Why is France experiencing an explosion of syphilis instances? | EUROtoday

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While most sexually transmitted infections are on the rise in France, the rise within the variety of syphilis instances is especially alarming to specialists. Long relegated to the background of public insurance policies, significantly within the face of the HIV epidemic, this bacterial an infection elevated by 110% between 2020 and 2022.

Just a few days earlier than Valentine's Day, there are surprises we want to do with out. Martin* has simply acquired unhealthy information from one in all his shut buddies, with whom he had intercourse: “I just got tested, you are the only person with whom I did not protect myself. And here it is, now I have syphilis.”

Martin quickly runs to get tested: positive for syphilis. Once the shock has passed, he quickly goes back through his multiple partners and remembers a recent adventure, also unprotected. After a brief exchange, this partner confirms that she has been carrying it for some time. But like Martin, she prefers to take the risk, rather than having protected sex.

Martin's case is not unique. Sexually transmitted infections (STIs) of bacterial origin (chlamydia, gonococci and syphilis, unlike HIV which is a virus) experienced a sharp increase between 2020 and 2022 in mainland France, according to the latest report from Public Health France, dated from December 2023.

If chlamydia remains the most recurrent STI in absolute figures (+16% compared to 2020, with 102 cases per 100,000 inhabitants), the evolution of gonorrhea and especially syphilis alarms specialists. The proportion of gonorrhea infections jumped by 91% (with 44 cases per 100,000) and that of syphilis increased by 110%, to reach 21 cases per 100,000.

Appeared within the Middle Ages, syphilis had nearly been eradicated for the reason that second half of the twentieth century. But it has resurfaced in most Western international locations in recent times, notably within the United States. According to the Agency for Disease Control and Prevention, infections with the illness have reached their highest fee for the reason that Nineteen Fifties, the New York Times reported in January.

With greater than 207,000 instances recognized in 2022, the most recent 12 months for which knowledge is out there, the United States now has a fee of 17 instances per 100,000 inhabitants, a rise of 80% since 2018.

PrEP, a false miracle answer

At the origin of the phenomenon? The scientific advances used to struggle AIDS, particularly, affirm the docs as a complete. “People protect themselves less and less, in part because they are no longer afraid of AIDS, since with scientific advances, it is now possible to lead a life without complications while carrying HIV,” summarizes Pierre Tattevin , head of the infectious illnesses division at Rennes University Hospital.

According to many docs, as soon as the concern of HIV disappears, folks “let go.” “There is also a perverse effect of PrEP,” factors out Jean-Paul Stahl, infectious illness specialist and professor emeritus of infectious illnesses on the University of Grenoble.

Read additionallyAgainst HIV, PrEP each answer and drawback

PrEP (for pre-exposure prophylaxis) is a retroviral treatment used earlier than doable publicity to HIV (the virus that causes AIDS), thus blocking any contamination. Now highly regarded particularly amongst gay and bisexual singles, it is usually systematically supplied in public hospitals to anybody indicating having had intercourse with greater than 10 totally different companions during the last 12 months, protected or not.

“PrEP gives users the impression that they are protected from everything, and they believe they are allowed all risky relationships, but it only protects against AIDS,” warns Jean-Paul Stahl.

Truvada pills, here in the hands of a doctor in San Francisco in May 2012, are the main drug used in pre-exposure prophylaxis (PrEP), which has been popularized in France in recent years.
Truvada capsules, right here within the palms of a physician in San Francisco in May 2012, are the principle drug utilized in pre-exposure prophylaxis (PrEP), which has been popularized in France in recent times. © Jeff Chiu/AP

The position of relationship apps

But in line with Pierre Tattevin, one other ingredient contributes to this enhance in instances. “It is now extremely easy to find partners thanks to dating applications. And in this case, we multiply our partners while not knowing who they are, what their practices are, nor their history,” signifies the physician, additionally president of the French-speaking Society of Infectious Pathology.

So many parts confirmed by the most recent research. According to researchers, the overwhelming majority of profiles most susceptible to an infection with gonorrhea or syphilis are males with a number of companions (practically 80%), in addition to a historical past of STIs.

More broadly, males are probably the most affected: they characterize 77% of instances of gonorrhea, and greater than 90% of instances of syphilis. For the vast majority of these, males aged 50 and over are probably the most affected.

Cases of chlamydia have an effect on extra ladies, particularly between 15 and 25 years outdated.

A specific concern for being pregnant

Syphilis had additionally disappeared from the collective creativeness due to a protected therapy: antibiotics. “This allows for a cure, of course, and once this is done, there are no more effects or complications if the infection is detected quickly,” signifies Dr. Jean-Paul Stahl.

Except that within the absence of therapy, syphilis will not be an anecdotal illness. It can injury the guts, mind and eyesight, in addition to trigger deafness and paralysis. Infection throughout being pregnant can result in miscarriage or stillbirth. Children who survive might have imaginative and prescient or listening to issues, in addition to extreme developmental delays.

If the variety of syphilis instances elevated barely in 2021 and 2022 “among heterosexual women”, “around three quarters of syphilis cases concerned MSM [hommes ayant des pratiques homosexuelles ou bisexuelles, ndlr]regardless of the year of monitoring”, factors out the research.

The authors of the Public Health France research warn that “STIs characterize a significant public well being drawback on account of their transmissibility (to companions and maternal-fetal), their frequency, and the long-term problems they induce ( power pelvic ache, higher genital infections, infertility, most cancers, and so forth.) and their position within the transmission of HIV.”

“The government cannot put condoms in everyone’s hands”

According to doctors, although the rate of STI infections is increasing in France, it is also proof of a good screening system, essential to stopping an epidemic.

“When you miss one case, you end up with two additional cases, and if you miss two cases, you end up with four cases,” summarizes Dr. Jay Varma, chief medical officer of Siga Technologies and former deputy commissioner for health of New York City, in an interview with the New York Times. “This is how epidemics develop.”

“The various governments have pursued good policies in recent years, with free screening centers. We need to test even more, especially patients at risk,” summarizes Pierre Tattevin.

Beyond information campaigns, Jean-Paul Stahl insists on individual responsibility: “There is the question of everyone's conscience. Some people use PrEP so they must know what they risk despite this. Because some people know the risks involved and take them anyway, he says. Real scientific information is always beneficial, but is it the final solution to the problem? No.”

“The authorities can not put condoms in everybody’s palms,” concludes Jean-Paul Stahl.

Martin continues his conquests: typically protected, typically unprotected, however now cured.

*The first identify has been modified on the request of the witness