While sexual relationships are essentially private matters, good sexual health is important to both individuals and society. Sexual health can affect a person’s physical and mental wellbeing. Some consequences of poor sexual health include:
•Teenage parenthood reduces the life chances of young people and their children.
•Sexually transmitted infections can cause long term and life threatening complications such as infertility.
•Bullying and discrimination can occur on the basis of sexuality
•Late diagnosis of HIV leads to avoidable illness and premature death as well as increased infection rates.

Sexual health in North Yorkshire is generally good, with rates of most STIs and unintended pregnancies better than or similar to the national average. However, despite efforts to control STIs, including the improved availability of sexual health screening, we are not seeing a significant impact on numbers of STIs diagnosed, with some STI rates continuing to rise.  Whilst some of the increase is associated with more testing, e.g. chlamydia, and more diagnostic sensitivity; it is clear that high rates of infection persist in population groups such as men who have sex with men (MSM) and young people. In North Yorkshire the most recent data (2014) shows that the most common STI is chlamydia with a diagnostic rate of 245 per 100,000, followed by genital warts (87.4 per 100,000), genital herpes (29.5 per 100,000), gonorrhoea (12.3 per 100,000), syphilis (3.8 per 100,000) and HIV (3 per 100,000).

Key issues 

Whilst the number of teenage pregnancies has significantly reduced across North Yorkshire over the last few years, Scarborough continues to have the highest rate in North Yorkshire at 26.3 per 1000 females aged 15-17 (similar to the England average of 24.3). Therefore work focused on identifying and supporting young people at risk of teenage pregnancy needs to be sustained to maintain reducing rates.

Long Acting Reversible Contraception (LARC) is the most effective form of contraception.  Provision of LARC services is good across North Yorkshire with a GP prescribed LARC rate of 100.6 per 1000 females aged 15-44 years (England average 55.2). Therefore maintaining the skills of healthcare professionals to support people to make informed choices about contraception and fit and remove LARC needs to be ensured.

Whilst the number of people diagnosed with HIV in North Yorkshire is lower than the national average, those that are diagnosed are diagnosed late. In North Yorkshire the percentage of adults (aged 15 or above) newly diagnosed with HIV with a CD4 count less than 350 cells cubic millimetre (after the recommended time to start therapy) is 55% which is worse than the national average of 42.2%. The areas with the highest percentage are Hambleton (66.7%) and Harrogate (77.85%). Improved uptake of HIV testing is vital for early detection and treatment to reduce morbidity and mortality. In order to achieve this, joint working between the integrated sexual health service – YorSexualHealth – and primary and secondary health care providers will be essential.

Chlamydia is the most commonly diagnosed STI, and is mostly asymptomatic. If untreated, chlamydia can lead to complications including pelvic inflammatory disease, ectopic pregnancy and infertility.  In North Yorkshire the chlamydia detection rate is 1,650 per 100,000 15-24 year olds; this is well below the national target of 2,300 per 100,000. Only Scarborough district is close to the target with a rate of 2,162. There remains an issue about whether there is a lower than average infection rate within the North Yorkshire population; or whether screening levels need to be increased. The proportion of 15-24 year olds screened for chlamydia is worse than the England average of 24.3% in the following districts: Craven, Hambleton, Ryedale, Selby. Therefore improved uptake of screening is important in these areas. In order to achieve this, joint working between YorSexualHealth and other workforces that focus on young people in both the statutory and non-statutory sectors will be essential. 

Please visit the Public Health England profile for sexual health below;

http://fingertips.phe.org.uk/profile/sexualhealth/data#page

Download the data here:

https://hub.datanorthyorkshire.org/dataset/jsna-data/resource/1ab672af-7dbc-49da-ab65-a0cbaeb9d916

Author: Claire Lawrence

Date published: 16/03/2016