Guidance

Spotlight on sexually transmitted infections in Yorkshire and Humber: 2022 data

Updated 1 October 2024

Applies to England

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Summary

This report primarily focuses on the trend between 2021 and 2022, however 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 challenge in Yorkshire and Humber. Out of all the UK Health Security Agency (UKHSA)’s regions it has the third highest rate of new STIs in England.

There were 33,378 new STIs diagnosed in Yorkshire and Humber residents in 2022, representing a rate of 609 diagnoses per 100,000 population. Rates of new STI diagnoses by upper tier local authority ranged from 374 per 100,000 population in North Yorkshire Unitary Authority (UA) to 888 per 100,000 population in City of Kingston upon Hull.

The number of new STIs diagnosed in Yorkshire and Humber residents increased by 29% between 2021 and 2022. Rises were seen in 4 of the 5 major STIs:

• gonorrhoea increased by 95%
• syphilis increased by 37%
• chlamydia increased by 25%
• genital herpes increased by 16%

Genital warts decreased by 9%.

A continued trend of higher number of online and telephone consultations, first noted in 2020 and likely impacted by the pandemic, has continued to be observed. This highlights the changing use of sexual health services in Yorkshire and Humber and in England as a whole.

In June 2021, the National Chlamydia Screening Programme (NCSP) changed to focus on reducing reproductive harm of untreated infection in young women. This led to a change in the recommended chlamydia detection rate indicator (DRI) included in the Public Health Outcomes Framework (PHOF). UKHSA recommends that local authorities work towards the revised female-only PHOF benchmark DRI of 3,250 per 100,000 females aged 15 to 24 years. In 2022, the chlamydia diagnosis rate among Yorkshire and Humber residents aged 15 to 24 years was 1,917 per 100,000 residents.

Where gender and sexual orientation are known and excluding chlamydia diagnoses reported via CTAD (76% of those diagnosed with syphilis and 28% of those diagnosed with gonorrhoea), gay, bisexual and other men who have sex with men (GBMSM) account for 17% (increasing from 15% in 2021) of Yorkshire and Humber residents diagnosed with a new STI.

STIs disproportionately affect young people. Yorkshire and Humber residents aged between 15 and 24 years accounted for 57% of all new STI diagnoses in 2022, with new STI diagnoses in females aged between 15 and 24 years accounting for 35% of all new diagnoses. A steep decline (94% decrease) has been seen between 2018 and 2022 in genital warts diagnosis rates in females aged 15 to 19 years. This follows the introduction in 2008 of vaccination against human papillomavirus (HPV), the virus that causes genital warts, for females (1).

The white ethnic group has the highest number of new STI diagnoses in Yorkshire and Humber: 21,388 (86%). Although less than 1% of new STIs are in black Caribbean residents, they have the highest rate: 1,051 per 100,000, which is twice the rate seen in the white ethnic group. Where country of birth was known, 90% of Yorkshire and Humber residents diagnosed with a new STI in 2022 (excluding chlamydia diagnoses reported via CTAD) were UK-born.

Conclusions

Across England, the number of consultations by Sexual Health Services (SHS) has recovered and now exceeds pre COVID-19 levels. The number of consultations (all types) delivered by SHS in England in 2022 was 8% higher than in 2021 (4,059,608 versus 4,394,404) and 14% higher than 2019 (3,869,728). Of all consultations in 2022, almost half (2,204,790) were delivered face-to-face, 39% (1,721,132) via the internet and 11% (468,482) via telephone (2). The greatest increase by type of consultation was for online consultations, which rose by 19% (from 1,446,001 to 1,721,132) (3). 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) (2). Further, online consultations may be higher in number due to potential underreporting where physical SHS provide both face-to-face and online consultations. Trends observed nationally were reflected in Yorkshire and Humber, with all types of consultations increasing between 2021 and 2022. Overall consultations reported in 2022 surpassed the number of consultations recorded in 2019 for Yorkshire and Humber.

