NewsDesk @bactiman63

The number of reported cases of chlamydia and gonorrhea increased significantly in the latter half of 2022. The HIV and syphilis numbers also increased from 2021 to 2022. This is shown by figures from the monitoring of sexually transmitted infections reported to the Norwegian Institute of Public Health in 2022.

Public domain Image/ Sanjay Rao via wikimedia commons

The figures appear in FHI’s annual report for 2022 on sexually transmitted infections reported to the Infectious Disease Reporting System (MSIS).

From August 2022, the number of reported cases of chlamydia has been higher than in previous years. This coincides with a corresponding increase in gonorrhea among young heterosexually infected people, and may be due to increased social contact after the reopening of society. Some changes in criteria for reporting and monitoring may also have contributed to the increase in the reporting rate, says senior physician Anne Olaug Olsen at FHI.

The chlamydia numbers are back at the level from before the pandemic 

  • After a decline during the pandemic, 29,271 cases of chlamydia were reported in Norway in 2022. There was a clear increase compared to the pandemic year 2021, when 23,447 cases were reported. The figures for 2022 are at the same level as in the peak year 2019.
  • In 2022, as in previous years, the majority of reported cases were among women (58 per cent).
  • The group under the age of 25 accounted for 67 per cent of all chlamydia cases in 2022.
  • The number of reported cases has increased in all counties from 2021 to 2022, with the exception of Agder (where there was an increase in 2021).
  • In 2022, as in the previous year, the majority of those tested were women (69 per cent). Over the past couple of decades, men have made up an increasingly large proportion of those tested.

– Sampling should be targeted at the group with the highest risk of infection, i.e. young people under the age of 25, says Anne Olaug Olsen.

– In case of symptoms and/or suspicion of a sexually transmitted infection, it is now important to test for both gonorrhea and chlamydia, she adds.

– Increased condom use is crucial to limiting the spread of chlamydia and gonorrhea. At the same time, it is very important to have good infection control guidance and thorough infection tracing around each case, says Olsen.

She points out that these measures are extra important now that the gonorrhea infection has been introduced in heterosexually infected women and men.

Gonorrhea: Strong increase in young heterosexuals

After a sharp decline in reported gonorrhea cases during the pandemic, the number of cases rose sharply again in 2022. Then 1,857 cases were reported, compared to 555 cases in 2021. The increase is particularly large among young women compared to the situation before the pandemic.

Increase in syphilis

After what was probably a pandemic-related decline in syphilis in 2021, the number of reported cases increased both among men who have sex with men and heterosexually infected in 2022.

  • 192 cases (184 men and 8 women) of syphilis were reported in 2022 compared to 163 cases in 2021.
  • Of the cases in 2022, 163 (85%) were in MSM.
  • HIV-positive men who have sex with men (MSM) and MSM with an immigrant background are most susceptible to syphilis infection.

– Few cases of syphilis are detected through infection tracing. Frequent testing and routine screening in particularly at-risk groups is therefore important to uncover the infection in people without symptoms, says Olsen.

HIV numbers have increased

The HIV situation is now characterized by a large number of HIV-positive refugees and immigrants who come to Norway.

  • There were 245 HIV cases reported in 2022 compared to 102 HIV cases in 2021. Of the 245 cases, 192 (78%) were infected before arriving in Norway, of which 97 came from Ukraine.
  • The proportion of HIV-positive people who become infected in Norway has fallen by almost 80 per cent over the past ten years. In 2022, 22 people were infected with HIV in Norway.
  • Men who have sex with men and heterosexual men traveling abroad, particularly in South-East Asia, are still most at risk of HIV infection.

No less than 37,000 refugees came from Ukraine to Norway in 2022, and of those, 97 were found to be HIV-positive in connection with the health check offered to everyone coming from medium- and high-endemic areas for HIV. 82 per cent of the HIV-positive refugees from Ukraine were known to be positive and under HIV treatment from their home country. Also among the other 95 immigrants infected before arriving in Norway, the proportion known to be HIV-positive was high (73 per cent). These therefore represent to a small extent infection control challenges in Norway, but like other HIV-positive people must have regular medical follow-up.

The drug prevention strategies (Tasp and PrEP) are believed to be the most important reasons for the decline in HIV among men who have sex with men over the past ten years. The sharp increase in the same period of gonorrhea and syphilis among men who have sex with men shows that it is not a change in behavior such as increased condom use or a reduction in the number of casual sex partners that explains the decrease in confirmed HIV cases.