Gay men and young adults most at risk from sexually transmitted infections in England

Besi Besemar June 17, 2014

There were 446,253 sexually transmitted infections (STIs) diagnosed in England in 2013, according to new Public Health England (PHE) data out today – close to the number diagnosed in 2012 (448,775 cases).

Public Health England

Chlamydia was the most common STI, making up 47% of all diagnoses (208,755), while gonorrhoea diagnoses saw a large rise, up 15% from 2012 to 2013 (29,291).

Among heterosexuals diagnosed in genitourinary medicine (GUM) clinics in 2013, young people (15-24 years) experienced the highest STI rates – 63% of chlamydia cases (56,034), 54% of genital warts (36,312), 42% of genital herpes (12,450) and 56% of gonorrhoea (8,122).

Gay men were also disproportionately affected, accounting for 81% of syphilis (2,393) and 63% of gonorrhoea (13,570) cases in male GUM clinic attendees. Gonorrhoea diagnoses rose 26% in this group, nearly double the national rate, which is of particular concern as harder to treat gonorrhoea strains emerge.

Dr Catherine Lowndes, consultant scientist in PHE’s STI surveillance team, said: “Sustained efforts to encourage people to regularly get checked for STIs means we are now finding and treating more infections – which is good news. Nevertheless these data show too many people are still getting STIs each year, especially young adults and gay men.

“Investment in promoting good sexual health awareness, contraception and condom use, and STI testing is vital, as is ongoing investment in easy to access sexual health services that meet the needs of local populations. Not only will this help bring down STI rates but abortion rates and under 18 conceptions as well.”

National guidance recommends local services routinely offer chlamydia screening to young adults but only 15% of young men and 35% of young women were tested in 2013. Wide variation across the country were seen in rates of chlamydia testing and diagnoses – with only around 1/3 of local authorities reaching the recommended chlamydia screening outcome (2,300 diagnoses per 100,000 young adults per year).

Dr Lowndes, continued: “Chlamydia can have serious consequences, including infertility, if it’s not treated. These data show we need to do more to encourage young adults to ask for testing every year when they attend health services.

“Local areas can look at embedding screening into a variety of settings to make it as easy as possible for this group to get tested. Offering a young adult a chlamydia test opens the door to conversations about other important aspects of good sexual health, such as contraception and condom use.”

Individuals can significantly reduce their risk of catching or passing on an STI by consistently and correctly using condoms until all partners have had a sexual health screen, by reducing the number of sexual partners, and by avoiding overlapping sexual relationships.

For anyone in the  highest risk groups, getting screened regularly will lead to early identification and treatment, as these infections are frequently asymptomatic:

· Sexually active under 25 year olds should be screened for chlamydia every year, and on change of sexual partner

· MSM should have an HIV/STI screen at least annually or every three months if having unprotected sex with new or casual partners

· Black African men and women should also have an HIV test and a regular HIV/STI screen if having unprotected sex with new or casual partners.

Cary JamesCary James, Head of Health Improvement at Terrence Higgins Trust, said: “These figures show we now have more gay men testing more regularly, and that’s a good thing. However, it’s not the whole picture. Too many men are taking risks with their sexual health, more often than not because they believe they share a HIV status with their partner. Even if they’re right – which many of them aren’t – eliminating HIV risk does not make you immune to other STIs. The sharp increase in rates of both gonorrhoea and syphilis is concerning, especially in the context of emerging drug-resistant strains of gonorrhoea.

“Part of the problem is that the current approach to sex education in schools is leaving gay and bisexual men out in the cold. Gay men will continue to be disproportionately affected by sexual ill health until we have a proper programme of sex and relationships education in all schools, that is fit for the 21st century and covers all types of relationship. Taught properly, sex and relationships education has been shown to delay sexual activity, reduce the number of sexual partners, and increase the use of condoms. Having that bedrock in place is a vital step to give gay and bisexual men the confidence as adults to make healthy decisions about sex.”