State of the Nation, map of England

The impact of rising sexually transmitted infections (STIs) has been laid bare in a wide-ranging new report that shows widening inequalities, brutal funding cuts and limited action by Government is resulting in an STI diagnosis every 70 seconds. 
Terrence Higgins Trust and BASHH have found overwhelming evidence for the Government to implement a new sexual health strategy. This includes the need for immediate steps to be taken to get a grip on the threat of drug resistant STIs which pose a real risk to the nation’s health.
The State of the Nation report calls on the Government to make improving sexual health a priority following nearly half a million (447,694) cases of STIs diagnosed in England in 2018 alone.
Despite cases of many STIs having soared in the last decade – with gonorrhoea up 249% and syphilis up 165%, while rates of chlamydia increased by 6% in 2018 alone – the Government has slashed spending on sexual health services by a quarter since 2014. 
This snapshot provides a worrying picture of increasing STIs, including the highest rates of syphilis since the second world war and inconsistent testing across sexual health clinics meaning emerging STIs such as Mgen are being undiagnosed. There’s also examples of people with symptomatic STIs being unable to access appointments.  
The burden of STIs was found to disproportionally impact young people, gay and bisexual men, individuals from some ethnic minority populations and people living with HIV. 
Young people account for nearly half of all new STI diagnoses (48%), with gay and men accounting for three in four (75%) of all syphilis diagnoses and some of the highest overall rates of STIs were reported in Black Caribbean and Black non-Caribbean/non-African populations. The report calls for a greater understanding of why this is happening and how this trend can be halted. 
The report contains clear recommendations to improve the nation’s sexual health, but much relies on political will and immediate action by the Government. Tellingly, it has been seven years since the Government last published a framework on sexual health.
There are examples of targeted interventions within sexual health working, including the utilisation of HIV prevention tools leading to a drop of 28% since 2015 and the introduction of a HPV vaccine programme for girls drastically reducing cases of genital warts. A joined up approach to tackle STIs is now needed. 
Jonathan McShane, Chair of Terrence Higgins Trust, said: ‘This report shows that the nation’s sexual health is not in good shape and this must be a wake up call to the Government to take action. Local government has played a key role in improving sexual health but has been held back by a combination of severe cuts to their public health budgets and the lack of a clear national strategy. This has resulted in the rates of some STIs spiralling and services struggling to cope with demand. It’s clear to see that sexual health has been neglected for too long and has not been a priority for successive governments.
‘The impact of this is being felt most by groups already facing discrimination and stigma who are shouldering the heaviest burden of new STIs. Yet very little has been done to tackle these widening health inequalities. 
‘We urgently need comprehensive action that can help to halt the rising tide of STIs. There needs to be a long-term approach to improving sexual health. An ambitious strategy, matched with proper funding, is the only way we can support people to have healthy and fulfilling sex lives. The Government must roll up its sleeves and get to work because the current state of the nation is simply not good enough.’
Dr John McSorley, President of the British Association for Sexual Health and HIV, said: ‘Years of Government funding cuts and disruption caused by fragmented commissioning structures have placed incredible pressures on sexual health services in this country. At a time when we are seeing significantly increased demand from the public and record levels of sexual infection, including the spread of difficult to treat antibiotic-resistant strains of disease, the decision to disinvest in this vital public health area is nonsensical.
‘As this report highlights, building a clear and positive new vision for the sector and its workforce is critical. To realise this ambition, the Government must now provide the leadership to ensure that a new national strategy is developed and implemented as soon as is possible. This strategy needs to set out how all parts of the system should work together to commission and deliver sexual health services in a joined-up way, and must also be accompanied by a fair and robust funding settlement to support long-term planning. Failure to do so is not an option.’ 

Read our State of the Nation report.