Research and analysis

Spotlight on sexually transmitted infections in the North West: 2023 data

Updated 8 July 2025

Applies to England

Summary

This report primarily focuses on the trend in sexually transmitted infections (STIs) in the North West between 2022 and 2023, but also includes some trends from 2019 or earlier to compare the service provision of sexual health services (SHSs) and STI diagnoses prior to the COVID-19 pandemic. For England, the number of consultations, sexual health screens and STI diagnoses in 2020 and 2021 are lower than in preceding years and any trends in diagnoses between 2021 and 2022 must be interpreted in that context.

STIs represent an important public health problem in the North West. Out of the UK Health Security Agency (UKHSA)’s regions, the North West has the second highest rate (698.2) of STIs in England.

New STIs diagnoses

A total of 52,477 new STIs were diagnosed in North West residents in 2023, representing a rate of 698 diagnoses per 100,000 population (Figure 1). This represented a 7% increase from 2022 but a 3% decline compared to 2019 (Table 1). In 2023, rates by upper tier local authority ranged from 297 new STI diagnoses per 100,000 population in Westmorland and Furness to 1,647 new STI diagnoses per 100,000 population in Manchester (Figure 11a). Rates of new STIs are higher in men than women (675 and 631 per 100,000 residents, respectively). Changes were seen in the numbers of the 5 major STIs: syphilis, gonorrhoea, chlamydia, genital herpes and genital warts:

• chlamydia diagnoses (all ages) continued the steady upward trend following the decline during the COVID-19 pandemic with 28,053 diagnoses in 2023 compared to 26,374 diagnoses in 2022, an increase of 6%; diagnoses in 2023 exceeded the 2019 pre-pandemic level
• following a 93% increase in gonorrhoea diagnoses between 2021 and 2022, numbers have begun to stabilise in 2023 with a 2% increase from 9,840 diagnoses in 2022 to 9,910 diagnoses in 2023
• infectious syphilis diagnoses increased by 2% from 943 diagnoses in 2022 to 961 diagnoses in 2023. This rate of increase is small in comparison to the 15% increase observed between 2021 and 2022
• genital herpes diagnoses increased by 8% from 3,139 diagnoses in 2022 to 3,383 diagnoses in 2023
• there was a small increase in genital warts diagnoses of 2% from 3,051 diagnoses in 2022 to 3,109 in 2023. The increase was observed in females only and is in contrast to the downward trend since 2019 (Figure 6)

UKHSA recommends that local areas should be working towards achieving a chlamydia detection rate no lower than 3,250 per 100,000 among individuals aged 15 to 24 years and this is an indicator in the Public Health Outcomes Framework (1). In 2023, the chlamydia detection rate among North West residents aged 15 to 24 years was 1,095 per 100,000 residents. Only one North West local authority (Liverpool) had a chlamydia detection rate above 3,250 per 100,000 (Figure 12).

Populations with greater sexual health needs

Young people aged 15 to 24 years

STIs disproportionately affect young people. North West residents aged between 15 and 24 years accounted for 48% of all new STI diagnoses in 2023. A steep decline (75% decrease) has been seen between 2019 and 2023 in genital warts diagnosis rates in females aged 15 to 19 (although there was a 2% increase between 2022 and 2023). This follows the introduction in 2008 of vaccination of girls against human papillomavirus (HPV), the virus which causes genital warts. The sharp rise in the rate of gonorrhoea diagnoses in 15 to 24 year olds in the North West between 2021 and 2022 stabilised in 2023.

Ethnic minority groups

The White ethnic group had the highest number of new STI diagnoses in 2023: 34,977 (83.8%) (Table 2). Although only 1.2% of new STI diagnoses were in the Black Caribbean ethnic group, this group had the highest rate: 1,975 per 100,000, which is 3.6 times the rate seen in the White ethnic group (Figure 7). The rate in the Black African ethnic group was twice that in the White ethnic group (Figure 7). Where country of birth was known, 87% of North West residents diagnosed with a new STI in 2023 (excluding chlamydia diagnoses reported via CTAD) were UK-born (Figure 8).

