Sexually transmitted infections diagnoses in Barcelona show potential inequalities by sex, country of birth and socioeconomic level, which are reflected in the type of healthcare setting where diagnoses are made.
Community-based services accounted for the largest share of STI diagnoses in Barcelona between 2007 and 2024, followed by primary care and hospital-based care.
Men accounted for the majority of STI cases and were predominantly diagnosed in community settings, while women were mainly diagnosed in primary care.
The probability of being diagnosed with an STI in any type of care setting decreased with increasing age compared to the 25-34-year age group.
Being born in Central or South America was associated with substantially higher probabilities of STI diagnosis in primary care and hospital-based care compared to other groups.
Low socioeconomic status was associated with a substantially higher probability of STI diagnosis in primary care.
The COVID-19 pandemic appears to have accentuated existing inequalities and was associated with a relative shift in STI diagnostic activity towards community-based services.
The authors identified a need to strengthen primary care and improve coordination between healthcare settings to move toward a more equitable model of sexual health care.
This research analyzed trends in sexually transmitted infections (STIs) — specifically syphilis, gonorrhea, chlamydia, and lymphogranuloma venereum — diagnosed in Barcelona, Spain, from 2007 to 2024. The study looked at where people were diagnosed (community health centers, primary care clinics, or hospitals) and how this varied by gender, age, country of birth, and socioeconomic status. The researchers found that community-based services handled the largest share of diagnoses (44%), while primary care and hospitals accounted for roughly 31% and 25%, respectively. The study found notable differences in who gets diagnosed where. Men, who made up nearly 79% of all cases, were more often diagnosed through community services, while women more frequently received diagnoses through primary care. People born in Central or South America were more than twice as likely to be diagnosed in primary care or hospital settings compared to other groups, and people with low socioeconomic status were more than three times as likely to be diagnosed in primary care. These patterns suggest that different population groups are accessing sexual health services through different — and potentially less targeted — pathways. The COVID-19 pandemic appeared to intensify these disparities and pushed more diagnostic activity toward community services. This research suggests that STI diagnosis in Barcelona is not equally distributed across different social groups or healthcare settings, pointing to potential inequalities in access to sexual health care. The findings highlight the importance of strengthening primary care services and improving coordination between different types of healthcare providers to ensure that all groups — regardless of gender, origin, or income — have equitable access to STI testing and diagnosis.
Carles Pericas, D. Palma, Marina Palau, L. Aguirre-Cañas, Soledad Castell, C. Rius, et al.. (2026). [Evolution of sexually transmitted infections cases in the city of Barcelona (2007-2024): profiles by reporting centre].. Gaceta Sanitaria. https://doi.org/10.1016/j.gaceta.2026.102589