Effectiveness of sexual health services

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

Rates of new STI diagnoses in England

In 2016 there were 417,584 new STI diagnoses in England, the most common being chlamydia (369.7 per 100,000 population) and genital warts (114.5 per 100,000 population). Between 2006 and 2016, there were increases in rates of new diagnoses for gonorrhoea (a 96% increase from 33.7 to 66.2 per 100,000 population), syphilis (a 77% increase from 6.1 to 10.8 per 100,000 population) and genital herpes (a 54% increase from 37.8 to 58.2 per 100,000 population). Over the same time period, there was a decline in genital warts (a 16% decrease from 136.8 to 114.5 per 100,000 population). From 2012 to 2016, the diagnosis rate for chlamydia decreased by 6% from 393.7 per 100,000 population to 369.7 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 January 2018.

Late HIV diagnosis

From 2007 to 2016, the proportion of new HIV cases which were diagnosed late in the UK decreased from 54% to 42%, with the absolute number decreasing from 3,152 to 1,645. However, the rate of decline has slowed since 2013, with the proportion of late HIV diagnoses fluctuating at around 42%. For England, figures show a similar decline over the period 2007 to 2013.

The decline is mostly attributable to reductions in late HIV diagnoses among MSM (from 42% in 2007 to 32% in 2016) with a smaller decline among heterosexual men (67% to 60%) and women (59% to 47%). Although MSM have the highest absolute number of people diagnosed late, new HIV cases which are diagnosed at a late stage of infection remains a significant concern among heterosexuals and disproportionately amongst black Africans.

Updated January 2018.

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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