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 years.

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 described in the “definitions” tab for each indicator. Comparative measures and terms used in this report (such as similar to, better than or higher than) are automatically calculated within the SRH profiles and use the confidence intervals around a value as part of this calculation. Further information on how to interpret spine charts, red-amber-green ratings and the assessment of trends can be found in the technical guide on the Sexual and Reproductive Health Profiles.

Please note that City of London and Isles of Scilly are not included in the rankings in this report. 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.

An introductory guide on sexual health data sources is available.

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Burden and trend of new STIs

A total of 2,742 new STIs were diagnosed in residents of Coventry in 2023. 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, for some infections, returned to and exceeded pre-pandemic levels by the end of 2022. Others, such as genital herpes have increased more slowly and remain lower than before the pandemic.
• 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 Coventry compared to the rest of England: 2023

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 West Midlands region.

Data for Chlamydia detection rate are benchmarked against goals, as follows:
Compared to England:

• Better
• Similar
• Worse
• or
• Lower
• Similar
• Higher
• or
• Not compared

Key for spine bars

– Data suppressed (due to small numbers or missing data)

 

Table 1. Rates per 100,000 population of new STIs in Coventry and England: 2022 to 2023

Diagnoses	2022	2023	% change 2022 to 2023*	Rank among 16 similar UTLAs/UAs†	Rank within England: 2023‡	Value for England: 2023
New STIs	876.0	771.1	-12.0%	7	33	703.6
New STIs (exc chlamydia aged <25)	543.6	520.2	-4.3%	11	41	519.9
Chlamydia	491.0	396.5	-19.2%	7	34	341.4
Gonorrhoea	175.8	170.7	-2.9%	8	33	149.2
Syphilis	16.9	15.7	-6.7%	11	51	16.7
Genital warts	45.0	36.0	-20.0%	15	98	45.8
Genital herpes	40.5	31.2	-22.9%	14	120	47.6
Mycoplasma genitalium1	2.0	1.1	-42.9%	16	149	15.6
Trichomoniasis1	14.3	13.2	-7.8%	12	57	16.0
Sexually transmitted Shigella spp.	1.0	1.0	0.0%	16	134	9.0
* Percent change not provided where the value in 2022 was 0.
† These are Coventry 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 Data for Mycoplasma genitalium and trichomoniasis were included for the first time in 2022. Testing for these infections is not included as part of a standard sexual health screen, but is advised for those with symptoms and the partners of those diagnosed (see BASHH guidelines for Mycoplasma genitalium and trichomoniasis).

 

Table 2. Number of new STIs by year, Coventry: 2012 to 2023

Diagnoses	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
New STIs	3,332	3,559	3,328	3,186	3,245	3,151	3,104	3,172	2,441	2,325	3,115	2,742
New STIs (exc chlamydia aged <25)	2,192	2,268	2,207	2,099	2,074	2,108	2,156	1,988	1,484	1,425	1,933	1,850
Chlamydia	1,470	1,656	1,524	1,507	1,576	1,435	1,353	1,632	1,272	1,287	1,746	1,410
Gonorrhoea	196	219	312	273	264	297	333	397	321	355	625	607
Syphilis	23	14	16	22	28	18	29	17	30	38	60	56
Genital warts	472	517	461	416	387	396	432	294	184	146	160	128
Genital herpes	245	279	234	263	273	236	226	212	137	124	144	111
Mycoplasma genitalium1	-	-	-	-	-	-	-	3	1	5	7	4
Trichomoniasis1	44	70	86	75	92	75	92	100	80	47	51	47
Sexually transmitted Shigella spp.	-	-	-	-	0	1	5	1	1	1	2	2
- Data suppressed (due to small numbers or missing data)
Disruption to sexual health services during the response to the COVID-19 pandemic led to reduced STI testing and diagnoses in 2020 and 2021.
1 Data for Mycoplasma genitalium and trichomoniasis were included for the first time in 2022. Testing for these infections is not included as part of a standard sexual health screen, but is advised for those with symptoms and the partners of those diagnosed (see BASHH guidelines for Mycoplasma genitalium and trichomoniasis).

