Worldwide we are seeing increasing notifications for syphilis and gonorrhoea.

This is despite effective treatments for both, with the caveat that resistance is emerging for gonorrhoea.

Why is this happening? Various theories.

What can we do about it? Infectivity, number of susceptible contacts, duration of infectivity.

Infectivity - use of condoms with oral sex? Little else we can do to influence this.

Number of susceptible contacts (the rate of change of sexual partners) - vaccinations, chemoprophylaxis (doxycycline)? Again, little else we can do to affect this.

Duration of infectivity - early detection and treatment (sexual history, is your practice gay friendly, doing the right test, point of care testing), strengthening partner notification? Yes, these are within our ability to affect change.

Most STIs are diagnosed in primary care.

Testing rates in primary care are low.

90% of Australians visit their GP annually.

We have the opportunity to affect change.