SPLASH Hackney 2026-02-05

Summary profile of
local authority sexual health

Hackney

Field Services Division, Health Protection in the Regions,
Chief Medical Advisor’s Group

STI team, Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division,
Chief Medical Advisor’s Group

03 March 2026

 

Warning: The data in this report either refers to Hackney or both Hackney and City of London combined. Unfortunately it has not been possible in this automated report to highlight which of these options applies for each data item. However, information on this is available on the online SRH profiles https://fingertips.phe.org.uk/profile/sexualhealth.

Report Update

  • Indicators for HIV diagnoses have been modified as follows:
    • New HIV diagnoses rate refers to diagnoses first made in England and excludes people diagnosed with HIV before continuing care in England.
    • HIV diagnoses among people diagnosed before continuing care in England refers to people previously diagnosed abroad.
    • All new HIV diagnoses refers to new diagnoses first made in England and people diagnosed with HIV before continuing care in England combined.

Key findings

  • This report summarises the latest available sexual and reproductive health data for Hackney.
  • Overall, the number of new sexually transmitted infections (STIs) diagnosed among residents of Hackney in 2024 was 7,055. The rate was 2,680 per 100,000 residents, higher than the rate of 632 per 100,000 in England, and higher than the average of 1,996 per 100,000 among its nearest neighbours.
  • Hackney ranked 3rd highest out of 151 upper tier local authorities (UTLAs) and unitary authorities (UAs) for new STI diagnoses excluding chlamydia in those aged under 25 in 2024, with a rate of 2,372 per 100,000 residents, worse than the rate of 482 per 100,000 for England.
  • The chlamydia detection rate per 100,000 females aged 15 to 24 years in Hackney was 2,713 in 2024, compared to the rate of 1,589 for England.
  • The rank for gonorrhoea diagnoses (which can be used as an indicator of local burden of STIs in general) in Hackney was 3rd highest (out of 151 UTLAs/UAs) in 2024. The rate per 100,000 was 836, worse than the rate of 124 in England.
  • Hackney ranked 8th highest out of 151 UTLAs/UAs for new diagnoses of syphilis in 2024, with a rate of 71.4 per 100,000 residents, higher than the rate of 16.5 per 100,000 for England overall.
  • In 2024, the rate of HIV testing among residents of Hackney at specialist (Level 3) and non-specialist (Level 2) sexual health services including online services was 14,649 per 100,000, which is higher than that seen in England overall (2,843 per 100,000).
  • The number of new HIV diagnoses in Hackney was 45 in 2024. The prevalence of diagnosed HIV in 2024 was 6.8 per 1,000 people aged 15 to 59 years, higher than the rate of 2.4 in England. Hackney was ranked 6th highest (out of 151 UTLAs/UAs).
  • In Hackney, in the three year period between 2022-24, 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 and no evidence of recent seroconversion) was 33.8%, 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 sexual health services (SHS) per 1,000 women aged 15 to 44 years living in Hackney was 37.4 in 2024, lower than the rate of 40.0 per 1,000 women in England. The rate prescribed in primary care was 8.9 in Hackney, lower than the rate of 23.7 in England. The rate prescribed in the other settings was 28.5 in Hackney, higher than the rate of 16.3 in England.
  • The total abortion rate per 1,000 women aged 15 to 44 years in 2023 was 22.4 in Hackney, similar to the England rate of 23.4 per 1,000. Of those women under 25 years who had an abortion in 2023 the proportion who had previously had an abortion was 30.0% similar to 29.0% in England.
  • In 2023/24, 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 Hackney compared to the rest of England: 2023 to 2024

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 region.

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

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

 

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 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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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. Newer interventions such as doxyPEP to prevent syphilis and 4CMenB vaccine to reduce gonorrhoea were introduced for eligible individuals during 2025.

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 During 2020 and 2021, the response to the COVID-19 pandemic disrupted sexual health services leading to a decline in testing and diagnoses of STIs. 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.3 Since 2021, there has been an overall increase in the number of consultations (including face to face consultations at physical clinics and those via telephone or internet) delivered by SHSs in England. Numbers of new STI diagnoses also increased generally, with national syphilis diagnoses levelling and gonorrhoea diagnoses falling in 2024, but both remaining relatively high compared to the past decade. STIs continue to disproportionately affect gay, bisexual and other men who have sex with men (GBMSM), young people (aged 15 to 24) and some minority ethnicities. Please see the official statistics report for more details and data.

