Research and analysis

Spotlight on sexually transmitted infections in the North East: 2022 data

Updated 5 March 2024

Applies to England

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Summary

While this report primarily focuses on the trend between 2021 and 2022, some trends relative to 2019 or earlier are included to provide a comparison to sexual health service provision and sexually transmitted infection (STI) diagnoses prior to the COVID-19 pandemic. For England, the numbers of consultations, sexual health screens and STI diagnoses in 2020 and 2021 are lower than preceding years and any trends in diagnoses between 2021 and 2022 must be interpreted in that context.

STIs represent an important public health problem in the North East. Out of 9 UK Health Security Agency (UKHSA) regions, it had the fourth highest rate of new STIs in 2022 (592.4 diagnoses per 100,000 population).

15,679 new STIs were diagnosed in North East residents in 2022, representing a rate of 592 diagnoses per 100,000 population. Rates by upper-tier local authority ranged from 387 new STI diagnoses per 100,000 population in Northumberland to 962 new STI diagnoses per 100,000 population in Newcastle upon Tyne.

The number of new STIs diagnosed in North East residents increased by 33% between 2021 and 2022. Rises were seen in the numbers of most of the 5 major STIs: syphilis increased by 55%, gonorrhoea by 153% and chlamydia by 27%. Genital herpes decreased by 4% and genital warts by 18%.

UKHSA recommends that local areas should be working towards achieving a chlamydia detection rate no lower than 2,300 per 100,000 among individuals aged 15 to 24 years and this is an indicator in the Public Health Outcomes Framework. In 2022, the chlamydia diagnosis rate among North East residents aged 15 to 24 years was 1,897 per 100,000 residents.

Rates of new STIs vary between men and women (537 and 562 per 100,000 residents, respectively). Where gender and sexual orientation are known, gay, bisexual, and other men who have sex with men (GBMSM) account for 19% of North East residents diagnosed with a new STI excluding chlamydia diagnoses reported via CTAD (44% of those diagnosed with syphilis and 31% of those diagnosed with gonorrhoea).

STIs disproportionately affect young people. North East residents aged between 15 and 24 years accounted for 59% of all new STI diagnoses in 2022.

A steep decline (94% decrease) has been seen between 2018 and 2022 in genital warts diagnosis rates in females aged 15 to 19. This follows the introduction in 2008 of vaccination against Human papillomavirus (HPV), the virus which causes genital warts, for girls.

The white ethnic group has the highest number of new STI diagnoses: 12,086 (92%). Although <1% of new STIs are in the black Caribbean group, this has the highest rate: 1,175 per 100,000, which is 2 times the rate seen in the white ethnic group. Where country of birth was known, 92% of North East residents diagnosed with a new STI in 2022 (excluding chlamydia diagnoses reported via CTAD) were UK-born.

Conclusion

In England, the number of consultations (all types) delivered by sexual health services (SHSs) in 2022 was 8% higher than in 2021 (4,059,608  versus 4,394,404) and 14% higher than 2019 (3,869,728) (1). Of all consultations in 2022, 50% (2,204,790) were delivered face-to-face, 39% (1,721,132) via the internet and 11% (468,482) via telephone1. The greatest increase by type of consultation was for online consultations, which rose by 19% (from 1,446,001 to 1,721,132) (1). Face-to-face consultations increased by 8% (from 2,037,468 to 2,204,790) while the number of telephone consultations decreased by 19% (from 576,139 to 468,482) (1). The number of online consultations may be underreported where physical SHSs provide both face-to-face and online consultations.

The most commonly diagnosed STIs in England in 2022 were chlamydia (51% of all new STI diagnoses), gonorrhoea (21%), first episode genital warts (7%) and first episode genital herpes (6%) (1). The greatest increase was in the number of gonorrhoea diagnoses (increase of 50%, from 54,961 to 82,592), with the largest increase among young people (1) and overall reaching the largest annual number reported since records began (2). Infectious syphilis (primary, secondary and early latent stages) diagnoses rose (from 7,543 to 8,692), the largest annual number reported since 1948 (2). Both gonorrhoea and syphilis exceeded levels reported in 2019 before the COVID-19 pandemic.

