Research and analysis

Spotlight on sexually transmitted infections in the North East: 2023 data

Updated 9 January 2025

Applies to England

Summary

Sexually transmitted infections (STIs) continue to represent an important public health problem in the North East. This report highlights the key findings from 2023 data, comparing with the previous year. Some longer trend data from 2019 or earlier is also included to provide a comparison for STI diagnoses and sexual health service (SHS) provision. Since the cessation of COVID-19 lockdown measures in summer 2021, and associated disruption to service provision, there is clear evidence of a rebound in service provision at SHSs both locally and nationally. Nonetheless, it is important to consider the impact of the COVID-19 pandemic when reviewing the trend data in this report. Furthermore, comparisons of STI trends over several decades should be made with caution given increases in population size and in testing for STIs using more sensitive diagnostic tests over time

While this report primarily focuses on data from the North East region, some data from other regions and England as a whole are presented for comparison. For more detailed information at the national level, please see the Sexually transmitted infections and screening for chlamydia in England: 2023 report and accompanying tables.     

Key findings

The North East had the third highest rate of new STIs (588.7 diagnoses per 100,000 population; 15,795 new STIs in North East residents) in 2023 when compared to other UK Health Security Agency (UKHSA) regions. This is lower than England as a whole (703.6 per 100,000).

The number of new STIs diagnosed in North East residents increased by 1% between 2022 and 2023. However, changes seen in the numbers of the five major STIs varied substantially. Of particular importance, there was a 45% increase in the number of syphilis diagnoses in North East residents between 2022 and 2023 (21.3 per 100,000 population). The number of gonorrhoea and chlamydia diagnoses have decreased by 1% and 5%, respectively. The number of genital herpes and genital warts diagnoses have increased by 27% and 1%, respectively.

Individuals aged between 15 and 24 years accounted for 54% of all new STI diagnoses in North East residents in 2023. Furthermore, the rate of new STIs amongst individuals aged 15 to 19 years is higher across the North East compared to England (2,111.4 compared to 1,637.4 per 100,000).

Nationally, there has been an increasing trend over the past decade in the number of syphilis diagnoses. This trend continued in 2023 with the numbers exceeding the high levels reported in 2019 (9,513 compared to 8,040, 18.3% increase). The trend in syphilis diagnoses in the North East mirrors the national trend with numbers 106% higher in 2023 compared to 2019 (572 compared to 277). This percentage increase is substantially greater than that seen across England, consequently the rate in the North East is now higher than the national rate (21.3 compared to 16.7 per 100,0000). This increase in diagnoses is seen in most age and sexual orientation groups, although the largest proportional increase has been observed in females and heterosexual men.

There has also been an increasing trend in the number of gonorrhoea diagnoses over the past decade. Although the number of diagnoses in 2023 declined slightly compared to 2022 in the North East, it remains 57% higher than in 2019 (3,070 compared to 1,958). The number across England also exceeded the high levels reported in 2019 (85,223 compared to 71,133, 20% increase). Of particular importance, 54% of gonorrhoea diagnoses in 2023 in North East residents were in individuals aged between 15 and 24. The rate in individuals aged 15 to 19 and 20 to 24 years is higher in the North East (405.7 and 625.9 per 100,0000, respectively) compared to those in England (284.9 and 596.1 per 100,000, respectively)

A steep decline (83% decrease) has been seen between 2019 and 2023 in genital warts diagnosis rates in females and males aged 15 to 19 years. This follows the introduction of immunisations against human papillomavirus (HPV), the virus which causes genital warts, for girls aged 12 to 13 years in 2008 and extended to boys of the same age group in 2019.

People of White ethnic group had the highest number of new STI diagnoses: 12,676 (91.7%). Although 0.2% of new STIs are in Black Caribbean ethnic group, they have the highest rate: 1,410 per 100,000, which is 2.7 times the rate seen in the White ethnic group.

Where country of birth was known, 91% of North East residents diagnosed with a new STI in 2023 (excluding chlamydia diagnoses reported via CTAD) were UK-born.