GBMSM

Where gender and sexual orientation are known, gay, bisexual, and other men who have sex with men (GBMSM) account for 22% of North West residents diagnosed with a new STI excluding chlamydia diagnoses reported via CTAD (77% of those diagnosed with syphilis and 38% of those diagnosed with gonorrhoea). New STI diagnoses in GBMSM increased by 9% (Table 3). Gonorrhoea diagnoses stabilized in GBMSM in 2023 following the sharp increase between 2021 and 2022 while chlamydia diagnoses continued to increase (Figure 10).

Residential area-level deprivation

The rate of new STIs among people who lived in the most deprived areas (799 per 100,000) was 2.3 times higher than the rate for people who lived in the least deprived areas (343 per 100,000) (Figure 9).

STI consultation and screens

The number of consultations delivered by sexual health services (clinic-based and online) for residents of the North West in 2023 (477,844) was 6% higher than in 2022 (452,247), but 6% lower than in 2019 (507,068) (Figure 18). There was an increase in the number of face-to-face consultations and online consultations at physical clinics delivered by SHSs in the North West in 2023 compared to 2022, while the number of telephone consultations decreased. The reduction in telephone consultations is likely to reflect the change in provision as services continued to recover from COVID-19. During the COVID-19 pandemic, many clinics introduced an initial telephone triage to manage the number of people attending in person. This practice has now ended.

Conclusion

In conclusion, the North West has the second-highest rate of new STI infections in England and continues to bear a heavy burden of STIs. The number of new STI diagnoses rose by 7% between 2022 and 2023 but there were 3% fewer diagnoses of new STIs in 2023 compared to 2019. Sexual health consultations carried out for North West residents increased by 6% between 2022 and 2023 but were 6% lower than in 2019.

Detections of chlamydia, gonorrhoea and syphilis, continued to increase between 2022 and 2023 but at a lower rate than between 2021 and 2022. Gonorrhoea diagnoses increased by 2% in 2022 to 2023 compared to 93% in 2021 to 2022. Syphilis diagnoses increased by 2% in 2022 to 23 compared to 15% in 2021 to 22. While diagnoses of genital herpes, genital warts and syphilis decreased compared to 2019, gonorrhoea diagnoses were 38% higher, an increase which has predominantly affected young people aged 15 to 24 years.

STIs continued to disproportionately impact young people aged 15 to 24, GBMSM, and people of Black Caribbean and Black African ethnicity in the North West. To mitigate the spread of sexually transmitted infections in the area, local health services must continue to place a strong priority on early detection, prevention, and focused interventions, especially in high-risk groups. Enhanced efforts towards achieving recommended chlamydia detection rates among young people and addressing gaps in STI rates across ethnic and socio-economic groups are critical for improving sexual health outcomes in the North West.

UKHSA’s main messages

Commissioners and providers of SHSs play a key role in communicating messages about safer sexual behaviours and how to access services. Main prevention messages include:

• using condoms consistently and correctly protects against HIV and other STIs such as chlamydia, gonorrhoea, and syphilis – condoms can also be used to prevent unplanned pregnancy
• regular screening for STIs and HIV is essential to maintain good sexual health – everyone should have an STI screen, including an HIV test, on at least an annual basis if having condomless sex with new or casual partners – and in addition:
  • women, and other people with a womb and ovaries, aged under 25 years who are sexually active should have a chlamydia test annually and on change of sexual partner
  • gay, bisexual, and other men who have sex with men (GBMSM) should have tests for HIV and STIs annually or every 3 months if having condomless sex with new or casual partners
• HIV pre-exposure prophylaxis (PrEP) is available for free from specialist SHSs and can be used to reduce an individual’s risk of acquiring HIV
• HIV post-exposure prophylaxis (PEP) can be used to reduce the risk of acquiring HIV following some sexual exposures – PEP is available for free from most specialist SHSs and most emergency departments
• people living with diagnosed HIV who are on treatment and have an undetectable viral load are unable to pass on the infection to others during sex – this is known as ‘Undetectable=Untransmittable’ or ‘U=U’
• vaccination against human papillomavirus (HPV), hepatitis A and hepatitis B will protect against disease caused by these viruses and prevent the spread of these infections:
  • GBMSM can obtain the hepatitis A and hepatitis B vaccines from specialist SHSs – these vaccines are also available for other people at high risk of exposure to the viruses
  • GBMSM aged up to and including 45 years can obtain the HPV vaccine from specialist SHSs
• specialist sexual health services are free and confidential and offer testing and treatment for HIV and STIs, condoms, vaccination, HIV PrEP and PEP:
  • clinic-based services are commissioned for residents of all areas in England
  • online self-sampling for HIV and STIs is widely available
  • information and advice about sexual health including how to access services is available on the NHS website and from the national sexual health helpline on 0300 123 7123