A notable increase was also seen in diagnoses of chlamydia (24%, from 160,279 to 199,233). Since June 2021, the primary aim of the NCSP is to reduce reproductive harm in young women (15 to 24 years) (3). In England in 2022 there was a 22% increase in the number of chlamydia diagnoses in this age group compared to 2021 (68,882  versus 56,562) with concurrent increases in detection rate (22%) and test positivity (10.0% in 2022  versus 8.1% in 2021) (1).

Young people experience the highest diagnosis rates of the most common STIs, and this may be due to higher rates of partner change among those aged 16 to 24 years (4). Young women may be more likely to diagnosed with an STI due to disassortative sexual mixing by age and gender (5). Compared to 2021, the number of new STI diagnoses in 2022 among young people aged 15 to 24 years increased by 27% (129,938 to 164,337), largely due to the near doubling of cases of gonorrhoea over the same period (92% increase from 16,191 to 31,037) (1).

There have also been increases among GBMSM in less frequently reported STIs such as lymphogranuloma venereum (LGV) (82.8%, 570 in 2021 to 1,042 in 2022) (6), as well as an increase in cases of shigellosis and recent outbreaks in 2022 of extensively drug-resistant Shigella sonnei and S. flexneri (7). There is evidence of a rebound in sexual mixing among GBMSM between 2020 and 2021, and this is likely to have contributed to the rise in STIs within this population in 2022 (8).

UKHSA’s main messages

Commissioners and providers of SHSs have an important role in communicating messages about safer sexual behaviours and how to access services. 

Main prevention messages

Using condoms consistently and correctly protects against HIV and other STIs such as chlamydia, gonorrhoea, and syphilis – condoms can also be used to prevent unplanned pregnancy.

Regular screening for STIs and HIV is essential to maintain good sexual health – everyone should have an STI screen, including an HIV test, on at least an annual basis if having condomless sex with new or casual partners. In addition:

• women, and other people with a womb and ovaries, aged under 25 years who are sexually active should have a chlamydia test annually and on change of sexual partner
• gay, bisexual and other men who have sex with men (GBMSM) should have tests for HIV and STIs annually or every 3 months if having condomless sex with new or casual partners

HIV pre-exposure prophylaxis (PrEP) is available for free from specialist SHSs and can be used to reduce an individual’s risk of acquiring HIV.

HIV post-exposure prophylaxis (PEP) can be used to reduce the risk of acquiring HIV following some sexual exposures – PEP is available for free from most specialist SHSs and most emergency departments.

People living with diagnosed HIV who are on treatment and have an undetectable viral load are unable to pass on the infection to others during sex – this is known as ‘Undetectable=Untransmittable’ or ‘U=U’.

Vaccination against human papillomavirus (HPV), hepatitis A, hepatitis B and mpox will protect against disease caused by these viruses and prevent the spread of these infections:

• GBMSM can obtain the hepatitis A and hepatitis B vaccines from specialist SHSs – these vaccines are also available for other people at high risk of exposure to the viruses
• GBMSM aged up to and including 45 years can obtain the HPV vaccine from specialist SHSs

Specialist sexual health services are free and confidential and offer testing and treatment for HIV and STIs, condoms, vaccination, HIV PrEP and PEP:

• clinic-based services are commissioned for residents of all areas in England
• online self-sampling for HIV and STIs is widely available
• information and advice about sexual health including how to access services is available at Sexwise, NHS.UK and from the national sexual health helpline on 0300 123 7123

Charts, tables and maps

Figure 1. New STI diagnosis rates by UKHSA region of residence, England, 2022

Data sources: GUMCAD, CTAD

Figure 1 is a bar graph showing the North East remained the fourth highest region by new STI diagnosis rate in England, with 592.4 per 100,000 population, an increase from 439.9 per 100,000 in 2021. All UKHSA regions showed increased rates in 2022 compared to 2021.

Figure 2. Number of diagnoses of the 5 main STIs, North East residents, 2018 to 2022

Data sources: GUMCAD, CTAD

Note 1: Any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM.

Note 2: Any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination.

Note 3: Any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs.

Note 4: Increases or decreases may also reflect changes in testing practices.

Figure 2 is a line graph showing the number of diagnoses of the 5 main STIs in the North East remained highest in chlamydia in 2022 (8,884 compared to 6,994 in 2021). The number of gonorrhea diagnoses increased by 153% in 2022 (3,110) compared to 2021 (1,231). The number of syphilis diagnoses also increased in 2022 (393, compared to 253 in 2021), by 55%. The number of genital herpes (1,023) and genital warts (893) decreased in 2022, compared to 2021.

