Doctors warn: sexually transmitted infections affect all age groups

Sexually transmitted infections have long ceased to be an issue only for young people. That is the point made by Prof. Snezhina Vasileva, a dermatovenereologist at Alexandrovska University Hospital and lecturer at the Medical University of Sofia. A piece by the medical portal MedReport, republished by broadcaster Efir 2 on 18 October, says age no longer draws a clear line on risk. She cites more travel and easier contacts, more frequent changes of partner and unprotected contacts, and an underestimated risk. Sexual activity also continues into later life – helped by erectile dysfunction drugs and because the risk of pregnancy falls away for some older women. Better diagnostics such as rapid tests also make more cases visible.

The Bulgarian figures are clear: the director of the National Centre of Infectious and Parasitic Diseases, Prof. Iva Hristova, told broadcaster Bulgaria ON AIR in July that compared with the previous year, syphilis cases had risen from 187 to more than 240, gonorrhoea from 50 to 140 and urogenital chlamydia from just under 100 to just over 200. People aged 20 to 30 are the most affected. In Germany, too, the picture is shifting: an analysis of around 84,000 reports to the Robert Koch Institute from 2019 to 2025 – compiled by the erotica portal Erobella and therefore not a scientific study – found a median age of 41 at syphilis diagnosis, according to the portal GGG.at; almost one in three new diagnoses concerns people over 50. Per head of population, however, the risk remains highest among 25- to 39-year-olds.

Many of these infections cause no symptoms at first and are passed on unnoticed; shame and lack of knowledge further delay a visit to the doctor. Vasileva advises early testing – with a family doctor or directly with a dermatovenereologist. HIV prevention drugs (PrEP and PEP) do not protect against bacterial infections such as syphilis, gonorrhoea or chlamydia; taking the antibiotic doxycycline after risky contact (doxy-PEP) raises the question of antibiotic resistance. Vaccines are available against hepatitis B and HPV – in Bulgaria, the HPV vaccine is now also available for boys.