Sexual and reproductive health statistics for England

‘Sexual and reproductive health’ covers a broad range of health matters, from sexually transmitted infections (STIs) and contraception to relationships and conception. It is an important aspect of the overall health and wellbeing of both individuals and communities.

Poor sexual health can have numerous consequences, including unplanned pregnancies and abortions, as well as the transmission of STIs and HIV.

The most recent sexual health strategy, ‘A Framework for Sexual Health Improvement in England’, was published by the Department of Health in March 2013. It set an ambition to “improve the sexual health of the whole population”. There have been calls from select committees and other stakeholders for the government to produce a new strategy. In October 2019, the Johnson government said that the Department of Health and Social Care was leading work to develop an updated sexual and reproductive health strategy. This had not been published at the time of writing.

Commissioning sexual health services

In England, sexual health services are part of public health. This means that most ‘open access’ services (where people can use any sexual health clinic, in any area) are commissioned by local authorities rather than by the NHS. Responsibility for commissioning more specialised sexual health services, such as HIV treatment and care, is split between NHS England and integrated care systems (ICSs).

In 2023, there were 4.6 million consultations delivered by sexual health services in England. Except for a slight dip in 2020, due to disruption to services during the covid-19 pandemic, the number of consultations has increased steadily over the last decade. The scaling up of online and telephone service provision has contributed to this increase.

Spending on local authority-funded sexual health services in England has reduced in real terms from £776 million in 2013/14, when responsibility for public health was transferred from the NHS to local authorities, to
£547 million in 2022/23.

Sexually transmitted infections (STIs)

Sexually transmitted infections (STIs) are diseases, caused by bacteria, viruses, and parasites, that can be passed from one person to another through condomless sexual contact with an infected partner. Some STIs can also be transmitted to a baby during pregnancy, childbirth and breastfeeding. Other routes of transmission include sharing needles.

The prevention, diagnosis and treatment of STIs is vital to stop their onward transmission and to prevent the development of long-term health problems from undiagnosed and untreated STIs.

The chart below shows trends in the number of sexual health screens – diagnostic tests for chlamydia, gonorrhoea, syphilis or HIV – and new STI diagnoses since 2015. In 2023, 2.4 million sexual health screens were carried out and around 402,000 new STIs were diagnosed.

The pandemic disrupted sexual health screens and diagnoses, meaning there were fewer in 2020 and 2021 than in previous years, although numbers have since recovered.

Data on STI diagnosis indicates that young people; gay, bisexual and other men who have sex with men; and people from Black Caribbean ethnic backgrounds have disproportionately high rates of certain STIs.

The most commonly diagnosed STIs in 2023 were chlamydia (49% of all new STI diagnoses), gonorrhoea (21%), first episode genital herpes (7%) and first episode genital warts (7%).

Over the last 10 years, there has been a decrease in the number of new diagnoses of many STIs, but gonorrhoea and syphilis have increased.

The number of gonorrhoea diagnoses in 2023 was the highest since records began in 1918, while the number of syphilis diagnoses was the highest reported since 1948. There is also concern that gonorrhoea has developed resistance to certain antibiotics, limiting the treatment options available.

HIV

Human immunodeficiency virus (HIV) weakens a person’s immune system and their ability to “fight everyday infections and disease”. HIV does this by destroying certain white blood cells (known as ‘CD4 cells’) that tackle infection.

HIV is treated using antiretroviral medicines (sometimes called antiretroviral therapy – ART). These stop the virus replicating in the body and allow the immune system to repair itself and prevent further damage. While there is currently no cure for HIV, ART is effective and can enable people with HIV to live a long and healthy life.

In January 2019, the government committed to achieving zero new transmissions of HIV in England by 2030 and, in 2021, put in place an action plan setting out how it would achieve this target.

The chart below shows a decline in the number of new cases of HIV diagnosed in England between 2014 and 2021, followed by an increase in 2022.

This increase was largely explained by a rise in cases which were first diagnosed abroad. These infections were likely acquired abroad and therefore do not reflect a rise in transmission in England.

Reproductive health

Reproductive health affects both men and women; the World Health Organization says that it includes “all matters relating to the reproductive system and to its functions and processes”. The British Medical Association, however, notes that the reproductive health of a population is “typically measured by pregnancy related ‘morbidity’ outcomes such as rates of abortion or repeat abortion and teenage pregnancy”.

Conception rates among women of childbearing age in England have declined in recent years, with the data suggesting that the rate in 2021 was the lowest since 2001.

Conception rates among girls under the age of 18 fell year-on-year between 2007 and 2020, before increasingly slightly in 2021.

There were 252,000 legal abortions carried out in England and Wales in 2022, which is the highest number ever recorded. Between 2012 and 2022, abortion rates increased for women of all ages, except for those aged 18 and below.