Charts, tables, and maps

Figure 1. New STI diagnosis rates by UKHSA region of residence, England, 2023

Data sources: GUMCAD, CTAD

Figure 1 is a bar chart showing that the rate of new STI diagnoses per 100,000 in the North West (698.2) was the second highest in England, with London having the highest rate.

Figure 2. Number of diagnoses of the 5 main STIs, North West residents, 2019 to 2023

Data sources: GUMCAD, CTAD

Note 1: it is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination
• any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs

Increases or decreases may also reflect changes in testing practices.

Figure 2 shows trend lines of the number of diagnoses of syphilis, gonorrhoea, chlamydia, genital herpes and genital warts for North West residents from 2019 to 2023. Chlamydia is the most diagnosed bacterial STI in part reflecting the wide availability of chlamydia testing across a range of settings. The figure shows that chlamydia has been increasing since 2020, with 28,053 diagnoses in 2023. A similar trend has been seen for gonorrhoea, increasing to 9,910 diagnoses in 2023, however the rate of increase in was lower in 2022 to 2023 than in 2021 to 2022. The number of diagnoses of syphilis, genital herpes, and genital warts are smaller in comparison to chlamydia and gonorrhoea and therefore the trend is difficult to see due to the scale used for this figure. Diagnoses of genital warts and genital herpes declined by 51% and 23% respectively between 2019 and 2023, while diagnoses of syphilis increased by 2%.

Figure 3. Diagnosis rates of the 5 main STIs, North West residents, 2019 to 2023

Data sources: GUMCAD, CTAD

Note 1: it is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination
• any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs

Increases or decreases may also reflect changes in testing practices.

Figure 3 shows trend lines of diagnosis rates of chlamydia, genital herpes, genital warts, gonorrhoea, and syphilis for North West residents from 2019 to 2023. It displays the same trends as Figure 2.

Table 1. Percentage change in new STI diagnoses, North West residents

Diagnoses	2023	Percentage change 2019 to 2023	Percentage change 2022 to 2023
New STIs	52,477	-3%	7%
Syphilis	961	-3%	2%
Gonorrhoea	9,910	38%	2%
Genital warts	3,109	-51%	2%
Genital herpes	3,383	-23%	8%
Chlamydia	28,053	2%	6%

Data sources: GUMCAD, CTAD

Note 1: it is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination
• any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs

Increases or decreases may also reflect changes in testing practices.

Table 1 shows that chlamydia was the most diagnosed STI among North West residents in 2023 with 28,053 diagnoses. The biggest percentage increase from 2022 to 2023 was seen in genital herpes and chlamydia diagnoses which increased by 8% and 6% respectively. The highest percentage decrease from 2019 to 2023 was seen in genital warts diagnoses which fell by 51%.

Figure 4. Rates of new STIs per 100,000 North West residents by age group (for those aged 15 to 64 years only) and gender, 2023

Data sources: GUMCAD, CTAD

Figure 4 is a bar chart showing rates of new STI diagnoses in North West residents by age group and gender. The highest rates are seen in females aged 20 to 24 years.

Figure 5. Rates of gonorrhoea per 100,000 residents by age group (note 2) (for those aged 15 to 64 years only) in the North West, 2019 to 2023

Data sources: GUMCAD

Note 2: age-specific rates are shown for those aged 15 to 64 years only.

Figure 5 shows a line graph of the rate of gonorrhea per 100,000 population by age group in the North West from 2019 to 2023. The rate was consistently highest in those aged 20 to 24 years. Rates in all age groups declined in 2020 but increased between 2021 and 2022. Rates in the 15 to 19 years and 25 to 34 year age groups decreased slightly in 2023 but there was a small increase in the 20 to 24 and 35 to 44 year old age groups.

