Recent data from the UK Health Security Agency (UKHSA) reveals important trends in sexually transmitted infections (STIs) in the UK, including a rise in syphilis diagnoses and a decline in gonorrhoea cases. While the overall picture shows some positive changes, there are still significant concerns, particularly around the increase in antibiotic-resistant gonorrhoea. In this article, we’ll explore these findings and the measures being taken to address the situation.
Syphilis Diagnoses on the Rise
The number of early-stage syphilis diagnoses in England has risen by 2% in 2024, with 9,535 diagnoses compared to 9,375 in 2023. More concerning is the overall increase in syphilis cases, including late-stage syphilis, which has grown by 5%. The total number of syphilis diagnoses for 2024 stands at 13,030, up from 12,456 the previous year. This increase underscores the need for greater awareness and testing, as untreated syphilis can cause severe health issues like brain damage, heart problems, and nerve damage.
Gonorrhoea Cases Decrease, But Concerns Remain
Gonorrhoea diagnoses have decreased by 16%, with 71,802 cases in 2024 compared to 85,370 in 2023. The reduction has been especially notable among young people aged 15 to 24, with a 36% decrease in cases. While this decline is encouraging, it is too early to determine whether this trend will continue.
However, the rise in antibiotic-resistant gonorrhoea remains a concern. Ceftriaxone, the primary treatment for gonorrhoea, has shown resistance in some cases. In the first five months of 2025 alone, there have been 14 ceftriaxone-resistant cases, surpassing the total of 13 cases in all of 2024. Six of these cases were extensively drug-resistant, meaning they were resistant to both ceftriaxone and other second-line treatments. The majority of these cases are linked to travel in the Asia-Pacific region, where resistance to ceftriaxone is more prevalent.
Other STI Trends: Chlamydia and Genital Warts
Chlamydia diagnoses in the UK dropped by 13% in 2024, with 168,889 cases reported, down from 194,143 in 2023. This decline is a positive sign, but chlamydia remains one of the most common STIs, and continued efforts in prevention and education are essential.
The number of first-episode genital warts diagnoses decreased by 4%, with 25,056 cases in 2024, compared to 26,193 in 2023. It is worth noting that the incidence of genital warts remains low among young people aged 15 to 17, who are the target group for the school-based HPV vaccination program.
The Importance of Regular Testing and Prevention
Despite some declines in certain STIs, the overall numbers remain concerning, especially among young people, gay and bisexual men, and some minority ethnic groups. The UKHSA continues to encourage everyone, especially those with new or casual sexual partners, to use condoms and get tested regularly, even if they have no symptoms. Many STIs, such as chlamydia and gonorrhoea, can cause serious health issues like infertility and pelvic inflammatory disease if left untreated. Syphilis can lead to life-threatening complications if not addressed promptly.
Antibiotic-Resistant Gonorrhoea: A Growing Threat
Antibiotic resistance in gonorrhoea is becoming an increasingly serious issue. While most gonorrhoea infections can be treated with antibiotics, the rise of drug-resistant strains, particularly those resistant to ceftriaxone, poses a significant challenge to public health. Ceftriaxone-resistant gonorrhoea cases are being detected more frequently, and the rise of extensively drug-resistant strains, resistant to both ceftriaxone and second-line treatments, is particularly alarming.
The UKHSA is closely monitoring this situation and continues to stress the importance of regular testing and safe sexual practices to help prevent the spread of resistant infections.
New Vaccination Program for Gonorrhoea
In a major step forward, the UK is set to roll out the world’s first vaccination program for gonorrhoea. Starting in August 2025, eligible individuals, including gay and bisexual men with multiple sexual partners or a history of bacterial STIs, will be offered the 4CMenB vaccine, which provides 30% to 40% protection against gonorrhoea. This program is expected to reduce the number of gonorrhoea cases in the coming years and will be a vital tool in controlling the spread of this infection.
The Path Forward
While there are positive signs, such as the decline in gonorrhoea cases, the rise in syphilis and antibiotic-resistant gonorrhoea remains a significant concern. The UKHSA continues to focus on prevention, regular testing, and improving access to sexual health services. As part of the government’s broader health plan, STI testing is free and confidential, available at local clinics, universities, and through self-sampling kits.
The latest data highlights both progress and ongoing challenges in tackling STIs in the UK. While some infections are on the decline, the rise in syphilis cases and the growing threat of antibiotic-resistant gonorrhoea are alarming. The government’s efforts, including the new gonorrhoea vaccination program, are steps in the right direction, but continued vigilance, education, and testing are crucial to improving sexual health outcomes for all.