Figure 3. Diagnosis rates of the 5 main STIs, North East residents, 2018 to 2022

Data sources: GUMCAD, CTAD

See notes for Figure 2

Figure 3 is a line graph showing the trend of diagnosis rates, with chlamydia having the highest rate in 2022 (335.7 per 100,000), an increase compared to 2021 (260.9 per 100,000). Notably, the rate of gonorrhoea has increased in 2022 compared to 2021 (117.5 per 100,000 versus 45.9 per 100,000; respectively). Syphilis also showed an increased rate in 2022 (14.8 per 100,000  versus 9.4 per 100,000 in 2021). Genital herpes and genital warts were the only STIs with decreased rates.

Table 1. Percentage change in new STI diagnoses, North East residents

Diagnoses	2022	Percentage change 2018 to 2022	Percentage change 2021 to 2022
New STIs	15,679	-8%	33%
Syphilis	393	59%	55%
Gonorrhoea	3,110	76%	153%
Chlamydia	8,884	1%	27%
Genital Herpes	1,023	-36%	-4%
Genital Warts	893	-64%	-18%

Data sources: GUMCAD, CTAD

See notes for Figure 2

Table 1 shows a 33% increase in new STI diagnoses in North East residents in 2022 compared to 2021. Gonorrhoea and syphilis had the highest percentage increase of new STI diagnoses in North East residents from 2018 compared to 2022 (gonorrhoea 76% and syphilis 59%) and from 2021 to 2022 (gonorrhoea 153% and syphilis 55%).

Figure 4. Rates of new STIs per 100,000 residents by age group (for those aged 15 to 64 years only) and gender in the North East, 2022

Data sources: GUMCAD, CTAD

Figure 4 shows the age and gender breakdown of new STIs. The highest rates in males and females aged between 20 to 24 years old. This pattern was similar in 2021, except the rate of new STIs in males aged 15 to 19 years old has increased to be similar to the 25- to 34-year-olds in 2022.

Figure 5. Rates of gonorrhoea per 100,000 residents by age group (note 5) in the North East, 2018 to 2022

Data sources: GUMCAD

Note 5: Age-specific rates are shown for those aged 15 to 64 years only.

Figure 5 is a line graph showing those aged 20 to 24 years to have the highest rate of gonorrhoea in North East residents in 2022 (695.1 per 100,000), a large increase compared to 2021 (194.7 per 100,000). The rate in those aged 15 to 19 years was the second highest age group in 2022 (473.2 per 100,000), followed by 25 to 34 years (238.9 per 100,000). Although the rate in those aged 35 to 44 and 45 to 64 years remained the lowest, both rates increased in 2022 compared to 2021. Rates in all age groups have increased higher than in 2019, after a decline in 2020 and 2021.

Figure 6. Rates of syphilis per 100,000 residents by age group (note 5) in the North East, 2018 to 2022

Data sources: GUMCAD

Figure 6 is a line graph showing North East residents aged 20 to 24 years had the highest rate of syphilis per 100,000 in 2022 (62.3), an increase compared to the rate in 2021 (46.9 per 100,000). Rates increased for all age groups in 2022, compared to 2021 and 2018. The rate of syphilis diagnoses in people aged 20 to 24 years old increased by 93% and in 15 to 19 year olds by 90% from 2018 to 2022. Whilst most other STI diagnoses saw a large decrease in 2020 due to the COVID-19 pandemic, syphilis diagnoses did not follow this trend and remained the same (except a decrease in GBMSM diagnoses) and have since continued to increase.

Figure 7. Rates of syphilis per 100,000 residents by age group (note 5) and gender in the North East, 2018 to 2022

Figure 7 shows the rate of syphilis diagnoses for females (top) and males (bottom) by age group. In both females and males, the 20-to-24-year age group had the highest rate of diagnoses. However, younger females are also affected, with the 15-to-19-year age group second highest in 2022 (31.5 per 100,000). For males, this age group had the lowest rate of diagnoses (9.2 per 100,000). In contrast, the age group with the second highest rate in males diagnosed with syphilis was the 25 to 34 year age group (58.3 per 100,000).