An increase in the number of sexual health screens (diagnostic tests for one or more of chlamydia, gonorrhoea, syphilis and HIV) was also observed in England in 2022. These increased by 13% (1,934,347 to 2,193,801) compared to 2021, but remained 3% lower than 2019 (2,255,992) (2). The number of new STIs in England increased by 24% (317,022 to 392,453) in 2022 but was 16% lower than 2019 (468,260) (2). The larger increase in diagnoses relative to sexual health screens may reflect more targeted testing of those more likely to have an STI, or an increase in STI transmission in the community.

In Yorkshire and Humber, diagnosis rates of gonorrhoea and syphilis have increased between 2018 and 2022 (increasing by 78% and 8%, respectively) whereas chlamydia, genital warts and genital herpes have either decreased or remained stable. It is important to continue to monitor these trends and the populations affected. Similar trends were also seen across England with the greatest increase seen in the number of gonorrhoea diagnoses (increasing from 54,961 to 82,592), with the largest increase among young people (2) and overall reaching the largest annual number reported since records began (3). Infectious syphilis (primary, secondary and early latent stages) diagnoses rose by 15% (from 7,543 to 8,692), the largest annual number reported since 1948, not adjusting for population (3). Both gonorrhoea and syphilis exceeded levels reported in 2019 before the COVID-19 pandemic.

Females aged between 20 to 24 years and 15 to 19 years have the highest rate of new STIs per 100,000 in Yorkshire and Humber. The increased frequency of new STI diagnoses among young people is also observed across England with the number of new STI diagnoses in 2022, compared to 2021, among young people aged 15 to 24 years increasing 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) (2).

Diagnoses of STIs have increased in GBMSM between 2018 and 2022 in Yorkshire and Humber, reflecting national trends. The number of bacterial STI diagnoses among GBMSM increased from 2013 to 2019 before dropping in 2020. In keeping with the recovery of SHS provision and increased STI testing in 2021 and 2022, there were increases in bacterial STI diagnoses amongst GBMSM over this period: gonorrhoea increased 41% (27,545 to 38,923), chlamydia increased by 25% (15,267 to 19,129) and infectious syphilis increased 13% (5,316 to 6,003) (2). 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 (4).

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) (5), as well as an increase in cases of shigellosis and recent outbreaks in 2022 of extensively drug-resistant Shigella sonnei and S. flexneri (6).

UKHSA’s main messages

Commissioners and providers of SHS 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:

• 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 SHS 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 SHS 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 SHS – 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 SHS

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

• 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 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, 2022

Data sources: GUMCAD, CTAD

Figure 1 is a bar chart showing that London reported the highest rate of new STI diagnosis per 100,000 population in 2022, with the North West and Yorkshire and Humber reporting the second and third highest rate (661.8 and 608.9, respectively).

Figure 2. Number of diagnoses of the 5 main STIs, Yorkshire and Humber residents, 2018 to 2022

Data sources: GUMCAD, CTAD

Notes: 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.

Figure 2 shows trend lines for the number of diagnoses of the 5 main STIs among Yorkshire and Humber residents. Of the 5 STIs presented, the number of diagnoses of chlamydia has varied the most over the 5-year period between 2018 to 2022 (decreasing from approximately 21,000 to 15,000 then increasing to more than 19,000 diagnoses). The number of diagnoses of genital warts and genital herpes have declined over this period. Gonorrhoea diagnoses have increased during this time (increasing from 3,712 to 6,598). Diagnoses of syphilis have also observed a small increase (increasing from 411 to 442).

Figure 3. Diagnosis rates of the 5 main STIs, Yorkshire and Humber residents, 2018 to 2022

Data sources: GUMCAD, CTAD

See notes for Figure 2

Figure 3 shows trend lines for diagnosis rates of the 5 main STIs among Yorkshire and Humber residents. Of the 5 STIs presented, the diagnoses rate of chlamydia has most notably varied over the 5-year period (fluctuating from greater than 370 per 100,000 residents to less than 300 per 100,000 residents to 351 per 100,000 residents). The diagnoses rate of genital warts and genital herpes have declined over this period. Whereas the diagnoses rate of gonorrhoea has increased during this time (increasing from 67.7 to 120.4), with an increase also being observed in the diagnosis rate of syphilis (increasing from 7.5 per 100,000 residents to 8.1 per 100,000 residents).