The STI section of this report has been compiled using data from sexual health services (SHSs) reported to UKHSA via the GUMCAD STI Surveillance System and data on chlamydia testing and diagnoses from all settings reported to UKHSA via the CTAD Chlamydia Surveillance System.

‘Sexual health services’ refer to services offering specialist STI related care (e.g. services offering Level 3 care including integrated sexual and reproductive health services) and non-specialist sexual health services (e.g. services offering Level 2 care including online services and contraception and sexual health services for young people). Data on chlamydia testing and diagnoses are collected from SHSs via GUMCAD and from other settings including general practice, pharmacies, abortion services, and other services via CTAD.

Burden and trend of new STIs

A total of 7,055 new STIs were diagnosed in residents of Hackney in 2024. 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 Hackney compared to the rest of England: 2024

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 region.

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

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

 

Table 1. Rates per 100,000 population of new STIs in Hackney and England: 2023 to 2024

Diagnoses 2023 2024 % change 2023 to 2024* Rank among 16 similar UTLAs/UAs Rank within England: 2024 Value for England: 2024
New STIs 2,922.7 2,679.6 -8.3% 3 3 632.3
New STIs (exc chlamydia aged <25) 2,530.4 2,372.4 -6.2% 3 3 482.3
Chlamydia 1,277.0 1,014.9 -20.5% 2 2 292.8
Gonorrhoea 860.7 835.6 -2.9% 3 3 124.5
Syphilis 66.5 71.4 7.4% 8 8 16.5
Genital warts 136.7 141.7 3.6% 1 1 43.4
Genital herpes 136.7 139.4 1.9% 5 5 48.3
Mycoplasma genitalium1 42.5 53.9 26.8% 9 10 15.7
Trichomoniasis1 131.0 113.9 -13.0% 1 2 17.4
Sexually transmitted Shigella spp. 85.0 72.0 -15.3% 3 3 10.0
* Percent change not provided where the value in 2023 was 0.
These are Hackney 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, Hackney: 2013 to 2024

Diagnoses 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024
New STIs 6,668 7,001 6,819 6,947 7,278 8,361 9,425 5,389 5,483 7,287 7,695 7,055
New STIs (exc chlamydia aged <25) 5,252 5,622 5,639 5,566 5,916 6,560 7,677 4,439 4,629 6,151 6,662 6,246
Chlamydia 2,707 2,870 2,545 2,865 3,062 3,922 4,394 2,412 2,462 3,517 3,362 2,672
Gonorrhoea 902 1,050 1,130 1,010 1,301 1,543 2,003 1,389 1,445 1,979 2,266 2,200
Syphilis 94 111 132 152 156 172 187 172 156 166 175 188
Genital warts 716 728 758 684 662 616 603 282 349 343 360 373
Genital herpes 550 550 555 536 465 459 522 200 237 319 360 367
Mycoplasma genitalium1 - - - - - - 135 87 85 81 112 142
Trichomoniasis1 253 238 202 333 425 472 498 203 239 263 345 300
Sexually transmitted Shigella spp. - - - 20 8 26 31 13 22 44 92 78
- 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 Hackney by Middle Super Output Area: 2024

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 (excl. chlamydia <25) per 100,000 <300 300 - <600 600 - <900 900 - <1,200 1,200+
New STI diagnoses in Hackney 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: 2024

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 5. Rates per 100,000 population by diagnosis by year in Hackney compared to rates in England: 2012 to 2024

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: 2024

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 Hackney, compared to national, regional, and neighbouring rates. The UKHSA has published analyses of the changing epidemiology of syphilis in England,4 and is reviewing the Syphilis Action Plan (2019).5

 

Figure 7. Rates per 100,000 population of syphilis in 16 similar local authorities compared to England: 2024.

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 2024 in Hackney was 2,713 per 100,000 population (481 positives out of 5,801 screened), lower than the 3,250 target. 32.7% of 15 to 24 year old females were tested for chlamydia, compared to 18.0% 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 Hackney and England: 2023 to 2024

2023 2024 % change 2023 to 2024* Rank among 16 similar UTLAs/UAs Rank within England: 2024 Value for England: 2024
Detection rate
Female 3,390.1 2,713.2 -20.0% 3 6 1,589
Male 2,527.5 1,971.9 -22.0% 4 4 837
Total 3,390.1 2,713.2 -20.0% 3 6 1,589
Proportion screened
Females aged 15-24 37.2 32.7 -12.0% 2 2 18
* Percent change proportional to the value in 2023, not a change in percentage points. Percent change not provided where the value in 2023 was 0.
These are Hackney 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 Hackney by Middle Super Output Area: 2024

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).

