New data for 2005 from the UK's Health Protection Agency (HPA) are "disappointing" and suggest that the country's sexual health continues to decline. 2005 saw a 3% increase in the number of sexually transmitted infections (STIs) diagnosed in genitourinary medicine (GUM) clinics in the UK. However, new cases of gonorrhoea fell by 13%, continuing the reversal first seen last year.
“Today's figures contain mixed news," said Professor Peter Borriello, Director of the HPA's Centre for Infections," noting that "it is disappointing to see that there was a further rise in new diagnoses of STIs in 2005."
Chlamydia remains the most commonly diagnosed STI in the UK, possibly as a result of the scaling-up of the National Chlamydia Screening Programme. In 2005, 109,832 new cases were diagnosed - a 5% increase on the previous year. The highest rates of infection and highest increases in diagnoses were seen for both genders in the 16 to 24 age group. However, young women aged between 16 and 19 are particularly affected: one in every 73 young women in this age group were diagnosed with this bacterial STI in 2005.
Genital warts were the second most commonly diagnosed STI in 2005, with an increase of 1% from the previous year to 81,203 cases. Genital warts are caused by human papilloma virus (HPV), which is also associated with cervical and anal cancers. A study published last month found that women whose male sexual partners consistently used condoms were significantly less likely to become infected with HPV.
Although the absolute numbers are low compared with chlamydia and genital warts, new diagnoses of primary and secondary infectious syphilis continued to significantly increase in 2005, up by 23% in 2004 to 2,807. Syphilis continues to disproportionally affect gay and bisexual men, many of whom are also HIV-positive: 60% of all new syphilis diagnoses were in this risk group. However, syphilis is affecting heterosexual men and women, too, and the 2005 increases were particularly marked among women, where the increase was almost two and a half times higher than that seen among men.
"These figures show there is still much to be done to tackle the continuing spread of infection," commented Professor Borriello, and they "serve as a reminder for people to take responsibility for their own sexual health and that of their partners, and to use a condom with new and casual partners."
However, there was some good news. The number of new cases of gonorrhoea fell by 13%, from 22,350 in 2004 to 19,495 in 2005, with fewer cases reported across all English regions. This is the first time less than 20,000 new cases have been diagnosed since 1999 and suggests that "real progress is being made," said Professor Borriello. In addition, although new diagnoses of genital herpes increased by 4% (from 19,074 in 2004 to 19,771 in 2005), new diagnoses have remained under 20,000 since they dramatically increased at the turn of the century.
"The overall trend of increasing numbers shows the full extent of the challenge facing healthcare professionals as they try to limit the spread of STIs," noted Professor Borriello. "We support the Government's commitment to improve the nation's sexual health and at a local level will continue to work closely in partnership with clinicians and Primary Care Trusts on initiatives to tackle STIs."
However, the Government's commitment, as outlined in Choosing Health – which included £130m in 2004 to improve access to GUM services and a further £15m last year – is not resulting in improved sexual health. Data from the HPA reported on aidsmap last year, suggest that waiting times for GUM services in England did not improve in 2005, and may have actually worsened.
And a recent report from the Terence Higgins Trust (THT), the British HIV Association (BHIVA), the British Association of Sexual Health and HIV (BASHH) and the National Association of NHS Providers of AIDS Care and Treatment (PACT) on how primary care trusts (PCTs) managed sexual health in 2005, entitled Disturbing Symptoms 4, available to download from the THT website, found "a noticeable disconnect between Governmental strategic plans and local practical action.
"It is clear that money intended for the improvement of sexual health services is, in many cases, not reaching the intended target," the report's authors wrote, "and if continued this will have long term consequences for the sexual health of the country.
"Despite extra Government funding allocated to GUM and sexual health services," concludes the report, "only half of PCTs reported a real increase in funding of their sexual health services and almost one in five reported a real-term decrease or were unable to answer at all."