ABSTRACT
BACKGROUND: The growing trend of STIs in recent years was altered after the outbreak of the SARS-CoV-2 pandemic. OBJECTIVES: Describe the impact of the SARS-CoV-2 pandemic on STI declarations received during the pre-pandemic to pandemic period and estimate the number of STI cases expected for the pandemic period. MATERIAL AND METHODS: Descriptive analysis of STI declarations received during the pre-pandemic (2018-2019) and pandemic (2020-2021) periods. The influence of the number of positive cases of SARS-CoV-2 with the number of positive cases of STIs during the months of the pandemic was studied using a correlation model. Using the Holt-Wilson time series model, an estimate was made of the number of STI cases expected for the pandemic period. RESULTS: The global incidence rate for all STIs in 2020 decreased by 18.3% compared to 2019. Chlamydia and syphilis presented a greater reduction in their incidence from 2019 to 2020 of 22.7% and 20.9%, respectively and 9.5% and 2.5% for gonorrhea and LGV. Estimates showed that in 2020 there would have been 44.6% more STIs than those declared. The proportions according to sex, country of birth and sexual orientation changed significantly in chlamydia and gonorrhea. CONCLUSIONS: The measures adopted for the prevention of SARS-CoV-2 infections were able to achieve an initial decrease in STI cases in 2020, however, this change was not maintained during 2021, which ended with higher incidences recorded to date.
ABSTRACT
BACKGROUND: Before the COVID-19 pandemic, Sexually transmitted infections (STIs) were increasing in Europe, and Spain and Catalonia were not an exception. Catalonia has been one of the regions with the highest number of COVID-19 confirmed cases in Spain. The objective of this study was to estimate the magnitude of the decline, due to the COVID-19 pandemic, in the number of STI confirmed cases in Catalonia during the lockdown and de-escalation phases. METHODS: Interrupted time series analysis was performed to estimate the magnitude of decline in the number of STI reported confirmed cases - chlamydia, gonorrhoea, syphilis, and lymphogranuloma venereum- in Catalonia since lockdown with historical data, from March 13th to August 1st 2020, comparing the observed with the expected values. RESULTS: We found that since the start of COVID-19 pandemic the number of STI reported cases was 51% less than expected, reaching an average of 56% during lockdown (50% and 45% during de-escalation and new normality) with a maximum decrease of 72% for chlamydia and minimum of 22% for syphilis. Our results indicate that fewer STIs were reported in females, people living in more deprived areas, people with no previous STI episodes during the last three years, and in the HIV negative. CONCLUSIONS: The STI notification sharp decline was maintained almost five months after lockdown started, well into the new normality. This fact can hardly be explained without significant underdiagnosis and underreporting. There is an urgent need to strengthen STI/HIV diagnostic programs and services, as well as surveillance, as the pandemic could be concealing the real size of the already described re-emergence of STIs in most of the European countries.