The rate of new STIs among people who lived in the most deprived areas (767 per 100,000) was 1.9 times higher than the rate for people who live in the least deprived areas (400 per 100,000).

Where gender and sexual orientation are known, gay, bisexual and other men who have sex with men (GBMSM) accounted for 17% of North East residents diagnosed with a new STI (excluding chlamydia diagnoses reported via CTAD), 49% of those diagnosed with syphilis and 32% of those diagnosed with gonorrhoea. The number of new STIs in GBMSM has increased by 10% in 2023 (2,011) compared to 2022 (1,828) and was higher than 2019 (1,664). However, changes seen in the numbers of the five major STIs varied substantially. Of particular importance, the number of syphilis diagnoses in 2023 (267) increased by 67% compared to 2022 (160) and by 88% compared to 2019 (142).

Rates of new STI diagnoses by upper tier local authority ranged from 406 per 100,000 population in Northumberland to 849 per 100,000 population in Newcastle upon Tyne. UKHSA recommends that local areas should be working towards achieving a chlamydia detection rate no lower than 3,250 per 100,000 among females aged 15 to 24 years and this is an indicator in the Public Health Outcomes Framework. In 2023, the chlamydia detection rate among North East female residents aged 15 to 24 years ranged from 1,847 per 100,000 in Sunderland to 3,694 per 100,000 in Hartlepool. Rates of gonorrhoea diagnoses ranged from 66 per 100,000 in Sunderland to 210 per 100,000 in Newcastle upon Tyne; Newcastle was the only local authority with a rate higher than that of England (149 per 100,000). Rates of syphilis diagnoses ranged from 11 per 100,000 in Sunderland to 47 per 100,000 in Middlesbrough. Seven of the 12 North East local authorities had rates higher than England (16.7 per 100,000) namely, Middlesbrough, Stockton-on-Tees, Hartlepool, Redcar and Cleveland, Gateshead, South Tyneside and Newcastle upon Tyne.

Testing rates in 2023 in the North East (2,783 per 100,000) and England (4,111 per 100,000) have continued to increase and are now higher than those observed in 2019. The proportion of STIs tests being positive has decreased slightly in the North East (8.0% in 2023 compared to 8.6% in 2022) but remains higher than that in 2019 (4.6%) in line with the increasing trend seen prior to 2019.

Across England as a whole, the number of consultations increased by 5% from 2022 to 2023 (4,392,466 to 4,610,410, respectively) and have surpassed those of 2019 (3,869,725) (1). Of all consultations in England in 2023, 49.1% were delivered face-to-face (down from 85% in 2019), 42.3% were online (up from 13% in 2019) and 8.6% were via telephone (up from 1% in 2019). In the North East, the total number of consultations in 2023 (137,811) surpassed the number in 2019 (118,723). Although face-to-face consultations remain the predominant format in 2023 (68% compared to 96% in 2029), online consultations continue to increase and now account for 23% of all consultations (compared to 4% in 2029). Furthermore, the number of online consultations may be underreported where physical SHS provide both face-to-face and online consultations. Telephone consultations accounted for 10% of all consultations in 2023.

Conclusion

For all STIs, early diagnosis and effective partner notification remain crucial; the on-going increase in cases of syphilis in the North East highlight the importance and challenges of this work. Further work to tackle syphilis has continued in Teesside and across the whole region, including a deep-dive into local data using the care pathway toolkit, establishing a regional multi-disciplinary Tackling Syphilis steering group and developing a regional action plan which has used the national syphilis action plan and update reports (2,3) as a guide, adding locally specific actions where needed. The Regional Steering group will monitor the evolving epidemiology of syphilis in the region as well as progress against action plan objectives.

STIs disproportionately affect young people and this is increasingly more apparent in the North East with rates of new STIs and gonorrhoea higher in 15 to 19 years olds when compared to England. It has previously been documented that 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 also be more likely to be diagnosed with an STI due to disassortative sexual mixing by age and gender (5). Nonetheless, these groups may benefit from further targeted health promotion messaging within the North East.