 

Figure 3. Map of new STI diagnoses (excluding chlamydia in under 25-year olds) per 100,000 population in Coventry by Middle Super Output Area: 2023

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 UKHSA GUMCAD STI Surveillance System and from routine non-specialist sexual health services’ returns to the CTAD Chlamydia Surveillance System.

New STI diagnoses in Coventry by MSOA

Contains Ordnance Survey data © Crown copyright and database right 2021
Contains National Statistics data © Crown copyright and database right 2021

 

Figure 4. Rates per 100,000 population of new STIs (excluding chlamydia in under 25-year olds) in 16 similar local authorities compared to England: 2023

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

Value suppressed for 1 local authority.

 

Figure 5. Rates per 100,000 population by diagnosis by year in Coventry compared to rates in England: 2012 to 2023

Please note the charts have different y axis scales.

As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.

 

Figure 6. Rates per 100,000 population of gonorrhoea in 16 similar local authorities compared to England: 2023

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

Figure 7 shows rates of syphilis per 100,000 population for Coventry, compared to national, regional, and neighbouring rates. The UKHSA has published analyses of the epidemiology of syphilis,⁴ in alignment with the Syphilis Action Plan (2019).⁵

 

Figure 7. Rates per 100,000 population of syphilis in 16 similar local authorities compared to England: 2023.

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

Chlamydia detection

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. In June 2021, the primary aim of NCSP changed, focusing on reducing the harms from untreated chlamydia infection, which occur predominantly in young women and other people with a womb or ovaries.⁶ Therefore, opportunistic screening should be offered to these groups, combined with reducing time to test results and treatment, strengthening partner notification and re-testing after treatment. The NCSP data tables provide additional data on chlamydia testing coverage, positivity, and diagnostic rates (for those aged 15 to 24 years).

Since chlamydia is most often asymptomatic, a high detection rate reflects success at identifying infections that, if left untreated, may lead to serious reproductive health consequences.

The chlamydia detection rate in 15 to 24 year old females in 2023 in Coventry was 1,582 per 100,000 population (438 positives out of 3,803 screened), lower than the 3,250 target. 13.7% of 15 to 24 year old females were tested for chlamydia, compared to 20.4% nationally. The detection rate per 100,000 and its rank among CIPFA nearest neighbours and England are shown in Table 3.

 

Table 3. Chlamydia detection rate per 100,000 population and percentage screened in 15 to 24 year olds in Coventry and England: 2022 to 2023

	2022	2023	% change 2022 to 2023*	Rank among 16 similar UTLAs/UAs†	Rank within England: 2023‡	Value for England: 2023
Detection rate
Female	2,206.7	1,581.9	-28.3%	11	103	1,961.7
Male	1,025.0	482.2	-53.0%	16	150	1,041.6
Total	2,206.7	1,581.9	-28.3%	11	103	1,961.7
Proportion screened
Females aged 15-24	19.3	13.7	-29.0%	14	135	20.4
* Percent change proportional to the value in 2022, not a change in percentage points. Percent change not provided where the value in 2022 was 0.
† These are Coventry 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.

Variation in rates of chlamydia detection (Figure 8) may represent differences in prevalence, but are influenced by screening coverage and whether most at risk populations are being reached (i.e. the proportion testing positive).

 

Figure 8. Map of chlamydia detection rate per 100,000 females aged 15 to 24 in Coventry by Middle Super Output Area: 2023

Please note that this data is not available on the online Sexual and Reproductive Health Profiles. Data is sourced from the CTAD Chlamydia Surveillance System (CTAD).

New Chlamydia diagnoses in Coventry by MSOA

Contains Ordnance Survey data © Crown copyright and database right 2021
Contains National Statistics data © Crown copyright and database right 2021

 

Figure 9. Chlamydia detection rate per 100,000 females aged 15 to 24 in 16 similar local authorities compared to benchmark goals: 2023

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

Data for Chlamydia detection rate are benchmarked against goals, as follows:

In the five years from 2018 to 2023, there was a 24% decrease in the chlamydia detection rate among 15 to 24 year olds in Coventry. From 2022 to 2023, the decrease was 28%.

 

Figure 10. Chlamydia detection rate per 100,000 population in 15 to 24 year olds females in Coventry and England, 2012 to 2023

As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.

