SPLASH Croydon 2021-01-27

Summary profile of
local authority sexual health

Croydon

27 January 2021

 

Key findings

Figure 1. Chart showing key sexual and reproductive health indicators in Croydon compared to the rest of England

The local result for each indicator is shown as a circle, against the range of results for England shown as a grey bar. The line at the centre of the chart shows the England average, the diamond shows the average for the London PHE Centre.

Compared to England:

  • Better Better
  • Similar Similar
  • Worse Worse
  • or
  • Lower Lower
  • Similar Similar
  • Higher Higher
  • or
  • Not compared Not compared
Key for spine bars

Key for spine bars

Introduction

Aim

This report describes sexual and reproductive health in a local area in an integrated way, including sexually transmitted infections (STIs), HIV, under-18 conceptions, abortion and Long Acting Reversible Contraception rates for women aged 15-44.

This is produced alongside other PHE local HIV, sexual and reproductive health intelligence tools to help inform local Joint Strategic Needs Assessments (JSNAs) so that commissioners can effectively target service provision.

Information used in this report

Unless otherwise indicated this report is compiled from publicly available data on the online Sexual and Reproductive Health Profiles. Please access this tool for further data analysis and more information about the data included in this report which is described in the 'definitions' tab for each indicator.

Please note that City of London and Isles of Scilly and not included in the rankings in this document. Where comparisons are made to Hackney or Cornwall, please note that the data for these areas may have been combined with City of London and Isles of Scilly respectively. Please check the online Profiles.

For an introductory guide on sexual health data sources, please access https://www.gov.uk/government/publications/sexual-and-reproductive-health-in-england-local-and-national-data.

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STIs

As STIs are often asymptomatic, frequent screening of risk groups is important. Early detection and treatment can reduce important long-term consequences, such as infertility and ectopic pregnancy. While vaccination is a measure that can be used to control genital warts, hepatitis A and hepatitis B, control of other STIs relies on consistent and correct condom use, behaviour change to decrease overlapping and multiple partners, ensuring prompt access to testing and treatment, and ensuring partners of cases are notified and tested.

Over the past decade, diagnoses of gonorrhoea and syphilis have increased considerably in England, most notably in males, while diagnoses of genital warts have decreased.2 The full-scale implementation of the National Chlamydia Screening Programme (NCSP) in 2008 led to increases in diagnoses rates in men and women. More STI testing in sexual health services and through the NCSP with routine use of more sensitive diagnostic tests, such as nucleic acid amplification tests (NAATs), will partly explain increases in the early part of the decade, although ongoing high levels of condomless sex will have played a role.

The burden of STIs in England continues to be greatest in young people, gay, bisexual and other men who have sex with men (MSM) and black ethnic minorities. Of all age-groups, the highest STI diagnosis rates in England are in young people aged 15-24 years.

The number of STI diagnoses in MSM has risen sharply in England over the past decade. Several factors may have contributed to this, including behavioural changes such as an increase in partner numbers and condomless anal intercourse, as well as, for some high risk MSM, 'chemsex' (the use of drugs before or during planned sexual activity to sustain, enhance, disinhibit or facilitate the experience) and group sex facilitated by geosocial networking applications. More screening of extra-genital (rectal and pharyngeal) sites in MSM using NAATs will also have improved detection of gonococcal and chlamydial infections, although this will have had less impact in recent years as these developments have become more established.

High levels of gonorrhoea transmission are of particular concern due to the emergence of extensively drug resistant gonorrhoea (XDR-NG) in England. In 2018, a case of infection with Neisseria gonorrhoeae with ceftriaxone resistance and high-level azithromycin resistance was detected in a UK resident man who had acquired the infection from Thailand3; later that year, two additional cases of infection with a strain of N. gonorrhoeae with ceftriaxone resistance and intermediate azithromycin resistance were detected in two women in different regions of England, both of whom had overlapping sexual networks with UK residents who had travelled to Ibiza, Spain.

