STI Statistics In England 2022

STI Statistics In England 2022

A header image for Chemist4U's STI Statistics guide 2022

In our previous 2021 STI statistics guide, we reported on the impact of COVID-19 lockdowns on STI prevalence in the UK and how it affected access to sexual health services (SHSs).

 

In this updated guide for 2022, we wanted to find out how the lifting of restrictions has impacted the prevalence of STIs in England.

 

This update includes January - December 2020 figures and STI statistics up to June 2021.

 

Here’s what we found:
 

Sexually Transmitted Infections (STIs) in England

 
While sex shouldn’t be a taboo subject, many people in Britain underestimate the risk of STIs, which can lead to risky behaviour, like unprotected sex.

 

In a 2018 study, 64% of men and 73% of women in the UK perceived themselves as not at all at risk for STIs.

 

What’s more, over 70% of men and over 85% of women classified as having had unsafe sex in the past year. Similar proportions of those with a prevalent STI, perceived themselves as not at all or not very much at risk. [1]

 

In 2020, there were 317,901 diagnoses of STIs made in England, a 32% (31.9%), decrease on the 467,079 total diagnoses made in 2019. [2]

 

Annual STI diagnosis rate

 

The most commonly diagnosed STI in 2020 was Chlamydia which made up 51% of total diagnoses (161,672 diagnoses). 67,822 of those diagnosed were over the age of 25 and 92,790 of cases were detected in 15 - 24 year olds.

 

31,095 cases were detected in males aged between 15 - 24 and 60,343 cases were detected in females aged between 15 - 24 years old [2].

 

Whilst these numbers were impacted by COVID 19 restrictions, it’s important to highlight that testing rates for chlamydia in 15 - 24 year olds were significantly down versus 2019, at 33% [2].

 

There were 57,084 diagnoses of gonorrhoea reported in 2020, a 20% (19.5% ) decrease on the reported 70,936 in 2019.

 

There was a total of 27,473 diagnoses of genital warts in 2020, down almost 50% (45.8% on the number of genital warts cases reported in 2019, 50,700).

 

You can view the 2020 diagnoses totals by STI type in the graphic below:

 

2020 STI diagnosis rate.

 

STI diagnosis January - June 2021

 

Since our last guide was published in 2021, Public Health England has released STI diagnoses up until June 2021.

 

In the graph below, you can see the month on month diagnosis for three common STIs reported in England: Chlamydia, Gonorrhoea and Syphilis.

 

Sexually transmitted infections in England January 2019 - June 2021

 

From January - June 2021, Public Health England figures show that a total of 71,519 Chlamydia diagnoses have been made.

 

In the same period in 2020, 80,454 Chlamydia diagnoses were made.

 

That’s an 11% (11.11%) decrease on the previous period, suggesting that COVID-19 restrictions that were still in place during that time, might still have been impacting people seeking consultations, however the numbers suggest that they’re not far behind previous pandemic levels.

 

There were 17,130 Gonorrhoea diagnoses made between January - June 2021, a 64% (63.9%) decrease in the 28,089 diagnoses made during the same time period in 2020.

 

In terms of syphilis diagnoses, there were 2,709 diagnoses made during that same six month period, only 578 fewer cases than the previous period in 2020.

 

Despite the overall decrease in STI diagnoses, STIs continued to disproportionately impact young people aged 15 to 24 years, and gay, bisexual and other men who have sex with men [2].

 

STIs Across England’s Regions

 

London consistently has the highest diagnosis rate when compared to all other regions for all of the most common STIs, while Oxford sees the lowest rate of STIs.

 

City and town local authorities with the highest number of STIs per 100,000 people:

 

Regions with the highest STI diagnoses per 100,000 people

 

Larger local authorities with the lowest number of STIs per 100,000 people include:

 

Regions with the lowest STI diagnoses per 100,000 people

 

Chlamydia is the most diagnosed STI per 100,000 people across all ten cities with the highest number of STIs overall. [4]
 

London districts STI diagnosis per 100,000 people

 
Over 105,000 new STIs were diagnosed in London residents in 2020. This equates to a rate of 1,167 diagnoses per 100,000 people. [3]

 

Of the 20 upper tier local authorities in England with the highest STI rates in 2020, 19 of those were in London.

 

These ranged from 442 new STI diagnoses per 100,000 people in Havering to 3,060 per 100,000 people in Lambeth.

 

The number of new STIs diagnosed in London residents declined by 30% between 2019 and 2020.

 

Reported numbers of the 5 major STIs declined: syphilis decreased by 8%, gonorrhoea by 15%, chlamydia by 33%, genital herpes by 41% and genital warts by 43% [3].

