UK STI Statistics 2021
With the unprecedented disruption of the COVID-19 lockdown, the UK’s sex lives have taken a downturn. But has the prevalence of STIs also receded?
At Chemist4U, we were curious as to the impact of COVID-19 lockdowns on STI prevalence in the UK and how it has affected access to sexual health services (SHSs).
To find out more, we gathered the latest research, statistics and data on the diagnosis of STIs, their prevalence, and the number of positive cases in the UK as of 2020.
Here’s what we found:
Sexually Transmitted Infections (STIs) in the UK
While sex shouldn’t be a taboo subject, many people at risk of STIs in Britain underestimate their risk, which can lead to dangerous behaviour, like unprotected sex.
In fact, in the UK, 64% of men and 73% of women perceive 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, and similar proportions of those with a prevalent STI, perceived themselves as not at all or not very much at risk.
In 2019, there were 468,342 diagnoses of STIs made in England, a 5% increase since 2018.
The most commonly diagnosed STI is chlamydia, with 49% of diagnoses being for chlamydia. There’s a similar trend in young people, with 63% of STI diagnoses for young people being chlamydia.
There were 70,936 diagnoses of gonorrhoea reported in 2019, a 26% increase since 2018.
STIs Across The Region
London consistently has the highest diagnosis rate when compared to all other regions for all of the most common STIs and sees a higher proportion of STIs in men who sleep with men (MSM), while Bradford sees the lowest rate of STIs.
The second-highest rate of STIs is in the North West, whilst the East of England sees the lowest overall rate of STIs.
Cities with the highest number of STIs per 100,000 people:
- London – 5,319 cases
- Westminster – 1,660 cases
- Southampton – 1,170 cases
- Manchester – 1,143 cases
- Brighton – 1,138 cases
- Portsmouth – 1, 043 cases
- Nottingham – 1, 042 cases
- Salford – 1.007 cases
- Liverpool – 1,005 cases
- Leeds – 988 cases
- Newcastle – 912 cases
Cities with the lowest number of STIs per 100,000 people:
- Worcester – 335 cases
- Cambridge – 422 cases
- Exeter – 423 cases
- Norwich – 444 cases
- Canterbury – 447 cases
- Oxford – 461 cases
- Bath – 466 cases
- Wakefield – 479 cases
- Durham – 480 cases
- Bradford – 491 cases
Chlamydia is the most prominent in eight of the ten cities with the fewest number of STIs overall, followed by genital warts, which impacts five of the ten cities analysed.
SHS Consultations in 2020
Between January and June 2020, when comparing data from SHSs from January to June in 2019 and January to June in 2020, there was a 13% decrease in consultations at SHSs in England, including both face to face and online consultations). Consultations were on a downward trend from January to April 2020, which recovered shortly after in May and June. However, the number of consultations reported in June 2020 was 11% lower than in June 2019.
Most consultations undertaken by SHSs are face to face, but there has been a two-fold increase in online consultations since April 2020. Between January and March 2020, approximately 26% of consultations were delivered via the internet monthly, compared to 45% in April, 46% in May, and 41% in June.
Trends in the number of consultations were similar across different age groups, gender and sexual risk groups, ethnic groups and deprivation levels. However, between April and June 2020, a slightly lower proportion of consultations undertaken by SHSs were among people aged 15 to 19 (10% vs 12%) and 45 to 64 years (8% vs 10%) and a higher proportion were among people aged 25 to 34 (39% vs 36%) and 20 to 24 years (27% vs 26%) than in January to March 2020.
Over the same period, a lower proportion of consultations were among heterosexuals (men 23% vs 25%; women 61% vs 62%), and a higher proportion was among MSM.
HIV Outpatient Care
Between January and September 2020, there was an 8% decrease in consultations for HIV outpatient care, including face to face and over the phone consultations, compared to the same period in 2019. This followed a downward trend from March to May 2020, followed by a recovery from June to September.
There were 45% fewer consultations reported in May 2020 than in May 2019, though, consultations in September 2020 were 25% higher than in 2019.
