New figures for 2004 from the UK's Health Protection Agency (HPA) suggest there is still much cause for concern over the country's sexual health. Overall, there were more than 750,000 new diagnoses of non-HIV sexually transmitted infections (STIs), a 2% increase from the previous year. However, although there was an increase in the number of cases of syphilis, chlamydia, and genital warts, a decrease was seen in cases of gonorrhoea and genital herpes.
“A further rise in new diagnoses of STIs during 2004 is disappointing," noted the HPA's Dr Helen Ward, "but some encouragement can be taken from the slower growth seen in recent years." However, Dr Ward adds that "we cannot be complacent about the continuing spread of infection."
Syphilis increase
The greatest rise in diagnoses of any STI in 2004 was for syphilis, which is affecting increasing numbers of heterosexual women and men. Diagnoses increased by 37% from the previous year, from 1641 to 2252 cases. Cases diagnosed in women increased by 47% and in heterosexual men by 45%. In addition, the epidemic of syphilis acquired through sex between men continued in 2004, with a 29% increase in new diagnoses. Although the actual number of diagnosed syphilis infections remain lower than for other STIs, the HPA notes that in the past four years syphilis diagnoses have increased more than 500%, and now affect most areas of the country. London, however, continues to bear the brunt of the syphilis epidemic (an increase of 18% in heterosexual men, 12% in women and 11% in gay and bisexual men), although the biggest yearly increase seen was in Greater Manchester. Given the increase of diagnoses in women, the HPA notes that antenatal screening for syphilis needs to be universal to prevent the possibility of the re-emergence of congenital syphilis.
Chlamydia rise
Genital chlamydial infection is the most commonly diagnosed STI in the UK, with a total of 103,932 diagnoses in 2004, an 8% increase from 2003. One per cent of women aged between 16 and 24 were diagnosed with this bacterial STI in most areas of the UK last year. The same high incidence was seen in heterosexual men aged between 20 and 24 in London, the North East, the North West, and the Yorkshire and Humber regions. However, according to the HPA's Dr Ward, this increase "is to be expected since it reflects the greater availability of testing to detect cases that otherwise would remain undiagnosed."
Gonorrhoea decrease
Public health officials did provide some better news, reporting that the number of diagnoses of gonorrhoea decreased by 10% between 2003 and 2004. However, the reductions in diagnoses were not universal. Although nationally there was a 3% reduction in diagnosed gonorrhoea acquired via sex between men, there was actually an 8% increase seen in London in gay and bisexual men, set against a 21% decrease in the North West region. Nationally, diagnoses fell by 12% in both women and heterosexual men.
Overall increase
Genital warts were the second most commonly diagnosed STI in 2004, with an increase of 4% from the previous year to just under 80,000 cases. Meanwhile, diagnoses of genital herpes simplex infection decreased by 1% between 2003 and 2004. “These figures show that the overall increase in STIs has continued in the last year," comments the HPA's Dr Ward. "Overall there is a long way to go before we have turned the tide in reducing the spread of STIs, and prevent the many cases of infertility that follow for women.
The HPA data consist of statistical returns from diagnoses made at genitourinary medicine (GUM) clinics in England, Scotland, Wales and Northern Ireland and do not include cases in other clinical settings or cases diagnosed by GPs. Due to the increasing numbers of people unable to access timely GUM appointments, individuals may now be receiving STI diagnoses and care at their GPs, and consequently STIs may be underreported.