Chlamydia detection rate per 100,000 aged 15-24 (Female) 1 - <1200 1200 - <2400 2400 - <3250 3250 - <4400 4400+
New Chlamydia diagnoses in Hackney 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: 2024

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: Benchmark for Chlamydia detection rate


In the five years from 2019 to 2024, there was a 59% decrease in the chlamydia detection rate among 15 to 24 year olds in Hackney. From 2023 to 2024, the decrease was 20%.

 

Figure 10. Chlamydia detection rate per 100,000 population in 15 to 24 year olds females in Hackney and England, 2012 to 2024

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 2024 the rate of STI testing (excluding chlamydia in under 25 year individuals) in SHS in Hackney was 19,133 per 100,000, a 2% increase compared to 2023. This is higher than the rate of 4,089 per 100,000 in England in 2024. The positivity rate in Hackney was 8.0% in 2024, higher than 6.4% 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.

 

Figure 11. STI testing rate and positivity rate (excluding chlamydia in under 25 year olds) per 100,000 population by year in Hackney and England: 2012 to 2024

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 to occur.16

HIV

England has set an ambition to end HIV transmission and reduce AIDS-related deaths by 2030. The HIV Action Plan for England 2025 to 2030 sets out the strategic priorities to achieve this.17 The first HIV Action Plan monitoring and evaluation framework was published in December 2022 setting out the indicators used to monitor progress,18 and UKHSA has published annual updates.19 The monitoring and evaluation framework will be refreshed during 2026 to align with the updated action plan.

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. In 2024, 10.6% (146,098 of 1,379,884) of HIV-negative people accessing specialist SHSs in England were defined as having a PrEP need. Among these, 76.1% (111,123 out of 146,098) 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]).

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 2024, 5,298 people were newly diagnosed with HIV in England. Among these, men exposed through sex between men accounted for 29% (810), women exposed by heterosexual contact for 27% (749), men exposed by heterosexual contact for 23% (634), injecting drug use for 1% (32).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 2024, 42% (928 of 2,196) of those first diagnosed in England were diagnosed at a late stage. People first diagnosed late in England in 2023 were 10 times more likely to die within a year of their diagnosis compared to those who were diagnosed promptly.21

 

Figure 12. Chart showing key HIV indicators in Hackney compared to the rest of England, 2024

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 region.

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

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 Hackney in 2024, 38,568 HIV tests were conducted through SHSs. This equates to a testing rate of 14,649 tests per 100,000 Hackney residents, which is higher than that seen in Hackney in 2020 (8,991 per 100,000) and higher than that seen in 2024 in England overall (2,843 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 Hackney, 2015 to 2024.

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 London region (statistical), compared to England: 2024

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 rate

New HIV diagnoses rate refers to diagnoses first made in England and excludes people diagnosed with HIV before continuing care in England.

In 2024, the number of Hackney residents aged 15 years and older who were newly diagnosed with HIV was 45. The rate of new diagnoses per 100,000 residents was 16.9, worse than the rate of 4.7 per 100,000 in England. This represented a 37% decrease since 2023 and a 12% increase in the 5 years since 2019 (Figure 15 and Figure 16). Hackney was ranked 5th highest (out of 151 UTLAs/UAs) for the rate of new HIV diagnoses.

 

Figure 15. Rate of new HIV diagnoses per 100,000 population* by year in Hackney compared to rates in the London region and England: 2015 to 2024.

* 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 rate per 100,000* in 16 similar local authorities and the London region, compared to England: 2024

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 Hackney, the percentage of HIV diagnoses made at a late stage of infection in the three-year period between 2022-24 was 33.8%, similar to 43.3% in England (Figure 17 and Figure 18).

 

Figure 17. Percentage of late HIV diagnoses (all CD4<350) in 16 similar local authorities and London region, compared to England: 2022-24

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 Hackney compared to the London region (statistical) and England: 2009-11 to 2022-24

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 Hackney 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 2022-24 was as follows: GBMSM - 10.6% compared to 32.6% in England; heterosexual men - 37.1% compared to 54.3% in England; heterosexual women - 53.1% compared to 47.2% in England.

HIV treatment and care

In 2024, 1,272 Hackney residents aged 15 to 59 years and 1,622 residents aged 15 years and over accessed HIV care. People who are accessing healthcare in high (greater than 2 to 5 per 1,000 aged 15 to 59 years old) and extremely HIV diagnosed prevalence areas (greater than 5 per 1,000 residents aged 15 to 59 years old) should be offered an HIV test.21 The diagnosed prevalence (number of people diagnosed and seen for HIV care) was 6.8 per 1,000 Hackney residents aged 15 to 59 years, worse than 2.4 per 1,000 in England (Figure 19). Hackney was ranked 6th highest (out of 151 UTLAs/UAs) (Figure 20). Since 2023, diagnosed HIV prevalence in Hackney has decreased by 4%; and decreased by 7% in the 5 years since 2019.

 

Figure 19. Diagnosed HIV prevalence per 1,000 population* by year in Hackney compared to rates in the London region and England: 2011 to 2024.

* aged 15 to 59 years.
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 20. Diagnosed HIV prevalence per 1,000 population* in 16 similar local authorities and the London region, compared to England: 2024

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 21. Map of diagnosed HIV prevalence among people of all ages in Hackney by Middle Super Output Area: 2024

Diagnosed HIV prevalence per 1,000 residents <1 1 - <2 2 - <5 5 - <10 10+ Suppressed
HIV prevalence in Hackney by MSOA

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

 

The percentage of people (aged 15 years and over) in Hackney accessing HIV care who were prescribed ART in 2024 was 99.2%, similar to 99.0% in England. The percentage of people in Hackney newly diagnosed with HIV in the three-year period between 2022-24 who started antiretroviral therapy (ART) promptly (within 91 days of their diagnosis) was 80.0%, similar to 81.2% in England. The percentage of adults in Hackney accessing HIV care in 2024 who were virally suppressed (undetectable viral load) was 96.8%, similar to 97.5% in England. The Sexual and Reproductive Health Profiles also provides these data at lower tier local authority geographies.

Reproductive health

Abortion

The total abortion rate, under 25 years repeat abortion rate, under 25 years abortions after a birth, and over 25 years abortion rates may be indicators of lack of access to good quality contraception services and advice, as well as problems with individual use of contraceptive method.

In Hackney the total number of abortions in 2023 was 1,670. The total abortion rate per 1,000 female population aged 15 to 44 years was 22.4 similar to the rate in England of 23.4 per 1,000. Hackney’s rank (out of 151 UTLAs/UAs) within England for the total abortion rate was 91st highest.

 

Figure 22. Chart showing key abortion indicators in Hackney UTLAs/UAs 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 London region.

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 4. Abortion figures in Hackney 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
Rates
Total abortion rate / 1000 20.7 22.4 8.0% 9 91 23.4
Under 18s abortions rate 7.3 7.8 7.2% 4 78 7.8
Over 25s abortion rate / 1000 19.3 21.2 9.8% 10 79 21.6
Percentages
Under 25s repeat abortions (%) 32.1 30.0 -6.5% 7 70 29.0
Under 25s abortion after a birth (%) 12.4 13.0 4.8% 7 135 21.5
* 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 Hackney 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.

 

Figure 23. Abortion rates per 1,000 women by age in Hackney compared to the London region 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.

 

Figure 24. Characteristics of abortions over time in Hackney compared to the London region 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.

 

Figure 25. Abortion rate per 1,000 women in 16 similar local authorities and London 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

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.

 

The earlier abortions are performed the lower the risk of complications. Prompt access to abortion, enabling provision earlier in pregnancy, is also cost-effective and an indicator of service quality.

In Hackney the proportion of NHS-funded abortions that were under 10 weeks was 87.0% in 2023, which is lower than that seen for England overall (89.0%). The rank within England for this indicator was 131st highest (out of 151 UTLAs/UAs).

Since the introduction of early medical abortion (EMA) methods, there has been an increase in the overall percentage of abortions performed at under 10 weeks gestation in England. Ensuring women have access to a method of contraception of their choice post-abortion is recommended practice. Provision of LARC methods post-abortion has been shown to lower subsequent unintended pregnancy rates.22

An indicator relating to the use of medical procedures will help to improve transparency at a local level on the extent of medical and surgical services available to women, and is therefore an indicator of patient choice. A very low or a very high percentage of medical abortions compared to other areas could be an issue for concern.