Table 1. Percentage change in new STI diagnoses, Yorkshire and Humber residents

Diagnoses	2022	Percentage change 2018 to 2022	Percentage change 2021 to 2022
New STIs	33,378	-8%	29%
Gonorrhoea	6,598	78%	95%
Syphilis	442	8%	37%
Chlamydia	19,239	-5%	25%
Genital herpes	2,084	-18%	16%
Genital warts	2,021	-56%	-9%

Data sources: GUMCAD, CTAD

See notes for Figure 2

Table 1 shows that between 2021 and 2022 new STI diagnoses increased by 29%. Gonorrhoea diagnoses reported the largest percentage change increase, followed by syphilis (increasing by 95% and 37%, respectively). Between 2018 and 2022 the diagnoses of new STIs went down (decreasing by 8%) with a notable exception to this trend being observed with gonorrhoea and syphilis diagnoses, which increased by 78% and 8%, respectively, between 2018 to 2022.

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

Data sources: GUMCAD, CTAD

Figure 4 is a bar chart that shows rates of new STIs in Yorkshire and Humber in 2022 were highest in those aged 24 years and under. Females aged between 20 to 24 years reported the highest rate of new STIs per 100,000, followed by females aged between 15 to 19 years.

Figure 5. Rates of gonorrhoea per 100,000 residents by age group (note 1) in Yorkshire and Humber, 2018 to 2022

Data sources: GUMCAD

Note 1: Age-specific rates are shown for those aged 15 to 64 years only.

Figure 5 shows trend lines for the rates of gonorrhoea by age group (for those aged 15 to 64 years only) showing that rates have increased for all age groups between 2018 and 2022. Rates have increased most notably in those aged 20 to 24 years, and those aged 15 to 19 years.

Figure 6. Rates of genital warts per 100,000 residents aged 15 to 19 years by gender in Yorkshire and Humber, 2018 to 2022

Data sources: GUMCAD

Figure 6 shows trend lines of the rates of genital warts, which have substantially decreased amongst both females and males aged between 15 to 19 years from 2018 and 2022.

Figure 7. Rates of new STIs by ethnic group per 100,000 residents in Yorkshire and Humber, 2022

Data sources: GUMCAD, CTAD

Figure 7 is a bar chart showing that rates of new STIs are highest amongst people with black Caribbean and black African ethnicity and lowest amongst people with white ethnicity and all other ethnic groups combined.

Table 2. Proportion of Yorkshire and Humber residents diagnosed with a new STI by ethnicity, 2022

Ethnic group	Number	Percentage excluding unknown
White	21,388	86%
Black African	549	2%
Black Caribbean	239	1%
All other ethnic groups combined	2,619	11%
Unknown	8,583

Data sources: GUMCAD, CTAD

Table 2 shows that, of the 33,378 new STI diagnoses where ethnic group were provided, the majority were those of white ethnicity (86%), followed by black African ethnicity and then black Caribbean ethnicity. Ethnicity information was not available for 8,583 and this may demonstrate a need to improve collection of ethnicity data.

Figure 8. Proportions of Yorkshire and Humber residents diagnosed with a new STI by world region of birth (note 2), 2022

Data sources: GUMCAD data only

Note 2: 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 8 is a bar chart showing the majority (90%) of those diagnosed with a new STI in 2022 were born in the UK.

Figure 9. Rates of new STIs per 100,000 residents by decile of deprivation (note 3) in Yorkshire and Humber, 2022

Data sources: UKHSA, GUMCAD

Note 3: Deciles run from 1 to 10 in order of decreasing deprivation.

Figure 9 is a bar chart that shows a decreasing rate of new STIs per 100,000 moving from the most deprived decile (1) to the least deprived decile (10). With an exception to this trend being observed in decile-5 residents, which reports a rate of new STIs of 681 per 100,000.

Figure 10. Diagnosis rates of the 5 main STIs among GBMSM (note 4), Yorkshire and Humber residents, 2018 to 2022

Data sources: GUMCAD data only

Note 4: 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.

