Page last updated: 30-SEP-2009
Sexual Health
Statistical Publication Notice
30 September 2008
Key Clinical Indicators for Sexual Health: Data for Population Based Indicators 2007
INTRODUCTION
“Respect and Responsibility: Strategy and Action Plan for Improving Sexual Health” highlighted the need to monitor sexual health service development both nationally and at an NHS board level. A set of Key Clinical Indicators (KCIs) has been developed for this purpose.
This document reports on the chlamydia, sterilisation, termination of pregnancy, hepatitis B and long acting reversible methods of contraception (LARC) indicators with data from calendar year 2007 and for LARC from financial year 2007 / 2008. The termination of pregnancy data have been published previously at www.isdscotland.org/abortions.
KEY POINTS
Chlamydia: Although sexually active individuals aged less than 25 are at greatest risk of chlamydia infection and the majority (71%) of positive tests were noted in this age group, less than half (47%) of all chlamydia testing in Scotland during 2007 was performed on those aged less than 25.
Sterilisation
Female Sterilisation: 12.6 women per 10,000 (aged 15 – 49) had a sterilisation procedure in 2007, compared to 15.6 in 2006.
Vasectomy: A total of 40.1 per 10,000 men (aged 15 – 59) in Scotland had a vasectomy in 2007, compared with 42.7 in 2006.
It should be noted that it is not currently possible to quality assure the vasectomy data provided by NHS boards to the same extent as the ISD national data returns.
Termination of Pregnancy: The proportion of terminations performed at under 10 weeks gestation has been relatively stable since 2000, with 69.1% of all terminations performed at less than 10 weeks in 2007. This has increased from 67.3% in 2006.
Hepatitis B Vaccination in men who have sex with men (MSM): This is the first year that these data have been published. They show that a higher percentage of vaccinations are being offered to MSM by GUM clinics (56.9% of eligible individuals) than are being received by individuals (45.8% of eligible individuals) due to those individuals who decide that they do not want the vaccination. These reasons are not recorded.
Long acting reversible methods of contraception (LARC): The uptake of LARC continues to increase.
The uptake of very long acting methods (Implanon (the implant), IUDs (the coil) and Mirena (IUS)) increased from 33.7 per 1000 women aged 15 – 49 in 2006/2007 to 40.6 in 2007/2008. The majority of the mainland NHS boards (91% - 10 out of 11) have increased their uptake of these very long acting or ‘lasting’ methods.
The uptake of very long acting methods (Implanon (the implant), IUDs (the coil) and Mirena (IUS)) increased from 33.7 per 1000 women aged 15 – 49 in 2006/2007 to 40.6 in 2007/2008. The majority of the mainland NHS boards (91% - 10 out of 11) have increased their uptake of these very long acting or ‘lasting’ methods.
INTERPRETATION
Female sterilisation:
The denominator for the female sterilisation data has been changed from 15 – 44 to 15 – 49 to reflect the standard age band used for women of reproductive age
The denominator for the female sterilisation data has been changed from 15 – 44 to 15 – 49 to reflect the standard age band used for women of reproductive age
Hepatitis B:
The interpretation of the hepatitis B status of individuals and the indications for vaccination are very complicated and require the ongoing training of coding staff to ensure the accuracy of the data recorded onto STISS.
The interpretation of the hepatitis B status of individuals and the indications for vaccination are very complicated and require the ongoing training of coding staff to ensure the accuracy of the data recorded onto STISS.
LARC:
Unlike the other indicators on this report, the LARC data are reported by financial year 2007/2008 rather than calendar year 2007.
Unlike the other indicators on this report, the LARC data are reported by financial year 2007/2008 rather than calendar year 2007.
DETAILED FINDINGS
“Respect and Responsibility: Strategy and Action Plan for Improving Sexual Health” highlighted the need to monitor sexual health service development both nationally and at an NHS board level. A set of Key Clinical Indicators (KCIs) has been developed for this purpose.
This document reports on the chlamydia, sterilisation, termination of pregnancy, hepatitis B and long acting reversible methods of contraception (LARC) indicators.
The indicators upon in this publication, in addition to the KCI on HIV therapy, represent the ‘Population Based Indicators’.
The Key Clinical Indicators for sexual health were developed on behalf of the National Sexual Health Advisory Committee (NSHAC).
The Key Clinical Indicators are part of the wider quality framework for sexual health. The indicators helped to inform the development of the Quality Improvement Scotland (NHS QIS) Sexual Health Service Standards and also the National Sexual Health System (NaSH).
