Only 15% of young men in England were tested for chlamydia last year despite recommendations

BMJ 2014; 348 doi: (Published 19 June 2014) Cite this as: BMJ 2014;348:g4121
  1. Jacqui Wise
  1. 1London

Only a third of local authorities are reaching the recommended levels for chlamydia screening, the latest data from Public Health England have shown.1

National guidance recommends that sexually active under 25 year olds should be screened for chlamydia every year, and on changing their sexual partner. In 2013 over 1.7 million chlamydia tests were carried out in England among young people aged 15 to 24, and more than 139 000 chlamydia diagnoses were made.

The figures showed that only 15% of young men and 35% of young women were tested for chlamydia in England in 2013, and the data showed wide variation across the country in the rates of chlamydia testing and diagnoses. The percentage of young people tested for chlamydia ranged from 20% in the Thames Valley region to 31% in the North East.

The rates of chlamydia diagnoses also showed large geographical variation, ranging from under 560 in the City of London to 5768 in Lambeth for every 100 000 people aged 15-24. Thirty per cent of local authorities achieved the recommended level of chlamydia diagnosis, of at least 2300 per 100 000 young adults per year.

Catherine Lowndes, consultant scientist in Public Health England’s sexually transmitted infection surveillance team, said, “Chlamydia can have serious consequences, including infertility, if it’s not treated. These data show we need to do more to encourage young adults to ask for testing every year when they attend health services.”

She added, “Local areas can look at embedding screening into a variety of settings to make it as easy as possible for this group to get tested. Offering a young adult a chlamydia test opens the door to conversations about other important aspects of good sexual health, such as contraception and condom use.”

Genevieve Edwards, director of policy at Marie Stopes UK, commented, “I find it particularly worrying to see that so few local authorities are meeting recommended chlamydia screening targets. It’s hugely concerning that just 13% of young men were screened for chlamydia last year. It might be a challenge to engage young men in sexual health services, but it’s one we should strain every sinew to meet.”

The latest figures showed little change in the overall number of sexually transmitted infections in England: 446 253 cases were diagnosed in 2013 compared with 448 775 in 2012. Chlamydia was the most common, making up 47% of all diagnoses (208 775), while gonorrhoea diagnoses saw a large rise of 15% from 2012 to 2013.

Among heterosexuals seen in genitourinary medicine clinics, young people aged 15-24 had the highest sexually transmitted infection rates, with 63% of chlamydia cases, 54% of genital warts, 42% of genital herpes, and 56% of gonorrhoea.

Gay men were also disproportionately affected, accounting for 81% of syphilis and 63% of gonorrhoea cases in male genitourinary medicine clinics. Gonorrhoea diagnoses rose by 26% in this group—nearly double the national rate. Public Health England said that this was a particular concern as new gonorrhoea strains became harder to treat. It recommended that men who have sex with men should have an HIV and sexually transmitted infection screen at least once a year, or every three months if having unprotected sex with new or casual partners.


Cite this as: BMJ 2014;348:g4121


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