Plans to improve sexual health after sharp rise in Waltham Forest STIs

Concern has been raised after the rate of sexually-transmitted infections was said to have “risen sharply” in Waltham Forest in recent years.

A total of 3,321 new infections (STIs) were diagnosed in the east London borough in 2022, a rate of 1,194 diagnoses per 100,000 residents, according to figures from Waltham Forest Council.

While it is lower than the London average of 1,397 per 100,000, it is significantly higher than the England rate of 694.

The council’s draft sexual and reproductive health strategy, which looks to improve sexual wellbeing in Waltham Forest and the wider northeast over the next five years, was put before the authority’s health scrutiny committee on Tuesday.

It revealed that the rate of residents contracting gonorrhea and syphilis, both of which can lead to serious health issues if they go untreated, had also spiked over the last decade.

In 2022, 903 gonorrhea and 104 syphilis cases were diagnosed, up by 36 per cent and 28 per cent respectively from 2021.

Gay, bisexual and men who have sex with men (GBMSM), alongside black and minority ethnic residents and people aged between 15 and 24, have been “disproportionately” affected, the draft report said.

Black African residents also comprised 38 per cent of HIV diagnoses, with white residents trailing at 29 per cent.

Though there was “no firm answer” to the question why gonorrhea and syphilis were spreading, the council’s corporate director of public health Joe McDonnell said officials were looking into the “driving” factors behind the “sharp rise”.

He suggested changes in safe sex behaviour, especially with regards to men who have sex with men, as well as in “patterns of access” to sexual health services were to blame.

He added that Waltham Forest was not an “outlier,” as government data shows the national rate of gonorrhea diagnoses doubled in 2022.

According to figures from the UK Health Security Agency, the south London borough of Lambeth saw the highest rate of gonorrhea diagnoses in England in 2022, sitting at 1,220 new infections – up by 19 per cent from 2021, and above Waltham Forest by 317 cases.

It also had the highest rate of syphilis infections, followed closely by the borough of Southwark and city of Westminster.

In keeping with Waltham Forest’s sexual health landscape, people who live with HIV numbered around 760, or 4.1 people per 1,000 – higher than the England average of 2.34 but lower than the London average of 5.1.

25 new diagnoses were made in Waltham Forest in 2022. Again, that rate of nine per 100,000 was higher than the rest of England – 6.7 per 100,000 – but lower than the London rate of 15.5.

Out of 124 local authorities, the borough ranked 22nd for the prevalence of the disease.

Health director Joe McDonnell said the service was “quite good” at early detection, but found that one-third of cases could have been diagnosed sooner.

He pointed to a possible lack of awareness from residents about services, which he said the council would try to remedy through improved messaging.

Going forward, the council health service plans to tackle the issues it has identified in the whole of northeast London and “reverse the trend” of STI diagnoses.

As well as in Waltham Forest, officials will work to improve sexual health in Barking and Dagenham, Hackney, Havering, Newham, Redbridge, and Tower Hamlets, where STI rates all increased.

If the strategy is approved, the council will “improve knowledge and choice” around reproductive health measures, with a view to increasing the uptake of contraception such as coils and implants.

Teenage pregnancy rates in Waltham Forest were found to have dropped by two-thirds since 2014, though committee chairwoman Karen Bellamy expressed worry over the repeat uses of abortions.

The borough mayor said terminations were effectively being used as a form of contraception, in some cases, and that young women were “risking their lives” – especially when it involved hospitalisation.

As part of the strategy, the council hopes to reduce the numbers of unplanned and teenage pregnancies, as well as abortions and repeat abortions.

Work would also be carried out to reduce “demographic inequities” where they are known.

The health director said the service was still working to “improve knowledge and awareness” of contraception and had been focusing heavily on prevention.

He added the authority would be looking at how it supports residents after they’ve had an abortion.

Richard Sweden, vice-chair of the committee, suggested hiring a dedicated member of staff for young people to “confide in,” if they were worried they had fallen pregnant or been infected.

The committee recommended the plan emphasised messaging aimed directly at males and not just young girls.

Cllr Bellamy added: “Young men need to be educated as well to have healthy sexual relationships.”

The overall rate of STIs in Waltham Forest was twice as high for men than women: 1,580 per 100,000 versus 766.

Men also accounted for two-thirds of new diagnoses in 2022.

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Sebastian Mann

Local democracy reporter