Public Health England’s most recent insights into trends of sexually transmitted infections have revealed that diagnosis of the most common infections are on the up. Overall, there was a 5% increase in cases in 2018, with almost 450,000 diagnoses.

The largest increase in diagnosed cases is for Gonorrhoea. In 2018, cases rose by 26% with 56,259 positive results. This correlates with a substantial increase over the last number of years - as the number of Gonorrhoea cases has increased by a staggering 249% since 2009. Case figures are at their highest for 40 years. 

As Gonorrhoea continues to spread with so many cases annually, it’s a real cause for concern with the discovery of a resistant strain of Gonorrhoea in the UK, dubbed ‘super gonorrhoea’. Resistant strains of STIs are believed to be one of the greatest health risks of modern times.  

Dr Daniel Atkinson, Clinical Lead at commented, “The significant rise in Gonorrhoea cases in less than a decade is worrying. With an infection like Gonorrhoea, as many as half of the women who are affected do not have any symptoms - which leaves you at a higher risk as you may not think you should get tested. The longer the condition is left, more serious health problems can occur as a result, like fertility problems. It raises alarm bells as to how to reduce this; be it with education, being more proactive with testing or making testing more accessible.” 

Syphilis cases have increased by 5% in 2018 overall, with just over 7,500 new cases. Syphilis is rarely diagnosed in young people - however, there has been a 23% increase in cases for 15 to 19 year olds. For 20 to 24 year olds, cases have risen by 9% - the same percentage rise for 25 to 32 year olds. Cases are less frequent for 45 to 64 year olds with a 5% increase, and those who are 65 and older have seen a 5% increase too. The most prominent age group are 25 to 32 year olds, with 2,597 cases in 2018.

On the rise of syphilis, Daniel added, “Syphilis may be seen as a disease of the past but it needs to be taken very seriously. There are a number of ways the infection could have spread - not just through unprotected sex but also through sharing sex toys or needle-sharing amongst drug users. The condition will not normally go away on its own, and the symptoms may be more noticeable than with other STIs. For pregnant women, syphilis can be extremely dangerous as it can lead to miscarriage, stillbirth or infections in the baby.”

For 15 to 19 year olds, diagnoses of genital warts are declining considerably. In 2018, cases were down by 56% for young girls, believed to be down to the widespread use of the quadrivalent HPV vaccine. As a result of the vaccine, herd protection has meant there has been a decline for young boys too (46%). Since 2014, case numbers are down by 92% and 82% respectively. 

Daniel expanded, “As of September 2019, the successful HPV vaccination has been offered to 12-13 year old boys in school too, meaning that theoretically we should continue to see these figures dropping. The girls’ vaccination programme has been active for a decade and the figures speak for themselves - and thankfully through the herd method, boys have been benefitting too.”

Of the diagnosed STI cases in 2018, the most common is chlamydia with 49% or 218,095 cases. Increases in cases of chlamydia - and Gonorrhoea - have been seen across all age groups between 2017 and 2018, with the largest increase in people 65 and older (24% for chlamydia). There is a shift in how young people are being tested for this infection; online testing for chlamydia increased by 54% in 2018, accounting for 17% of the tests and 14% of diagnosis for 15-24 year olds. 

“It’s great to see more people utilising online services to get tested,” Daniel noted. “As we have seen, as a forerunner for online consultations, there is an increasing demand to access healthcare in a quick and convenient way. Ordering a test kit online is a simple process and your test results are easy to access - be it right away on the testing device or getting an alert sent to you. It wouldn’t be surprising if this method were to continue to grow in popularity.” 

The increases in online testing for sexually transmitted diseases have been prominent in the North East (253%), London (134%) and in Yorkshire and the Humber (12%). 

Public Health England have provided guidelines on regular testing, advising that anyone who is under 25 and sexually active should be screened annually for chlamydia, or when they change their sexual partner. For gay, bisexual or other men who have sex with men, advise from Public Health England states that testing for HIV and STIs should take place annually or every three months if having condomless sex casually or with new partners. 

From September 2020, relationship and sex education will be effectively implemented in all secondary schools, helping to educate young people about their sexual health. These programmes are to include information regarding the internet and social media - how information is stored and potential threats online as well as covering topics like sexual violence. 

STINew cases in 2017New cases in 2018% change
Gonorrhoea44,81256,259+ 26%
Chlamydia205,365218,095+ 6%
Syphilis7,1497,541+ 5%
First episode genital herpes32,82833,867+ 3%
Genital warts59,17857,318- 3%