This report has been compiled using routine STI data, the majority of which comes from specialist sexual health services.4 Chlamydia test and diagnosis data from community services are sourced from the CTAD Chlamydia Surveillance System. Please see the link below for further details on chlamydia data from community services and for additional data on chlamydia testing coverage, positivity and diagnostic rates (for those aged 15-24 years).5 Diagnoses of all STIs made in specialist and non-specialist sexual health services are reported using the GUMCAD STI Surveillance System.

Burden and trend of new STIs

A total of 5,292 new STIs were diagnosed in residents of Croydon in 2019. It should be noted that if high rates of gonorrhoea and syphilis are observed in a population, this reflects high levels of risky sexual behaviour.

When interpreting trends, please note:

Figure 2. Chart showing key STI indicators in Croydon compared to the rest of England

The local result for each indicator is shown as a circle, against the range of results for England shown as a grey bar. The line at the centre of the chart shows the England average, the diamond shows the average for the London PHE Centre.

Compared to England:

  • Better Better
  • Similar Similar
  • Worse Worse
  • or
  • Lower Lower
  • Similar Similar
  • Higher Higher
  • or
  • Not compared Not compared
Key for spine bars

Key for spine bars

Table 1. Rates per 100,000 population of new STIs in Croydon and England: 2018-2019

Diagnoses 2018 2019 % change 2018 to 2019* Rank among 16 similar UTLAs/UAs Rank within England: 2019 Value for England: 2019
New STIs 1,304.3 1,368.5 4.9% 6 20 815.7
New STIs (exc chlamydia aged <25)1 1,446.9 1,567.7 8.3% 5 18 900.3
Chlamydia 564.2 576.4 2.2% 6 26 400.8
Gonorrhoea 203.7 246.4 21.0% 7 22 123.5
Syphilis 20.8 24.3 17.1% 5 23 13.8
Genital warts 110.8 104.5 -5.7% 8 34 89.0
Genital herpes 89.0 90.8 2.0% 4 19 60.0
* Percent change not provided where the value in 2018 was 0.
These are Croydon and its 15 statistical nearest neighbours, excluding those where values were suppressed due to small numbers. First rank has the highest value. Nearest neighbours are derived from CIPFA's Nearest Neighbours Model.
Out of 151 UTLAs/UAs in England, excluding those where values were suppressed due to small numbers. City of London and Isles of Scilly are always excluded. First rank has the highest value. Where the value was 0, ranks are based on order of local authority names.
1 Population is restricted to those aged 15-64 years

Table 2. Number of new STIs by year, Croydon

Diagnoses 2012 2013 2014 2015 2016 2017 2018 2019
New STIs 4,872 4,730 4,835 4,857 4,562 4,363 5,026 5,292
New STIs (exc chlamydia aged <25)1 3,522 3,318 3,440 3,632 3,383 3,247 3,652 3,960
Chlamydia 1,981 2,048 2,101 2,017 1,980 1,884 2,174 2,229
Gonorrhoea 511 507 617 630 530 621 785 953
Syphilis 25 46 39 82 55 68 80 94
Genital warts 503 461 497 521 428 372 427 404
Genital herpes 365 311 248 311 315 282 343 351
1 Population is restricted to those aged 15-64 years

Figure 3. Map of new STI diagnoses (excluding chlamydia in under 25-year olds) per 100,000 population aged 15–64 years in Croydon by Middle Super Output Area: 2019

Please note that this data is not available on the online Sexual and Reproductive Health profiles. Data is sourced from routine specialist and non-specialist sexual health services' returns to the PHE GUMCAD STI Surveillance System and from routine non-specialist sexual health services' returns to the CTAD Chlamydia Surveillance System.

New STI diagnoses in Croydon by MSOA

Contains Ordnance Survey data © Crown copyright and database right 2019
Contains National Statistics data © Crown copyright and database right 2019

Figure 4. Rates per 100,000 population of new STIs excluding chlamydia in <25 years in 16 similar local authorities and the London PHE Centre, compared to England: 2019

Similar refers to statistical nearest neighbours, derived from CIPFA's Nearest Neighbours Model

Figure 5. Rates per 100,000 population by diagnosis by year in Croydon compared to rates in the London PHE Centre and England: 2012 to 2019

Please note the charts have different y axis scales.