The state of STIs in England 2018

Sex is one of the joys of the human experience, but with that intimacy comes the chance of contracting sexually transmitted infections, commonly referred to as STIs.

Although the overall number of diagnosed STI cases has remained steady in recent years, a report* published by Public Health England (PHE) reveals there was a 20% increase in cases of syphilis and a 22% increase in cases of gonorrhoea in England between 2016 and 2017. This is very worrying for syphilis as it’s the highest number of diagnosed cases in the country since 1949.

Data taken from Public Health England's Sexually Transmitted Infections: annual data tables 2018

What’s causing the increase in some STIs?

It’s tough to pin down the answer to one simple fact. This rise in STI diagnosis is most likely connected to a variety of causes – everything from reduced funding for STI testing centres, a drop in the use of condoms, easy access to various sexual partners thanks to online dating apps to the fact that more people are attending STI clinics to get tested (and thus more diagnoses being made) could be influencing the increase in the overall number of STI diagnoses.

STIs in England – the latest data

The newest figures are a mix of the good and the bad for the sexually active population.

The good news is the number of STI cases diagnosed has stayed roughly the same, with 422,147 cases in England in 2017*, down very slightly from 2016.

Other data published within the report shows a fall in rates of genital warts, reflecting the widespread uptake of the HPV (human papillomavirus) vaccine. The research also indicates a 2% drop in chlamydia diagnoses in 15 to 24-year-olds.

However, gonorrhoea has increased across the population with a fifth more cases diagnosed in 2017 compared to 2016.

By far the most common STI diagnosed last year was chlamydia, which can cause fertility problems if left untreated, making up 48% of all new cases.

STI hotspots in the UK

London currently has the unfortunate title of STI capital in the UK with more than double the number of diagnosed infections compared to any other region, accounting for one in four of all new cases of STIs.

In fact, London’s rate of STI diagnoses is 83% higher than any other region in England – 17 of the 20 local authorities with the highest rates of STIs are in the capital. On the opposite end of the scale, the North East of England has seen the lowest number of cases.

Who is most at risk?

The impact of STIs is the greatest among three particular groups – young heterosexuals aged 15-24, men who have sex with men (MSM) and black ethnic minorities.

The first of these is young heterosexuals aged 15-24. They top the league of those most at risk, according to Public Health England, because they change partners more regularly than other age groups. In fact, almost half of last year’s diagnoses were in young men and women in this group. Men in this age group are more than twice as likely to be diagnosed with an STI than their counterparts aged 25-59 years old, while young women aged 15-24 are six times more likely.

The second of these groups, gay, bisexual and other men who have sex with men, are at great risk. In 2017, 55,224 STIs were diagnosed among this group – in particular, gonorrhoea and chlamydia with rates up by a fifth from 2016, and cases of syphilis up by 17%. 78% of new cases of gonorrhoea and syphilis across all demographics came from this group.

Finally, the rates of chlamydia and gonorrhoea are also three times higher in black ethnic minorities than they are across the general population, meaning they are disproportionately affected.

STIs in certain English populations and tips for staying safe

Sex workers
Whilst no official figures exist for the UK’s sex workers, there are a variety of ways for those in this industry to stay safe, including:

• Using condoms and dental dams
• Staying up to date on vaccinations to reduce the risk of certain blood-borne and genital infections, such as HPV
• Booking in for regular STI tests

People with multiple partners
It’s a good idea to undergo sexual health testing at the start of any new relationship.

Being in a polyamorous or sexually open in a relationship, or having multiple casual sex partners, will put you at greater risk simply because you’re having more sexual contact with more people. Basically, the more sex you have with different partners, the higher your chances of catching an STI. That risk can be managed with regular testing and talking openly to your prospective sexual partners – there’s no shame in asking whether they’ve been recently tested before sexual contact occurs, and nothing wrong with refusing to engage in sexual behaviour, especially if it’s unprotected, before you both have the all-clear.

