Page last updated: 27-NOV-2007

Sexual Health


Statistical Publication Notice

27 November 2007

Nat_stat_1

Sexually Transmitted Infections and Other Sexual Health Information for Scotland. Year of publication 2007   


INTRODUCTION

This is the first time this report has included data on aspects of sexual health other than STIs.  This report should be regarded as a start in the process of drawing together information on sexual health and we hope to make further progress in future reports.  The data relate to the calendar year 2006.
The sexual health strategy for Scotland, "Respect and Responsibility", recognises the importance of information as a way of describing and understanding the sexual health of the population, and also monitoring change.  This report is intended to contribute to this process.
During the preparation of this report, we have liaised with colleagues in the UK Collaborative Group for HIV and STI Surveillance in London and have arranged that their report, which covers STIs over the whole UK, and our Scottish report will be published at approximately the same time www.hpa.org.uk. Both reports are published shortly before World AIDS Day in order to maximize the impact of the information.

KEY POINTS

  • There was a 13% increase in workload in GUM clinics between 2005 and 2006.  This compares with a 10% increase between 2004 and 2005.
  • The number of chlamydia diagnoses in Scotland increased by 4% between 2005 and 2006 to 17926. This represents a smaller increase than in recent years.
  • In 2006, 345 new cases of HIV were identified in Scotland; this includes 127 presumed infected in Scotland, 37 elsewhere in the UK and 172 outwith the UK, some of whom will have been previously diagnosed outside Scotland.  The numbers of AIDS diagnoses and AIDS related deaths in HIV infected individuals have fallen by threefold and tenfold, respectively (AIDS diagnoses - 41, deaths - 32) since the introduction of effective therapies in 1996.
  • The incidence of acute STIs amongst men who have sex with men (MSM) continues to increase in spite of innovative awareness-raising campaigns.
  • There is an overall rise in rates of abortion although for those aged under 16 and those aged 40 and over, these remain static.

DETAILED FINDINGS

This is the first time this report has included data on aspects of sexual health other than STIs.  This report should be regarded as a start in the process of drawing together information on sexual health and we hope to make further progress in future reports.  The data relate to the calendar year 2006.
The sexual health strategy for Scotland, "Respect and Responsibility", recognises the importance of information as a way of describing and understanding the sexual health of the population, and also monitoring change.  This report is intended to contribute to this process.
During the preparation of this report, we have liaised with colleagues in the UK Collaborative Group for HIV and STI Surveillance in London and have arranged that their report, which covers STIs over the whole UK, and our Scottish report will be published at approximately the same time www.hpa.org.uk. Both reports are published shortly before World AIDS Day in order to maximize the impact of the information.
 
Workload:
There was a 13% increase in workload in GUM clinics between 2005 and 2006.  This compares with a 10% increase between 2004 and 2005.
 
Sexually Transmitted Infections:
 
