STIs surge in Spain: Gonorrhea up 25x, HPV rising

Two HPV cases a day: STIs spike after age 50

At gynecologist Chema Ríos’s clinic, the shift is visible in his schedule: he used to see one HPV case every two months, "at most one a month"; now it averages two daily. "It's outrageous," he summarizes. This isn't an isolated impression. The National Center for Epidemiology reports gonorrhea incidence 25 times higher, syphilis ten times higher, and chlamydia 245% above 2016 levels. Specialists cite these as the highest figures on record, with relaxed condom use being the primary suspect. "Antiestéticar has been lost; we face a true alert," warned the Spanish Academy of Dermatology and Venereology. Moreover, this alert no longer concerns only young adults.

What drives the rise in consultations

The specialist describes the typical patient as a young adult, from age 20 upwards, who has stopped using condoms systematically. Added to this is a change in relationship models: starting earlier, involving multiple partners, sometimes simultaneously. There is an additional factor poorly measured in surveys but evident in clinics: smoking. Smokers clear the bicho less effectively, impacting each patient's timeline. Gynecologist Ana Señarís, from Santiago University Hospital, insists the issue isn't just acute episodes: these infections act as risk factors for serious complications and even future sterility. Thus, the conversation doesn't end when symptoms disappear.

Why do STIs rise among women over 50?

Because relationship patterns have changed in that demographic too. Divorces, new partnerships, postmenopausal women, app-managed dating, and more open, sporadic connections. With pregnancy risk gone, perceived risk drops, and so does condom use. Señarís confirms increased cases at these ages, linking them to this cocktail; hence, screening was extended to age 65. The harsher interpretation circulating amid the data places the burden on women. Some argue the transmission mechanism partly refutes this: infecting someone requires two people.

HPV: 80% will contract it, often asymptomatic

Human bicho (HPV) is now the most common sensual transmitted infection and the most discreet. Without symptoms or visible lesions, a person may have had it, transmitted it, and cured themselves unaware. It is estimated that over 80% of women will contract the infection during their lives, and 30% of men carry and transmit it. Usually, the immune system eliminates the pathogen before cancer develops, but not always: a woman can be infected at 20 and show manifestations much later. HPV causes over 90% of cervical and traseril cancers and may underlie penile, oral, and throat tumors.

Screening, vaccine, and the 90-70-90 strategy

Without lesions, cytology leaves no trace, which is the problem: screening is the only way to get ahead. In Galicia, since last year, it is offered to all women aged 35 to 65, with sampling at health centers or home, and positive results referred to cytology to check for lesions. None of this equals cancer. The challenge's scale is measured by the WHO strategy launched in 2020 for 2030: vaccinate 90% of girls under 15, screen 70% of women under 45, and treat 90% of patients with lesions. Conization removes the lesion, not the bicho; that remains with the immune system, and reinfection is possible. The full protocol, step-by-step from sample to intervention decision, cannot be summarized in two lines.

Who pays for STI treatment?

Here the matter shifts from clinical to budgetary. Public commentary suggests those taking risks should bear treatment costs, paid by everyone else. In between lies an unquantified area: consultations, tests, and treatments absorbed annually by the public system. A detail often forgotten in discussions: bacterial infections have antibiotics, and HPV has a vaccine. Cost isn't the only variable, but it's the one missing from headlines.

With over 80% of women exposed to HPV in their lifetime and 30% of men unknowingly carrying it, the disconcerting calculation isn't cost. It's time. The bicho can remain dormant for years, appearing only when damage begins. Detection happens precisely then.