Chlamydia
Although sexually active individuals aged less than 25 are at greatest risk of chlamydia infection and the majority (71%) of positive tests were noted in this age group, less than half (47%) of all chlamydia testing in Scotland during 2007 was performed on those aged less than 25. For women, 47% of all tests and 78% of positive diagnoses were in those aged 15-24. For men, 45% of all tests and 60% of all positive diagnoses were in those aged 15-24.
Although sexually active individuals aged less than 25 are at greatest risk of chlamydia infection and the majority (71%) of positive tests were noted in this age group, less than half (47%) of all chlamydia testing in Scotland during 2007 was performed on those aged less than 25. For women, 47% of all tests and 78% of positive diagnoses were in those aged 15-24. For men, 45% of all tests and 60% of all positive diagnoses were in those aged 15-24.
Male and female sterilisation:
Female sterilisation
12.6 women per 10,000 (aged 15 - 49) had a sterilisation procedure in 2007, compared to 15.6 in 2006.
35.5% women having the procedure waited over three months. This has reduced from 40.6% in 2006.
Vasectomy
A total of 40.1 per 10,000 men (aged 15 – 59) in Scotland had a vasectomy in 2007.
2007 data show a slight decrease in the numbers of vasectomies performed inhospital since 2006, (2,835 vs. 3,350) and a decrease in the total numbers (6,217 vs. 6,611).
A total of 40.1 per 10,000 men (aged 15 – 59) in Scotland had a vasectomy in 2007.
2007 data show a slight decrease in the numbers of vasectomies performed inhospital since 2006, (2,835 vs. 3,350) and a decrease in the total numbers (6,217 vs. 6,611).
Termination of Pregnancy
The proportion of terminations which are performed at under 10 weeks gestation has been relatively stable since 2000. 69.1% of all terminations were performed at less than 10 weeks in 2007. This has increased from 67.3% in 2005.
The proportion of terminations which are performed at under 10 weeks gestation has been relatively stable since 2000. 69.1% of all terminations were performed at less than 10 weeks in 2007. This has increased from 67.3% in 2005.
29% of all terminations carried out in Scotland in 2007 were done for residents of SIMD 5 areas (the most deprived population). SIMD 1, the least deprived, represents 15%.
Hepatitis B Vaccination in MSM:
This is the first occasion that data for this KCI have been published. The data are presented in two ways, each representing a slightly different aspect of the indicator depending on the method of analysis - percentage offered and percentage received. A higher percentage of vaccinations are being offered by clinics (56.9%) than are being received (45.8%) due to individuals who decide that they do not want the vaccination. The reasons for this decision are not recorded.
This is the first occasion that data for this KCI have been published. The data are presented in two ways, each representing a slightly different aspect of the indicator depending on the method of analysis - percentage offered and percentage received. A higher percentage of vaccinations are being offered by clinics (56.9%) than are being received (45.8%) due to individuals who decide that they do not want the vaccination. The reasons for this decision are not recorded.
Long acting reversible methods of contraception (LARC):
In typical use, the ‘long-acting’ or ‘lasting’ methods of contraception have a lower failure rate than alternative reversible methods (for example, contraceptive pill, condoms).
The uptake of very long acting methods (Implanon (the implant), IUDs (the coil) and Mirena (IUS)) has increased from 33.7 in 2006/2007 to 40.6 in 2007/2008.
In typical use, the ‘long-acting’ or ‘lasting’ methods of contraception have a lower failure rate than alternative reversible methods (for example, contraceptive pill, condoms).
The uptake of very long acting methods (Implanon (the implant), IUDs (the coil) and Mirena (IUS)) has increased from 33.7 in 2006/2007 to 40.6 in 2007/2008.
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MAIN CONTACTS:
Felicity Naughton
DASH Project Manager
0131 275 7148
Jim Chalmers
Head of Programme WCHIP
0131 275 6136
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GLOSSARY:
KCI – key clinical indicator
Termination of pregnancy – abortion
SMR - Scottish Morbidity Records
LARC - long acting reversible methods of contraception
MSM – men who have sex with men
Termination of pregnancy – abortion
SMR - Scottish Morbidity Records
LARC - long acting reversible methods of contraception
MSM – men who have sex with men
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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:
The Sexual Health policy team at the SG
Lead Clinicians for Sexual Health (NHS boards)
GUM Lead Clinicians (NHS boards)
Directors of Public Health
NHS Board Chief Executives
Executive Directors for Sexual Health
Lead Clinicians for Sexual Health (NHS boards)
GUM Lead Clinicians (NHS boards)
Directors of Public Health
NHS Board Chief Executives
Executive Directors for Sexual Health
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HISTORY OF THIS PUBLICATION:
Last Published: February 2008
Next Due: September 2009
Data Avaliable Since: February 2007
Main contact: 
Felicity Naughton
Felicity Naughton
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