Diagnoses of the sexually transmitted infection lymphogranuloma venereum (LGV) in England reached record levels in 2019, with almost all cases involving gay and bisexual men. According to an Aidsmap report, the data is set out in a report published by Public Health England and shows that the number of diagnoses increased steadily from 2017, reaching a peak in the second half of 2019.
LGV diagnoses had previously been concentrated among HIV-positive gay men, but the latest report shows there have been large increases in cases among men who were HIV-negative or of unknown HIV status, reflecting changes in sexual behaviour linked to use of PrEP and awareness of the U=U (undetectable = untransmissable) message.
LGV is a bacterial STI caused by a strain of chlamydia and is treated with a three-week course of the antibiotic doxycycline. It was very rare in the UK until 2003 when cases started to be diagnosed among HIV-positive gay men. All these early diagnoses involved rectal infection and were linked to condomless anal sex and fisting.
The headline finding from Public Health England’s latest report is that cases of LGV in 2019 were at their highest since the reemergence of the infection in 2013. There were 1133 cases reported by laboratories, a 33% increase on 2018, and there were 1076 diagnoses reported by sexual health clinics to the GUMCAD surveillance system, a 56% increase on 2018.
The report’s authors emphasise the increase in diagnosis among HIV-negative/unknown status men. “The increase…may reflect greater mixing between sexual networks as HIV interventions improve…this may indicate that increased access to HIV prevention is altering sexual risk behaviour,” write the authors.
“Findings of this report cement the need for continued use of targeted control interventions including increased health promotion and testing in populations with higher rates of LGV, as well as the opportunity to review national guidelines.”
Full Aidsmap report
PHE Health Protection Report