Men or women: who’s more at risk?
The short answer is anyone who has sexual contact with another person is at risk of contracting an STI. The figures reveal a fairly even split between the genders – 218,633 STIs in men last year compared to 201,403 for women.

However, more than three times as many men had gonorrhoea, while twice as many women were diagnosed with genital warts.

Sexually Transmitted Infections 101

Chlamydia
Chlamydia is often symptomless, but if left undiagnosed it can cause infertility in both men and women and lead to ectopic pregnancy.

Find out more about chlamydia symptoms.

Gonorrhoea
Gonorrhoea can be symptomless or cause mild symptoms in women which can often be mistaken for a less serious infection such as cystitis. Left untreated, it can lead to infertility, pelvic inflammatory disease, serious infections of the brain, blood or heart, miscarriage or babies being born blind.

Find out more about gonorrhoea.

Genital herpes
This highly contagious STI that can be caught even if a condom is used during sex, via contact with infected skin. It can cause painful red blisters, but not all carriers show symptoms.

Read more about genital warts and what to watch out for.

Syphilis
If left untreated over a long period of time this infection can spread around your body, even damaging the brain. It can also cause miscarriages and stillbirth.

Syphilis is usually caught by coming into contact with an infected sore, so using a condom reduces the risk of it spreading.

Find out how you can be tested for syphilis at home.

Testing, treatment and protection against STIs

What should you do if you think you are at risk of having an STI?

• Use our home STI testing kits – the results will be returned privately within three days
• Talk to someone you trust for support
• Visit your local sexual health clinic
• Book an appointment with your GP

It can be a worrying time if you think you might have an STI, but there’s plenty of help readily available, including from our doctors who offer professional advice on any sexual health problems you may be experiencing and are happy to help you take control.

What happens at a sexual health clinic?

You’ll be asked questions about your symptoms and sexual history. Just like at your GP, all your answers will be confidential. Men will give a urine sample, while women will be given a self-swab kit which they use in private.

Depending on any symptoms shown, you may need an examination. You could also be offered a blood test to test for HIV or syphilis.

Some results are available the same day, while for others you may have to wait a week or two.

How does an online assessment work?

If you don’t want to visit a centre, you can take an online sexual health consultation and have a testing kit sent to your home.

The consultation consists of a confidential questionnaire that will ask you the same questions that a sexual health clinician would — for example if you have any symptoms, you will be asked how long you’ve had them, whether they’ve worsened and if you’ve had sex since you noticed any problems. This is then reviewed by one of our clinical team and, depending on your answers, you could be sent a testing kit straight to your home or advised to have a physical examination.

It’s worth noting that we also provide free treatment if you test positive for chlamydia and can offer you expert advice and treatments for several STIs.

How can I tell my partner and former partners I have an STI?

There’s no getting out of this potentially awkward conversation, but this is truly a case where honesty is the best policy. The earlier an STI is diagnosed, the easier it is to treat.

However, if you need some help, did you know you can ask your sexual health clinic to do it for you, or even your GP? There are even some apps that allow you to text former sex partners anonymously to let them know they should go and be tested.

Taking control of your sexual health 

Today is the day. It’s normal and responsible to have concerns about your sexual health. Some people want to treat an existing condition, while others want to take a test to put their mind at ease.

Hundreds of thousands of people each year are diagnosed with and treated for sexually transmitted infections, but there’s no data available for how many people have an STI without knowing it and continue to have sex with different partners, spreading the infection.

Protecting yourself is the first step – use a condom, ask if your partner(s) have been tested, make sure you’ve been recently tested and be confident in abstaining from sex until you can do it safely. But if you do have unprotected sex and think you may have contracted an STI, your next steps are testing and treatment if required.

If you think you might be at risk take our free online STI assessment, or you can find your local sexual health clinic online. 

References

*Data taken from Public Health England's Sexually Transmitted Infections: annual data tables 2018 -  https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables