Report Update

The existing summary on sexually-transmitted Shigella has been removed from the “Other infections transmitted sexually” section of this report and is now presented within a standalone section.
The regional comparison used in figures throughout the report has changed from UKHSA Region to Government Office Region (in line with the Sexual and Reproductive Health profiles).
Abortion data for 2022 were not available for this report and therefore the most recent published data is presented.
Note: Maps of Under-18s conception by ward will no longer be produced for inclusion within this report (Figure 30 and Figure 31 in previous reports).

Key findings

This report summarises the latest available sexual and reproductive health data for Brighton and Hove.
Overall, the number of new sexually transmitted infections (STIs) diagnosed among residents of Brighton and Hove in 2022 was 3,152. The rate was 1,141 per 100,000 residents, higher than the rate of 694 per 100,000 in England, and higher than the average of 933 per 100,000 among its nearest neighbours.
Brighton and Hove ranked 16th highest out of 147 upper tier local authorities (UTLAs) and unitary authorities (UAs) for new STI diagnoses excluding chlamydia in those aged under 25 in 2022, with a rate of 954 per 100,000 residents, worse than the rate of 496 per 100,000 for England.
The chlamydia detection rate per 100,000 females aged 15 to 24 years in Brighton and Hove was 1,301 in 2022, worse than the rate of 2,110 for England.
The rank for gonorrhoea diagnoses (which can be used as an indicator of local burden of STIs in general) in Brighton and Hove was 19th highest (out of 147 UTLAs/UAs) in 2022. The rate per 100,000 was 276, worse than the rate of 146 in England.
Among specialist sexual health service (SHS) patients from Brighton and Hove who were eligible to be tested for HIV, the percentage tested in 2022 was 54.8%, better than the 48.2% in England.
The number of new HIV diagnoses in Brighton and Hove was 25 in 2022. The prevalence of diagnosed HIV per 1,000 people aged 15 to 59 years in 2022 was 7.3, compared to the rate of 2.3 in England. The rank for HIV prevalence in Brighton and Hove was 7th highest (out of 147 UTLAs/UAs).
In Brighton and Hove, in the three year period between 2020 - 22, the percentage of HIV diagnoses made at a late stage of infection amongst those first diagnosed in the UK (all individuals with CD4 count ≤350 cells/mm³ within 3 months of diagnosis) was 29.6%, compared to 43.3% in England.
The total rate of long-acting reversible contraception (LARC) (excluding injections) prescribed in primary care, specialist and non-specialist SHS per 1,000 women aged 15 to 44 years living in Brighton and Hove was 59.6 in 2022, higher than the rate of 44.1 per 1,000 women in England. The rate prescribed in primary care was 34.5 in Brighton and Hove, higher than the rate of 26.5 in England. The rate prescribed in the other settings was 25.0 in Brighton and Hove, higher than the rate of 17.7 in England.
The total abortion rate per 1,000 women aged 15 to 44 years in 2021 was 15.2 in Brighton and Hove, lower than the England rate of 19.2 per 1,000. Of those women under 25 years who had an abortion in 2021, the proportion who had had a previous abortion was 28.0%, similar to 29.7% in England.
In 2021, the conception rate for under-18s in Brighton and Hove was 9.9 per 1,000 girls aged 15 to 17 years, similar to the rate of 13.1 in England.
In 2021/22, the percentage of births to mothers under 18 years was suppressed, and not compared to 0.6% in England overall.

Figure 1. Chart showing key sexual and reproductive health indicators in Brighton and Hove 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 South East region.

Compared to England:

Better
Similar
Worse
or
Lower
Similar
Higher
or
Not compared

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 to 44.

This is produced alongside other local HIV, sexual and reproductive health intelligence tools provided by the UK Health Security Agency (UKHSA) to help inform local Joint Strategic Needs Assessments (JSNAs) so that commissioners can effectively target service provision.

