About this release

This publication by Public Health Scotland (PHS) presents information on gonorrhoea infection in Scotland to the end of December 2022. The report provides ten-year data trends and presents data observed during the COVID-19 pandemic which impacted significantly on the routes through which individuals have been able to access sexual health services.

Main points

  • In 2022, there were 5,641 diagnoses of gonorrhoea in Scotland. This is higher than recent years and represents a 49% increase on that observed in 2019 (3,776).
  • Most diagnoses were in men (3,793) and were more than two times higher than diagnoses in women (1,822).
  • In 2022, 77% of diagnoses in women were in those aged less than 25 years compared to 39% in men. This compares to data in previous years when historically, gonorrhoea diagnoses in women have been mostly in those aged less than 25 years, while in men, diagnoses are more likely to be in older age groups.
  • Diagnoses of rectal gonorrhoea in men, a marker for condomless anal intercourse (CAI), were at the highest levels over the last decade in 2022 (1,308), however, the percentage of episodes with a positive rectal sample was similar to previous years (36%).
  • Incidence of diagnosed gonorrhoea infection has increased rapidly since May 2021 from 3 positives per 100,000 people to a historical high of 17.2 per 100,000 in November 2022.
  • At the end of December 2022, levels of testing for gonorrhoea in sexual health clinics have not yet fully recovered to levels observed prior to the COVID-19 pandemic; there were 605 positive individuals per 10,000 people tested in the last quarter of 2022.
  • The increase in the incidence of diagnosed gonorrhoea infection beginning during 2021 was initially driven by gay, bisexual, and other men who have sex with men (GBMSM). However, since quarter two of 2022, gonorrhoea diagnoses have decreased in GBMSM and increased in women and heterosexual men.¬†
  • There were no reports of ceftriaxone resistance in gonococcal isolates in 2020 or 2021 and there were no documented treatment failures during this time.
Image caption Figure 1: Incidence of diagnosed gonorrhoea infection per 100,000 persons aged 15-64 years per month in Scotland, 2018-2022

Data source: ECOSS
Incidence is based on number of positives per 100,000 population aged 15-64 years using the National Records for Scotland estimate as at 30 June 2021.

Background

Gonorrhoea infection is caused by the bacteria Neisseria gonorrhoeae and is the second most common bacterial STI in Scotland and the UK. Gonorrhoea can be transmitted through unprotected vaginal, anal, or oral intercourse with an infected partner. Infected individuals may have no symptoms but can still pass on the infection. Gonorrhoea can be treated with antibiotics, but if left untreated can result in reproductive morbidities in women, including pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility, while men can experience epididymo-orchitis or prostatitis. Disseminated gonococcal infection can also occur leading to skin lesions, arthralgia, arthritis, and tenosynovitis.

Further information

The next release of this publication will be April 2024.

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Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 07 March 2023
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