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 10 is a line chart that shows diagnoses of gonorrhoea, chlamydia and genital herpes have increased in GBMSM between 2018 and 2022. Diagnoses of syphilis experienced a reduction and then a resurgence leading to the number of diagnoses reported in 2018 and 2022 being approximately the same. Genital warts have experienced a decline reducing from 209 to 82, respectively.

Figure 11. Diagnosis rates of the 5 main STIs among GBMSM (note 5), Yorkshire and Humber residents, 2018 to 2022

Data sources: GUMCAD, CTAD

Note 5: 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.

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 11 is a line chart that shows the diagnoses rates of gonorrhoea, chlamydia and genital herpes have increased among GBMSM between 2018 and 2022. The diagnosis rate of syphilis has remained fairly constant, and the rate of genital warts has decreased during this time period (reducing from 326.6 to 128.1, respectively).

Table 3. Percentage change in new STI diagnoses in GBMSM (note 3) resident in Yorkshire and Humber

Diagnoses	2022	Percentage change 2018 to 2022	Percentage change 2021 to 2022
New STIs	3,248	9%	44%
Gonorrhoea	1,596	30%	58%
Syphilis	296	0%	43%
Chlamydia	932	13%	39%
Genital herpes	88	26%	38%
Genital warts	82	-61%	-27%

Data sources: GUMCAD data only

See notes for Figure 9

Table 3 shows the total number of new STIs in GBMSM has increased by 9% between 2018 and 2022. The number of new diagnoses of gonorrhoea, chlamydia and genital herpes have increased between 2018 and 2022 compared to number of new diagnoses of syphilis which remained constant and genital warts which have decreased over this time.

Compared to 2021, all STIs included in this table increased in 2022 except genital warts. However, when comparing 2021 and 2022, it is important to remember the disruption caused by the COVID-19 pandemic on sexual health services and individual’s behaviour.

Figure 12a. Rate of new STI diagnoses per 100,000 population by upper-tier local authority of residence, Yorkshire and Humber residents, 2022

Data sources: GUMCAD, CTAD

Figure 12a is a bar chart showing the regional rate of new STI diagnoses for Yorkshire and Humber is 609 per 100,000 population, compared to 694 per 100,000 population across England (Figure 10a). Kingston upon Hull, North East Lincolnshire, Leeds, Sheffield and York reported rates higher than the region and England (888, 851, 842, 720, 699, respectively).

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, Yorkshire and Humber, 2022

Data sources: GUMCAD, CTAD

Note 6: 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 chart showing Kingston upon Hull reported the highest rate of new STI diagnoses, excluding chlamydia diagnoses in Yorkshire and Humber residents aged under 25 years, followed by North East Lincolnshire and Calderdale (547, 485 and 476, respectively).

Figure 13. Chlamydia detection rate per 100,000 female residents aged 15 to 24 years by upper-tier local authority of residence, Yorkshire and Humber, 2022

Data sources: GUMCAD, CTAD

Note 7: Prior to 2023, this figure showed rates for the whole population aged 15 to 24 years, regardless of gender.

Figure 13 is a bar chart showing North East Lincolnshire reported the highest rate of chlamydia detected amongst female residents aged 15 to 24 years in 2022, followed by Leeds and Kingston upon Hull (4,536, 3,665 and 3,594, respectively).

Figure 14. Rate of gonorrhoea diagnoses per 100,000 population by upper-tier local authority of residence, Yorkshire and Humber residents, 2022

Data sources: GUMCAD

Figure 14 is a bar chart showing Leeds reported the highest rate of gonorrhoea diagnoses followed by North East Lincolnshire and Sheffield (206, 160 and 146, respectively; Figure 12).

Figure 15. Map of new STI rates per 100,000 residents by upper-tier local authority in Yorkshire and Humber, 2022

Data sources: GUMCAD, CTAD

Figure 15 is a map showing that Kingston upon Hull, followed by North East Lincolnshire and Leeds reported the highest rates of new STI diagnoses in Yorkshire and Humber in 2022 (888.3, 850.5 and 842.4 respectively).