Figure 6. Rates of genital warts per 100,000 residents aged 15 to 19 years by gender in the North West, 2019 to 2023                          

Data source: GUMCAD

Figure 6 is a line graph showing rates of genital warts per 100,000 among North West residents aged 15 to 19 years by gender from 2019 to 2023. The graph shows that rates in both males and females fell from 2019 to 2022, with the rate of decrease being higher among females. The rate increased slightly in 2023 in females to 19.0 cases per 100,000.

Figure 7. Rates of new STIs by Ethnic group per 100,000 residents in the North West, 2023

Data sources: GUMCAD, CTAD

Figure 7 is a bar chart showing the rates of new STIs by ethnic group per 100,000 residents in the North West in 2023. It shows that the rate of new STI diagnoses was higher among the Black Caribbean ethnic group (1,975.2 cases per 100,000) compared to the Black African ethnic group (1,106.6 per 100,000), White Ethnic group (551.0 per 100,000), and all other Ethnic groups combined (526.5 per 100,000).

Table 2. Percentage of new STI diagnoses in Northwest residents by ethnic group, 2023

Ethnic group	Number	Percentage (excluding unknown)
All other ethnic groups combined	4,831	11.6%
Black African	1,401	3.4%
Black Caribbean	512	1.2%
White	34,977	83.8%
Unknown	10,756

Data sources: GUMCAD, CTAD

Table 2 shows that the highest number of new STI diagnoses were in people in the White ethnic group (34,277), representing 83.8% of all new STI diagnoses. The Black Caribbean and Black African ethnic groups made up 1.2%, and 3.4% respectively, while all other ethnic groups made up of 11.6%.

Figure 8. Percentage of new STI diagnoses in North West residents by world region of birth (note 3), 2023

Data source: GUMCAD data only

Note 3: Data on country of birth is not collected by CTAD. All information about world region of birth is based on diagnoses made in specialist and non-specialist services which report to GUMCAD.

Figure 8 is a bar chart showing the percentage of North West residents diagnosed with a new STI in 2023 by world region of birth. It shows that people born in the UK constitute the highest proportion of 87%, with the second highest being European Union born (excluding the UK) at 5%.

Figure 9. Rates of new STIs per 100,000 residents by decile of deprivation [note 4] in North West residents, 2023

Data sources: GUMCAD, CTAD

Note 4: deciles run from 1 to 10 in order of decreasing deprivation, with 1 being the decile for the most deprived area.

Figure 9 is a bar chart displaying the rate of new STI diagnoses in 2023 per 100,000 North West residents by decile of deprivation. Decile 1 is the most deprived while decile 10 is the least deprived. It shows that the rate of new STI diagnoses is similar across deciles 1 to 4. Across deciles 10 to 4, the rate of new STI diagnoses generally increases with increased deprivation (from 343 to 739 diagnoses per 100,000 residents in deciles 10 and 4, respectively).

Figure 10. Diagnoses of the 5 main STIs among GBMSM [note 5], North West residents, 2019 to 2023

Data source: GUMCAD data only

Note 5: data on sexual orientation is not collected by CTAD. All information about GBMSM is based on diagnoses made in specialist and non-specialist services which report to GUMCAD and exclude chlamydia diagnoses via online services.

Note 6: it is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• increases in gonorrhoea may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• decreases in genital wart diagnoses may be due to the moderately protective effect of HPV-16/18 vaccination
• increases in genital herpes diagnoses may be due to the use of more sensitive NAATs

Figure 10 is a line graph that shows trends of diagnoses of the 5 main STIs (chlamydia, genital herpes, genital warts, gonorrhea, and syphilis) among GBMSM North West residents from 2019 to 2023. The graph shows a significant fall in gonorrhea, chlamydia and syphilis in 2020 during the COVID-19 pandemic followed by a consistent increase until 2022. Chlamydia diagnoses continued to increase between 2022 and 2023 while gonorrhea diagnoses levelled off and syphilis diagnoses fell slightly.

Table 3. Percentage change in new STI diagnoses in GBMSM, North West resident, 2019 to 2023

Diagnoses	2023	Percentage change 2019 to 2023	Percentage change 2022 to 2023
New STIs	7,881	12%	9%
Syphilis	646	3%	-3%
Gonorrhoea	3,398	17%	1%
Genital warts	183	-50%	4%
Genital herpes	182	-6%	19%
Chlamydia	2,447	23%	13%

Data source: GUMCAD data only

Note 5: data on sexual orientation is not collected by CTAD. All information about GBMSM is based on diagnoses made in specialist and non-specialist services which report to GUMCAD and exclude chlamydia diagnoses via online services.