Figure 8. Rates of genital warts per 100,000 residents aged 15 to 19 years by gender in the North East, 2018 to 2022

Data sources: GUMCAD

Figure 8 is a line graph showing the rate of genital warts has further decreased in females in 2022 (16.4 per 100,000) compared to 2021 (21.1 per 100,000). There was a slight increase in males in 2022 compared to 2021 (19.7 versus 11.9 per 100,000). However, both remain low compared to 2018. There has been a known decreasing trend over the past decade due to the effective HPV vaccination programme seen nationally (3).

Figure 9. Rates of new STIs by ethnic group per 100,000 residents in the North East, 2022

Data sources: GUMCAD, CTAD

Figure 9 is a bar chart showing the rate of new STIs by ethnic group was highest in the black Caribbean ethnic group, in the North East in 2022 (1,175.1 per 100,000), the same as in 2021 although the rate decreased (1,927.9 per 100,000). Black African was the second highest ethnic group (679.8 per 100,000), followed by white (490.8 per 100,000) which both showed decreases compared to 2021. ‘All other ethnic groups combined’ showed the only increase this year. However, the number of diagnoses in black Caribbean and black African ethnic groups is very small and high rates should be interpreted with caution (as seen in Table 2).

Table 2. Proportion of North East residents diagnosed with a new STI by ethnicity, 2022

Ethnic group	Number	Percentage excluding unknown
White	12,086	92%
Black Caribbean	20	0%
Black African	150	1%
All other ethnic groups combined	813	6%
Unknown	2,610

Data sources: GUMCAD, CTAD

Table 2 shows the white ethnic group as the highest proportion of newly diagnosed STIs in North East residents by ethnic group in 2022 (92%). The number of cases amongst black Caribbean and black African ethnic groups remained small.

Figure 10. Proportions of North East residents diagnosed with a new STI by world region of birth (note 6), 2022

Data sources: GUMCAD data only

Note 6: Data on country of birth is not collected by CTAD. All information about world region of birth is based on diagnoses made in specialist and non-specialist services which report to GUMCAD.

Figure 10 is a bar chart showing the proportion of North East residents diagnoses with a new STI were mostly UK born (92%), with all other regions at 3% or below. This was the same in 2021.

Figure 11. Rates of new STIs per 100,000 residents by decile of deprivation (note 7) in the North East, 2022

Data sources: GUMCAD, CTAD

Note 7: Deciles run from 1 to 10 in order of decreasing deprivation.

Figure 11 is a bar graph showing the rate of new STIs was highest in the most deprived areas (748 per 100,000; decile of deprivation of one) and lowest in the least deprived areas (424 per 100,000) of the North East region. Although, areas with decile of deprivation 2 to 8 had similar rates. Approximately a third of the North East population live in areas of relative high deprivation which may contribute to less variation in rates by decile of deprivation, compared to other regions (9).

Figure 12. Diagnoses of the 5 main STIs among GBMSM (note 8), North East residents, 2018 to 2022

Data sources: GUMCAD data only

Note 8: Data on sexual orientation is not collected by CTAD. All information about GBMSM is based on diagnoses made in specialist and non-specialist services which report to GUMCAD and exclude chlamydia diagnoses via online services.

Note 9: It is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• increases in gonorrhoea may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• decreases in genital wart diagnoses may be due to the moderately protective effect of HPV-16/18 vaccination
• increases in genital herpes diagnoses may be due to the use of more sensitive NAATs

Figure 12 is a line graph showing an increasing number of diagnoses of all 5 main STIs among GBMSM North East residents in 2022 compared to 2021. Gonorrhoea remained the highest by number diagnosed (882), followed by chlamydia (574) and syphilis (160). Syphilis diagnoses increased by 146% in 2022 compared to 2021 (65). The number of diagnoses in 2022 were also higher than 2018 for gonorrhoea and chlamydia but lower for syphilis, genital warts, and genital herpes.

Figure 13. Diagnosis rates of the 5 main STIs among GBMSM (note 10), North East residents, 2018 to 2022

Data sources: GUMCAD, CTAD

Note 10: Data on sexual orientation is not collected by CTAD. All information about GBMSM is based on diagnoses made in specialist and non-specialist services which report to GUMCAD and exclude chlamydia diagnoses via online services. The denominators for rates are based on sexual orientation information collected by the 2021 census and for each region the same estimate has been used for all years in the chart.

