It has been six months since we released the findings of our wide-ranging joint report looking at the impact of rising sexually transmitted infections (STIs). In partnership with the British Association for Sexual Health and HIV, The State of the Nation report uncovered widening sexual health inequalities, brutal funding cuts and limited action by government. With an STI diagnosis every 70 seconds in 2018, this is hugely concerning.
The report had a number of recommendations focusing on access to sexual health services, action to address drug-resistant strains, and prioritising steps to tackle inequalities. Underpinning all these was an urgent need for a fully funded and cross-sector national sexual health strategy.
Although the government committed to the national sexual health and reproductive health strategy in October 2019, it has understandably taken a backseat during the COVID-19 pandemic. But as England starts to open up again, we have to face the facts: we needed this strategy before COVID, we need it during, and we will need it after.
STIs haven’t gone anywhere. New challenges face sexual health in these uncertain times but what is apparent is that the need for a national sexual health strategy remains.
STIs have been rising with gonorrhoea and chlamydia increasing by 165% and 249% respectively between 2009 and 2018. In 2018, there were three cases of extensively drug-resistant gonorrhoea.
What’s more, there are clear inequalities with a disproportionate burden of STIs facing some. Recent events have provided further evidence for the long-standing and urgent need to tackle health inequalities and sexual health should be no different.
The need for action is evident in the higher rates of syphilis among men who have sex with men and the higher rates of gonorrhoea experienced by people of black Caribbean ethnicity.
Further to this, current STI surveillance data fails to include trans and non-binary, including gender diverse, people. These inequalities need to be dismantled and the national strategy must include an actionable stance on this.
There has also been a 15% rise in demand for sexual health services between 2014 and 2018. On top of this, funding for sexual health services has been repeatedly cut and the future of public health funding is not clear. Unfortunately, the result is that services are under-resourced and overstretched and so keeping up with this demand, especially as the country emerges from COVID-19 lockdown, is no mean feat.
The stark lack of priority and vision surrounding sexual health does little to help any of these issues. A cross-sector and fully funded strategy is needed to ensure priority, a common vision, action, and accountability. The strategy needs to lay out a clear plan of how to tackle these STI trends, as well as facilitating access to sexual health services and dismantling sexual health inequalities.
Whilst it has been reported that work on the strategy is set to resume, we still have no understanding of the timeline or process for the strategy. We need to see that the government is still committed to this strategy with an outline for when and how it will advance.
We cannot be in the same situation with the nation’s sexual health in six months' time.
