SPLASH Portsmouth 2020-01-08

Summary profile of
local authority sexual health

Portsmouth

08 January 2020

 

Key findings

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

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

Compared to England:

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

Key for spine bars

Introduction

Aim

This report describes sexual and reproductive health in a local area in an integrated way, including sexually transmitted infections (STIs), HIV, teenage conceptions, abortions and contraception.

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

Information used in this report

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

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

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

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STIs

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

Over the past decade, diagnoses of gonorrhoea and syphilis have increased considerably in England, most notably in males, while diagnoses of genital warts have decreased.1 The full-scale implementation of the National Chlamydia Screening Programme (NCSP) in 2008 led to increases in diagnoses rates in men and women. More STI testing in sexual health services and through the NCSP with routine use of more sensitive diagnostic tests, such as nucleic acid amplification tests (NAATs), will partly explain increases in the early part of the decade, although ongoing high levels of condomless sex will have played a role.

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

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

High levels of gonorrhoea transmission are of particular concern due to the emergence of extensively drug resistant gonorrhoea (XDR-NG) in England. In 2018, a case of infection with Neisseria gonorrhoeae with ceftriaxone resistance and high-level azithromycin resistance was detected in a UK resident man who had acquired the infection from Thailand2; later that year, two additional cases of infection with a strain of N. gonorrhoeae with ceftriaxone resistance and intermediate azithromycin resistance were detected in two women in different regions of England, both of whom had overlapping sexual networks with UK residents who had travelled to Ibiza, Spain.

This report has been compiled using routine STI data, the majority of which comes from specialist sexual health services.3 Chlamydia test and diagnosis data from community services are sourced from the CTAD Chlamydia Surveillance System. Please see the link below for further details on chlamydia data from community services and for additional data on chlamydia testing coverage, positivity and diagnostic rates (for those aged 15-24 years).4 Diagnoses of all STIs made in specialist and non-specialist sexual health services are reported using the GUMCAD STI Surveillance System.

Burden and trend of new STIs

A total of 2,607 new STIs were diagnosed in residents of Portsmouth in 2018. It should be noted that if high rates of gonorrhoea and syphilis are observed in a population, this reflects high levels of risky sexual behaviour.

When interpreting trends, please note:

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

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

Compared to England:

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

Key for spine bars

Table 1. Rates per 100,000 population of new STIs in Portsmouth and England: 2017-2018

Diagnoses 2017 2018 % change 2017 to 2018* Rank among 16 similar UTLAs/UAs Rank within England: 2018 Value for England: 2018
New STIs 1,061.9 1,214.2 14.3% 3 21 784.4
New STIs (exc chlamydia aged <25)1 911.3 1,099.3 20.6% 6 29 850.6
Chlamydia 596.6 640.8 7.4% 2 17 384.4
Gonorrhoea 78.2 133.7 70.8% 4 29 98.5
Syphilis 25.6 45.6 78.2% 1 12 13.1
Genital warts 153.2 127.6 -16.7% 9 28 100.1
Genital herpes 75.9 94.1 23.9% 1 16 59.0
* Percent change not provided where the value in 2017 was 0. Calculated from unrounded values.
These are Portsmouth 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 150 UTLAs/UAs in England, excluding those where values were suppressed due to small numbers. City of London and Isles of Scilly are always excluded. First rank has the highest value. Where the value was 0, ranks are based on order of local authority names.
1 Population is restricted to those aged 15-64 years

Table 2. Number of new STIs by year, Portsmouth

Diagnoses 2012 2013 2014 2015 2016 2017 2018
New STIs 2,242 2,075 1,967 2,018 2,069 2,280 2,607
New STIs (exc chlamydia aged <25)1 1,314 1,295 1,233 1,221 1,213 1,338 1,614
Chlamydia 1,202 1,018 946 1,069 1,148 1,281 1,376
Gonorrhoea 96 74 133 129 119 168 287
Syphilis 3 7 8 19 25 55 98
Genital warts 398 426 384 343 346 329 274
Genital herpes 184 195 168 167 150 163 202
1 Population is restricted to those aged 15-64 years
Figure 3. Rates per 100,000 population of new STIs excluding chlamydia in <25 years in 16 similar local authorities and the South East PHE Centre, compared to England: 2018

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

Value suppressed for 1 local authority.

Figure 4. Rates per 100,000 population by diagnosis by year in Portsmouth compared to rates in the South East PHE Centre and England: 2012 to 2018

Please note the charts have different y axis scales.

Figure 5. Rates per 100,000 population of gonorrhoea in 16 similar local authorities and the South East PHE Centre, compared to England: 2018

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

Value suppressed for 1 local authority.

Figure 6. Rates per 100,000 population of syphilis in 16 similar local authorities and the South East PHE Centre, compared to England: 2018.

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