Note 11: It is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• increases in gonorrhoea may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• decreases in genital wart diagnoses may be due to the moderately protective effect of HPV-16/18 vaccination
• increases in genital herpes diagnoses may be due to the use of more sensitive NAATs

Figure 13 shows the diagnoses rate of gonorrhoea (2,940 per 100,000) to be the highest of the 5 main STIs among GBMSM North East residents in 2022. Diagnoses rates for gonorrhoea, chlamydia and syphilis increased in 2022 compared to 2021. Gonorrhoea and chlamydia rates in 2022 were highest since 2018. Rates of genital warts and genital herpes have shown a decreasing trend since 2018 but remained similar in 2022 compared to 2021.

Table 3. Percentage change in new STI diagnoses in GBMSM (note 8) resident in the North East

Diagnoses	2022	Percentage change 2018 to 2022	Percentage change 2021 to 2022
New STIs	1,827	18%	75%
Syphilis	160	-2%	146%
Gonorrhoea	882	72%	81%
Chlamydia	574	21%	79%
Genital Herpes	31	-37%	3%
Genital Warts	38	-66%	-7%

Data sources: GUMCAD data only

See note 9

Table 3 shows the number of new syphilis, gonorrhoea, chlamydia, and genital herpes diagnoses in GBMSM resident in the North East to have increased in 2022 compared 2021. Syphilis showed the highest increase (146%), but the number diagnosed in 2022 was a small decrease compared to 2018 (-2%). The number of genital warts diagnosed decreased in 2022 compared to 2021, by 7%.

Figure 14a. Rate of new STI diagnoses per 100,000 population by upper-tier local authority of residence, North East residents, 2022

Data sources: GUMCAD, CTAD

Figure 14a is a bar graph showing Newcastle as the North East local authority with the highest rate of new STI diagnoses in 2022 (962 per 100,000, compared to 548 per 100,0000 in 2021). In 2021, Middlesbrough had the highest rate in the North East region. Rates in Newcastle and Middlesbrough were higher than the region and England rate, the same as in 2021. All local authorities showed an increased rate in 2022 compared to 2021. Northumberland remained the local authority with the lowest rate in 2022 (387 per 100,000), below the region and England rate.

Figure 14b. Rate of new STI diagnoses (excluding chlamydia diagnoses in residents aged <25 years) per 100,000 population by upper-tier local authority of residence, the North East, 2022

Data sources: GUMCAD, CTAD

Note 12: Prior to 2023, this figure showed rates for the population aged 15 to 64 years, excluding chlamydia in those aged 15 to 24 years.

Figure 14b is a bar graph showing the rate of new STI diagnoses excluding chlamydia diagnoses in residents aged less than 25 years. Newcastle remained the local authority with the highest rate (556 per 100,000), above the region and England rate.

Figure 15. Chlamydia detection rate per 100,000 female residents aged 15 to 24 years by upper-tier local authority of residence, the North East, 2022

Data sources: GUMCAD, CTAD

Note 13: Prior to 2023, this figure showed rates for the whole population aged 15 to 24 years, regardless of gender.

Figure 15 is a bar chart showing the female only chlamydia detection rate was highest in Hartlepool (4,014 per 100,000 female residents aged 15 to 24 years) in 2022. The target is 3,250 which has been surpassed by Hartlepool and Stockton-on-Tees in 2022. The North East detection rate was 2,375 per 100,000 female residents aged 15 to 24 years in 2022, which is higher than the England rate of 2,110.

Figure 16. Rate of gonorrhoea diagnoses per 100,000 population by upper-tier local authority of residence, North East residents, 2022

Data sources: GUMCAD

Figure 16 is a bar graph showing Newcastle upon Tyne as the North East local authority with the highest rate of gonorrhoea diagnoses in 2022 (232 versus 80 per 100,000 in 2022 and 2021 respectively). All North East local authorities showed increased rates in 2022 compared to 2021.

Figure 17. Rate of syphilis diagnoses per 100,000 population by upper-tier local authority of residence, North East residents, 2022

Data sources: GUMCAD

Figure 17 is a bar graph showing Middlesbrough as the North East local authority with the highest rate of syphilis diagnoses in 2022 (45 per 100,000), the same as in 2021 (40 per 100,000). Stockton-on-Tees and Redcar and Cleveland were the only local authorities with decreased rates of syphilis diagnoses in 2022 compared to 2021.

