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Projected service use and outcomes

Background papers: Lifestyle and wider determinants :: Sexual health :: Projected service use and outcomes

  15 - 24 25 - 34 35 - 49 50 - 64 65 +
2018 36.4 40.7 55.3 53.0 45.4
2022 36.3 41.9 55.6 56.1 49.4
2026 38.2 41.0 59.0 56.1 54.5
Table 1: Medway population projections 2012 - 2026 (ONS sub-national population projections). Note: Figures are in thousands

Older age groups, who have less contraceptive- or STI- related sexual ill-health, (50-64 and 65+) are projected to grow at a faster rate than younger groups. This older group may experience other forms of sexual ill-health but these are more likely to be age-related.

ONS figures suggest that the population of 15-24 year olds in Medway will decrease over the next ten years and then gradually increase again. This dip may result in a decrease in sexual health and contraception needs short term but the need is likely to increase back to current levels.

The net international migration component of these figures is fixed at about 500-600 people per year. Data from the 2011 census indicates that 1,953 Medway residents reported living outside the UK one year previously. The impact of the current migration trends is unclear.

Factors that may contribute to a reduction in attendances:

• Change to integrated sexual health services; service users will attend fewer appointments as they will be treated holistically.
• Increase in home sampling/self-managed care; cost effective solutions will reduce physical attendances at clinics for regular testers and asymptomatic service users.
• Increased focus on prevention is likely to reduce ill-health but may lead to an increase in lower level interventions such as contraception/contra-infection services.
• Accessibility of purchased 'over-the-counter' and 'over-the-internet' screening at affordable prices; as screening becomes more accessible some potential service users may choose to access private health care to maintain anonymity.

Factors that may contribute to an increase in attendances:

• Gonorrhoea or chlamydia with antimicrobial resistance; STIs that do not respond to current treatment programmes will lead to an increase in follow-up visits and increased drug costs.
• Improved accessibility of services will remove a barrier to asymptomatic clients, any anticipated increase should be met with cost-effective solutions such as online services.

HIV Pre-Exposure Prophylaxis (PrEP) trials have indicated the effectiveness of PrEP; this may be viewed as a cost effective preventive intervention and may be rolled out nationally.