By Tobias Mapulanga  MSc MIBMS

Sexually transmitted infections (STIs) remain a significant public health concern in the UK, with chlamydia and gonorrhea among the most commonly reported infections. As cases continue to rise, concerns over antibiotic resistance and accessibility to testing and treatment highlight the importance of awareness, prevention, and innovation in STI management.

Prevalence of Chlamydia and Gonorrhea in the UK

According to UK Health Security Agency (UKHSA) data, chlamydia and gonorrhea infections have been on an upward trajectory in recent years. In 2022, there were over 200,000 reported cases of chlamydia and nearly 80,000 cases of gonorrhea, with the highest rates observed in young adults aged 15–24. Urban areas, particularly London, tend to report the highest infection rates due to population density and increased sexual network connectivity.

Chlamydia is often asymptomatic, with around 70% of women and 50% of men showing no symptoms, which contributes to its high prevalence and continued transmission. Gonorrhea, while also capable of being asymptomatic, more commonly presents with symptoms such as pain during urination and unusual discharge.

Antimicrobial Resistance Trends

The rise of antimicrobial resistance (AMR) in gonorrhea has been a growing concern worldwide. The UK has reported increasing resistance to first-line antibiotics such as azithromycin, leading to changes in treatment guidelines. The emergence of multidrug-resistant strains, including those resistant to ceftriaxone (the current first-line treatment), poses a significant public health challenge.

Chlamydia remains treatable with doxycycline, but inappropriate antibiotic use and incomplete adherence to treatment regimens risk the development of resistance over time.

Current Treatment Guidelines

• Chlamydia: First-line treatment is a 7-day course of doxycycline (100 mg twice daily). Azithromycin, previously recommended, is now less commonly used due to resistance concerns.
• Gonorrhea: Ceftriaxone (1g intramuscular injection) is the recommended first-line treatment. A test of cure is advised, especially in cases of suspected antimicrobial resistance.

For both infections, sexual partners must also be tested and treated to prevent reinfection and further spread.

Prevention Strategies

Preventing chlamydia and gonorrhea involves a combination of safe sex practices, education, and regular screening. Key strategies include:

• Condom use: Consistent and correct condom use significantly reduces the risk of transmission.
• Regular STI testing: Routine screening, particularly for sexually active individuals under 25 or those with multiple partners, helps early detection and treatment.
• Partner notification: Informing and treating partners to prevent reinfection.
• Sexual health education: Awareness campaigns and sex education programs encourage safer sexual behaviors and reduce stigma around STI testing.

The Role of Self-Testing in STI Control

Self-testing has become a game-changer in the detection and management of STIs, offering individuals a discreet, convenient, and accessible way to get tested without visiting a clinic.

At Repose Healthcare, we empower you to take control of your health with easy, reliable at-home testing. Our STI tests help you detect infections like chlamydia, gonorrhea, syphilis, and more—allowing you to take action early. If needed, you can also consult a medical practitioner for a referral or prescription. Order your test today at Repose Healthcare and stay proactive about your health.

Benefits of Self-Testing for Chlamydia and Gonorrhea:

• Privacy & Convenience: Individuals can test at home without the discomfort or stigma associated with visiting a clinic.
• Early Detection & Treatment: Faster diagnosis helps reduce transmission rates and complications like pelvic inflammatory disease (PID) and infertility.
• Increased Testing Rates: Many people, particularly those in remote areas or with limited access to healthcare, are more likely to test if self-testing options are available.

How Self-Testing Works

Home STI testing kits typically involve providing a urine sample or a vaginal, rectal, or throat swab, depending on the risk factors. The sample is then sent to a laboratory for analysis, with results delivered confidentially via an online portal or secure communication.

Conclusion

With chlamydia and gonorrhea cases rising in the UK, proactive approaches to prevention, testing, and treatment are more critical than ever. The growing threat of antimicrobial resistance further underscores the need for responsible antibiotic use and improved STI control strategies. Self-testing is a crucial innovation, enabling greater accessibility to sexual health services and empowering individuals to take control of their health.

Regular testing, safe sex practices, and timely treatment remain the pillars of STI prevention and control. By embracing self-testing solutions, we can help reduce transmission rates and support better sexual health outcomes across the UK.

References

1. UK Health Security Agency (UKHSA). Sexually transmitted infections and screening for chlamydia in England, 2022. Sexually transmitted infections and screening for chlamydia in England: 2023 report – GOV.UK
2. World Health Organization (WHO). Antimicrobial resistance in Neisseria gonorrhoeae. Sexually transmitted infections (STIs)
3. British Association for Sexual Health and HIV (BASHH). National guideline for the management of gonorrhoea in adults. Guidance on STI Testing, 2021 and 2023 | BASHH
4. National Institute for Health and Care Excellence (NICE). Management of chlamydia. Overview | Reducing sexually transmitted infections | Guidance | NICE
5. Public Health England. The role of self-testing in STI management. https://ukhsa.blog.gov.uk/2022/10/05/getting-tested-for-an-sti-your-guide-to-how-it-works/

The author is a senior Biomedical Scientist at Repose Healthcare