The number of cases of syphilis recorded in Scotland hit a 15-year high last year, figures* from Health Protection Scotland (HPS) show.
In 2018, 455 diagnoses of infectious syphilis were reported to HPS, a 14% increase on that reported in 2017 (399 cases) and the highest annual total recorded since this surveillance system was established in 2002/2003.
The increase was predominantly due to more infections among men, especially men who have sex with men (MSM). Of the 455 diagnoses recorded, the majority (96%) were male, 4% were female and one individual’s gender was unknown. Of the males, 87% were MSM, which included 28 bisexual males.
Diagnoses among MSM have increased year on year for four years and, in 2018, were three-fold higher than in 2014 - the highest number of diagnoses recorded since the previous peak in 2008.
HPS suggested that HIV pre-exposure prophylaxis may be driving the increase in MSM.
“The impact of NHS-funded HIV pre-exposure prophylaxis (PrEP) is not yet fully understood, but it now looks possible that this intervention is associated with the observed increase in the incidence of STI diagnoses in MSM,” its report says.
Syphilis continues to be acquired heterosexually (11%) with some diagnoses being made via routine screening programmes such as antenatal and blood donor testing. In 2018, there were 55 diagnoses of infectious syphilis in those who were thought to have acquired the infection through heterosexual intercourse; 17 were female (a small number of whom identified as bisexual) and 38 were male.
*Surveillance report: Syphilis in Scotland 2018: update. Report from Health Protection Scotland, 2019