• AIDS
• epidemiology
• syphilis

Dear Editor,

In a recent article, Latini et al 1 described a decline in reported cases of STIs, particularly syphilis, during the spring 2020 lockdown in Rome. Similarly, in Madrid, the number of diagnosed STIs decreased during the first semester of 2020 compared with the same period of 2019.2 The authors suggested that a possible driver for the reduction could be COVID-19 related social distancing interventions. In Taiwan, the health authority implemented several control interventions in response to the outbreak, particularly mask wearing and hand hygiene. As of 18 September 2020, a total of 503 confirmed COVID-19 cases had been reported.3 In the meanwhile, the case numbers for influenza, tuberculosis and invasive pneumococcal disease were found to be lower in 2020 than in 2019.3

We wondered whether the number of STIs also decreased in Taiwan as seen in Rome1 and Madrid.2 As reporting of syphilis and HIV infection is mandatory in Taiwan, we were able to access the reported case numbers via the website of Taiwan’s Centers for Disease Control.3 Here we describe the monthly cases of syphilis and HIV infection in the period January–August in the years 2018, 2019 and 2020 (online supplemental appendix figure 1).

A total of 5776 syphilis diagnoses were reported in 2020, which compared with 6294 in 2019 and 6591 in 2018. For HIV infection, a total of 1000 diagnoses were reported in 2020, which was lower than in 2019 (n=1293) and 2018 (n=1393).

Overall, our findings are consistent with those from Italy and Spain in suggesting that the reduction in STIs during the COVID-19 pandemic may reflect less frequent sexual encounters due to the fear of SARS-CoV-2 infection.1 2 However, these data should be interpretated with caution. Under-reporting of STIs may result if people are unwilling to visit hospitals for a diagnosis. Further study is warranted to investigate the definite cause.