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The Norwegian Institute of Public Health (NIPH) reports the number of reported cases of gonorrhea, syphilis and HIV decreased in 2021.

Gonorrhea numbers were halved

Image/CDC

In 2021, 555 gonorrhea cases were reported in Norway against 1045 cases in 2020 and 1704 cases in 2019. The decrease in reported cases was both in men who have sex with men and heterosexually infected men and women.

  • 425 men and 130 women were reported to be infected with gonorrhea in 2021.
    • Men: 308 (72 percent) were infected with homosexuality and 117 (28 percent) were infected with heterosexuality.
    • Women: All were infected heterosexually

Except during the pandemic, gonorrhea cases in Norway have increased for several years, despite extensive testing and screening in vulnerable groups.

– Increased condom use and safer sex in high-risk groups is absolutely necessary to reverse the trend, says senior adviser Øivind Nilsen at NIPH.

Significant decrease in syphilis

In 2021, 163 cases of syphilis were reported, compared with 287 cases in 2020.

syphilis
Image/CDC

After a marked increase in syphilis in 2020, which was surprising in light of the coronary restrictions, there was a significant decrease in reported syphilis cases in both homosexual and heterosexually infected people in 2021.

Some details about the syphilis numbers in Norway in 2021:

  • 159 men and four women were reported infected with syphilis.
  • 155 (95 percent) of those who contracted syphilis were homosexually infected.
  • The decline in 2021 is seen especially in Oslo, Viken and Innlandet, where the increase was particularly large in 2020.

The high number of cases of syphilis in men who have sex with men in recent years is characterized by a high infection pressure in environments with a lot of casual and anonymous sex – where infected people without symptoms are believed to play an important role in the spread of infection. Homosexually infected men with an immigrant background and HIV-positive people are particularly vulnerable to syphilis infection.

Øivind Nilsen says that in 2021, only 10 percent of syphilis cases among men who have sex with men were detected through infection detection.

– A more effective infection detection should therefore be sought around the infected person, Nilsen points out.

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HIV rates continue to fall

In 2021, 102 HIV cases were reported in Norway, compared with 137 cases in 2020. The trend of a decrease in reported cases continues, and we now see the lowest number of cases detected in more than 20 years.

– We assume that early diagnosis, the quickest possible start with antiretroviral treatment and the offer of preventive drug treatment (PrEP) to particularly vulnerable people, is the most important reason for the decline in HIV numbers, says Øivind Nilsen.

Facts about the HIV numbers in 2021:

  • The largest decrease was in men who have sex with men, where 36 new cases were detected against 63 in 2020.
  • Fewer HIV cases were reported in immigrants infected before arriving in Norway; 67 cases in 2021 against 79 cases in 2020 and 102 in 2019.
  • The number of people reported infected in Norway has decreased by 70 percent over the past 10 years to 15 cases in 2021.

Decrease in infection can largely be due to coronavirus measures

– The trend of decline in reported cases of HIV and gonorrhea in 2020 and HIV, gonorrhea and syphilis in 2021 must to a large extent be assumed to be coronaravirus related, Nilsen says.

He adds that extensive travel restrictions have led to a decline in import infections. Shutting down nightlife and social distancing have also probably contributed to a further decline.

– We must therefore be prepared for a change in the infection development in the future, Nilsen says.

Worrying trends

Gonorrhea in heterosexuals, especially women, has increased markedly

Øivind Nilsen says it is important that the health service is aware that gonorrhea and syphilis now occur more frequently in heterosexual men and women than just a few years ago. Especially among women, gonorrhea has increased markedly in recent years, where the number of cases has almost tenfold in the last ten years.

– Gonorrhea has a high level of infectivity. The spread potential is therefore high if the infection is introduced in environments with a lot of risky sex or in youth environments with frequent partner changes, says Øivind Nilsen.

Sharp increase in gonorrhea and syphilis in men who have sex with men

The number of people newly infected with HIV has decreased, but the incidence of gonorrhea and syphilis in men who have sex with men has increased sharply in recent years. The exception is the number of gonorrhea cases that have decreased during the pandemic.

Nilsen says that this indicates continued risky sex among men who have sex with men, both in Norway and abroad. He believes the possible negative effects of the treatment strategy against HIV must be counteracted with increased condom use and information about the risk of infection for other sexually transmitted infections.

– Gonorrhea and syphilis are in themselves potentially serious diseases that must be prevented. In particular, the increasing resistance to antibiotics in gonococci (a type of bacteria) is a serious threat, says Øivind Nilsen.

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