Gonorrhoea infection in Scotland
2014-2023

About this release

This publication by Public Health Scotland (PHS) presents information on gonorrhoea infection in Scotland to the end of December 2023. 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 2023, there were 5,999 diagnoses of gonorrhoea in Scotland. This is higher than in 2022 and represents a 6% increase.
• Most diagnoses were observed in men (3,843) and are consistently higher than in women across the ten-year period.
• In 2023, most diagnoses (73%) in women were in those aged less than 25 years compared to 39% in men. This trend is consistent with previous years where most gonorrhoea diagnoses are reported in younger women, while in men, diagnoses tend be more prevalent in older age groups.
• Diagnoses of rectal gonorrhoea in men, a marker for condomless anal intercourse (CAI), has decreased in 2023 (1,203) compared to 2022. In 2023, the percentage of diagnoses associated (31.3%) with a positive rectal sample was the lowest reported in the last ten-year period.
• Incidence of diagnosed gonorrhoea infections decreased across the course of 2023 with an average monthly incidence of 14 per 100,000 people aged 15-64 years.
• In 2023, the decrease in the incidence of diagnosed gonorrhoea infection is mainly driven by a decrease in the younger age groups of less than 25 years and in gay, bisexual, and other men who have sex with men (GBMSM) and heterosexual men.
• In 2022, two gonococcal isolates showed ceftriaxone resistance, but none were reported in 2023.

Figure one is a line chart showing incidence of gonorrhoea per 100,000 people in Scotland by month from 2019 to 2023. The graph shows that incidence was increasing steadily through 2019 and rapidly decreased due to the lockdown in response to the COVID-19 pandemic. Incidence has increased rapidly since mid-2021 and in January 2023 was at the highest level in the last decade.

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Figure 1: Incidence of diagnosed gonorrhoea infection per 100,000 persons aged 15-64 years per month in Scotland, 2019-2023

Data source: ECOSS

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 June 2025.