Sexually transmitted infections in 2019

Public Health England (PHE) has released the latest sexually transmitted infection (STI) surveillance data for 2019. Following the upward trend since 2015, STIs diagnoses have risen again and 468,342 diagnoses were made in England in 2019, a 5% increase from 2018.

Total number of STI diagnoses, England 2010 to 2019
Key findings

Diagnoses

  • 468,342 diagnoses of STIs in England in 2019.
    • 249,690 recorded gender ‘male’.
    • 216,058 recorded gender ‘female’.
  • 26% increase in gonorrhoea since 2018, the highest since records began in 1918.
  • 10% increase in syphilis since 2018. In women the increase is 36%, but 81% of infections were recorded in men who have sex with men (MSM), of which almost a third (31%) were MSM living with diagnosed HIV.
  • 7% increase in number of consultations at sexual health services.
    • This is largely driven by a 84% increase in consultations reported by internet services (from 260,708 to 480,112).
  • 11% decrease in genital warts.

Testing and screening

  • The National Chlamydia Screening Programme (NCSP) conducted 2% more tests in 2019 compared to 2018; however, there has been a 13% decline since 2015 (from 1,546,180 in 2015 to 1,339,913 in 2019).
  • 181 sexual health services reported testing for Mycoplasma genitalium (M.Gen) in 2019, compared to 107 in 2018.
    • This increase in testing capabilities has largely influenced the 196% increase in M.Gen diagnoses in 2019, up to 5,311.

Disproportionately impacted populations

Young heterosexuals 15 to 24 years; black ethnic minorities; and gay, bisexual and other MSM continue to report the highest rates of STIs in England.

Young heterosexuals

The majority of chlamydia diagnoses (62%) and gonorrhoea diagnoses (54%) in sexual health services were made in young heterosexuals. This group was also attributed to 41% of genital herpes diagnoses and 40% of genital warts.

MSM

Bacterial STIs are more likely to be diagnosed in MSM than other men. 81% of syphilis diagnoses were in MSM as well as 66% of gonorrhoea. The most common STIs have seen substantial increases in this population, with gonorrhoea diagnoses increasing by 26% and chlamydia diagnoses by 21%.

Of all MSM diagnosed with an STI in sexual health services in 2019, 18% were living with diagnosed HIV. A breakdown of STIs diagnosed in MSM by HIV status is provided in the graph below.

STI diagnoses among MSM by HIV status, 2010-2019

Black minority ethnic and other impacted populations

Black minority ethnic (BME) populations continue to be disproportionately impacted by STIs. In particular, the rate of gonorrhoea in BME people is 3.5x that of the general population and the rate of trichomoniasis is 9x that of the general population.
The largest proportional increase in all new STI diagnoses was in people of Asian ethnicity (16%; from 15,168 to 17,522), this was largely due to large increases in new gonorrhoea (36%) and chlamydia (27%) diagnoses.
The disparities between different ethnic groups are best seen in these images below, looking at rates of STIs for both men and women.

Rates of STI diagnoses by ethnic group among males, England 2019

Rates of STI diagnoses by ethnic group among females, England 2019

PHE has provided data based on World regions of birth, these have shown high overall increases of STI diagnoses in England with:

  • 9% of people born in the EU,
  • 11% of people born in North America,
  • 12% of people born in South Asia,
  • 16% of people born in South America,
  • 21% of people born in Central America.

Impact of COVID-19

The latest data release does not cover the period since the COVID-19 pandemic began. However, PHE has advised that they are already analysing the surveillance data and how the impact of the COVID-19 response in England has affected HIV and STI service provision and epidemiology. Provisional findings are due in the coming months.

The latest report outlines how the national programme with PHE, Terrence Higgins Trust and 56 Dean Street delivered 10,000 free self-sampling HIV (and opt-in syphilis test) kits as part of the summer ‘Break the chain’ campaign.

PHE has also published a new national framework for e-sexual and reproductive healthcare. This provides information on how e-sexual and reproductive services can complement specialist, clinic-based facilities in local areas, providing other methods of accessing healthcare.

Resources from PHE

Sexually transmitted infections and chlamydia screening in England: 2019 [PDF].

Latest STI data tables, infographics and supplemental information.

National framework for e-sexual and reproductive healthcare: User guide [PDF]

Time to test campaign

Test now before lockdown endsThe Time to Test campaign, founded by 56 Dean Street (Chelsea and Westminster Hospitals NHS Foundation Trust), seeks to maximise the current social distancing situation to identify everyone who has undiagnosed HIV so that they can start treatment early, improve their health and prevent them from passing on HIV to anyone else.

Public Health England (PHE) and HIV Prevention England (HPE) are supporting the campaign in the following ways:

  • PHE opened the National Home Sampling Service via https://freetesting.hiv on Friday, 5 June 2020 and residents in all local authorities in England can now order a free self-sampling kit.
  • PHE has committed to supplying 7,000 free HIV tests, including syphilis opt-out testing throughout the promotional period.
  • PHE will also provide co-ordination and leadership of the public health system through liaison with local authorities, professional bodies and ADPH to ensure that activity is as effective as possible.
  • HPE will promote the campaign via It Starts With Me using PR and targeted digital promotion across England.
  • Promotion will be targeted to black African people and gay and bisexual men across England, with 56 Dean Street fulfilling promotion to gay and bisexual men in London.

