STIs drop for first time in a decade

HPA: Young people under 25 the most at risk group

For the first time in more than 10 years, a small decrease has been noted in the total number of STIs diagnosed in England, most notably in young people.

New figures released by the Health Protection Agency (HPA) show that in 2010 there were 418,598 new STI diagnoses made in England, a decrease of one percent from the previous year when 424,782 cases were diagnosed.

This decrease occurred during a period of increased testing for sexually transmitted infections in health settings across England. For the first time new diagnoses of chlamydia did not rise but were stable and this occurred alongside more chlamydia testing through the National Chlamydia Screening Programme.

Last year 2.2 million chlamydia tests were carried out in England among young people aged 15 to 24, an increase of 196,500 from the previous year.

Dr. Gwenda Hughes, head of the HPA’s STI section said: “Although the drop is modest this is the first time we’ve seen a decrease in STIs in over 10 years so it is an important milestone. For the first time ever we have seen chlamydia diagnoses stabilise when testing for that particular infection is at its highest ever, thanks to community based testing through the National Chlamydia Screening Programme. These are very early days but we hope that this is the beginning of a downward trend.”

The two most at risk groups remain young people and men who have sex with men.

Young people under 25 are the age group that experience the highest rates of STIs overall. Among women in 2010, rates of diagnosis of chlamydia, genital warts and gonorrhoea peaked in those aged 19 and genital herpes peaked in 20 year olds. In men rates of chlamydia and genital warts peaked in those aged 21, while those of gonorrhoea and genital herpes peaked in those aged 22 and 23.

However, there has been a notable decline in some STIs in younger adults in recent years: Between 2008 and 2010, diagnoses of genital warts in women and men aged 15-19 fell by 13 per cent and eight per cent (11,669 to 10,101 and 4,695 to 4,306) while those of gonorrhoea fell by 13 per cent and 14 per cent (2,004 to 1,749 and 1,283 to 1,108).

Dr. Hughes continued: “It is particularly encouraging to see a decline in some STIs among young people, however, these latest figures show that the impact of STI diagnoses is still unacceptably high in this group. Studies suggest that those who become infected may be more likely to have unsafe sex or lack the skills and confidence to negotiate safer sex.

“These encouraging decreases do not however mean we can rest on our laurels. Prevention efforts, such as greater STI screening coverage and easier access to sexual health services, should be sustained and continue to focus on groups at highest risk. To reduce the risk of STIs, the HPA recommends using a condom when having sex with a new partner and continuing to do so until you both have been screened.”

The HPA encourages all sexually active under 25 year olds to be tested for chlamydia every year or sooner if they change their partner.

The latest figures, Dr. Hughes said, “suggest that the drive to encourage regular testing for STIs may be having an impact on STI rates but it’s too soon to know if this is definitely the case. In any case, the sooner people are diagnosed and treated, the less likely they are to pass on the infection or to develop complications later.”

For cases in men where sexual orientation was recorded, 64 per cent (1,070/1,671) of syphilis and 40 per cent (4,503/11,289) of gonorrhoea diagnoses in England last year were among men who have sex with men (MSM) and the number of diagnoses of STIs continues to rise in this group.

Gonorrhoea diagnoses in MSM increased by a third in the past year (3,379 to 4,503 diagnoses), chlamydia by 22 per cent from 4,084 in 2009 to 4,975 in 2010, and genital herpes by 19 per cent from 818 in 2009 to 973 in 2010.

Dr. Hughes added: “The message of consistent condom use is even more important for men who have sex with men because they are at particular risk of HIV as well as other STIs. This underlines the importance of regular sexual health screening for this group. The HPA currently recommends that men who have sex with men should be tested for HIV at least annually.”

Justin McCracken, chief executive of the HPA, said: “Although it is encouraging to see this small decrease, the total number of STIs remains very high and it is important to remember that all these sexually transmitted infections are preventable. Continuous reinforcement of the safe sex message is vital if we are to see a more significant decrease in the future.”