Sex at the MillenniumSexual behaviour in Britain: reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection
Introduction
The epidemiology of sexually transmitted infections (STIs) in populations results from the interaction between biological characteristics of the relevant organisms, the behaviours that transmit them, and the effectiveness of prevention and control interventions.1 In Britain, our understanding of STI epidemiology is largely based on surveillance data obtained from a national network of Genitourinary Medicine (GUM) clinics. Despite the declines in STI incidence in the 1980s, recent increases in the rates of STIs have led to growing concerns regarding deterioration in sexual health in Britain and the need to adopt a strategic, multidisciplinary approach to STI prevention.2 In this paper we examine the cumulative incidence of reported STIs and the prevalence of undiagnosed Chlamydia trachomatis infection in a national probability sample survey of sexual attitudes and lifestyles (Natsal 2000) undertaken in 1999–2001.
Section snippets
Methods
The second National Survey of Sexual Attitudes and Lifestyles (Natsal 2000) is a stratified probability sample survey of 11 161 men and women aged 16–44 years, resident in Great Britain, interviewed between May, 1999, and February, 2001.3 The response rate was 65·4%. Among a range of questions about respondents' sexual lifestyles and attitudes were items about their history of diagnosed STIs (which, when, and where diagnosed). In addition, 5026 respondents at alternative sampled addresses, aged
Results
10·8% of men and 12·6% of women, who had ever had sexual intercourse (vaginal, oral, or anal) reported ever having been diagnosed with at least one of eight major STIs (table 1). Genital warts were the most commonly reported STI, and genital chlamydia the most common bacterial STI among both men and women (table 1). Other commonly diagnosed infections among women included pelvic inflammatory disease (PID), non-specific genital infection (NSGI), and genital herpes. Non-specific urethritis (NSU)
Discussion
Our probability sample survey explores the detailed epidemiology of reported STIs and prevalent undiagnosed C trachomatis infection. Our data indicate that more than one tenth of the population aged 16–44 years have been diagnosed with an STI and that GUM clinics are a popular site for their diagnosis and treatment, particularly among men. The lower prevalence of GUM attendance among women with diagnosed STIs in part reflects health care seeking behaviours and STI screening outside of GUM
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