The number of consultations at SHSs has continued to recover following the disruption of services during the COVID-19 pandemic. However, there has been a clear change in how people seek advice and testing, which is likely to impact on both improving sexual health and reducing transmission of infections in the region. This is something we will continue to explore.

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 include:

• 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 – and 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 and hepatitis B 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 NHS.UK Sexual Health Services 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, 2023

Data sources: GUMCAD, CTAD

Figure 1 is a bar graph showing the North East was the third highest region by new STI diagnosis rate in England, with 588.7 per 100,000 population (15,795 new STI diagnoses in North East residents). This is similar to 2022 (583.4 per 100, 000 population, 15,652 new STI diagnoses).

Figure 2: Number of diagnoses of the 5 main STIs, North East residents, 2019 to 2023

Data sources: GUMCAD, CTAD

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

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.

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

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

Increases or decreases may also reflect changes in testing practices.

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Figure 2 is a line graph showing the number of diagnoses of the five main STIs in the North East since 2019. Chlamydia remained the most commonly diagnosed STI in North East residents in 2022 (8,448). Following a sharp increase in the number of gonorrhea diagnoses between 2021 and 2022 (1,230 compared to 3,091, 151% increase), the number in 2023 declined slightly (3,070; 1% decrease) but remained 57% higher than in 2019 (1,958). The number of syphilis diagnoses increased further in 2023 (394 in 2022 compared to 572 in 2023, 45% increase) and is now 106% higher than that in 2019 (572 compared to 277). The number of cases of genital herpes (1,294) and genital warts (902) have increased compared to 2022 (1,021 and 893, respectively) but remain below levels reported in 2019.  

Figure 3: Diagnosis rates of the 5 main STIs, North East residents, 2019 to 2023

Data sources: GUMCAD, CTAD

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

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.

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

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

Increases or decreases may also reflect changes in testing practices.

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Figure 3 is a line graph showing the trend of diagnosis rates over the last five years mirrors the trend in number of diagnoses (figure 2), with chlamydia having the highest rate in North East residents in 2023 (314.9 per 100,000) followed by gonorrhoea (114.4 per 100,000).

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

Diagnoses	2023	Percentage change 2019 to 2023	Percentage change 2022 to 2023
New STIs	15,795	-8%	1%
Syphilis	572	106%	45%
Gonorrhoea	3,070	57%	-1%
Genital Warts	902	-59%	1%
Genital Herpes	1,294	-17%	27%
Chlamydia	8,448	-6%	-5%

Data sources: GUMCAD, CTAD

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

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.

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

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

Increases or decreases may also reflect changes in testing practices.

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As can be seen in Table 1, the total number of new STI diagnoses in North East residents remains 8% lower in 2023 compared to 2019. Despite this, there has been a 106% and 57% increase in the number of syphilis and gonorrhoea diagnoses in 2023 compared to 2019.

Figure 4: Rates of new STIs per 100,000 North East residents by age group (for those aged 15 to 64 years only) and gender, 2023

Data sources: GUMCAD, CTAD

Figure 4 shows the age and gender breakdown of new STIs in 2023. The highest rates in both females and males were in the 20 to 24 year age group (3,496.4 and 2,674.2 per 100,000, respectively), followed by 15 to 19 year olds in females (2,870.4 per 100,000) and 25 to 34 year olds in males (1,487.9 per 100,000). This pattern was similar to previous years.

