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Summary

Background papers: Lifestyle and wider determinants :: Sexual health [Update in progress] :: Summary

The health and economic wellbeing of any population and the wellbeing of individuals can be critically influenced by sexual health. The financial case for sexual health services has been made repeatedly; effective sexual health services and the prevention of sexually transmitted infections (STI) and unplanned conceptions are cost-saving.

Since 2012, in England, total new STI diagnosis rates have fallen. Chlamydia infection is the most common followed by genital warts, non-specific genital infection (NSGI), gonorrhoea, herpes and syphilis (PHE, 2015). Chlamydia detection among 15-24 year olds has increased in Medway as screening in GPs and pharmacies has been promoted. However, late diagnosis of HIV is above the England average and remains a priority area.

This needs analysis does not include teenage pregnancy specifically as this is addressed elsewhere (link to the teen pregnancy section).

Key issues and gaps


• Sexual ill health is not equally distributed among the population with the highest levels seen in men-who-have-sex-with-men (MSM), teenagers, young adults and some black and minority ethnic groups. It is therefore a necessary to promote sexual health in a multifaceted manner as it is influenced by a number of issues including socio-economic and cultural issues.
• There is some correlation between deprivation and STI rates, with Chatham town centre having the highest concentration of GUM diagnoses per 100,000 population. The National Chlamydia Screening Programme (NCSP) has identified the highest rates of positivity in Strood North, Luton and Wayfield, and the Rochester wards; it should be noted that the Young Offenders Institution and the Secure Training Unit skew the data for Rochester West.
• The highest HIV prevalence rates are shown in Chatham with lower prevalence in rural areas.
• The Pelvic Inflammatory Disease rate is significantly higher in Medway than the England average.
• The total abortion rate in Medway is significantly above England average.
• It is anticipated that the move to an integrated service will improve access to STI screening generally.
• Additional research may be required to understand the cause of high prevalence in some areas of Medway to target identified causes.

Recommendations for Commissioning

We aim to complete commissioning of the integrated sexual health service by October 2016. Once the service is embedded a needs assessment should be conducted to identify remaining or new gaps. Additional research is required in a number of areas as set out below.