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25 Nov 2008 NHS Report Highlights Scotland’s Sexual Health

“Scotland’s Sexual Health Information” (SSHI), a comprehensive report released today by NHS National Services Scotland (NSS), shows that uptake of sexual health screening services in Scotland is on the rise, with a 13% increase in overall GUM (genitourinary medicine) clinic workload in 2007 compared to 2006. This is the second annual rise of 13%, and shows that more people in Scotland are taking steps to find out their sexual health status.

Collating high quality data from NSS divisions Health Protection Scotland (HPS) and Information Services Division (ISD) has allowed the authors to present a wide ranging examination of the sexual health of the nation, covering areas such as sexually transmitted infections (STIs); pregnancy; abortion; fertility control; and GUM clinic workload.

The report also shows that risk taking behaviour and deprivation continued to have a negative impact on Scotland’s sexual health in 2007.

High risk behaviour and poor contraception use is indicated by rising STI and abortion rates in young people, who continue to bear a disproportionate burden of STI diagnoses in Scotland. Young people comprise 13% of the population, but account for 58% of all STI diagnoses in Scotland; most notably, 71% of all chlamydia diagnoses are made in those aged less than 25.

Rising STI diagnoses in the over 40s in Scotland – a 29% increase in diagnoses of four major STIs (genital chlamydia; genital warts; genital herpes and gonorrhoea) made in the GUM clinic setting has been observed in this group in the last five years –also point to increasing sexual risk taking; reflecting social and demographic changes in this group, and reinforcing other recently published findings regarding sexual health and behaviour in older people.

Continued overall transmission of STIs in men who have sex with men (MSM), despite falls in diagnoses of one STI (gonorrhoea) in this period, suggest risk taking behaviour also continues in this population. There is, however, cause for positivity regarding uptake rates of HIV screening among MSM. Overall, the number of MSM undergoing HIV testing has increased by 67% since 2003. Testing in the GUM setting has markedly improved in the past three years with HIV test uptake rates in 2007 of over 80% among MSM presenting with an acute STI in most NHS board areas of Scotland.

Dr Andrew Winter, Consultant in GUM/HIV at NHS Greater Glasgow and Clyde, said: "I am delighted to see the sustained rise over three years in the proportion of men who have sex with men accepting an HIV test when having a sexual health screen. However, undiagnosed HIV remains a significant cause of premature illness and death, which is so sad as HIV infection, while incurable, is treatable and people can live out a normal life span. Testing rates in Scotland still lag behind many other countries. We have also seen continued rises in acute STIs in MSM, especially the ongoing syphilis outbreaks. We need to redouble efforts to involve everyone in looking after their sexual health, especially men who have sex with men."

The report also highlights the importance of prevention, especially through consistent condom use. Shirley Fraser, Health Improvement Programme Manager at NHS Health Scotland, said: “Since the launch of the strategy Respect and Responsibility in 2005, much has been done to improve access to sexual health services and improving sex and relationships education.However, we have a culture in Scotland that does not make it easy for us to talk about sexual health and then making sure we avoid poor sexual ill health outcomes. In particular, everyone, young and not so young, should aspire to use condoms regularly and correctly - only then will we see reductions in sexually transmitted infections.”

Deprivation was also shown to impact sexual health, with a clear association between deprivation and higher levels of teenage pregnancy. Anna Glasier, Lead Clinician for Sexual Health in NHS Lothian, said: “We have known for a long time that poor sexual health, and particularly teenage motherhood, is associated with deprivation. This highlights that while clinical services can do a lot to make it easier for people to stay sexually healthy any change in the trends will only come with political commitment and culture change.”

The SSHI report – available at http://www.isdscotland.org/isd/5717.html–is the fourth annual report from NSS on Scotland’s sexual health. The dataset has expanded over the years to present a fuller analysis of the sexual health of the nation, and this year for the first time the report is presented in a new format to accommodate this expanded dataset. The report has been produced in a digest format, providing readers with the headline data; while a more detailed STI chapter, including NHS board level data, is available on the HPS website at http://www.hps.scot.nhs.uk/bbvsti/sexuallytransmittedinfection.aspx.

Dr Jim Chalmers, Public Health Consultant at ISD and Chair of the group producing the report said “Those who deal with sexual health issues in Scotland need ready access to the relevant information in order to deliver the best care. With SSHI, we are bringing that information together in a meaningful, easy to access way.”

Contact:

Louise Kelly
Communications Officer
Health Protection Scotland
Clifton House
Clifton Place
Glasgow
G3 7LN
Tel: 0141 300 1117
Fax: 0141 300 1170
email: Louise.Kelly@hps.scot.nhs.uk
http://www.hps.scot.nhs.uk

Notes to the Editor

  1. The full SSHI report, including the digest of the STI chapter, is available online at http://www.isdscotland.org/isd/5717.html. The full SSHI report, including the expanded chapter on STIs is available online at http://www.hps.scot.nhs.uk/bbvsti/sexuallytransmittedinfection.aspx. Printed copies will be available on request from bbvsti@hps.scot.nhs.uk
  2. Health Protection Scotland (HPS) and Information Services Division (ISD) are part of NHS National Services Scotland (NSS); a special health board providing services critical to frontline patient care and supportive of the efficient and effective operation of NHS Scotland.
  3. All figures quoted in the report refer to 2007 data, unless otherwise stated.
  4. The previous reports are available at http://www.hps.scot.nhs.uk/bbvsti/sexuallytransmitte