Figure 5a: Rates of syphilis per 100,000 North East residents by age group (for those aged 15 to 64 years only), 2019 to 2023

Data source: GUMCAD

Figure 5a is a line graph showing the rates of syphilis in North East residents by age group. Those aged 20 to 24 years continue to have the highest rate in 2023 (67.3 per 100,000, 111 new diagnoses, 9% increase from 101 in 2022). However, following a 36% increase in the number of diagnoses between 2022 and 2023 (from 138 to 216), the rate in those aged 25 to 34 years (64.4 per 100,000) is now similar to that of those aged 20 to 24 years. A similar level of increase was observed in the number of new diagnoses in those aged 45 to 64 years (from 49 to 76 new diagnoses in 2023, 36% increase). The greatest increase was observed in individuals aged 35 to 44 years (from 66 in 2022 to 133 in 2023, 50% increase). This pattern mirrors that seen nationally, albeit to a greater extent, with the largest increase in the number of diagnoses observed in those aged 35 to 44 years (15%), followed by those aged 25 to 34 and 45 to 64 years (8% each), smaller increases were seen in those aged 15 to 19 and 20 to 24 years. Nationally, the number of syphilis diagnoses in 2023 was the largest annual number reported since 1948 (1).

Figure 5b: Rates of syphilis per 100,000 North East residents by gender and sexual orientation, 2019 to 2023

Data source: GUMCAD

Figure 5b is a line graph showing the rates of syphilis in North East residents by gender and sexual orientation. Numbers increased by 88% in GBMSM in 2023 when compared to 2019 (267 compared to 142), increased by 105% in men who sleep with women (MSW) (127 compared to 62) and increased by 166% in women (149 compared to 56).

Furthermore, as can be seen in Figures 5c and 5d, the rates in females and males in North East residents is higher than that in the England as a whole and higher than all other regions outside of London.

Figure 5c: Rates of syphilis per 100,000 female residents by UKHSA region, 2019 to 2023

Data source: GUMCAD

Figure 5d: Rates of syphilis per 100,000 male residents by UKHSA region, 2019 to 2023

Data source: GUMCAD

Figure 5e: Rates of syphilis per 100,000 male North East residents by age group (for those aged 15 to 64 years only), 2019 to 2023

Data source: GUMCAD

Figure 5f: Rates of syphilis per 100,000 female North East residents by age group (for those aged 15 to 64 years only), 2019 to 2023

Data source: GUMCAD

As can be seen in Figures 5e and 5f, the increase in the rate of syphilis varies by gender and age group. Whilst the numbers remain small, the greatest increase between 2019 and 2023 was seen in females aged 25 to 34 years (from 7.7 to 38.6 per 100,000 female population) and 35 to 44 (from 1.3 to 11.8 per 100,000 female population).

Figure 6: Rates of gonorrhoea per 100,000 North East residents by age group (for those aged 15 to 64 years only), 2019 to 2023

Data source: GUMCAD

Figure 6 is a line graph showing the rates of gonorrhoea in North East residents by age group. Those aged 20 to 24 years continue to have the highest rate of gonorrhoea in 2023 (625.9 per 100,000) followed by those aged 15 to 19 years (405.7 per 100,000). Rates in both these age groups have declined in 2023 compared to 2022 but remain substantially higher than 2019. A similar trend has been seen nationally, with a plateau in the number of gonorrhoea diagnoses in young people aged 15 to 24 in 2023 following a large increase between 2021 and 2022 (1). However, rates in North East residents aged 15 to 19 and 20 to 24 years old are higher compared to those in England (284.9 and 596.1 per 100,000, respectively). Rates of gonorrhoea in North East residents aged 25 to 34, 35 to 44 and 45 to 64 have continued to increase in 2023 and are all higher than in 2019, after a decline in 2020 and 2021.

Figure 7: Rates of genital warts per 100,000 North East residents aged 15 to 19 years by gender, 2019 to 2023

Data source: GUMCAD

Figure 7 is a line graph showing the rate of genital warts has remained low in both males and females in 2023. There has been a decreasing trend seen nationally over the past decade due to the effective HPV vaccination programme introduced to girls aged 12 to 13 years from September 2012 and extended to boys of the same age group from September 2019.

