Effectiveness of sexual health services

Sexual health promotion, alongside the provision of sexual and reproductive health and HIV services, makes an important contribution to individual and population health. Sexually transmitted infections (STIs) are often asymptomatic and if left untreated may cause pelvic inflammatory disease and infertility, and may be transmitted to others, highlighting the need for early detection and treatment (NICE guidance, Contraceptive services for under 25s, 2014).

Rates of newly diagnosed STIs in England

In 2015, there were approximately 430,000 diagnoses of STIs in England, the most common being chlamydia (368.7 per 100,000) and genital warts (125.8 per 100,000). Data from 2015 cannot be compared with that of previous years due to a change in the method of data collection. Between 2009 and 2014, the greatest increases in incidence rates of new STI diagnoses were in gonorrhoea (a 121% increase from 30.9 to 68.3 per 100,000 population), syphilis (a 49% increase from 5.5 to 8.1 per 100,000 population) and genital herpes (a 17% increase from 52.6 to 61.4 per 100,000 population). Over the same period, there has been a decline in genital warts (a 10% decrease from 149.2 to 134.6 per 100,000 population). From 2012 to 2014 the incidence rate of chlamydia increased by 8.9% from 182.1 per 100,000 population to 198.4 per 100,000 population.

The observed rising trends in STIs may be attributed both to more routine testing and case finding in genitourinary medicine and sexual and reproductive health services, but also to continued unsafe sexual behaviour. For example, it is likely that condomless sex associated with HIV seroadaptive behaviours is contributing to the increases in syphilis amongst men who have sex with men (MSM). Of increasing concern is the rise in gonorrhoea diagnosis, especially within a context of antimicrobial resistance for this STI.

Updated November 2016.

Late HIV diagnosis

From 2006 to 2015, the proportion of new HIV diagnoses diagnosed late in the UK decreased from 56% to 39%, with the absolute number decreasing from 7,316 to 6,028. However the rate of decline has slowed from 2013 to 2015, but it is too early to state if this reflects a true change in late diagnoses. For England, figures show a similar decline over the period 2005 to 2014.

The decline is mostly attributable to reductions in late diagnoses among MSM (from 42% in 2006 to 30% in 2015) with a smaller decline among heterosexual men (67% to 55%) and women (64% to 49%). Although MSM are the highest absolute number of people diagnosed late, newly diagnosed at a late stage of infection remains a significant concern among heterosexuals and disproportionately amongst black Africans.

Updated November 2016

About this data

Late diagnosis of HIV in adults is defined as those aged 15 years and above who are diagnosed with a CD4 Cell Count <350 within 91 days of diagnosis in the UK

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