Note 6: it is important to consider whether there have been any changes to testing or vaccination practices when interpreting increases or decreases in STIs:

• increases in gonorrhoea may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in GBMSM
• decreases in genital wart diagnoses may be due to the moderately protective effect of HPV-16/18 vaccination
• increases in genital herpes diagnoses may be due to the use of more sensitive NAATs

Table 3 shows the number of diagnoses of syphilis, gonorrhoea, genital warts, genital herpes, and chlamydia among GBMSM North West residents in 2023 and the percentage change between 2017 and 2023. The overall number of new STI diagnoses among GBMSM North West residents rose by 9% from 2022 to 2023. Gonorrhea was the most common STI with 3,398 new diagnoses among GBMSM in 2023. The largest percentage increase from 2022 to 2023 was seen in genital herpes, which increased by 19% while the only decrease from 2022 to 2023 was seen in syphilis diagnoses which fell by 3%. The number of genital warts and genital herpes diagnoses fell from 2019 to 2023.

Figure 11a. Rate of new STI diagnoses per 100,000 population by upper tier local authority of residence, North West residents, 2023

Data sources: GUMCAD, CTAD

Figure 11a is a bar chart showing the rate of new STI diagnoses in 2023 among North West residents by upper-tier local authority, compared to the region (698 diagnoses per 100,000) and England (704 diagnoses per 100,000) rates. The rates in local authorities ranged from 297 per 100,000 in Westmorland and Furness to 1,647 per 100,000 in Manchester. A total of 4 local authorities had a rate above the England rate (Manchester (1,647), Liverpool (1356), Blackpool (1,115) and Salford (1,012)).

Figure 11b. Rate of new STI diagnoses (excluding chlamydia diagnoses in residents aged under 25 years) per 100,000 population by upper tier local authority of residence, the North West, 2023

Data sources: GUMCAD, CTAD

Note 7: prior to 2023, this figure showed rates for the population aged 15 to 64 years, excluding chlamydia in those aged 15 to 24 years.

Figure 11b is a bar chart showing the rate of new STI diagnoses (excluding chlamydia diagnoses in people below 25 years) per 100,000 population in 2023 among North West residents by upper-tier local authority, compared to the region (481 diagnoses per 100,000) and England (520 diagnoses per 100,000) rates. The rates in local authorities ranged from 177 per 100,000 in Westmorland and Furness to 1127 per 100,000 in Manchester.

Figure 12. Chlamydia detection rate per 100,000 female residents aged 15 to 24 years by upper tier local authority of residence, the North West, 2023

Data sources: GUMCAD, CTAD

Note 8: prior to 2023, this figure showed rates for the whole population aged 15 to 24 years, regardless of gender.

The error bars show the confidence intervals for rates calculated to the 95% level using the Byar’s method.

Figure 12 is a bar chart showing the chlamydia detection rate in 2023 among female North West residents aged 15 to 24 years by upper-tier local authority. Only Liverpool had a detection rate above the Public Health Outcome Framework (PHOF) indicator of 3,250 diagnoses per 100 000 women. The lowest rate was in Bolton with 1,397 detections per 100,000.

Figure 13. Rate of gonorrhoea diagnoses per 100,000 population by upper tier local authority of residence, North West residents, 2023

Data source: GUMCAD

Figure 13 is a bar chart showing the rate of gonorrhoea diagnoses per 100,000 in 2023 among North West residents by upper-tier local authority. It shows a large variation in the rate of gonorrhoea diagnoses from 33 per 100,000 in Westmorland and Furness to 302 per 100,000 in Liverpool.

Figure 14. Map of new STI rates per 100,000 residents by upper tier local authority in the North West, 2023

Data sources: GUMCAD, CTAD

Figure 14 is a map of new STI rates in 2023 across the North West by local authority. In general, urban areas of the North West had higher STI rates compared to rural areas.

