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Rising STI Rates and New Prevention Tools for Men Who Have Sex with Men
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Sexually transmitted infections (STIs) are surging worldwide, with particular impact on gay, bisexual, and other men who have sex with men (MSM). The World Health Organization (WHO) recently reported a significant increase in new adult syphilis cases, reaching 8 million globally in 2022—a dramatic rise, especially in the Americas and Africa, despite global targets to reduce transmission by 2030 . MSM continue to experience higher rates of syphilis and account for more than half of all new HIV infections in many regions .
Research across multiple continents—including recent studies in India—confirms a post-pandemic rise in clinic visits for STIs among MSM, following a temporary drop during COVID-19 lockdowns . Factors contributing to this resurgence include increased sexual activity and improved access to testing as social restrictions ease. The rise is not limited to one region, echoing findings from Amsterdam, Kerala, and beyond .
Most STIs—including syphilis, gonorrhea, chlamydia, and HIV—often present without symptoms. This silent spread underlines the importance of regular testing, as emphasized by the Centers for Disease Control and Prevention (CDC), which warns that “the only way to know your STI status is to get tested” .
As of August 2025, no new sexually transmitted pathogens have been documented in the scientific literature or by major health organizations. The most prevalent threats—HIV, syphilis, gonorrhea, and chlamydia—continue to circulate, with rising incidence rates in some populations . The WHO’s consolidated guidance for 2025 focuses on strengthening prevention and management of these known infections, rather than addressing any newly discovered STIs .
Exciting advances in STI prevention and HIV care are reshaping options for MSM. Most notably, long-acting injectable pre-exposure prophylaxis (PrEP) for HIV—specifically, cabotegravir (CAB-LA)—has emerged as a game-changer. In Brazil, a major study of 1,200 participants using injectable PrEP reported zero new HIV infections, marking a significant achievement in HIV prevention . Injectable PrEP, administered every two months, overcomes many adherence challenges associated with daily oral medication and offers a discreet, effective option for those at highest risk.
The WHO’s 2025 guidelines now recommend targeted screening for gonorrhea and chlamydia in high-prevalence settings, explicitly prioritizing MSM for at least annual—and, where resources permit, 6-monthly—testing .
Treatment protocols for syphilis, gonorrhea, and chlamydia remain based on established antibiotic regimens, but health authorities stress the importance of early detection and partner notification to prevent further spread . Experts also warn of rising antimicrobial resistance in gonorrhea, underscoring the need for careful use of antibiotics and ongoing research .
The landscape of sexual health for MSM in 2025 is defined by both progress and ongoing challenges. Here’s what every sexually active man should know:
- Routine Testing Is Essential: Because most STIs show no symptoms, regular screening—at least once a year, or every six months for those at higher risk—is critical . Testing should include HIV, syphilis, gonorrhea, and chlamydia.
- PrEP Options Have Expanded: Injectable PrEP is now widely available and highly effective, providing an alternative for those unable or unwilling to take daily oral pills .
- Vaccination Remains Important: Vaccines for hepatitis A, hepatitis B, and human papillomavirus (HPV) are recommended for all MSM, as these infections remain prevalent .
- Partner Notification and Treatment: Prompt treatment and partner notification remain pillars of STI control, reducing the risk of reinfection and wider community spread .
- Access to Care Is Improving: Decriminalization, increasing social acceptance, and targeted health campaigns have led to higher rates of testing and care-seeking among MSM in many countries .
- Stay Informed about Drug Resistance: Be aware of the risk of antibiotic resistance in gonorrhea and the importance of following prescribed treatment courses exactly as directed .
Advocacy organizations continue to push for equitable access to testing, prevention, and care for all members of the LGBTQ+ community. In regions where decriminalization and destigmatization have advanced, MSM report increased willingness to seek medical attention, leading to earlier detection and better health outcomes . However, challenges remain in countries with restrictive laws or limited resources, where stigma and criminalization continue to hinder progress .
While no new STI pathogens have emerged in 2025, the rising rates of existing infections and the launch of new preventive tools create an urgent call to action. Sexually active MSM should make regular testing, vaccination, and use of PrEP central to their health routines. Public health experts stress that ending the global HIV and STI epidemics by 2030 remains an achievable goal—but only with sustained commitment, innovation, and inclusive care for all.