This report has been produced by the UKHSA, with support from the Office for Health Improvement and Disparities (OHID).

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 are 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.

Viewing this report and converting to PDF

This report has been developed for the best viewing experience in Google Chrome. It has also been tested with Internet Explorer 11 and Microsoft Edge, but some content may look different (for example, the table of contents is not available in Internet Explorer).

When viewed in Google Chrome, this report can be converted to a PDF through the Print menu. Select “Save as PDF” as the destination. For the best result, it is recommended to select the “background graphics” option, and deselect the “headers and footers” option.

Some other browsers also offer PDF conversion, but the formatting may not display as intended.

STIs

As STIs are often asymptomatic, frequent STI screening of groups with greater sexual health needs is important and should be conducted in line with national guidelines.¹ Early detection and treatment can reduce long-term consequences, such as infertility and ectopic pregnancy. Vaccination is an intervention that can be used to control genital warts, hepatitis A and hepatitis B, however, 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.

There was an increasing trend in diagnoses of chlamydia, gonorrhoea and syphilis in England from 2010 until 2019, while diagnoses of genital warts have decreased since 2013 due to the protective effect of HPV vaccination.² Increasing diagnosis rates for chlamydia among people aged 15 to 24 years are largely driven by changes in testing activity through the National Chlamydia Screening Programme (NCSP), although ongoing high levels of condomless sex will have played a role. The NCSP data tables provide additional data on chlamydia testing coverage, positivity and diagnostic rates (for those aged 15 to 24 years).³

In March 2020, in response to the Coronavirus Disease 2019 (COVID-19) pandemic, the UK Government implemented strict non-pharmaceutical interventions (NPIs) in the form of national and regional lockdowns, as well as social and physical distancing measures including an emphasis on staying at home. Sexual health services (SHS) in England had substantially reduced capacity to deliver face-to-face consultations but underwent rapid reconfiguration to increase access to STI testing via telephone or internet consultations. STI testing and diagnoses decreased across all infections during 2020. Larger decreases in diagnoses were observed for STIs that are usually diagnosed clinically at a face-to-face consultation, such as genital warts or genital herpes, when compared to those that could be diagnosed using remote self-sampling kits such as chlamydia and gonorrhoea.⁴ Testing levels largely recovered during 2021, while diagnoses returned to and, for some infections, exceeded pre-pandemic levels by the end of 2022. STIs continue to disproportionately impact gay, bisexual and other men who have sex with men (GBMSM), young people aged 15 to 24 years, and people of black Caribbean ethnicity.

This report has been compiled using data from SHS and ‘community-based’ settings routine returns to the GUMCAD STI and CTAD Chlamydia surveillance systems.

‘Sexual health services’ refer to services offering specialist (level 3) STI-related care such as genitourinary medicine (GUM) and integrated GUM and sexual and reproductive health (SRH) services. They also include other services offering non-specialist (level 1 or level 2) STI-related care and community-based settings such as young people’s services, internet services, termination of pregnancy services, pharmacies, outreach, and general practice. Further details on the levels of sexual healthcare provision are provided in Appendix B of the BASHH Standards for the Management of STIs.

Burden and trend of new STIs

A total of 3,152 new STIs were diagnosed in residents of Brighton and Hove in 2022. It should be noted that if high rates of gonorrhoea and syphilis are observed in a population, this suggests ongoing transmission of infections is occurring.

When interpreting trends, please note:

The decrease in STI testing and diagnoses in 2020 due to the disruption of sexual health services during the COVID-19 pandemic response, with testing rates largely recovering during 2021. Diagnoses levels returned to and, for some infections, exceeded pre-pandemic levels by the end of 2022.
Recent decreases in genital warts diagnoses are due to the protective effect of HPV vaccination, and are particularly evident in the younger age groups (25 and younger) who have been offered the vaccine since the national programme began.

Figure 2. Chart showing STI indicators in Brighton and Hove compared to the rest of England