Shigella

Shigellosis, or bacillary dysentery, spread through sexual contact has become endemic in England and in many other countries worldwide. Due to its presentation as an enteric illness, most symptomatic cases present to primary care (GPs, A&E) rather than SHS. Although most cases resolve without treatment, cases of shigellosis can be severe and require admission to hospital for treatment of complications.⁷ The management of sexually transmitted enteric infections should be conducted in line with national guidelines.⁸

The prevalence is highest in larger cities and towns in England, although the infection is becoming more widespread. Over the last decade, the number of cases of sexually transmitted shigella among GBMSM in England has increased,⁹ with concerning increases in antimicrobial resistance. Only a minority of GBMSM are thought to be aware of Shigella and how to avoid it,¹⁰ however, surveillance shows transmission of these infections is commonly associated with high risk behaviours such as sexualised drug use (including ‘chemsex’) and multiple casual sex partners.

A new indicator showing trends in sexually transmitted shigellosis in the adult male population was added to Sexual and Reproductive Health Profiles in June 2023.

STI testing in sexual health services (SHS)

In 2023 the rate of STI testing (excluding chlamydia in under 25 year individuals) in SHS in Coventry was 4,690 per 100,000, a 17% decrease compared to 2022. This is higher than the rate of 4,111 per 100,000 in England in 2023. The positivity rate in Coventry was 7.0% in 2023, similar to 7.3% in England. Positivity rates depend both on the number of diagnoses and the offer of testing; higher positivity rates compared with previous years can represent increased burden of infection, decreases in the number of tests, or both.

The methodology to calculate the STI positivity changed in September 2021 to better reflect testing within the population accessing SHSs by area. More details are available on the Sexual and Reproductive Health Profiles.

 

Figure 11. STI testing rate and positivity rate (excluding chlamydia in under 25 year olds) per 100,000 population by year in Coventry and England: 2012 to 2023

As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.

 

Other infections transmitted sexually

Some bloodborne viruses can be spread through sex as well as by other routes, e.g. hepatitis B, hepatitis C. Some gastro-intestinal infections, typically linked to contaminated food or water can also be spread faecal-orally during sexual activity: these are called sexually transmissible enteric infections (STEIs) e.g. hepatitis A and Shigella.

Lymphogranuloma venereum (LGV), an invasive form of chlamydia, is a sexually transmitted infection which disproportionately affects GBMSM. In the past decade, the number of LGV diagnoses has increased substantially in England. Historically, LGV was mainly concentrated among GBMSM living with HIV. However, in recent years, a greater proportion of cases have been among GBMSM who are HIV negative.¹¹

Hepatitis A vaccination is available for GBMSM in SHS. In 2016 an outbreak of hepatitis A was identified among GBMSM in England and across Europe. Between July 2016 and April 2017 266 cases associated with the outbreak had been identified in England, 74% of these among GBMSM.¹² This resulted in work to raise awareness of how to prevent infection through hygiene measures (e.g. washing hands after sex)¹³ and recommendations around hepatitis A vaccination of GBMSM attending SHS. This outbreak highlights how quickly and widely an infection can become established in key populations if prevention measures such as vaccination are not undertaken.

Most hepatitis B infections in England are acquired overseas in high prevalence countries; where infection is acquired in England it is most often acquired sexually. Where information on risk exposures was recorded on acute and probable acute cases of hepatitis B, the most commonly reported risk was heterosexual exposure (50%), followed by sex between men (17%).¹⁴ Vaccination can prevent infection and is recommended for GBMSM, for individuals with multiple sexual partners and for individuals engaging in sexual activity when travelling to high prevalence countries.

Most people in England acquire hepatitis C through injecting drug use.¹⁵ However, GBMSM are also a risk group for hepatitis C transmission. GBMSM living with diagnosed HIV, especially those reporting sexualised drug use, are disproportionately affected by hepatitis C compared to HIV-negative GBMSM; therefore guidance for hepatitis C testing in SHS has been targeted towards this group.

