Sexual Health

Statistical Publication Notice

24 November 2009

Scotland’s Sexual Health Information (SSHI) Report: 2009.

INTRODUCTION

• Abortions
• Teenage pregnancies
• GUM data
• STI Laboratory data
• HIV Surveillance data

KEY POINTS

• Overall workload (all diagnoses, screens and conditions seen) in GUM clinics continues to rise; a 16% increase was observed between 2007 and 2008 - this is slightly more than observed between 2006 and 2007 (13%). 
• The number of chlamydia diagnoses in Scotland, after increasing rapidly in first five years of this century, has remained steady over the past three years with a total of 19,054 diagnoses recorded in 2008. 
• HIV test uptake is increasing; between 2004 and 2008 a 71% increase in the numbers of persons undergoing HIV testing was observed. This trend reflects Scottish Government policy and a move towards normalising HIV testing.
• While syphilis diagnoses among MSM have remained steady between 2007 and 2008, the 19% decrease in gonorrhoea diagnoses during this period is encouraging and follows a decrease of 27% observed between 2006 and 2007.
• There continues to be a strong association between deprivation and rates of teenage pregnancy; based on 2007 conceptions, young women in the most deprived groups had over eight times the rate of delivery of those in the least deprived category.

INTERPRETATION

DETAILED FINDINGS

Workload:
Overall workload (all diagnoses, screens and conditions seen) in GUM clinics continues to rise; a 16% increase was observed between 2007 and 2008 - this is slightly more than observed between 2006 and 2007 (13%). 

Sexually Transmitted Infections:

Chlamydia:
The number of chlamydia diagnoses in Scotland, after increasing rapidly in first five years of this century, has remained steady over the past two years with a total of 19,054 in 2008.  There were more diagnoses in women than in men (ratio 1.6:1).

Gonorrhoea:
In Scotland’s GUM clinics, the number of diagnoses of gonorrhoea (829) decreased in 2008 for the second consecutive year; this was due to the 19% decrease in infection diagnosed in men who have sex with men (MSM).

Genital Herpes:
Over the past five years the number of new diagnoses in GUM clinics has risen by almost one third (28%). Of all new diagnoses of genital herpes in 2008, half (51%) of those in women and one third (33%) of those in men were made in those aged less than 25.

Infectious Syphilis:
In 2008, 264 infectious cases were recorded at GUM clinics; this exceeds the number of cases reported for 2007 (249). Following a five-fold increase in diagnoses among MSM between 2003 and 2006, the numbers in this population have stabilised in recent years. In contrast there has been an increase in the number of heterosexually acquired syphilis cases which appears to be due to an increase in the number of diagnoses among women (12 in 2006, 14 in 2007, and 18 in 2008).

Genital Warts:
In 2008, 7360 new cases were diagnosed; the annual number of new diagnoses has increased by 37% over the past ten years. In 2008, two-thirds of new diagnoses of genital warts in women and more than two thirds in men were in those aged 15-24.

HIV Infection:
In 2008, 412 new cases of HIV were identified in Scotland; this represents a 9% decrease on the 452 cases reported in 2007. There were 155, 204 and 19 new reports of infection among MSM, among non-injecting drug using (IDU) heterosexual men and women and IDUs, respectively.

Men who have sex with men (MSM):
A 19% decline was observed in the total number of gonorrhoea diagnoses between 2007 and 2008.

Pregnancy and abortion:
The teenage pregnancy rate has remained steady during the past decade.  In 2007 there were 58.6 pregnancies per 1000 females aged less than 20 and 8.1 pregnancies per 1000 females aged less than 16.

Deprivation:
There is a strong association between deprivation and rates of teenage pregnancy. The most deprived groups had over eight times the rate of delivery as the least deprived, and close to twice the rate of abortion.

Abortions:
There has been a slight decrease in the rate of abortions in all the teenage age groups from 2007 to 2008, whilst the rate in women aged 20-44 has been increasing slightly over recent years.

The number of repeat abortions in women aged 20-44 has been increasing since 1999.

CONCLUSIONS

The rise in the number of detected 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.

Young people remain particularly affected by the major acute STIs and should continue to be targeted for testing and prevention. Measures directed at effecting behavioural change are required, particularly in young people who fail to use condoms consistently with a new partner.

MAIN CONTACTS:

Jim Chalmers
Consultant in Public Health Medicine
0131 275 6163
Jim.chalmers@nhs.net

GLOSSARY:

AIDS – Acquired Immunodeficiency Syndrome
ART – Antiretroviral Therapy
CMO – Chief Medical Officer
EPR – Electronic Patient Record
GASS - Gonococcal Antibiotic Surveillance in Scotland
GP – General Practitioner
GROS – General Register Office for Scotland
GUM - Genitourinary Medicine
HCNA – Health Care Needs Assessment
HIV – Human Immunodeficiency Virus
HPS – Health Protection Scotland
HPV – Human Papilloma Virus
HSV – Herpes Simplex Virus
IDU – Injecting Drug Use(r)
ISD – Information Services Division
IUS – Intrauterine System
KCI(s) – Key Clinical Indicator(s)
LARC – Long Acting Reversible Contraception
LGV – Lymphogranuloma Venereum
MIC - Minimum Inhibitory Concentration
MRC – Medical Research Council
MSM - Men who have sex with men
NaSH – National Sexual Health System
NATSAL – National Survey of Sexual Attitudes and Lifestyle
NESISS – National Enhanced Surveillance of Infectious Syphilis in Scotland
NHS – National Health Service
NHS QIS – NHS Quality Improvement Scotland
NSHAC – National Sexual Health Advisory Committee
NSHHAC - National Sexual Health and HIV Advisory Committee
nvCT – new variant Chlamydia trachomatis
ONS – Office of National Statistics
PID – Pelvic Inflammatory Disease
PTI – Practice Team Information
SARC – Sexual Assault Referral Centre
SBSTIRL - Scottish Bacterial Sexually Transmitted Infection Reference Laboratory
ScotPHN – Scottish Public Health Network
SHEG – Sexual Health Epidemiology Group
SIGN – Scottish Intercollegiate Guidelines Network
SIMD – Scottish Index of Multiple Deprivation
SMR – Scottish Morbidity Record
SRE – Sex and Relationships Education
SSHI – Scotland’s Sexual Health Information
STI – Sexually Transmitted Infection
STIEAG – Sexually Transmitted Infection Epidemiology Advisory Group
STISS – Sexually Transmitted Infection Surveillance System
TFI – Tubal Factor Infertility
UAI – Unprotected Anal Intercourse
UK - United Kingdom
WISH – Wellbeing in Sexual Health

PRE-RELEASE ACCESS:

HISTORY OF THIS PUBLICATION:

Last Published: November 2008
Next Due: November 2010
Data Available Since: 2005 publication reporting on 2004 data

Main contact: Jim Chalmers

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