Among NHS-funded abortions in Hackney the percentage of those under 10 weeks gestation that were performed using a medical procedure in 2023 was 79.7%, lower than the percentage in England of 95.2%. The rank within England for this indicator was 151st highest (out of 151 UTLAs/UAs).

 

Table 5. Abortion figures for Hackney 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
Abortions under 10 weeks (%) 86.0 87.0 1.2% 11 129 89.0
Abortions under 10 weeks that are medical (%) 82.3 79.7 -3.2% 16 151 95.2
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.
* Percent change not provided where the value in 2022 was 0.
These are Hackney 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.

 

Figure 26. Early abortion over time in Hackney compared to the London region 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.

Under-18s Conception

Teenage pregnancy is a cause and consequence of education and health inequality for young parents and their children. Babies born to mothers under 20 years consistently have higher rates of stillbirth, infant mortality and low birthweight than average. Children born to teenage mothers have a 63% higher risk of living in poverty.23 Teenage mothers are more likely than other young people to not be in education, employment or training; and by the age of 30 years, are 22% more likely to be living in poverty than mothers giving birth aged 24 years or over.24 Young fathers are twice as likely to be unemployed aged 30 years, even after taking account of deprivation.25

Since the introduction of the Teenage Pregnancy Strategy in 1999, England has achieved a notable reduction in the under-18 conception rate. Further progress in both reducing the under-18s conception rate and improving the outcomes for young parents is central to improving young people’s sexual health and narrowing the health and educational inequalities experienced by young parents and their children.

Maintaining the downward trend is a priority in the Department of Health Framework for Sexual Health Improvement in England26 and addresses a number of key public health priorities including reducing health inequalities, ensuring every child gets the best start in life, and improving sexual and reproductive health. The Public Health Outcomes Framework (PHOF) includes the under-18 conception rate and a number of other indicators disproportionately affecting young parents and their children.

International evidence identifies the provision of high quality, comprehensive relationships and sex education (RSE) linked to improved use of contraception as the areas where the strongest empirical evidence exists on impact on teenage pregnancy rates.27, 28, 29 In September 2020, Statutory Guidance was introduced that requires all primary schools to provide relationships education, all secondary schools to provide relationships and sex education and both primary and secondary schools to provide health education, including puberty.30 This includes specific reference to ensuring all secondary school pupils know about local services providing confidential SRH advice and care.

Contraceptive services need to be accessible and youth friendly to encourage early uptake of advice, with consultations that recognise and address any knowledge gaps about fertility and concerns about side effects and support young people to choose and use their preferred method. Some young people will be at greater risk of early pregnancy and require more intensive RSE and contraceptive support, combined with programmes to build resilience and aspiration, providing the means and the motivation to prevent early pregnancy.

Reaching young people most in need involves looking at area and individual level associated risk factors. Child poverty and unemployment are the two area deprivation indicators with the strongest influence on under-18 conception rates.31 At an individual level, the strongest associated factors for pregnancy before 18 years are free school meal eligibility, persistent school absence by age 14 years, poorer than expected academic progress between ages 11-14 years, and being looked after or a care leaver.32, 33, 34

Teenagers are more likely to present late for abortion and to book late for antenatal care.35 The higher risk of unplanned pregnancy, late confirmation of pregnancy and fear of disclosure, all contribute to delays in accessing abortion and maternity services.36 Early pregnancy diagnosis, unbiased advice on pregnancy options and swift referral to maternity or abortion services are required to minimise delays.37 Young people who have experienced pregnancy are also at higher risk of subsequent unplanned conceptions.38

 

Figure 27. Chart showing under-18s conception indicators in Hackney compared to the rest of England: 2022 to 2023/24

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 region.

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

Spine charts will be unavailable where there is an insufficient number of values.

In 2022, the under-18s conception rate per 1,000 females aged 15 to 17 years in Hackney was 9.9, better than the rate of 13.9 per 1,000 in England (Figure 28). The decrease from 2021 was 21%. Hackney’s rank within England for the under-18s conception rate was 117th highest (out of 151 UTLAs/UAs). Between 1998 and 2022, the decrease in the under-18s conception rate in Hackney was 87%, compared to a 70% decrease in England (Figure 29).

 

Figure 28. Under-18s conception rate per 1,000 women in 16 similar local authorities and the London region, compared to England: 2022

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 29. Rates of under-18s conception and births over time in Hackney compared to the London region and England: 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.