In May 2022, an international outbreak of mpox (monkeypox) was detected with cases reported concurrently from many countries where the disease is not endemic. To date, most reported cases in the outbreak have involved mainly, but not exclusively, men who have sex with men. Over 3,500 individuals have been diagnosed in England. Vaccines developed to protect against smallpox have been approved and used for prevention of mpox and were used as part of the response. Preventative vaccination continues, with numbers of new cases falling to lower levels but continuing throughout 2023.¹⁶

HIV

England has set an ambition to end HIV transmission, AIDS and HIV-related deaths by 2030. The HIV Action Plan for England 2022 to 2025 sets out intermediate commitments to achieve this 2030 ambition, including reducing HIV transmission by 80% between 2019 and 2025.¹⁷ The HIV Action Plan monitoring and evaluation framework published in December 2022 sets out the indicators used to monitor the progress towards this goal,¹⁸ with an update assessing progress and addressing the commitments for 2025 and beyond published in December 2024.¹⁹

Use of condoms, partner notification, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) help maintain the negative HIV status of those who are HIV negative and are key prevention activities alongside HIV testing.¹⁸ In 2023, 10.1% (132,299 of 1,313,780) of HIV-negative people accessing specialist SHSs in England were defined as having a PrEP need. Among these, 73.0% (96,562 out of 132,299) initiated or continued PrEP.

In the UK, HIV testing identifies people living with undiagnosed HIV enabling them to access free and effective antiretroviral therapy (ART). This life-saving treatment has improved clinical outcomes and quality of life for people living with HIV who are diagnosed and treated promptly. In addition, those on ART can attain undetectable levels of the virus, preventing onwards HIV transmission even when having condomless sex (undetectable=untransmissible [U=U]).¹⁸

In England, HIV testing is undertaken in a number of settings including SHSs, in primary and secondary care, emergency departments and community settings. HIV testing rates in SHSs across England have increased substantially since 2022 but have not fully recovered to levels observed in 2019 in some demographic groups including heterosexual men and heterosexual and bisexual women.²⁰

In 2023, 6,008 people were reported as being diagnosed with HIV in England, of whom over half (3,198) were previously diagnosed abroad and tested again as part of linking to HIV care in the UK. The 2,810 new diagnoses that were first made in England represent a 15% rise from 2,451 (in 2022) but was similar to the number seen in 2019 (2,801). Among these, men exposed through sex between men accounted for 29% (811), women exposed by heterosexual contact for 28% (780), men exposed by heterosexual contact for 22% (605), injecting drug use for 2% (47).²¹

Late diagnosis is the most important predictor of HIV-related morbidity and short-term mortality. It is a Public Health Outcome Framework (PHOF) indicator, and its monitoring is essential to evaluate the success of HIV prevention and local HIV testing efforts. Late diagnosis is defined as having a CD4 count <350 cells/mm3 within 91 days of first HIV diagnosis in the UK and excludes people previously diagnosed abroad and people with evidence of recent seroconversion. Evidence of recent seroconversion is having either a negative HIV test within the 24 months before their diagnosis, or a positive Recent Infection Testing Algorithm (RITA) result, which is derived by combining a serological recency test result within 120 days of diagnosis with diagnosis and treatment data. In 2023, 40% (923 of 2,286) of those first diagnosed in England were diagnosed at a late stage. People first diagnosed late in England in 2022 were 10 times more likely to die within a year of their diagnosis compared to those who were diagnosed promptly.²¹

Of the estimated 104,000 (credible interval (CrI) 102,700 to 105,800) people living with HIV in 2023, an estimated 4,700 (95% CrI 3,700 to 6,300) were undiagnosed. In 2023, England again achieved the UNAIDS 95-95-95 target nationally, with 95% of people living with HIV being diagnosed, 98% of those diagnosed being on treatment and 98% of those on treatment having an undetectable viral load.¹⁹

 

Figure 12. Chart showing key HIV indicators in Coventry compared to the rest of England, 2023

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 West Midlands region.

Compared to England:

• Better
• Similar
• Worse
• or
• Lower
• Similar
• Higher
• or
• Not compared

Key for spine bars

As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.
HIV testing rate data represents the number of HIV tests, and not the number of people tested (one person may be tested multiple times) and only reflects tests conducted through SHSs.
HIV testing rates are calculated per 100,000 population using population estimates sourced from the Office for National Statistics based on the Census.
In areas with a higher proportion of diagnosed HIV, the HIV testing rate will be an underestimate as those living with HIV have not been removed from the denominator.

