Five times more people were diagnosed with syphilis in London last year than in any other English region, according to a report that says cases of the infection have more than doubled in the capital since 2010.
Nearly 60% of syphilis cases in England were diagnosed in London, according to research published on Wednesday by Public Health England, with rates increasing in 32 of the capital’s 33 boroughs in the five years to 2015.
Gay men were disproportionately affected, experiencing 90% of new diagnoses in 2015, despite comprising just 2% of the adult population. But experts are warning of a rise among heterosexuals as well.
Dr Patrick French, genitourinary medicine consultant at Central and North West London NHS Foundation Trust, said: “The increase we are seeing in syphilis and other sexually transmitted infections is a marker of a more general problem within sexual health, and tackling this must be a priority across London.
“More awareness is needed about STIs, how they can be prevented and why it is important to have a checkup if you think you are at risk. Anyone having sex with new or casual partners should always use condoms and have regular sexual health checks.”
Last year, there were 2,811 cases of syphilis in London, representing a rate of new infections of 32.9 per 100,000 people – more than five times higher than that of any other region in England, and three times higher than the rate for the country overall.
That figure represents a 163.4% rise in cases since 2010, when there were 1,067 diagnoses in the capital, and an increase of 21.9% on 2014, when there were 2,306 cases.
The overwhelming majority of cases in 2015 were among gay men, with 2,406 infections compared with 196 among heterosexual men and 70 among heterosexual women. Gay men have long been overrepresented, but the gap has widened significantly since 2010, when there were 724 infections compared with 130 among heterosexual males.
Syphilis infection is a marker of high-risk sexual activity, PHE’s report says, and comes amid evidence that Londoners, particularly gay men, are having more sex than ever.
Drug-fuelled “chemsex” parties, app-facilitated sexual networking and so-called “sero-sorting”, where people choose sexual partners based on their HIV status, are all associated with reduced use of condoms, the report says.
The recent rise in cases of syphilis comes after a historical decline in the late 1980s and early 90s, when the spectre of the HIV pandemic encouraged many people to change their sexual habits.
The first symptom of syphilis is a painless ulcer at the site of infection, lasting from three to six weeks. That is followed by general symptoms of illness including fever, headache, swollen glands and night sweats. If untreated it can lead to central nervous system disease, cardiovascular complications and death, but the widespread use of antibiotics means it rarely progresses that far.
Dr Yvonne Doyle, regional director for PHE London, said: “In London, we have excellent open-access sexual health services providing free STI testing and treatment, notification for the sexual partners of those diagnosed with an STI and free provision of contraception. With these services available across the capital, there is no reason for people to be taking unnecessary risks with their sexual health.
“I hope today’s report will further raise awareness of sexually transmitted infections including syphilis and drive home the messages about the importance of practising safe sex, which include using condoms, regularly being tested and avoiding overlapping sexual relationships. All of these will reduce the risk of STIs.”