Figure 16. STI testing rate (excluding chlamydia in those aged under 25 years) per 100,000 population in Yorkshire and Humber residents aged 15 to 64 years, 2018 to 2022

Data sources: GUMCAD, CTAD

Figure 16 shows trend lines for the STI testing rate, excluding chlamydia in those aged under 25 years, remained fairly consistent over the 5-year period between 2018 and 2022. Yorkshire and Humber have consistently reported a lower rate compared to that observed across all of England. Both Yorkshire and Humber and England demonstrated a recovery in testing rate in 2021 and 2022, following the decline in 2020.

Figure 17. STI testing positivity rate (note 8) (excluding chlamydia in those aged under 25 years) in Yorkshire and Humber residents, 2018 to 2022

Data sources: GUMCAD, CTAD

Note 8: 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 17 shows trend lines for the STI testing positivity rate (excluding chlamydia in people aged under 25 years), which has remained fairly stable with an overall incline in STI testing positivity rate observed between 2018 and 2022 in Yorkshire and Humber. England’s rate appears to have gone through a similar trend over the same period and has consistently been marginally higher than the rate reported in Yorkshire and Humber.

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 SHS	GUMCAD non-specialist SHS (note 9)	CTAD (note 10)	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 9: Diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘Non-specialist sexual health services (SHS)’ total.

Note 10: Including site type 12 chlamydia from GUMCAD.

Table 4 shows that London reported the largest number of new STI diagnoses (122,912 in total) followed by the North West and South East (49,122 and 45,214, respectively).

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

Five main STIs	Specialist SHS	Non-specialist SHS (note 9)	CTAD (note 10)	Total
Syphilis	442			442
Gonorrhoea	4,751	1,847		6,598
Chlamydia	8,126	1,379	9,734	19,239
Genital herpes	2,075	9		2,084
Genital warts	1,996	25		2,021

Data sources: GUMCAD, CTAD

Table 5 shows that all syphilis diagnoses were identified from specialist SHS as were the majority of all other STIs. Chlamydia and gonorrhoea diagnoses were the most common STI diagnosis made in non-specialist SHS. Non-specialist SHS include stand-alone online-testing services.

Figure 18. Consultations by medium: Yorkshire and Humber residents, 2018 to 2022

Data sources: GUMCAD

Figure 18 shows the number of consultations in Yorkshire and Humber residents attending SHS (including both specialist and non-specialist services) over the 5-year period: 2018 to 2022 by the type of consultation. It shows that the predominant type of consultation pre pandemic was face-to-face, whereas during and since the pandemic there has been an increase in online and telephone consultations. In 2022, face-to-face consultations were the majority, (accounting for 49% of consultations), however, the trend of higher volumes of online and telephone consultations, first observed in 2020 has continued.

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 disaggregate reporting system collects information about attendances and diagnoses at specialist (level 3) and non-specialist (level 2) SHSs. 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 SHS), 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. A number of infections are transmissible through direct sexual contact (such as mpox and hepatitis A) but are not included in totals of STI diagnoses for surveillance in England (2).

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) SHS and enhanced GP services as well as specialist (level 3) SHS.

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 Yorkshire and Humber, contact YHFS@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 Field Service team at YHFS@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:

• local SHS 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. UK Health Security Agency press release. HPV vaccination programme moves to single dose from September 2023

2. Migchelsen SJ, Enayat Q, Harb AK, Daahir U, Slater L, Anderson A and others. Sexually transmitted infections and screening for chlamydia in England: 2022 report

3. Mohammed H, Blomquist P, Ogaz D, Duffell S, Furegato M, Checchi M and others. 100 years of STIs in the UK: a review of national surveillance data Sexually Transmitted Infections 2018: volume 94, issue 8, pages 553 to 558

4. Brown JR, Reid D, Howarth AR, Mohammed H, Saunders J, Pulford CV and others. Sexual behaviour, STI and HIV testing and testing need among gay, bisexual and other men who have sex with men recruited for online surveys pre/post-COVID-19 restrictions in the UK Sexually Transmitted Infections March 2023

5. Public Health England. Trends of Lymphogranuloma venereum (LGV) in England: 2019

6. Thorley K, Charles H, Mitchell H, Jenkins C, Godbole G, Sinka K. Sexually transmitted Shigella spp. in England: data up to quarter 2, 2022