In response to this, a multi-agency group, with representatives from the local authorities, sexual health service and UKHSA developed a Teesside syphilis action plan, identifying key areas for action including awareness raising with clinicians and other healthcare providers, audits of clinical services and communication campaigns to raise awareness with the public. The group continues to closely monitor patterns of syphilis infection and the impact of these interventions. In 2022 it was also noted that rates of syphilis increased in Darlington and County Durham and a similar approach was taken.

Figure 18. Map of new STI rates per 100,000 residents by upper-tier local authority in the North East, 2022

Contains Ordnance Survey data © Crown copyright and database right 2023. Contains National Statistics data © Crown copyright and database right 2023. Data sources: GUMCAD, CTAD

Figure 18 shows a map of North East local authorities, showing all areas had new STI diagnoses rates below 1,000 per 100,000 population. Newcastle had the highest rate (961.6 per 100,000). In 2021, all areas had rates below 750 per 100,000.

Figure 19. STI testing rate (excluding chlamydia in under 25-year-olds) per 100,000 population in North East residents aged 15 to 64 years, 2018 to 2022

Data sources: GUMCAD, CTAD

Figure 19 is a line graph showing the STI testing rate (excluding chlamydia in people under 25 years old) in North East residents and England has continued to increase from 2021 to 2022. The North East rate although increased, remained slightly lower in 2022 (2,419.1 per 100,000) compared to 2018 (2,489.4 per 100,000). The England rate in 2022 (3,856.1 per 100,000) was above the rate in 2018 (3,616.0).

Figure 20. STI testing positivity rate (note 14) (excluding chlamydia in under 25-year-olds) in North East residents, 2018 to 2022

Data sources: GUMCAD, CTAD

Note 14: The numerator for the STI testing positivity rate now only includes infections which are also included in the denominator. These are: chlamydia (excluding diagnoses in those aged under 25 years), gonorrhoea, syphilis and HIV. Up to 2018 (data for 2017) it included all new STIs.

Figure 20 is a line graph showing the North East STI positivity rate in 2022 (8.6%) has increased from 2021 (5.7%) and is above the England rate (7.6%). This means there has been an increase in the proportion of STI tests being positive.

Table 4. Number of diagnoses of new STIs by UKHSA region of residence, data source and data subset 2022

UKHSA region of residence	GUMCAD: Specialist SHSs	GUMCAD: Non-specialist SHSs (note 15)	CTAD (note 16)	Total
East Midlands	13,901	8,518	5,492	27,911
East of England	16,850	6,310	6,377	29,537
London	82,589	11,598	28,725	122,912
North East	10,605	1,687	3,387	15,679
North West	33,005	5,925	10,192	49,122
South East	32,427	2,699	10,088	45,214
South West	17,085	4,187	6,660	27,932
West Midlands	18,965	4,920	5,982	29,867
Yorkshire and Humber	20,361	3,283	9,734	33,378

Data sources: GUMCAD, CTAD

Note 15: Diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘Non-specialist sexual health services (SHSs)’ total.

Note 16: Including site type 12 chlamydia from GUMCAD.

Table 4 shows the North East as the UKHSA region with the lowest number of new STI diagnoses, however as illustrated in Figure 1, the North East had the fourth highest rate of new STI diagnoses in 2022. The number of diagnoses was higher in 2022 (total 15,679) compared to 2021 (total 11,793). The highest increase was in specialist SHSs (40%).

Table 5. Number of diagnoses of the 5 main STIs in the North East by STI, data source and data subset 2022

Five main STIs	GUMCAD: Specialist SHSs	GUMCAD: Non-specialist SHSs (note 17)	CTAD (note 18)	Total
Syphilis	393	-	-	393
Gonorrhoea	2,726	384	-	3,110
Chlamydia	4,194	1,303	3,387	8,884
Genital Herpes	1,023	-	-	1,023
Genital Warts	893	-	-	893

Data sources: GUMCAD, CTAD

Note 17: Diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘Non-specialist sexual health services (SHSs)’ total.

Note 18: Including site type 12 chlamydia from GUMCAD.

Table 5 shows most STIs were diagnosed in specialist SHSs. Chlamydia and gonorrhoea were the only STIs diagnosed in both specialist SHSs and non-specialist SHSs.