Figure 8: Rates of new STIs by ethnic group per 100,000 North East residents, 2023

Data sources: GUMCAD, CTAD

Figure 8 is a bar chart showing the rate of new STIs by ethnic group was again highest in the Black Caribbean ethnic group in the North East in 2023 (1,410.1 per 100,000). Black African was the second highest ethnic group (1,042.3 per 100,000). 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: Percentage of North East residents diagnosed with a new STI by ethnic group, 2023

Ethnic group	Number	Percentage (excluding unknown)
All other ethnic groups combined	891	6.4%
Black African	230	1.7%
Black Caribbean	24	0.2%
White	12,676	91.7%
Unknown	1,974

Data sources: GUMCAD, CTAD

Figure 9: Percentage of North East residents diagnosed with a new STI by world region of birth [note 1], 2023

Data source: GUMCAD data only

Note 1: 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.

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Figure 9 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 2022.

Figure 10: Rates of new STIs per 100,000 North East residents by decile of deprivation [note 2], 2023

Data sources: GUMCAD, CTAD

Note 2:  Deciles run from 1 to 10 in order of decreasing deprivation, with 1 being the decile for the most deprived area.

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Figure 10 is a bar graph showing the rate of new STIs was highest in the most deprived areas (767 per 100,000; decile of deprivation of 1) and lowest in the least deprived areas (400 per 100,000) of the North East region in 2023. 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(6).

Figure 11: Diagnoses of the 5 main STIs among GBMSM [note 3], North East residents, 2019 to 2023

Data source: GUMCAD data only

Note 3: 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: 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

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Figure 11 is a line graph showing number of diagnoses of all five main STIs among GBMSM North East residents. Gonorrhoea and chlamydia remain the most commonly diagnosed STIs in this high risk group in 2023. The number of gonorrhoea diagnoses continued to increase in 2023 (922 up from 884 in 2022, 4%) in line with the increasing trend seen both locally and nationally prior to 2019. In contrast, the number of chlamydia diagnoses plateaued in 2023.

The number of syphilis diagnoses also continued to increase in 2023 in line with the increasing trend seen both locally and nationally prior to 2019. In 2023, the number of syphilis diagnoses (267) was 67% higher than in 2022 (160) and 88% higher than in 2019 (142).

The number of genital warts and herpes diagnoses in 2023 were slightly higher than in 2022 but remain lower than 2019.

Table 3: Percentage change in new STI diagnoses in GBMSM [note 3] residents in the North East

Diagnoses	2023	Percentage change 2019 to 2023	Percentage change 2022 to 2023
New STIs	2,011	21%	10%
Syphilis	267	88%	67%
Gonorrhoea	922	41%	4%
Genital Warts	46	-54%	21%
Genital Herpes	38	-25%	19%
Chlamydia	569	15%	0%

Data source: GUMCAD data only

Note 3: 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: 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

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As can be seen in Table 3, the total number of new STI diagnoses in North East GBMSM residents was 10% higher in 2023 compared to 2022. The greatest percentage increase was seen in the number of syphilis diagnoses.

Figure 12a: Rate of new STI diagnoses per 100,000 population by upper tier local authority of residence, North East residents, 2023

Data sources: GUMCAD, CTAD

Figure 12a is a bar graph showing the rate of new STI diagnoses per 100,000 population for the 12 local authorities in the North East in 2023. Rates ranged from 406 per 100,000 in Northumberland to 849 per 100,000 population in Newcastle. Rates in Newcastle and Middlesbrough were higher than the England rate. Compared to 2022, rates in 2023 had increased in Durham (10%), South Tyneside (8%), North Tyneside (7%) and Northumberland (5%). Rates in Newcastle, Darlington and Sunderland decreased by 12%, 11% and 7% in 2023 compared to 2022, respectively. Rates in the remaining local authorities decreased by 3% or less.

Figure 12b: Rate of new STI diagnoses (excluding chlamydia diagnoses in residents aged under 25 years) per 100,000 population by upper tier local authority of residence, the North East, 2023

Data sources: GUMCAD, CTAD

Note: 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 12b is a bar graph showing the rate of new STI diagnoses excluding chlamydia diagnoses in residents aged less than 25 years for the 12 local authorities in the North East in 2023. Rates ranged from 282 per 100,000 in Northumberland to 563 per 100,000 population in Newcastle. The rate in Newcastle was higher than the England rate. Compared to 2022, rates in 10 of the 12 local authorities increased in 2023. The greatest increase was observed in County Durham (from 280 to 358 per 100,000; 28%). Middlesbrough and Redcar and Cleveland observed small decreases (3% and 2%, respectively) in 2023 compared to 2022.