Between January and September 2019, 96% of all consultations for HIV outpatient care were face to face. Between April and September 2020, face to face consultations constituted 64% of all consultations, with telephone consultations and other forms constituting 33% and 3% respectively.
Testing for STIs and HIV
Between January and June 2020, there was a 30% reduction in tests for chlamydia, gonorrhoea and syphilis at SHSs compared to the same period in 2019. Similarly, for HIV, there was a 35% reduction in tests at SHSs.
As with consultations at SHSs, the number of bacterial STI and HIV tests in SHSs declined sharply between January and April 2020, by 71% for STIs and 77% for HIV.
There was a small increase in testing from May 2020, but the number of tests performed in May and June 2020 was significantly lower than in May and June 2019.
While testing has decreased overall during 2020, the proportion of bacterial STI and HIV tests accessed via internet services has increased substantially since April 2020.
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).
STI Testing by Age Group
Trends in the number of STI and HIV tests were similar across different age groups, gender and sexual risk groups, ethnic groups and deprivation levels. However, compared to January to March 2020, between April and June 2020, a higher amount of STI tests were accessed by people aged 25 to 34 years (51% vs 47%) and a lower amount by those in all other age groups (≤1% difference in each group).
For HIV tests, between April and June 2020, a lower proportion was accessed by people aged 15 to 19 (7% vs 9%) and 20 to 24 years (25% vs 26%) and by heterosexuals (men 25% vs 33%; women 49% vs 52%), than between January and March 2020.
Over the same time, a higher proportion of HIV tests were accessed by people aged 25 to 34 years (43% vs 39%) and by MSM (24% vs 15%) than between January and March 2020.
Between January and June 2020, the number of chlamydia tests carried out in 15 to 24 year olds through the NCSP was 29% lower than in 2019. There was a significant downward trend from January to April 2020, followed by a small recovery in May and June, however, the number of tests reported in June 2020 was 37% lower than in June 2019.
The reduction in chlamydia testing was greater among specialist SHSs (85%) than in non-specialist SHSs (56%), largely due to the higher proportion of internet-delivered tests offered between January and April 2020.
STI and HIV Positive Diagnoses
As we saw with consultations and testing at SHSs, there was an initial downward trend in the number of HIV and STI diagnoses from January 2020, with the lowest number of diagnoses reported in April and May, respectively. When compared to 2019, the number of gonorrhoea diagnoses fell by 18%. The number of gonorrhoea diagnoses declined by 58% between January and May 2020 and despite a slight increase in June 2020, the number of diagnoses was 31% lower than in June 2019.
For HIV, the number of diagnoses between January and June 2020 was 21% lower than in the same period in 2019. There was also a slight increase in May and June 2020, however, the number of HIV diagnoses was 11% lower than in June 2019.
While HIV and STI diagnoses overall have declined during 2020, the proportion of diagnoses made via internet services has increased substantially since April 2020.
Bacterial STI Testing
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.
The increase in bacterial STI positivity in March and April 2020 may reflect the prioritisation of testing for those with symptoms. Positive HIV tests increased slightly between January and March 2020 (from 0.11% to 0.15%) and peaked in April 2020 (0.19%). This initial increase was followed by slight fluctuations in May and June, but positivity remained slightly higher than equivalent months in 2019.
Men Who Have Sex With Men
During the lockdown, beginning in mid-March, 47% of surveyed MSM reported one or more new sexual partners and 20% reported condomless sex with multiple partners. This compared to 71% and 31%, respectively, from the same period in the equivalent survey conducted during 2017.
Of the MSM reporting condomless sex with multiple partners during the lockdown, 57% had not accessed STI testing at the time of survey completion.
People Who Inject Drugs
Data from the Public Health of England’s Unlinked Anonymous Monitoring (UAM) survey of People Who Inject Drugs (PWID) indicated that the COVID-19 response has affected access to essential services for PWID across England.
Just over a third of PWID participants reported that in 2020, drug and alcohol services were more difficult to access than in 2019, with 22% reporting difficulties accessing HIV and/or hepatitis testing and accessing equipment for safely using and/or injecting drugs (29%). 11% of surveyed PWID reported some form of HCV treatment disruption during 2020.