Figure 21. Consultations by consultation medium: North East residents, 2018 to 2022

Data sources: GUMCAD

Figure 21 is a bar graph showing the number of face-to-face consultations in North East residents in 2022 was higher than in 2021 and 2020 but still below 2019 numbers. Whilst the number of online and telephone consultations in 2022 decreased compared to 2021. The number of online consultations may be under reported where physical SHSs provide both face-to-face and online consultations.

Information on data sources

Find more information on local sexual health data sources in the UKHSA guide.

This report is based on data from the GUMCAD and CTAD surveillance systems published on 6 June 2023 (data to the end of calendar year 2022).

GUMCAD surveillance system

This disaggregates reporting system collects information about attendances and diagnoses at specialist (Level 3) and non-specialist (Level 2) sexual health services. Information about the patient’s area of residence is collected along with demographic data and other variables. GUMCAD superseded the earlier KC60 system and can provide data from 2009 onwards. GUMCAD is the main source of data for this report.

Due to limits on how much personally identifiable information sexual health clinics are able to share, it is not possible to deduplicate between different clinics. There is a possibility that some patients may be counted more than once if they are diagnosed with the same infection (for infection specific analyses) or a new STI of any type (for new STI analyses) at different clinics during the same calendar year.

CTAD surveillance system

CTAD collects data on all NHS and local authority, or NHS-commissioned chlamydia testing conducted in England. CTAD is comprised of all chlamydia (NAATs) tests for all ages (with the exception of conjunctival samples), from all venues and for all reasons. CTAD enables unified, comprehensive reporting of all chlamydia data, to effectively monitor the impact of the NCSP through estimation of the coverage of population screening, proportion of all tests that are positive and detection rates.

For services which report to GUMCAD and for which CTAD does not receive data on the patient’s area of residence (for example SHSs), information about chlamydia diagnoses is sourced from GUMCAD data.

CTAD does not collect information about sexual orientation or country of birth. Reports from CTAD are excluded from figures in this report which relate to analyses by sexual orientation or world region of birth.

 New STIs

New STI diagnoses comprise diagnoses of the following: chancroid, LGV, donovanosis, chlamydia, gonorrhoea, genital herpes (first episode), HIV (acute and AIDS defining), Molluscum contagiosum, non-specific genital infection (NSGI), non-specific pelvic inflammatory disease (PID) and epididymitis, chlamydial PID and epididymitis (presented in chlamydia total), gonococcal PID and epididymitis (presented in gonorrhoea total), scabies, pediculosis pubis, syphilis (primary, secondary and early latent), trichomoniasis and genital warts (first episode), Mycoplasma genitalium, shigella.

Calculations

Confidence Intervals were calculated using Byar’s method.

ONS mid-year population estimates for 2021 were used as a denominator for rates (other than by ethnic group) for 2022. Population estimates for 2021 are used as the denominator for rates for 2022. ONS estimates of population by ethnic group for the year 2021 were used as a denominator for rates by ethnic group for 2022. This is the first time that new estimates of population by ethnic group have been available since 2011. This must be considered if comparing rates for 2022 in this report with rates by 2021 in last year’s report, as the rates in the last report used the 2011 estimates.

Further information

As of 2020, all analyses for this report include data from non-specialist (Level 2) SHSs and enhanced GP services as well as specialist (Level 3) SHSs.

For further information, access the online Sexual and Reproductive Health Profiles.

For more information on local sexual health data sources, see the UKHSA guide.

Local authorities have access to The Summary Profile of Local Authority Sexual Health (SPLASH) Reports (accessible from the Sexual and Reproductive Health Profiles) and the SPLASH supplement reports via the HIV and STI Data exchange.

For an Annual Epidemiological Spotlight on HIV in the North East, contact FES.NorthEast@ukhsa.gov.uk

About the Field Service

The Field Service was established in 2018 as a national service comprising geographically dispersed multi-disciplinary teams integrating expertise in Field Epidemiology, Real-time Syndromic Surveillance, Public Health Microbiology and Food, Water and Environmental Microbiology to strengthen the surveillance, intelligence and response functions of UKHSA.

You can contact your local FS team at FES.NorthEast@ukhsa.gov.uk

If you have any comments or feedback regarding this report or the Field Service, contact josh.forde@ukhsa.gov.uk

Acknowledgements

We would like to thank the following:

• local SHSs for supplying the SHS data
• local laboratories for supplying the CTAD data
• UKHSA Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division for collection, analysis and distribution of data

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