 

Among the under-18 conceptions in Hackney, the percentage of those leading to abortion in 2022 was 72.7%, similar to the percentage in England of 58.2%. Hackney’s rank for the percentage of conceptions leading to abortion was 22nd highest (out of 151 UTLAs/UAs, excluding those where values were suppressed due to small numbers). A lower than average percentage may indicate a higher proportion of young women choosing to continue the pregnancy, but can also reflect barriers to accessing abortion care.

 

Figure 30. Percentage of under-18 conceptions leading to abortion, over time in Hackney compared to the London region and England: 1998 to 2022

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 31. Percentage of births where the mother is aged under 18 years, over time in Hackney compared to the London region and England: 2010/11 to 2023/24

Data are presented by financial years.
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.

 

Table 6. Under-18s conception and birth figures in Hackney and England: 2021 to 2022

2021 2022 % change 2021 to 2022* Rank among 16 similar UTLAs/UAs Rank within England: 2022 Value for England: 2022
Under 18s conception rate 12.4 9.9 -20.6% 9 117 13.9
Under 18s conceptions leading to abortion 74.5 72.7 -2.4% 7 22 58.2
Under 16s conception rate 2.4 1.5 -36.4% 10 111 2.2
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.
* Percent change not provided where the value in 2021 was 0.
These are Hackney 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.

Contraception

The government and the College of Sexual and Reproductive Healthcare (CoSRH) both highlight the importance of knowledge, access and choice for all women and men to all methods of contraception to help reduce unplanned pregnancies. Good contraception services have been shown to lower rates of teenage conceptions.

Contraception is available free of charge for people of all ages from a wide range of services in England. Contraceptive pills can be obtained from specialist sexual and reproductive health services, non-specialist sexual and reproductive health services including services for young people, some online services, pharmacies delivering the NHS Pharmacy Contraception Service, and general practice. LARC can be obtained from some general practices as well as all specialist and non-specialist sexual and reproductive health services. Other services that offer contraception include abortion services. Contraceptive pills can be purchased over-the-counter from most pharmacies and from online services.

Emergency hormonal contraception (levonorgestrel and/or ulipristal acetate) can be obtained free of charge from pharmacies, general practices, and from some online services. Specialist and non-specialist sexual and reproductive health services can fit intrauterine devices (IUDs) for use as emergency contraception in addition to emergency hormonal contraception. Emergency hormonal contraception can be purchased over-the-counter from most pharmacies and from online services.

Condoms can be obtained free of charge from sexual health services and from local condom distribution schemes, where available. Condoms can be purchased from pharmacies, supermarkets and other retailers.

Currently, data on contraception provision are only centrally collected from specialist SHS, Level 2 SRH services and some young person’s clinics through the Sexual and Reproductive Health Activity Dataset (SRHAD) and from NHS prescription forms within primary care. Data sources used in this report are SRHAD and Prescribing Analysis Cost Tabulation (ePACT2). ePACT2 data is available by number of prescriptions and is therefore a more useful indicator of use for LARC than short acting methods that require repeated prescription. However, there is no way of measuring method continuation, so the LARC data reflects method initiation only. The way in which this report presents total amount of contraception used in England should therefore be interpreted with care.

Attendance indicators provide a measure of young people’s access to specialist contraceptive services. The indicators are split by sex and unique attendances because there are different patterns of service access and recording relating to each sex. Females access services more than males and make more repeated visits in a year.

Attendance and service provision at SRH services is likely to be reflective of local service models and local geography e.g. more urban areas may have greater attendance at specialist SRH services as they may be easier to access, whereas in more rural areas it may be easier to attend general practice than travel to a specialist clinic.

 

Figure 32. Chart showing key contraception indicators in Hackney compared to the rest of England: 2024

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 region.

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

Attendance and service provision at sexual and reproductive health (SRH) clinics

Table 7. Attendance at specialist contraceptive services per 1,000 residents under 25 by gender, in Hackney and England: 2023 to 2024

2023 2024 % change 2023 to 2024* Rank among 16 similar UTLAs/UAs Rank within England: 2024 Value for England: 2024
Under 25s individuals attend specialist contraceptive services rate / 1000 - Females 154.7 146.3 -5.4% 5 26 95.6
Under 25s individuals attend specialist contraceptive services rate / 1000 - Males 12.4 7.8 -37.3% 14 70 12.4
* Percent change not provided where the value in 2023 was 0.
These are Hackney 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.