Figure 13: Chlamydia detection rate per 100,000 female residents aged 15 to 24 years by upper tier local authority of residence, the North East, 2023

Data sources: GUMCAD, CTAD

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

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Figure 13 is a bar chart showing chlamydia detection rates in female residents aged 15 to 24 years by local authority in 2023. Hartlepool had the highest detection rate (3,694 per 100,000) followed by Redcar and Cleveland (3,327 per 100,000), achieving the 3,250 target. The North East detection rate was 2,173 per 100,000 female residents aged 15 to 24 years in 2023, which is higher than the England rate of 1,962.

Figure 14: Rate of gonorrhoea diagnoses per 100,000 population by upper tier local authority of residence, North East residents, 2023

Data source: GUMCAD

Figure 14 is a bar graph showing the rate of gonorrhoea diagnoses per 100,000 population by local authority. Rates ranged from 66 per 100,000 in Sunderland to 210 per 100,000 in Newcastle upon Tyne. Compared to 2022, rates increased in Stockton-on-Tees and Hartlepool by 23% and 25% respectively, in 2023. Smaller increases were observed in North Tyneside, Redcar and Cleveland, Middlesbrough and Gateshead (5% increase or less). In contrast, compared to 2022, rates in 2023 decreased in the other North East local authorities by 4% in County Durham and South Tyneside to 19% in Darlington.

Figure 15: Rate of syphilis diagnoses per 100,000 population by upper tier local authority of residence, North East residents, 2023

Data sources: GUMCAD

Figure 15 is a bar graph showing the rate of syphilis diagnoses per 100,000 population by local authority. Rates ranged from 11 per 100,000 in Sunderland to 47 per 100,000 in Middlesbrough. Seven of the 12 North East local authorities had rates higher than England (16.7 per 100,000), rates in Northumberland, North Tyneside, County Durham, Darlington and Sunderland were lower than England. Rates of syphilis have been increasing since 2018 in Middlesbrough, Stockton-on-Tees, Hartlepool and Redcar and Cleveland and increased again compared to 2022. All other local authorities in the North East, except Darlington, reported increases in the rate of syphilis diagnoses in 2023 compared to 2022 and all local authorities have exceeded rates reported in 2019.

Figure 16: Map of new STI rates per 100,000 residents by upper tier local authority in the North East, 2023

Data sources: GUMCAD, CTAD

Figure 16 shows a map of North East local authorities, showing all areas had new STI diagnoses rates below 1,000 per 100,000 population in 2023. Newcastle had the highest rate (849.3 per 100,000) Northumberland had the lowest (406.3 per 100,000).

Figure 17: Map of new STI rates per 100,000 residents by middle super output area (MSOA) in the North East, 2023

Data sources: GUMCAD, CTAD

MSOA: census boundary areas that contain an average population of 7,700.

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In 2023, a number of middle super output areas within Newcastle had rates of new STI diagnoses equal to or greater than 2,500 per 100,000 residents. A number of middle super output areas within Newcastle, Gateshead and County Durham had rates between 2,000 and 2,500 per 100,000 residents.

Figure 18: STI testing rate (excluding chlamydia in under 25 year olds) per 100,000 population in North East residents aged 15 to 64 years, 2012 to 2023

Data sources: GUMCAD, CTAD

Figure 18 is a line graph showing the STI testing rate (excluding chlamydia in under 25 year olds) in North East residents and England has continued to increase from 2022 to 2023. Testing rates in 2023 in the North East and England are higher than those observed in 2019.

Figure 19: STI testing positivity rate [note  4] (excluding chlamydia in under 25 year olds) in North East residents, 2019 to 2023

Data sources: GUMCAD, CTAD

Note 4: 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.

