Hospital indicators of poor sexual health

The recent UK white paper on public health^w1 included sexual health as one of the main targets for improvement. Poor sexual health is generally measured in terms of acute infections and unplanned pregnancies, with a focus within the UK on incident infections, and is obtained from returns from genitourinary medicine clinics. With the exception of HIV infection and some cases of hepatitis B, most people with a sexually transmitted infection are not admitted to hospital. However, many of the longer term sequelae (particularly, asymptomatic infections in women and untreated syphilis) may lead to hospital admission. Might these admissions be used as a proxy measure for trends in acute infections? We looked at hospital admissions data for congenital and acquired syphilis, pelvic inflammatory disease, and ectopic pregnancy.