 

Figure 33. Attendance at specialist contraceptive services among under 25s by gender, in Hackney compared to the London region and England: 2016 to 2024

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.

Contraceptive care

Table 8. Women’s choice of contraception at SRH services and GP practices in Hackney and England: 2023 to 2024

2023 2024 % change 2023 to 2024* Rank among 16 similar UTLAs/UAs Rank within England: 2024 Value for England: 2024
Women prescribed short acting combined hormonal contraception at SRH services: rate per 1,000 20.2 19.9 -1.3% 5 9 8.3
Women prescribed short acting combined hormonal contraception in GP practices: rate per 1,000 86.8 80.7 -7.0% 8 112 94.5
Women prescribed injectable contraception at SRH services: rate per 1,000 4.2 3.6 -13.0% 5 71 4.8
Women prescribed injectable contraception in GP practices: rate per 1,000 6.7 5.9 -13.1% 10 141 23.5
Women prescribed progesterone only pill at SRH services: rate per 1,000 14.0 13.5 -3.2% 7 44 10.8
Women prescribed progesterone only pill in GP practices: rate per 1,000 64.3 62.2 -3.2% 4 129 116.9
* Percent change proportional to the value in 2023, not a change in percentage points. Percent change not provided where the value in 2023 was 0.
These are Hackney 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.

 

Table 9. Usage of LARC (excluding injections) at SRH services in Hackney and England: 2023 to 2024

2023 2024 % change 2023 to 2024* Rank among 16 similar UTLAs/UAs Rank within England: 2024 Value for England: 2024
Under 25s choose LARC excluding injections at SRH Services (%) 34.5 35.1 1.5% 7 75 35.2
Over 25s choose LARC excluding injections at SRH Services (%) 51.3 50.3 -1.8% 6 70 48.2
* Percent change proportional to the value in 2023, not a change in percentage points. Percent change not provided where the value in 2023 was 0.
These are Hackney 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.

Focus on Long Acting Reversible Contraceptives (LARCs)

The total rate of LARC (excluding injections) prescribed in Hackney primary care, specialist and non-specialist SHS was 37.4 per 1,000 women aged 15 to 44 years in 2024, lower than the rate of 40.0 per 1,000 women in England.

LARC provision is likely to reflect local geography and service models e.g. there may be more provision in primary care in more rural and semi-rural areas. In Hackney, the rate prescribed in primary care was 8.9 in 2024, lower than the rate of 23.7 in England. The rate prescribed in SRH services was 28.5 in 2024, higher than the rate of 16.3 in England.

 

Table 10. Rate of LARCs (excluding injections) prescribed per 1,000 women aged 15-44 years by setting, Hackney and England: 2023 to 2024

2023 2024 % change 2023 to 2024* Rank among 16 similar UTLAs/UAs Rank within England: 2024 Value for England: 2024
Total prescribed LARC excluding injections rate / 1,000 41.5 37.4 -10.0% 4 83 40.0
GP prescribed LARC excluding injections rate / 1,000 10.4 8.9 -14.3% 5 118 23.7
SRH Services prescribed LARC excluding injections rate / 1,000 31.1 28.5 -8.6% 4 11 16.3
* Percent change not provided where the value in 2023 was 0.
These are Hackney 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.

 

Figure 34. Total rate of LARC (excluding injections) prescribed in primary care and in SRH services per 1,000 women aged 15 to 44 years in 16 similar local authorities and the London region, compared to England: 2024

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 sources

  • Abortions under 10 weeks (%). Data source: DHSC

  • Abortions under 10 weeks that are medical (%). Data source: DHSC

  • All new HIV diagnoses rate per 100,000. Data source: UKHSA

  • All new STI diagnoses rate per 100,000. Data source: UKHSA

  • Antiretroviral therapy (ART) coverage in people accessing HIV care. Data source: UKHSA

  • Chlamydia detection rate per 100,000 aged 15 to 24 years. Data source: UKHSA

  • Chlamydia detection rate per 100,000 aged 15 to 24 years. Data source: UKHSA

  • Chlamydia diagnostic rate per 100,000. Data source: UKHSA

  • Chlamydia diagnostic rate per 100,000 aged 25 years and over. Data source: UKHSA

  • Chlamydia proportion of females aged 15 to 24 years screened. Data source: UKHSA

  • Deliveries to women aged 12 to 17. Data source: OHID, based on NHS England data