 

Access to sexual health services was impacted by the coronavirus (COVID-19) pandemic.

 

STI testing (excluding chlamydia in under 25 year olds) fell between 2019 and 2020, dropping by 25% in London, similar to the decrease seen in England (26% fall).

 

There was also an increase in the STI positivity reported in London, from 9.1% in 2019 to 9.6% in 2020 [3].

 

London borough STI diagnosis per 100,000 people 2020
Lambeth 3060
Southwark 2377
Hackney 1943
Hammersmith and Fulham 1940
Islington 1746
Tower Hamlets 1690
Westminster 1655
Wandsworth 1652
Haringey 1564
Lewisham 1532
Kensington and Chelsea 1482
Brent 1327
Camden 1209
Newham 1127
Waltham Forest 1072
Enfield 973
Ealing 963
Croydon 895
Greenwich 889
Merton 873
Barnet 721
Barking and Dagenham 690
Hounslow 665
Harrow 635
Kingston upon Thames 596
Hillingdon 592
Bromley 582
Richmond upon Thames 536
Redbridge 475
Sutton 452
Bexley 447
Havering 442

 

Men have higher rates of new STIs than women (1,511 and 804 per 100,000 residents respectively).

 

Gay, bisexual and other men who have sex with men (MSM) experience health inequalities related to STIs.

 

They account for 43% of London residents diagnosed with a new STI (excluding chlamydia diagnoses reported via CTAD).

 

STIs also continue to disproportionately affect young people with those aged between 15 and 24 years accounting for 32% of all new STI diagnoses in 2020 [3].
 

Sexual Health Screening (SHS) Consultations in 2020

 
Overall, there was a decrease in consultations delivered by SHSs in 2020 compared to 2019 (10%; from 3,853,387 to 3,482,700) [5].

 

Of all consultations in 2020, 62% (2,151,145) were delivered face-to-face, 30% (1,062,157) via the internet and 8% (269,398) via telephone.

 

Compared to 2019, face-to-face consultations in 2020 reduced by 35% (from 3,288,261 to 2,151,145); however, there was a two-fold and five-fold increase in internet (from 511,979 to 1,062,157) and telephone (from 53,147 to 269,398) consultations, respectively [5].

 

It’s important to note that the number of internet consultations is likely to be underreported as it only includes consultations provided by standalone internet SHSs.
 
The number of sexual health screens (tests for chlamydia, gonorrhoea, syphilis or HIV) in 2020 decreased by 25% (from 2,190,227 to 1,649,429) compared to 2019. This reduction in testing contributed to a decrease in STI diagnoses, compared to 2019. [5]

 

The scale up of remote testing via internet consultations in 2020 coincided with the first national lockdown from late March to June 2020.

 

For example, the proportion of gonorrhoea tests delivered via internet consultations peaked in April (69%; 41,836 out of 60,563) and May (69%; 51,159 out of 78,319) before gradually decreasing by December (53%; 61,922 out of 117,442). [5]

 

There were similar trends in chlamydia and syphilis tests delivered via internet consultations during 2020.
 

Bacterial Testing for STIs by age group and sexual risk

 
Between January - June 2020, there was a 30% reduction in tests for chlamydia, gonorrhoea and syphilis at SHSs compared to the same period in 2019.

 

Between January - June 2021, the number of chlamydia tests carried out in 15 - 24 year olds was only 1% (1.2%) higher than the same period in 2020.

 

Bacterial STI testing by age group January 2019 - June 2020

 

There was a significant downward trend from January - April 2020, followed by a small recovery in May and June, however, the number of tests reported in June 2020 was 47% (-46.5%) lower than in June 2019.

 

In June 2021, the numbers of tests reported were 54% (53.6%) higher than June 2020, which has followed a steady trend in testing since January 2021.

 

As with consultations at SHSs, the number of bacterial tests in SHSs declined sharply when comparing the total bacterial tests in January versus April 2020, which were 325% (324.6%) lower.

 

Trends in the number of STI tests were similar across different age groups, gender and sexual risk groups, ethnic groups and deprivation levels in 2020 and up until June 2021.

 

However, in February 2021, 27% (26.5%) of bacterial STIs tests were taken by the sexual risk group “men who have sex with men” at sexual health centres in England, a much higher rate than 18.% (17.5%) of the same sexual risk group in the previous year (February 2020).

 

When looking at 2020’s data, between January and February 2020, the proportion of bacterial STI tests (excluding blood tests) that were positive at SHSs was similar to January and February 2019.

 

Bacterial STI positive tests saw an increase during March and April 2020 - 17% of tests in April 2020 were positive compared to 13% in April 2019. In May and June 2020, the number of positive bacterial STI tests was similar to the same period in 2019. [6]

 

The increase in bacterial STI positivity in March and April 2020 may reflect the prioritisation of testing for those with symptoms.
 

