Unmet needs
Nationally the diagnosis rates of STIs remains greatest in young heterosexuals aged 15 to 24 years, black minority ethnic (BME) populations, MSM, and people residing in the most deprived areas in England. Not all of these inequalities are evident in local services and data indicating a possible unmet need.
Gonorrhoea and syphilis have re-emerged as major public health concerns, especially among gay, bisexual and MSM.
The rise in syphilis, gonorrhoea and chlamydia diagnoses among MSM is probably primarily associated with behavioural changes such as an increase in partner numbers and condomless anal intercourse with new or casual partners.
The national rise in chlamydia is generated, in part, by the increasing positivity of tests delivered through the National Chlamydia Screening Programme (NCSP) but increasing transmission in people aged 25 years and older is also likely. Locally testing is on the decline indicating a possible unmet need. This is especially important as nationally 70-80% of positive cases on asymptomatic and only identified through screening.