STIs Spiked in This Italian City Despite Lockdown Banning People From Meeting

Cases of sexually transmitted infections (STIs) rose in an Italian city that was under lockdown due to COVID-19, according to research that raises questions about how strictly some residents stuck to the rules.

The authors of the paper compared how many people were diagnosed with the most common STIs at two clinics in the Italian city of Milan between 15 March and 14 April 2020, compared with the same period in the previous year. Milan is the capital of Lombardy, one of the first areas outside of China to be hit hard by the coronavirus during the COVID-19 pandemic.

Between 15 March and 14 April 2020, the number of people visiting the clinics dropped by 37 percent, from 233 in 2019 to 147 in 2020. But the number of what are known as acute infections—including gonorrhoea, secondary syphilis and mycoplasma genitalium—went up between 15 March and 14 April, 2020. An acute infection is where symptoms come on quickly. Cases of non-acute infections like gential warts and a condition called molluscum contagiosum went down.

STI202020192020 vs 2019
Primary syphilis11121
Secondary syphilis3330-3
Mycoplasma genitalium128-4
Anogenital warts187254
Mollsucum contagiosum21816

During this period, the Italian government had imposed a national lockdown, meaning people could only leave home for essential reasons, and the majority of shops, restaurants, and bars were shut. Prime minister Giuseppe Conte described it as the "I stay home" decree.

The team believe acute cases may have risen in 2020 as only patients with symptoms visited the clinics.

"It appears that the COVID-19 pandemic, despite lockdown and advice on Social/Physical distancing, did not inhibit risky behaviours," the authors wrote.

The research was published as a research letter in the journal Sexually Transmitted Infections in August, and presented as a poster at the European Academy of Dermatology and Venereology Congress that was held between 29 to 30 October.

Co-author Dr. Marco Cusini, of La Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy, said in a statement that he was surprised by the number of new acute infections that his team found in the time period, having thought that the lockdown would limit the opportunities for sexual encounters and in turn the spread of STDs.

Cusini said gonorrhea and syphilis are generally more common among people in their 30s. As older people are more likely to develop severe or fatal COVID-19, young people may have continued with sexual encounters, feeling their risk of falling ill with COVID-19 was lower, according to the team.

"Whilst it is unrealistic to prevent people from having sex, even in this extraordinary pandemic, close contact during sexual intercourse inevitably involves an increased risk of SARS-CoV-2 [coronavirus] contagion," said Cusini.

"The findings show the importance of ongoing screening for STIs and the real benefit of having these types of services open and available during these unprecedented times."

The research is the latest to shine a light on sexual health amid the COVID-19 pandemic. Staff at an STI clinic at the Santa Chiara Hospital in Trento, northern Italy, raised similar concerns in July in an article titled "STIs and the COVID‐19 pandemic: the lockdown does not stop sexual infections."

In a letter to the editor of the Journal of the European Academy of Dermatology and Venereology, they wrote that "scarce attention was paid to sexually transmitted infections (STIs) and STI clinics" during the country's lockdown. They documented 15 STI cases between March 9 to May 4, down from 17 in the previous year. Nine of those diagnosed in 2020 said they had sexual encounters during lockdown.

The authors wrote that while "common sense" would suggest that people would have less casual sex when venues were shut and people were isolating, the team said their study shows that "risky behaviours do not seem to decrease during the pandemic."

sexual health, sti, std, stock, getty
A stock image shows a sheet of paper used by a healthcare worker to examine a patient's sexual health. Research suggests people may still be having risky sex despite COVID-19 pandemic lockdowns. Getty