer til ungdommer. [The government ensures free condoms for young people]. Regjeringen.no; 2023. Norwegian. Available from: https://www.regjeringen.no/id3015925
  21. Folkhälsomyndigheten (Fohm). Gonorré – statistik. [Gonorrhoea - statistics]. Stockholm: Fohm. [Accessed: 31 Oct 2025]. Swedish. Available from: https://www.folkhalsomyndigheten.se/statistik-och-data/hitta-statistik-och-data/gonorre-statistik/?year%5B%5D=2024&tab=tab-report
  22. Statens Serum Institut (SSI). Overvågning i tal, grafer og kort: Gonoré, Individuelle anmeldelsespligtige sygdomme. [Surveillance in numbers, graphs and maps: Gonorrhea, Individual notifiable diseases.]. Copenhagen: SSI. [Accessed: 31 Oct 2025]. Danish. Available from: https://statistik.ssi.dk/sygdomsdata#!/?sygdomskode=GONO&xaxis=Aar&show=Graph&datatype=Individual
  23. Finnish Institute for Health and Welfare (THL). Tippurin esiintyvyys Suomessa. [Prevalence of gonorrhoea in Finland]. Helsinki: THL; 2025. Finnish. Available from: https://thl.fi/aiheet/infektiotaudit-ja-rokotukset/taudit-ja-torjunta/taudit-ja-taudinaiheuttajat-a-o/tippuri/tippurin-esiintyvyys-suomessa
  24. Smid JH, Althaus CL, Low N, Unemo M, Herrmann B. Rise and fall of the new variant of Chlamydia trachomatis in Sweden: mathematical modelling study. Sex Transm Infect. 2020;96(5):375-9.  https://doi.org/10.1136/sextrans-2019-054057 
  25. Rantakokko-Jalava K, Hokynar K, Hieta N, Keskitalo A, Jokela P, Muotiala A, et al. Chlamydia trachomatis samples testing falsely negative in the Aptima Combo 2 test in Finland, 2019. Euro Surveill. 2019;24(22):1900298.  https://doi.org/10.2807/1560-7917.ES.2019.24.22.1900298 
  26. European Centre for Disease Prevention and Control (ECDC). Chlamydia trachomatis false-negative test results by Aptima Combo 2 CT/NG assay (Hologic) in the EU/EEA, 2019. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/RRA-Chlamydia%20trachomatis-17%20June.pdf
  27. Sumray K, Lloyd KC, Estcourt CS, Burns F, Gibbs J. Access to, usage and clinic outcomes of, online postal sexually transmitted infection services: a scoping review. Sex Transm Infect. 2022;98(7):528-35.  https://doi.org/10.1136/sextrans-2021-055376 
  28. Sonubi T, Sheik-Mohamud D, Ratna N, Bell J, Talebi A, Mercer CH, et al. STI testing, diagnoses and online chlamydia self-sampling among young people during the first year of the COVID-19 pandemic in England. Int J STD AIDS. 2023;34(12):841-53.  https://doi.org/10.1177/09564624231180641 
  29. Howarth A, Harb A, Mohammed H, Burns F, Estcourt C, Bloch SCM, et al. Uptake, positivity, and equity of online postal self-sampling for chlamydia testing in England: a retrospective cohort study. Lancet Reg Health Eur. 2025;56:101412.  https://doi.org/10.1016/j.lanepe.2025.101412 
  30. Health Service Executive (HSE). HSE interim guidance on doxycycline as prophylaxis for sexually transmitted infections, July 2024. Dublin: HSE; 2024.
