Sexual and reproductive health

Main Points

• The under 18 conception rate in Herefordshire continues to fall and the 2018 figure was one third of that recorded in 2000 and was similar to the rate for England.
• Under 18 conception rates are generally higher in more deprived areas of Herefordshire.
• The abortion rate for women aged 15 to 44 varied little since 2012 and remains lower than the national figure.
• The under 18 abortion rate rose in 2018 but the figure remains less than half of that recorded in 2013 and is similar to that recorded across England as a whole.
• The 2018 STI diagnosis rate was the second lowest recorded during the last seven years and was lower than the national rate.
• In 2017 the HIV diagnosis rate was the third lowest recorded in the last seven years and was similar to that observed nationally.

Under 18 pregnancy rate continues to fall

Since 2007 the Herefordshire under 18 conception rate has fallen by almost two thirds and the 2017 figure of 13.2 per 1,000 was similar to that observed across England as a whole – Figure 1.

Under 18 conception rates are generally higher in more deprived areas of Herefordshire, particularly north Leominster and South Wye.

Figure 1: Under 18s conception rate, 2000 - 2017.

Under 18 abortions rise for first time since 2013

In 2018 there were 399 women aged between 15 and 44 years who underwent an abortion in Herefordshire which resulted in a crude abortion rate of 13.3 per 1,000 which was similar to the figure recorded in the previous six years – Figure 2. Between 2012 and 2018 the local rate has remained significantly lower that for England as a whole.

In 2018 there were 19 under 18s who underwent an abortion in Herefordshire which was the first rise recorded since 2013. This pattern reflected in the crude abortion rate, although the 2018 figure of 6.4 per 1,000 was less than half that reported in 2013 and was not significantly different from that for England – Figure 2.

Figure 2: Crude abortion rates.

Marginal rise in STI detections

In 2018 there were 865 new diagnoses of sexually transmitted infections (STI) in Herefordshire. This returned a crude diagnosis rate of 453 per 100,000 which is an increase on the 2017 figure although was the second lowest recorded between 2012 and 2018; the local rate was significantly lower than that for England throughout this seven year period. Of all new diagnoses 461 (53%) were for chlamydia, 129 (15%) for, genital warts, 70 (8%) for genital herpes and 48 (6%) for gonorrhoea.

Figure 3: Crude STI diagnosis rate.

In 2018 the detection rate for chlamydia in 15 to 24 year olds in Herefordshire was 1,588 per 100,000 a figure significantly lower than the national rate.

The genital warts diagnostic rate in Herefordshire has fallen since 2012 and the 2018 rate of 67.5 per 100,000 was significantly lower than the national rate.

The genital herpes diagnostic rate in Herefordshire was 36.6 per 100,000 in 2018 was significantly lower than figure for England.

While the national diagnosis rate for gonorrhoea has risen steadily since 20012 the local rate has shown some variability and in 2018 was 25.1 per 100,000 a figure significantly lower than that reported for England.

Incidence of syphilis is on the increase nationally as has the Herefordshire figure since 2015. In 2018 the local rate of 10.5 per 100,000 was almost four times that recorded in 2015, although it was not significantly different from the national figure.

HIV diagnosis rate

Between 2011 and 2017 the rate of new HIV diagnoses in Herefordshire showed some variability with a minimum of 1.9 per 100,000 population recorded in 2013 and a maximum of 9.4 per 100,000 in 2015 – Figure 4. In 2017 the rate was 4.3 per 100,000 which is the third lowest recorded in the last seven years and was not significantly different from the England rate (8.7 per 100,000).

Figure 4: HIV diagnosis rate.