State of the Nation, map of England

We’ve launched a report with British Association for Sexual Health and HIV (BASHH) focusing on the state of sexually transmitted infections (STIs) in England.

Key findings

  • New diagnoses have increased by 5% in 2018 from 2017. 
  • While some progress is being made – with declines in rates of STIs such as genital warts – other STIs are skyrocketing. Syphilis and gonorrhoea have increased by 165% and 249% respectively in the past decade. 
  • There is no current long-term vision for sexual health, including STIs, in England and a national sexual health strategy is urgently needed.
  • Men who have sex with men, young people and some ethnic minority communities are among those disproportionately impacted by STIs.
  • Current available research does not provide an adequate understanding of the inequalities in sexual health, with little focus on the impact of structural inequalities on STIs. Surveillance data erases the identities of many communities who may be at risk of STIs resulting in a gap in services that meet their needs.
  • There’s a lack of up-to-date research on why we're seeing these trends. For instance, data on behaviours associated with STIs is outdated with gaps in research focused on many communities at greatest risk of STIs.
  • Access to sexual health services has been compromised by the impact of funding cuts on overstretched services in the face of rising demand. There’s a clear need for fully funded, sustainable sexual health services.
  • There’s a lack of sexual health champions speaking out about STIs. The lack of these voices, as well as visibility in the wider media, creates a barrier in the fight against STI stigma.

About the project


Sexually Transmitted Infections in England: The State of the Nation was a project led by us and BASHH. It aimed to provide a stocktake of the current evidence available on STIs in England and provide recommendations on how to improve the nation’s sexual health.

The project used existing evidence, carrying out a review of the data available in the public domain. It aimed to provide a comprehensive overview of the trends in STIs, who was affected, why we were seeing these trends, and where the gaps are in our understanding. 

What we’re calling for


The full report makes a number of recommendations

A major focus of the recommendations is the need for a timely, fully funded national sexual health and reproductive health strategy. In order for this strategy to be effective it should take a holistic approach, including a focus on the wider determinants of STIs.

In tandem with this is the need to fill the gaps in the research which have been identified. Spanning topics of inequalities, access to services, awareness, and behaviours, there’s a need for research that answers the ‘why’ question of STIs.

Why it’s important to focus on STIs in England


STIs in England are on the rise. With massively concerning trends occurring- we need a way to overcome them. It is, therefore, imperative to understand what's happening, why it’s happening, who it’s happening to, and what is currently being done to stem the rising tide of infections.

We and BASHH have produced this report focusing on STIs. The report delves into the trends, looking at the political and economic context in which they occur, including commissioning structures and funding. Further to this, behaviours, public awareness, health inequalities and access to services are all considered in their potential to impact STIs.

The report also unearths more questions to be answered, highlighting major gaps in knowledge of STIs in England. In doing this, it's clear that the current approach is simply not good enough – we’re far from being able to reverse the trends seen in STIs and more needs to urgently be done. 

Why is it that STIs have not been prioritised? This report makes a number of recommendations for how the situation can be improved to better tackle the trends in STIs.

Next steps


The Government has committed to a national sexual health and reproductive health strategy. We’ll be working to ensure the strategy is developed as a matter of urgency, that it's fully funded and that it address the key recommendations in this report. 

The report has also made a number of recommendations for organisations working in the sexual health sector. We all must play our part if we're to tackle the increasing STIs seen in England.  

Read the executive summary

Read the full list of recommendations