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Rates of sexually transmitted infections continue to rise

London

Caroline White

Current efforts to curb the spread of sexually transmitted infections in the United Kingdom are failing, the head of the government’s infectious disease surveillance agency has said.

Pat Troop, chief executive of the Health Protection Agency, said that the latest figures, in the agency’s third annual surveillance report on HIV and sexually transmitted infections, present "a grim picture."

"The information contained in this report makes clear that transmission of HIV and [sexually transmitted infections] are not being controlled by current efforts," she stated in her foreword. "More needs to be done at a local and at a national level if we are to prevent these infections," she concluded.

The report, which was published this week, covers returns from UK sexual health clinics in 2004. The figures show that some progress has been made in screening. More than 90% of HIV positive pregnant women were diagnosed before they gave birth. And voluntary HIV testing among gay men at clinics rose to 79%, up from 50% in 2000.

But infection data among gay men were considerably less encouraging. Estimated rates of new HIV infections stood at 3%, while cases of ciprofloxacin resistant gonorrhoea more than doubled from 11% in 2003 to 25%.

New diagnoses of HIV infection among black African people remained high. Most of these infections were acquired overseas, but the number of black and ethnic minority adults who probably became infected in the UK has been rising steadily from around 95 in 2000 to 249 in 2004, says the report.

Chlamydia remained the most commonly diagnosed sexually transmitted infection, increasing by 223% since 1995. Three out of four female diagnoses were in 16 to 24 year olds and over half the male diagnoses were in 20 to 24 year olds.

New diagnoses of gonorrhoea and genital warts were also highest among young adults. More than four out of 10 women diagnosed with gonorrhoea were under 20.

With the exception of chlamydia, genital warts, and herpes, there was considerable geographical variation in infection rates across the UK, particularly for HIV, syphilis, and gonorrhoea.

The number of gonorrhoea diagnoses in England was more than double that in Wales and Scotland, and five times higher than that in Northern Ireland.

Prompt access to treatment continued to be an issue in 2004 with less than half of all sexual health clinic patients being seen within the recommended 48 hours.

Valerie Delpech, a consultant epidemiologist at the agency and one of the report’s authors, pointed out that the latest data did not present the full picture. "We recognise that a lot of sexually transmitted infections are being treated in general practice, but we don’t know how much," she said. "We need to start looking at the burden of disease [here]."

The report, Mapping the Issues: HIV and Other Sexually Transmitted Infections in the United Kingdom 2005, is available at www.hpa.org.uk .