The UK is facing a growing threat of antibiotic-resistant gonorrhea, a sexually transmitted infection (STI). While overall gonorrhea cases decreased by 16% in England in 2024, the number of cases resistant to ceftriaxone, the primary antibiotic used for treatment, has risen alarmingly. In the first five months of 2025 alone, 14 cases of ceftriaxone-resistant gonorrhea were reported, surpassing the total of 13 cases recorded in the entirety of 2024. Even more concerning is the rise of extensively drug-resistant gonorrhea, which doesn’t respond to ceftriaxone or second-line treatment options. Six such cases have been identified in 2025, raising significant concerns among health experts. The majority of these drug-resistant cases are linked to travel to or from the Asia-Pacific region, a known hotspot for ceftriaxone resistance.
This surge in antibiotic-resistant gonorrhea underscores the urgent need for effective prevention and control measures. Health officials stress the importance of safe sex practices, particularly condom use, to curb the spread of STIs. Regular testing is crucial for individuals who have had condomless sex with new or casual partners, whether in the UK or abroad, even in the absence of symptoms. Early detection and treatment are essential to prevent further transmission and the development of drug resistance. A new gonorrhea vaccination program, slated to begin in August, offers hope for reducing the incidence of this STI in the coming years.
While the overall decline in gonorrhea cases is a positive sign, the rise of other STIs paints a more complex picture. Syphilis diagnoses continued to climb in 2024, reaching their highest levels ever recorded. Early-stage syphilis cases increased by 1.7%, while overall syphilis diagnoses, including late-stage infections and complications, rose by 5%. The persistent increase in syphilis cases highlights the need for continued vigilance and enhanced public health interventions.
In contrast to the trends observed for gonorrhea and syphilis, chlamydia cases saw a significant decline of 13% in 2024. Genital warts diagnoses also decreased, indicating some success in prevention and control efforts for these STIs. However, a concerning 10.7% reduction in chlamydia screening among young women aged 15 to 24 raises concerns about potential underdiagnosis and delayed treatment. This decline in screening participation underscores the need for increased awareness campaigns and improved access to testing services.
The contrasting trends observed across different STIs highlight the complex challenges facing sexual health services. While progress has been made in reducing certain infections, the rise of antibiotic-resistant gonorrhea and the persistent increase in syphilis cases pose significant threats. Health officials emphasize the importance of a multi-pronged approach, including promoting safe sex practices, expanding access to testing and treatment, and implementing effective vaccination programs.
Experts warn that the current strain on sexual health services necessitates a comprehensive national strategy to address these challenges effectively. Adequate resources and a coordinated approach are essential to ensure the long-term viability of sexual health services and to protect the public from the increasing threat of STIs, including drug-resistant strains. The UKHSA’s warning serves as a call to action for increased investment, innovative strategies, and a renewed commitment to prioritizing sexual health.
