The pathology college is urgently calling for increased vigilance in response to recent surges in syphilis, gonorrhoea and HIV.
Sexually transmitted infections are an increasing public health concern in Australia and require immediate attention to stop the spread, says the Royal College of Pathologists of Australasia.
Data from 2022-2023 show a nearly 20% increase in gonorrhoea notifications alone, and further increases are expected this year.
Gonorrhoea has emerged as a leading cause of antibiotic-resistant infections, and resistance to frontline treatments are increasing rapidly. Despite this surge in STIs, the RCPA reports that testing levels have not notably increased.
A rise in syphilis rates is also a concern. Congenital syphilis can result in stillbirth, neonatal death, and long-term neurological and developmental issues in affected infants.
Given the range of symptoms syphilis can present with – including none at all – and the severe complications it can cause, the RCPA is urging an increase in regular testing for all sexually active individuals, regardless of age, saying it’s particularly important for gonorrhoea, syphilis and HIV.
The college attributes the rise in STI cases to changing sexual practices such as reduced use of condoms across various demographics.
Indigenous Australians face substantially higher rates of STIs. For gonorrhoea and syphilis, the prevalence is over five times higher among Aboriginal and Torres Strait Islander peoples than non-indigenous Australians.
“This highlights the critical need for culturally sensitive health promotion, testing, and treatment initiatives,” the college said in a statement this week.
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A recent study shows the increase in syphilis notifications over a decade in women aged 15-44, highlighting the rise in cases between 2011 and 2021 and the outcomes of congenital syphilis.
Syphilis cases rose from 141 to 902, while congenital syphilis cases rose from six to a peak of 17 in 2020. Of the 72 babies born with congenital syphilis in this period, 14 were stillborn and another later died of syphilis-related causes.
Syphilis cases in non-indigenous women rose from 1.1 per 100,000 people to 9.2, while in Indigenous women, the rise was from 56 per 100,000 people to 227.
“We need to see testing levels increase across Australia,” said RCPA spokeswoman Associate Professor Keighley, a microbiologist and infectious diseases physician.
“Despite a concerning rise in cases, we are not seeing a corresponding increase in testing rates. This includes older adults who may not be forthcoming about changes in their sexual practices. Low testing levels mean that infections can go undiagnosed and untreated, leading to severe health complications and further transmission. This leaves many individuals unknowingly at risk and is particularly concerning for pregnant women, where untreated STIs can result in congenital infections with devastating outcomes.”