HIV Outpatient Care

 
Between January and June 2021, there was an 12% (11.6%) increase in consultations for HIV in England, including face to face and over the phone conversations compared to the same period in 2020.

 

This followed an upward trend from March - June 2021, where consultations had almost reached pre-pandemic levels in 2019.

 

There were 59% (59.2%) more consultations reported in May 2021 than in May 2020, though consultations had started off much higher at the start of the year in January 2020, where they were 17% (17.2%) higher than in January 2021.

 

Between January and June 2021, 66% (65.9%) of all consultations for HIV care were face to face, 28% over the telephone and 4% (3.61%) by other means.

 

For the same period in 2020, face to face consultations constituted 67% of all consultations, with telephone consultations and other forms of consulting 25% (25.4%) and 1% (1.4%) respectively.

 

HIV tests

 
Between January - June 2021, a total of 316,281 HIV tests were taken across these months at SHS by persons of all ages.

 

This is an increase of 12% (12.2%) verses the previous period in 2020, where a total of 281,927 HIV tests were reported by sexual health services in England.

 

HIV testing in February 2021, increased by 30% (30.4%) on January 2021, but started to decline again in March and April 2021.

 

However, HIV tests in June 2021, the latest figures released, show that HIV tests in that month had increased by 12% (11.9%) versus May 2021 - 70% (70.4%) more tests recorded than in June 2020.

 

The reported number of tests at sexual health services have steadily increased from April 2021 onwards, with 157,555 HIV tests reported - an increase of 56% (55.5%) from the same period in 2020.

 

However, this same period in 2020 was when the percentage of HIV tests accessed via internet service in England were at their peak, which is when the UK was still under lockdown restrictions, explaining why tests reported by the SHS would be much lower.

 

May 2020 saw the highest number of HIV tests accessed via internet services that entire year, at 51%.

 

The shift to online service provision was also apparent through the National HIV and Syphilis Self-Sampling Service, an online service jointly commissioned by PHE and local authorities.

 

Between January and August 2020, PHE tested just under 6,000 HIV and syphilis self-sampling kits.

 

Overall, a higher number of HIV tests were performed by the self-sampling service between January and August 2020 compared to the same period in 2019 (14,872 vs 13,064). [7]

 

While testing decreased overall during 2020, the proportion of HIV tests accessed via internet services increased substantially since April 2020.

 

However, the percentage of HIV tests accessed via internet service in England has declined since February 2021, which coincides with an increase in HIV consultations being carried out face to face and over the phone in England.
 

HIV Positive Diagnoses

 
The number of people positively diagnosed with HIV between January - June 2021 was 6% (5.5%) higher than in the same period in 2020.

 

There was also a slight increase in diagnosis from April to May 2021, however, the number of people diagnosed with HIV in June 2021 was only 5 fewer than in June 2020, therefore this doesn’t represent an increasing trend.

 

While HIV diagnoses overall have declined during 2020, the proportion of diagnoses made via internet services has increased substantially since April 2020.

 

According to the World Health Organisation, when used correctly and consistently, condoms “offer one of the most effective methods of protection against STIs, including HIV”. [8]

 

Although it is important to note, condoms are highly effective, they do not provide protection against extra-genital ulcers (i.e., syphilis or genital herpes), but when possible, condoms should be used in all vaginal and anal sex.

 

Safeguarding your sexual health should be a prioirity if you are sexually active. This includes looking after your physical and mental wellbeing.

 

Neglecting it can have an impact on your happiness, and result in things like unwanted pregnancies and STIs.

 

Although incredibly important, sexual wellbeing doesn’t just revolve around your physical health and symptoms, being sexually positive also includes safe, pleasureable sex, where you’re educated about your body and exploring your sexuality in a way that isn’t putting you or others at risk of an STI.

 

References

  1. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180228/
  2. [2] https://www.gov.uk/government/news/sti-rates-remain-a-concern-despite-fall-in-2020
  3. [3] https://assets.publishing.service.gov.uk/
  4. [4] https://fingertips.phe.org.uk
  5. [5] https://assets.publishing.service.gov.uk
  6. [6] https://assets.publishing.service.gov.uk
  7. [7] https://assets.publishing.service.gov.uk
  8. [8] https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

 

Methodology
Data for this guide was collated and downloaded from the official online report released from Public Health England. The data included in this guide is from January 2019 until the latest government release of STI and HIV statistics in June 2021.

 

Data
A full set of the data is available on request.

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James O'Loan - CEO & Superintendent Pharmacist
James O'Loan , CEO & Superintendent Pharmacist on 11 October 2022
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