  31. Nerlander L, Champezou L, Gomes Dias J, Aspelund G, Berlot L, Constantinou E, et al. Sharp increase in gonorrhoea notifications among young people, EU/EEA, July 2022 to June 2023. Euro Surveill. 2024;29(10):2400113.  https://doi.org/10.2807/1560-7917.ES.2024.29.10.2400113 
  32. Fountain H, Migchelsen SJ, Charles H, Ram T, Fifer H, Mohammed H, et al. Rebound of gonorrhea after lifting of COVID-19 preventive measures, England. Emerg Infect Dis. 2024;30(2):329-32.  https://doi.org/10.3201/eid3002.231148 
  33. Riksförbundet för sexuell upplysning (RFSU). Kondomkollen 2024. [Condom check 2024]. Stockholm: RFSU; 2025. Swedish. Available from: https://www.rfsu.com/wp-content/uploads/2025/03/RFSU_Kondomkollen_2024_.pdf
  34. de Graaf H, Vermey K, Oldenhof A, Kraan Y, Beek T, Kuipers L. Seks onder je 25e. Seksuele gezondheid van jongeren in Nederland anno 2023. [Sex under 25. Sexual health of young people in the Netherlands in 2023.]. Utrecht: Rutgers; 2024. Dutch. Available from: https://rutgers.nl/wp-content/uploads/2024/03/Boek-S25-2023-DEF.pdf
  35. Gavin A, Költő A, Lunney L, Maloney R, Walker L, Gabhainn SN, et al. The Irish Health Behaviour in school-aged Children (HBSC) study 2022. Galway: University of Galway; 2024. Available from: https://www.universityofgalway.ie/media/healthpromotionresearchcentre/hbscdocs/nationalreports/HBSC-2022-National-Report.pdf
  36. de Graaf H, Schouten F, van Dorsselaer S, Költő A, Ball J, Stevens GWJM, et al. Trends and the gender gap in the reporting of sexual initiation among 15-year-olds: a comparison of 33 European countries. J Sex Res. 2025;62(4):445-54.  https://doi.org/10.1080/00224499.2023.2297906 
  37. Ball J, Grucza R, Livingston M, Ter Bogt T, Currie C, de Looze M. The great decline in adolescent risk behaviours: Unitary trend, separate trends, or cascade? Soc Sci Med. 2023;317:115616.  https://doi.org/10.1016/j.socscimed.2022.115616 
  38. Mercer CH, Clifton S, Riddell J, Tanton C, Freeman L, Copas AJ, et al. Impacts of COVID-19 on sexual behaviour in Britain: findings from a large, quasi-representative survey (Natsal-COVID). Sex Transm Infect. 2022;98(7):469-77.  https://doi.org/10.1136/sextrans-2021-055210 
  39. Mourikis I, Kokka I, Koumantarou-Malisiova E, Kontoangelos K, Konstantakopoulos G, Papageorgiou C. Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis. Front Psychiatry. 2022;13:949077.  https://doi.org/10.3389/fpsyt.2022.949077 
  40. Mitchell KR, Willis M, Dema E, Baxter AJ, Connolly A, Riddell J, et al. Sexual and reproductive health in Britain during the first year of the COVID-19 pandemic: cross-sectional population survey (Natsal-COVID-Wave 2) and national surveillance data. Sex Transm Infect. 2023;99(6):386-97.  https://doi.org/10.1136/sextrans-2022-055680 
  41. Jenness SM, Le Guillou A, Chandra C, Mann LM, Sanchez T, Westreich D, et al. Projected HIV and bacterial sexually transmitted infection incidence following COVID-19–related sexual distancing and clinical service interruption. J Infect Dis. 2021;223(6):1019-28.  https://doi.org/10.1093/infdis/jiab051 
Decreased chlamydia notifications in six European Union/European Economic Area countries and England, 2024
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Ana+Martina+Astorga+Alsina&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Astorga Alsina Ana Martina</a>, <a href="/search?value1=Joana+Gomes+Dias&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gomes Dias Joana</a>, <a href="/search?value1=Cornelia+Adlhoch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Adlhoch Cornelia</a>, <a href="/search?value1=Lina+Nerlander&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nerlander Lina</a>, <a href="/search?value1=Anne+Olaug+Olsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Olsen Anne Olaug</a>, <a href="/search?value1=Derval+Igoe&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Igoe Derval</a>, <a href="/search?value1=Eija+Hiltunen-Back&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hiltunen-Back Eija</a>, <a href="/search?value1=Fiona+Lyons&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lyons Fiona</a>, <a href="/search?value1=Inga+Velicko&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Velicko Inga</a>, <a href="/search?value1=Kate+O%26apos%3BDonnell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O&apos;Donnell Kate</a>, <a href="/search?value1=Kate+Folkard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Folkard Kate</a>, <a href="/search?value1=Katerina+Crawford&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Crawford Katerina</a>, <a href="/search?value1=Kirsi+Liitsola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Liitsola Kirsi</a>, <a href="/search?value1=Maartje+Visser&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Visser Maartje</a>, <a href="/search?value1=Maria+Wessman&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wessman Maria</a>, <a href="/search?value1=Martha+Neary&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Neary Martha</a>, <a href="/search?value1=Miranda+Ferguson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ferguson Miranda</a>, <a href="/search?value1=Mirja+Puolakkainen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Puolakkainen Mirja</a>, <a href="/search?value1=Steen+Hoffmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoffmann Steen</a>, <a href="/search?value1=Thomas+Roland+Pedersen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pedersen Thomas Roland</a>, <a href="/search?value1=Tuula+Hannila-Handelberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hannila-Handelberg Tuula</a>, <a href="/search?value1=Otilia+M%C3%A5rdh&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mårdh Otilia</a></span>. Decreased chlamydia notifications in six European Union/European Economic Area countries and England, 2024. <a href="/content/ecdc">Euro Surveill.</a> 2026;31(21):pii=2500846. <a href="https://doi.org/10.2807/1560-7917.ES.2026.31.21.2500846" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2026.31.21.2500846</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 04 Nov 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 26 Mar 2026 </span> </p>
/content/10.2807/1560-7917.ES.2026.31.21.2500846
/content/10.2807/1560-7917.ES.2026.31.21.2500846
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error