Figure 15. Map of new STI rates per 100,000 residents by middle super output area (MSOA) in the North West, 2023

Data sources: GUMCAD, CTAD

Figure 15. Map of new STI rates per 100,000 residents by middle super output area (MSOA) in the North West, 2023

Figure 16: STI testing rate (excluding chlamydia in under 25 year olds) per 100,000 population in North West residents aged 15 to 64 years, 2012 to 2023

Data sources: GUMCAD, CTAD

Figure 16 is a line graph showing the trend lines for the STI testing rate among North West and England residents aged 15 to 64 from 2012 to 2023. The graph excludes chlamydia diagnoses in those aged 25 and under. The testing rate fell in both the North West and England in 2020 but has increased since. The testing rate in the North West remained lower than the rate in England throughout.

Figure 17. STI testing positivity rate [note 9] (excluding chlamydia in under 25 year olds) in North West residents, 2012 to 2023

Data sources: GUMCAD, CTAD

Note 9: the numerator for the STI testing positivity rate now only includes infections which are also included in the denominator. These are: chlamydia (excluding diagnoses in those aged under 25 years), gonorrhoea, syphilis and HIV. Up to 2018 (data for 2017) it included all new STIs.

Figure 17 is a line graph showing the trends for the STI positivity rate (excluding chlamydia in those aged under 25 years) in the North West and England residents from 2012 to 2023. It shows that there was a sharp increase in positivity in the North West in 2022. This declined to 8.4% in 2023 but remained higher than the North West rate in the previous 10 years. The positivity rate in the North West was consistent with the England rate between 2017 and 2021 but was higher than the England rate in 2023 (7.2%).

Table 4. Number of diagnoses of new STIs by UKHSA region of residence, data source and data subset 2023

UKHSA region of residence	GUMCAD: Specialist SHSs	GUMCAD: Non-specialist SHSs [note 10]	CTAD [note 11]	Total
East Midlands	14,758	8,212	5,029	27,999
East of England	18,062	4,855	7,409	30,326
London	87,279	12,689	28,444	128,412
North East	11,007	2,045	2,743	15,795
North West	35,993	4,742	11,742	52,477
South East	31,875	2,495	11,671	46,041
South West	17,956	3,944	6,017	27,917
West Midlands	20,031	4,588	5,183	29,802
Yorkshire and Humber	21,991	2,478	7,895	32,364

Data sources: GUMCAD, CTAD

 Note 10: diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘non-specialist sexual health services (SHSs)’ total.

Note 11: including site type 12 chlamydia from GUMCAD.

Table 4 shows the number of diagnoses of new STIs in 2023 by UKHSA region of residence, data source, and data subset. It shows that the highest number of new STIs were diagnosed in London residents (128, 412), and the lowest in North East residents (15, 795). The majority of new STIs were diagnosed in specialist sexual health services.

Table 5. Number of diagnoses of the 5 main STIs in the North West by STI, data source and data subset 2023

5 main STIs	GUMCAD: Specialist SHSs	GUMCAD: Non-specialist SHSs [note 10]	CTAD [note 11]	Total
Chlamydia	12,979	3,332	11,742	28,053
Genital herpes	3,343	40		3,383
Genital warts	3,073	36		3,109
Gonorrhoea	8,622	1,288		9,910
Syphilis	941	20		961

Data sources: GUMCAD, CTAD

Note 10: diagnoses from enhanced GPs reporting to GUMCAD are included in the ‘non-specialist sexual health services (SHSs)’ total.

Note 11: including site type 12 chlamydia from GUMCAD.

Table 5 shows the number of diagnoses of chlamydia, genital herpes, genital warts, syphilis, and gonorrhoea in 2023 in the North West by data source and data subset. It shows that the majority of new STIs are diagnosed in specialist specialist sexual health services.

Figure 18. Consultations by service medium: North West residents, 2019 to 2023

Data source: GUMCAD

Figure 18 is a bar chart showing consultations in the North West by service medium (face-to-face, online or telephone) from 2019 to 2023. It shows that there was a large reduction in face-to-face consultations in 2020 and 2021 during the COVID-19 pandemic followed by a gradual increase in 2022 and 2023. However, the number of face-to-face consultations in 2023 remains lower than in 2019 before the pandemic. In contrast, online consultations increased between 2020 and 2022 and remained stable in 2023, while telephone consultations declined between 2021 and 2023. Both the number of online and telephone consultations in 2023 are higher than in 2019 but overall consultations in 2023 remain lower than in 2019. The change in medium is the result of increased access to online and telephone consultations since the COVID-19 pandemic.