HIV testing in SHSs

In Coventry in 2023, 10,792 HIV tests were conducted through SHSs. This equates to a testing rate of 3,035 tests per 100,000 Coventry residents, which is higher than that seen in Coventry in 2019 (2,863 per 100,000) and higher than that seen in 2023 in England overall (2,771 per 100,000).

There is no established target for HIV testing rate, rates should therefore be interpreted relative to other benchmarks such as:

1. Comparison with the national rate for England, the regional rate and with the rates for statistically similar areas (see CIPFA’s Nearest Neighbours Model for more information), these data can be found on the Sexual and Reproductive Health Profiles.

2. Comparison of the trend over time, examining increases, decreases or stable rates to understand the effectiveness of testing initiatives and identify changes in testing behaviour.

 

Figure 13. HIV testing rate per 100,000 persons resident in Coventry, 2013 to 2023.

As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.
Data represents the number of HIV tests, and not the number of people tested (one person may be tested multiple times) and only reflects tests conducted through SHSs.
Rates are calculated per 100,000 population using population estimates sourced from the Office for National Statistics based on the Census. Rates are calculated based on using the 2021 Census as a proxy for all years (2019 to 2023) due to the unavailability of annual data.
In areas with a higher proportion of diagnosed HIV, the HIV testing rate will be an underestimate as those living with HIV have not been removed from the denominator.

 

Figure 14. HIV testing rate per 100,000 population in 16 similar local authorities and the West Midlands region (statistical), compared to England: 2023

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

Data represents the number of HIV tests, and not the number of people tested (one person may be tested multiple times) and only reflects tests conducted through SHSs.
Rates are calculated per 100,000 population using population estimates sourced from the Office for National Statistics based on the Census.
Rates are calculated based on using the 2021 Census as a proxy due to the unavailability of annual data. In areas with a higher proportion of diagnosed HIV, the HIV testing rate will be an underestimate as those living with HIV have not been removed from the denominator.

 

New HIV diagnoses among persons first diagnosed in the UK

As a proxy for HIV transmission in the UK, diagnoses where the first positive HIV test occurred in the UK are considered in this section.

In 2023, the number of Coventry residents aged 15 years and older who were newly diagnosed with HIV in the UK was 24. The rate of new diagnoses per 100,000 residents was 6.7, similar to the rate of 4.9 per 100,000 in England. This represented a 57% increase since 2022 and a 6% increase in the 5 years since 2018 (Figure 15 and Figure 16). Coventry was ranked 43rd highest (out of 151 UTLAs/UAs) for the rate of new HIV diagnoses.

 

Figure 15. Rate of new HIV diagnoses among persons first diagnosed^* in the UK per 100,000 population by year in Coventry compared to rates in the West Midlands region and England: 2011 to 2023.

^* Persons aged 15 years or older.
As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.

 

Figure 16. New HIV diagnoses among persons first diagnosed in the UK rate per 100,000^* in 16 similar local authorities and the West Midlands region, compared to England: 2023

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

^* Persons aged 15 years or older.

 

Late HIV diagnosis

Late diagnosis is defined as having a CD4 count <350 cells/mm³ within 91 days of diagnosis excluding people previously diagnosed abroad and people with evidence of recent seroconversion.

In Coventry, the percentage of HIV diagnoses made at a late stage of infection in the three-year period between 2021-23 was 37.8%, similar to 43.5% in England (Figure 17 and Figure 18).

 

Figure 17. Percentage of late HIV diagnoses (all CD4<350) in 16 similar local authorities and West Midlands region, compared to England: 2021-23

Benchmarking refers to statistical nearest neighbours (comparison of local authorities with the most similar characteristics in England), derived from CIPFA’s Nearest Neighbours Model

 

Figure 18. Percentage of late HIV diagnoses (all CD4<350) in Coventry compared to the West Midlands region (statistical) and England: 2009-11 to 2021-23

As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider these factors, especially when comparing with data from pre-pandemic years.

 

For Coventry residents, the percentage of HIV diagnoses made at a late stage of infection for different probable route of exposure groups in the three-year period between 2021-23 was as follows: MSM - 28.6% not compared to 34.3% in England; heterosexual men - 50.0% similar to 56.6% in England; heterosexual women - 30.8% similar to 46.4% in England.