Campaign Information Briefing [PDF]

Download social media assets (Please contact [email protected] if you are unable to access Dropbox from your workplace)

 

Using online video conferencing platforms safely and securely

As we navigate new ways to deliver care and support through online services, it’s important to ensure the safety and security of people accessing these services, especially where their personal information is concerned.

The following information provides some guidance for people working in HIV and sexual health organisations who are currently delivering services through popular webinar, virtual meeting and video conferencing platforms.

Platforms and applications

Zoom has become the video conferencing platform of choice for most organisations and the majority of information herein will refer to this application. However, there are alternatives available:

Suitable for work with service users

  • Google Duo provides video conferencing for up to 12 people and is available via web and mobile devices. Video and audio calls are end-to-end encrypted.
  • Webex is a popular video conferencing and webinar platform already used by many businesses. Video calling supports end-to-end encryption.
  • GoToMeeting provides a similar service and includes end-to-end encryption as standard. There are no free plans.

Suitable for work with teams and colleagues

  • Microsoft Teams is a ‘full-package’ collaborating tool which is one of the most comprehensive options available; with good security features and streamlined synchronisation with other Microsoft Office applications. However, it can be complicated and clunky compared to Zoom, which is simple and straightforward to use, or other options.
  • Skype, Slack (paid plan only) and Facebook Messenger provide means to communicate by video but without full end-to-end encryption.

Using Zoom safely and securely

There has been noticeable media attention relating to ‘zoombombs’ in which uninvited trolls enter meetings and disrupt them by talking over meeting hosts or sharing undesirable content via video or screen share options.

There are some simple steps to avoid this practice:

  • Do not share Zoom meeting numbers publically, send the joining information in private emails to registered attendees.
  • Create a new meeting ID for each event or meeting rather than using your own personal meeting ID.
  • Create a password for your meeting, and never share this publicly.
  • Enable a waiting room (see advanced options), this will allow you to block anyone from joining who you were not expecting.
  • As a meeting host you can decide whether you want to give all meeting attendees the option of sharing their screens.
  • Once all of your attendees have arrived you can lock meetings to prevent anyone else from joining.

Recording meetings

Hosts can record audio and video from meetings and capture the chat function via meeting reports, including private 1-2-1 conversations between attendees.

  • Hosts should advise people in advance if they intend to record and share webinars and other educational meetings.
  • Avoid discussing confidential matters with other attendees if you do not want the information shared with the meeting organiser.

Zoom provides a comprehensive guide to security of their platform including information on:

  • Protecting your meetings
  • Protecting your data
  • Protecting your privacy

If you are concerned about the security and privacy in relation to providing services where personal information may be shared (for example online counselling), read more about Zoom’s security features and specific information regarding encryption for meetings.

Coronavirus (COVID-19) guidelines and resources for HIV and sexual health sector

Coronavirus (COVID-19) has created the biggest public health challenge in living memory. As the NHS continues to respond to the pandemic, the HIV and sexual health sector has adapted quickly to continue to support the populations it serves.

Our health systems and services delivered by the Voluntary, Community and Social Enterprise (VCSE) sector are finding new ways to deliver care and support by telephone, online and via their communication channels.

The following information provides sector guidelines for people working in HIV and sexual health, including resources for communities in response to the challenges coronavirus have presented.

Guidelines for health and sector professionals

British HIV Association (BHIVA)

British Association for Sexual Health and HIV (BASHH)

Faculty of Sexual and Reproductive Healthcare (FRSH)

FRSH, BASHH and BHIVA

The Association of Directors of Public Health (ADPH)

Community resources and information

Terrence Higgins Trust

NAT (National AIDS Trust)

NAM

i-base

Joint Council for the Welfare of Immigrants (JCWI), Migrants Organise, and Medact

Correlation Network, Europe

International

World Health Organisation (WHO)

UNAIDS

As new information arises we will update accordingly.

Introducing the HIV Prevention England Faith Engagement Strategy

Despite the excellent headway the UK has made to reduce new HIV transmissions, stigma is prevalent and may curtail our ambitions for ending new HIV transmissions by 2030.

  • Stigma is a barrier to people testing and accessing biomedical interventions such as pre-exposure prophylaxis (PrEP).
  • Stigma affects the wellbeing, health and overall quality of life of people living with HIV.

We have produced a national faith engagement strategy which aims to increase the involvement of faith leaders and communities in challenging HIV-related stigma, supporting the uptake of HIV testing and prevention, and promoting the good health and wellbeing of people living with HIV.

Faith leaders are well-respected role models in their communities; they have the ability to reach people who do not necessarily access health services, and they have a role in supporting efforts to end discrimination against marginalised people.

HIV Prevention England (HPE) will provide opportunities to support faith leaders and communities, including through National HIV Testing Week, providing free resources, information briefings, and sector training events.

Download the strategy document

HIV Prevention England Faith Engagement Strategy [PDF]

Get involved

HPE provides resources and training. If you are a faith leader or work with faith communities:

  • Take advantage of our free resources.
  • Sign-up to our monthly newsletter to keep up-to-date with our latest news and events (complete the form opposite or below).

Forthcoming events

National HIV Testing Week starts Saturday 16 November 2019.

This year, World AIDS Day is on Sunday 1 December 2019.