  • Determining PrEP need. Data source: UKHSA

  • GP prescribed LARC excluding injections rate / 1,000. Data source: OHID, based on NHS Business Services Authority and ONS data

  • Genital herpes diagnosis rate per 100,000. Data source: UKHSA

  • Genital warts diagnostic rate per 100,000. Data source: UKHSA

  • Gonorrhoea diagnostic rate per 100,000. Data source: UKHSA

  • HIV diagnosed prevalence rate per 1,000. Data source: UKHSA

  • HIV diagnosed prevalence rate per 1,000 aged 15 to 59 years. Data source: UKHSA

  • HIV diagnoses among people diagnosed before continuing care in England per 100,000. Data source: UKHSA

  • HIV late diagnosis. Data source: UKHSA

  • HIV late diagnosis in gay, bisexual and all men who have sex with men. Data source: UKHSA

  • HIV late diagnosis in heterosexual and bisexual women. Data source: UKHSA

  • HIV late diagnosis in heterosexual men. Data source: UKHSA

  • HIV testing rate per 100,000 population. Data source: UKHSA

  • Initiation or continuation of PrEP among those with PrEP need. Data source: UKHSA

  • Mycoplasma genitalium diagnostic rate per 100,000. Data source: UKHSA

  • New HIV diagnoses rate per 100,000. Data source: UKHSA

  • New STI diagnoses (excluding chlamydia aged 24 years and under) per 100,000. Data source: UKHSA

  • Over 25s choose LARC excluding injections at SRH Services (%). Data source: OHID, based on NHS England data

  • Over 25s abortion rate / 1000. Data source: OHID, based on DHSC and ONS data

  • Prompt antiretroviral therapy (ART) initiation in people newly diagnosed with HIV. Data source: UKHSA

  • SRH Services prescribed LARC excluding injections rate / 1,000. Data source: OHID, based on NHS England and ONS data

  • STI testing positivity (excluding chlamydia aged 24 years and under). Data source: UKHSA

  • STI testing rate (exclude chlamydia aged 24 years and under) per 100,000. Data source: UKHSA

  • Sexually transmitted Shigella spp. per 100,000 adult male population. Data source: UKHSA

  • Syphilis diagnostic rate per 100,000. Data source: UKHSA

  • Total abortion rate / 1000. Data source: OHID, based on DHSC and ONS data

  • Total prescribed LARC excluding injections rate / 1,000. Data source: OHID, based on NHS Business Services Authority, NHS England and ONS data

  • Trichomoniasis diagnostic rate per 100,000. Data source: UKHSA

  • Under 16s conception rate. Data source: OHID, based on ONS data

  • Under 18s abortions rate. Data source: OHID, based on DHSC and ONS data

  • Under 18s births rate. Data source: OHID, based on ONS data

  • Under 18s conception rate. Data source: OHID, based on ONS data

  • Under 18s conceptions leading to abortion. Data source: OHID, based on ONS data

  • Under 25s abortion after a birth (%). Data source: DHSC

  • Under 25s choose LARC excluding injections at SRH Services (%). Data source: OHID, based on NHS England data

  • Under 25s individuals attend specialist contraceptive services rate / 1000 - Females. Data source: OHID, based on NHS England and ONS data

  • Under 25s individuals attend specialist contraceptive services rate / 1000 - Males. Data source: OHID, based on NHS England and ONS data

  • Under 25s repeat abortions (%). Data source: DHSC

  • Violent crime - sexual offences per 1,000 population. Data source: OHID, based on Home Office and ONS data

  • Virological success in people accessing HIV care. Data source: UKHSA

  • Women prescribed injectable contraception at SRH services: rate per 1,000. Data source: OHID, based on NHS England and ONS data

  • Women prescribed injectable contraception in GP practices: rate per 1,000. Data source: OHID, based on NHS Business Services Authority and ONS data

  • Women prescribed progesterone only pill at SRH services: rate per 1,000. Data source: OHID, based on NHS England and ONS data

  • Women prescribed progesterone only pill in GP practices: rate per 1,000. Data source: OHID, based on NHS Business Services Authority and ONS data

  • Women prescribed short acting combined hormonal contraception at SRH services: rate per 1,000. Data source: OHID, based on NHS England and ONS data

  • Women prescribed short acting combined hormonal contraception in GP practices: rate per 1,000. Data source: OHID, based on NHS Business Services Authority and ONS data

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