Intended for healthcare professionals


Sexual health: government “should set clear targets” to tackle rising number of STIs in England

BMJ 2020; 368 doi: (Published 05 February 2020) Cite this as: BMJ 2020;368:m475
  1. Gareth Iacobucci
  1. The BMJ

The UK government must implement a new national strategy for tackling sexually transmitted infections (STIs) with clear targets for reducing rates, experts have urged.

In a report published on 5 February,1 the Terrence Higgins Trust and the British Association for Sexual Health & HIV said that “brutal” funding cuts and inaction by the government had led to cases of many STIs soaring in the past decade, during which time rates of gonorrhoea rose by 249% and rates of syphilis rose by 165%, reaching their highest level since the second world war.

In 2018 chlamydia rates rose by 6%, and overall nearly half a million (447 694) cases of STIs were diagnosed in England, the report said. It also highlighted inconsistent testing at sexual health clinics, meaning that emerging STIs such as Mgen (Mycoplasma genitalium) were being missed. It warned of the “damaging” impact of the government slashing spending on sexual health services by a quarter since 2014.

Drug resistance

Any new government strategy should set “ambitious targets” to tackle STIs in England, provide detail on how these targets will be achieved, and set out clearly the responsibilities of each statutory (and non-statutory) organisation in working towards them, the report advised. It also recommended a focus on the threat of drug resistant STIs, which pose a risk to the nation’s health.

The report called for greater efforts to understand and halt the disproportionate impact of STIs on young people, gay and bisexual men, people from some ethnic minority populations, and people with HIV.

John McSorley, president of the British Association for Sexual Health and HIV, said, “Years of government funding cuts and disruption caused by fragmented commissioning structures have placed incredible pressures on sexual health services in this country. At a time when we are seeing significantly increased demand from the public and record levels of sexual infection, including the spread of difficult-to-treat antibiotic resistant strains of disease, the decision to disinvest in this vital public health area is nonsensical.”

He said it was “critical” that a new national strategy for the sector should be delivered as soon as possible. “This needs to set out how all parts of the system should work together to commission and deliver sexual health services in a joined-up way and must also be accompanied by a fair and robust funding settlement to support long term planning,” said McSorley.

Jonathan McShane, chair of the Terrence Higgins Trust, said, “It’s clear to see that sexual health has been neglected for too long and has not been a priority for successive governments. An ambitious strategy, matched with proper funding, is the only way we can support people to have healthy and fulfilling sex lives.

“The government must roll up its sleeves and get to work, because the current state of the nation is simply not good enough.”


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