Genital chlamydia: The number of chlamydia diagnoses in Scotland increased by 4% between 2005 and 2006 to 17926. This represents a smaller increase than in recent years. Two thirds of women were diagnosed in clinical settings other than the GUM clinic (for example at their GP or a community family planning clinic); in contrast two thirds of men were diagnosed at GUM clinics. Over 70% of genital chlamydia diagnoses were made in those aged less than 25 and the majority of these were in men and women aged 20-24.
Gonorrhoea: in 2006, 900 laboratory diagnoses of gonorrhoea were made.  This figure is similar to that for 2005. There was an increase in the number of diagnoses in men (4%) and a decrease in those among women (13%).
Genital herpes: In 2006, 1390 persons attending GUM clinics were diagnosed with genital herpes for the first time. More than half of genital herpes diagnoses made in GUM clinics (58%) were in women.
Infectious syphilis:  Syphilis re-emerged in Scotland during 2000/2001 following outbreaks elsewhere in the UK; since then, the number of diagnoses has increased annually. In 2006, 246 infectious cases were recorded at GUM clinics; this is the highest annual total recorded since 1952 and represents a 31% increase on that reported for 2005 (188). 95% of all diagnoses were men, the majority of whom were men who have sex with men (MSM) (85%).
Genital warts: This is the most common acute viral (as opposed to bacterial) STI diagnosed in the GUM clinic setting with almost 7000 new cases seen in 2006. This represents  a 7% increase on the total for 2005. 30% were referred to GUM by their GP. Two prophylactic HPV vaccines have been developed and are now licensed in the European Community.
HIV infection: in 2006, 345 new cases of HIV were identified in Scotland; this includes 127 presumed infected in Scotland, 37 elsewhere in the UK and 172 outwith the UK, some of whom will have been previously diagnosed outside Scotland. The numbers of AIDS diagnoses and AIDS related deaths in HIV infected individuals have fallen by threefold and tenfold, respectively (AIDS diagnoses - 41, deaths - 32) since the introduction of effective therapies in 1996.  Over two thirds of new cases identified were men. Over 80% of non-IDU heterosexual cases probably acquired their infection outside the UK, predominantly in African countries - the number of non-IDU heterosexuals who probably acquired their HIV in Africa has decreased during the past two years.
Men who have sex with men (MSM): The incidence of acute STIs amongst MSM continues to increase in spite of innovative awareness-raising campaigns.
 
Pregnancy and abortion
 
Teenage pregnancy: rates of teenage pregnancy have remained steady during the past decade. In 2005 there were 56.7 pregnancies per 1000 females aged less than 20 and 7.1 pregnancies per 1000 females aged less than 16. Deprivation: Those under age 20 living in the most deprived areas have approximately ten times the rate of delivery as those in the least deprived, and twice the rate of abortion.  These proportions varied little from 2000 to 2005.
Abortions: rates of abortions in those aged 15 - 19 continue to rise, although abortion rates in those under 16 and those aged 40 and over remain static.
Contraception and fertility control Efforts should be made to encourage women to ask for the most effective and suitable contraception method available.
Sterilisation in women reduced by 76% between 1985 and 2005; this indicates a decrease in popularity of this method of contraception.

CONCLUSIONS

The rise in the number of STIs continues. Some of the rise is attributable to the success of efforts to encourage wider uptake of testing, for example chlamydia and HIV.  Much of the increase probably results from a genuine underlying increase in the incidence of STIs, for example genital warts and genital herpes.
There are specific conditions which are a particular problem for men who have sex with men and these include syphilis, gonorrhoea and HIV.  Young people remain particularly affected by the major acute STIs and should continue to be targeted for testing and prevention. The use of condoms should be encouraged in all age groups.
More accurate data on contraception uptake will be available with the implementation of the national sexual health system (NaSH) in GUM and community family planning clinics.
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MAIN CONTACTS:

Jim Chalmers
Head of Programme
Women and Children Health Information Programme
0131 275 6136
jim.chalmers@isd.csa.scot.nhs.uk
Felicity Naughton
Data Augmentation for Sexual Health (DASH) Project Manager
0131 275 7148
felicity.naughton@isd.csa.scot.nhs.uk
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GLOSSARY:

STI - sexually transmitted infection
GUM - genitor-urinary medicine
HIV - human immunodeficiency virus
AIDS - acquired immunodeficiency syndrome
MSM - men who have sex with men
HSV - herpes simplex virus
HPV - human papillomavirus
IDU - injecting drug users
HPA - Health Protection Agency
KCI - key clinical indicator
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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

Sexually Transmitted Infection Epidemiology Advisory Group (STIEAG)
SGHD
NHS Board Chief Executives
Directors of Public Health
Lead Genitourinary Medicine Consultants at Clinics
Lead Clinicians for Sexual Health.
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HISTORY OF THIS PUBLICATION:

Last Published: 22 November 2006
Next Due:  Autumn 2008
Dat Avaliable Since: 24 November 2005

 


Main contact: Email Jim Chalmers