Information on data sources

Find more information on local sexual health data sources in the UKHSA guide.

This report is based on data from the GUMCAD and CTAD surveillance systems published on 6 June 2024 (data to the end of calendar year 2023).

GUMCAD surveillance system

This disaggregated reporting system collects information about attendances and diagnoses at specialist (Level 3) and non-specialist (Level 2) sexual health services. Information about the patient’s area of residence is collected along with demographic data and other variables. GUMCAD superseded the earlier KC60 system and can provide data from 2009 onwards. GUMCAD is the main source of data for this report.

Due to limits on how much personally identifiable information sexual health clinics are able to share, it is not possible to deduplicate between different clinics. There is a possibility that some patients may be counted more than once if they are diagnosed with the same infection (for infection specific analyses) or a new STI of any type (for new STI analyses) at different clinics during the same calendar year.

CTAD surveillance system

CTAD collects data on all NHS and local authority, or NHS-commissioned chlamydia testing carried out in England. CTAD is comprised of all chlamydia (NAATs) tests for all ages (with the exception of conjunctival samples), from all venues and for all reasons. CTAD enables unified, comprehensive reporting of all chlamydia data, to effectively monitor the impact of the NCSP through estimation of the coverage of population screening, proportion of all tests that are positive and detection rates.

For services which report to GUMCAD and for which CTAD does not receive data on the patient’s area of residence (for example, SHSs), information about chlamydia diagnoses is sourced from GUMCAD data.

CTAD does not collect information about sexual orientation or country of birth. Reports from CTAD are excluded from figures in this report which relate to analyses by sexual orientation or world region of birth.

New STIs

New STI diagnoses comprise diagnoses of the following:

• chancroid
• lymphogranuloma venereum (LGV)
• donovanosis
• chlamydia
• gonorrhoea
• genital herpes (first episode)
• HIV (acute and AIDS defining)
• Molluscum contagiosum
• non-specific genital infection (NSGI)
• non-specific pelvic inflammatory disease (PID) and epididymitis
• chlamydial PID and epididymitis (presented in chlamydia total)
• gonococcal PID and epididymitis (presented in gonorrhoea total)
• scabies
• pediculosis pubis
• syphilis (primary, secondary, and early latent)
• trichomoniasis and genital warts (first episode)
• Mycoplasma genitalium
• Shigella

Calculations

Confidence intervals were calculated using Byar’s method.

Office for National Statistics (ONS) mid-year population estimates for 2022 were used as a denominator for rates (other than by ethnic group) for 2023. ONS estimates of population by ethnic group for the year 2019 were used as a denominator for rates by ethnic group for 2023. This is the first time that new estimates of population by ethnic group have been available since 2011. This must be considered if comparing rates for 2023 in this report with rates by 2022 in last year’s report, as the rates in the last report used the 2011 estimates.

Further information

As of 2020, all analyses for this report include data from non-specialist (Level 2) SHSs and enhanced GP services as well as specialist (Level 3) SHSs.

For further information, access the online Sexual and Reproductive Health Profiles.

For more information on local sexual health data sources, see the UKHSA guide.

Local authorities have access to the Summary Profile of Local Authority Sexual Health (SPLASH) Reports (accessible from the Sexual and Reproductive Health Profiles) and the SPLASH supplement reports via the HIV and STI Data exchange.

For an Annual Epidemiological Spotlight on HIV in the North West, contact FES.northwest@ukhsa.gov.uk

About the Field Service

The Field Service was established in 2018 as a national service comprising geographically dispersed multi-disciplinary teams integrating expertise in Field Epidemiology, Real-time Syndromic Surveillance and Public Health Microbiology to strengthen the surveillance, intelligence, and response functions of UKHSA.

You can contact your local FS team at FES.northwest@ukhsa.gov.uk

Acknowledgements

We would like to thank the following:

• local SHSs for supplying the SHS data
• local laboratories for supplying the CTAD data
• UKHSA Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division for collection, analysis, and distribution of data

References

1. UK Health Security Agency. ‘English National Chlamydia Screening Programme (eighth edition)