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Figure 19 is a line graph showing the North East STI positivity rate in 2023 (8.0%) has decreased slightly from 2022 (8.6%) and remains above the England rate (7.3%). Although the proportion of STI tests being positive has decreased slightly compared to 2022, it remains higher than that in 2019 and is in line with the increasing trend seen prior to 2019.

Table 4: Number of diagnoses of new STIs by UKHSA region of residence, data source and data subset 2023

UKHSA region of residence	GUMCAD Specialist SHSs	GUMCAD non-specialist SHSs [note 5]	CTAD [note 6]	Total
East Midlands	14,758	8,212	5,029	27,999
East of England	18,062	4,855	7,409	30,326
London	87,279	12,689	28,444	128,412
North East	11,007	2,045	2,743	15,795
North West	35,993	4,742	11,742	52,477
South East	31,875	2,495	11,671	46,041
South West	17,956	3,944	6,017	27,917
West Midlands	20,031	4,588	5,183	29,802
Yorkshire and Humber	21,991	2,478	7,895	32,364

Data sources: GUMCAD, CTAD

Note 5: Diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘Non-specialist sexual health services (SHSs)’ total.

Note 6: Including site type 12 chlamydia from GUMCAD.

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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 third highest rate of new STI diagnoses in 2023.

Table 5: Number of diagnoses of the 5 main STIs in the North East by STI, data source and data subset 2023

Five main STIs	GUMCAD specialist SHSs	GUMCAD non-specialist SHSs [note 5]	CTAD [note 6]	Total
Chlamydia	4,169	1,536	2,743	8,448
Genital Herpes	1,294	0		1,294
Genital Warts	901	<5		902
Gonorrhoea	2,566	504		3,070
Syphilis	572	0		572

Data sources: GUMCAD, CTAD

Note 5: Diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘Non-specialist sexual health services (SHSs)’ total.

Note 6: Including site type 12 chlamydia from GUMCAD.

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Table 5 shows most STIs were diagnosed in specialist SHSs. Except for one case of genital warts, chlamydia and gonorrhoea were the only STIs diagnosed in both specialist SHSs and non-specialist SHSs.

Figure 20: Consultations by service medium – North East residents, 2019 to 2023

Data source: GUMCAD

Figure 20 is a bar graph showing the number of consultations amongst North East residents by consultation type. The number of online consultations have increased in 2023 compared to 2022 whilst the number of telephone consultations have continued to decline since 2020. The number of face-to-face consultations continued to increase compared to 2021 and 2022 but remains below that of 2019. The number of online consultations may be underreported 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 Sexual health, reproductive health and HIV in England: a guide to local and national data.

This report is based on data from the GUMCAD and CTAD surveillance systems published on 6 June 2024 (data to the end of calendar year 2023).

GUMCAD surveillance system

This disaggregate 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 carried out 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 2022 were used as a denominator for rates (other than by ethnic group) for 2023. ONS estimates of population by ethnic group for the year 2019 were used as a denominator for rates by ethnic group for 2023. 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 2023 in this report with rates by 2022 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 and Public Health Microbiology to strengthen the surveillance, intelligence and response functions of UKHSA.

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

Acknowledgements

We would like to thank:

• 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

References

1. Sexually transmitted infections and screening for chlamydia in England: 2023 report UK Government White Paper 2024

2. Syphilis: Public Health England action plan UK Government White Paper 2019

3. Tracking the syphilis epidemic in England UK Government White Paper 2024

4. Mercer CH, Tanton C, Prah P, Erens B, Sonnenberg P, Clifton S and others. ‘Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal)’ Lancet 2013: volume 382, issue 9,907, pages 1,781 to 1,794

5. Geary RS, Copas AJ, Sonnenberg P, Tanton C, King E, Jones KG and others. ‘Sexual mixing in opposite-sex partnerships in Britain and its implications for STI risk: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)’ International Journal of Epidemiology 2019: volume 48, issue 1, pages 228 to 242

6. Office for Health Improvement and Disparities. Health Profile for the North East of England 2021