Parts of Tupsley, South Wye, Hereford City Centre and Leominster have the highest rates of Chlamydia detection in Herefordshire, but the overall trend is down, but lockdown may have something to do with that!
Overall, the number of new sexually transmitted infections (STIs) diagnosed among residents of Herefordshire in 2021 was 529.
The rate was 273 per 100,000 residents, lower than the rate of 551 per 100,000 in England, and lower than the average of 335 per 100,000 among its nearest neighbours.
Herefordshire ranked 139th highest out of 150 upper tier local authorities (UTLAs) and unitary authorities (UAs) for new STI diagnoses excluding chlamydia in those aged under 25 in 2021, with a rate of 184 per 100,000 residents, better than the rate of 394 per 100,000 for England.
The chlamydia detection rate per 100,000 young people aged 15 to 24 years in Herefordshire was 955 in 2021, worse than the rate of 1,334 for England.
The rank for gonorrhoea diagnoses (which can be used as an indicator of local burden of STIs in general) in Herefordshire was 145th highest (out of 150 UTLAs/UAs) in 2021. The rate per 100,000 was 16.0, better than the rate of 90.3 in England.
As a response to the COVID-19 pandemic, in March 2020 the Government implemented national and regional lockdowns and social and physical distancing measures. These measures affected sexual behaviour and health service provision, which is reflected in sexual and reproductive health indicator data. Interpreting data from 2020 onwards should consider this reconfiguration, especially when comparing with data from pre-pandemic years.
In June 2021, the National Chlamydia Screening Programme (NCSP) changed to focus on reducing the harms from untreated chlamydia infection.6 These harms occur predominantly in young women and other people with a womb or ovaries – this includes transgender men, non-binary people assigned female at birth, and intersex people with a womb or ovaries. Therefore, opportunistic screening should focus on these groups, combined with reducing time to test results and treatment, strengthening partner notification and re-testing after treatment.
In practice this means that chlamydia screening in community settings (e.g. GP and Community Pharmacy) will only be proactively offered to young women and other people with a womb or ovaries. Services provided by sexual health services remain unchanged and everyone can still get tested if needed.
Given the change in programme aim, the Public Health Outcome Framework (PHOF) Detection Rate Indicator (DRI) benchmarking thresholds have been revised and will be measured against females only. A new female-only PHOF benchmark DRI will be included in the PHOF from January 2022 (to be reported in 2023).
This report covers 2021 data and benchmarks against the rate for England. Since chlamydia is most often asymptomatic, a high detection rate reflects success at identifying infections that, if left untreated, may lead to serious reproductive health consequences.
The chlamydia detection rate in 15 to 24 year olds in 2021 in Herefordshire was 955 per 100,000 population (171 positives out of 2,421 screened), lower than the 2,300 target. 13.5% of 15 to 24 year olds were tested for chlamydia, compared to 14.8% nationally. The detection rate per 100,000 and its rank among CIPFA nearest neighbours and England are shown in Table 3.
Chlamydia detection rate per 100,000 population and percentage screened in 15 to 24 year olds in Herefordshire and England: 2021
| 2020 | 2021 | % change 2020 to 2021* | Rank among 16 similar UTLAs/UAs†| Rank within England: 2021‡ | Value for England: 2021 | |
|---|---|---|---|---|---|---|
| Detection rate | ||||||
| Total | 1,184.5 | 955.4 | -19.3% | 8 | 120 | 1,334.2 |
| Women | 1,618.4 | 1,310.7 | -19.0% | 8 | 117 | 1,762.5 |
| Men | 734.3 | 591.8 | -19.4% | 9 | 115 | 859.8 |
| Percentage screened | ||||||
| People aged 15-24 | 13.3 | 13.5 | 2.0% | 7 | 83 | 1 |
In 2021 the rate of STI testing (excluding chlamydia in under 25 year individuals) in SHS in Herefordshire was 2,391 per 100,000, a 12% increase compared to 2020. This is lower than the rate of 3,422 per 100,000 in England in 2021. The positivity rate in Herefordshire was 3.0% in 2021, lower than 6.1% in England. Positivity rates depend both on the number of diagnoses and the offer of testing: higher positivity rates compared with previous years can represent increased burden of infection, decreases in the number of tests, or both.
Full report – SPLASH Herefordshire 2023-02-01 (phe.org.uk)
