In-person sexual health appointments are down across Hertfordshire as gonorrhoea and syphilis rates rise.

The number of in-person sexual health appointments in the county halved between 2017/18 and 2022/23 – from 21,867 to 10,742.

Despite a testing dip, the number of people protecting themselves against sexually transmitted infections (STIs) which require long-term management – such as HIV and Hepatitis B – is stable in Hertfordshire.

The data does not cover testing kits ordered online.

In January 2024, the Local Government Association (LGA) warned of an "STI surge" across the country.

The organisation's analysis of Office for Health Improvement and Disparities data found gonorrhoea diagnosis rates had risen in 97 per cent of council areas across England and Wales.

Debbie Laycock, head of policy at HIV and sexual health charity Terrence Higgins Trust, has told the Local Democracy Reporting Service (LDRS) it is "fiercely competitive to get a sexual health appointment" across the country.

She said: "The opportunity to order an STI kit online to do at home is a great one – particularly for those living in rural counties and far away from a sexual health clinic – but it can't come at the expense of face-to-face support for those who need it.

"We urgently need a national strategy to improve the country's sexual health and bolster sexual health services, with a response that works for all areas in England, including rural ones in the East."

A freedom of information request by the LDRS has revealed the number of sexual health testing appointments in Hertfordshire hit 21,867 in the 2017/18 financial year and remained steady into 2018/19 (21,490 appointments) and 2019/20 (20,537).

But appointments plummeted to 4,399 in 2020/21 during the Covid-19 lockdowns before recovering slightly to 10,742 in 2022/23 – less than half the figure from five years before.

There were 10,615 appointments between April 2023 and February 2024.

The number of Hertfordshire patients taking pre-exposure prophylaxis (PrEP) for HIV – available on the NHS in the form of small pills which reduce the risk of contracting HIV by around 99 per cent – stood at 1,604 in 2022/23.

A total 885 Hepatitis B vaccinations were administered in 2018/19, rising by around 63 per cent to 1,445 in the last financial year.

There are no known cures for HIV or Hepatitis B.

"To end new HIV cases in the UK by 2030, we need to be making progress across the board and right across the country," Ms Laycock said.

"A crucial piece of that jigsaw is ensuring local government is properly funded to ensure sexual health services can play their crucial role in ending new HIV cases and finally tackle soaring STI rates."

The Westminster government has said it wants to end new HIV transmissions by 2030.

According to the government's sexual health dashboard, the number of new STI diagnoses in Hertfordshire stood at 330 cases per 100,000 in 2022.

This is down from 443 cases per 100,000 pre-pandemic in 2019 and 498 per 100,000 a decade before in 2012.

HIV diagnosis rates which fell from 7.7 per 100,000 in 2012 to 4.5 per 100,000 in 2019 are back up – to 6.2 per 100,000 in 2022.

Gonorrhoea diagnosis rates rose from 23 per 100,000 in 2012 to 76 per 100,000 in 2019, and remain steady at 73 per 100,000.

Syphilis diagnosis rates rose five-fold from 1.7 per 100,000 in 2012 to 8.2 per 100,000 in 2019, and remain steady at 8.5 per 100,000.

Sexual Health Hertfordshire is run by Central London Community Healthcare NHS Trust in partnership with other organisations, including Hertfordshire County Council.

An NHS Trust spokesperson told the LDRS: "As well as offering in-person STI testing and contraception, we have increased our online offer so that Hertfordshire residents can order self-testing kits, treatment and contraception online.

"The number of at-home STI testing kits ordered online has more than doubled over the last four years, with over 18,500 kits returned between April-December 2023.

"Last year we launched a text message advice line so residents can quickly and easily contact a health advisor for confidential sexual health advice.

"We also added a chatbot to our Sexual Health Hertfordshire website, which all residents can use 24 hours a day to find NHS sexual health information and book appointments.

"We have a partnership with METRO charity to provide community outreach and sexual health promotion to vulnerable groups in Hertfordshire, such as the LGBTQ+ community, young people in education, asylum seekers and people experiencing homelessness.

"We also work with a range of partners, including GPs, pharmacies, universities and colleges to provide dual testing of chlamydia and gonorrhoea in the community.

"We encourage all sexually active people to get regular testing, including for HIV.

"The earlier HIV is detected, the more likely it is that treatment will be successful and the easier it is to prevent passing the infection to someone else."

Hertfordshire County Council has planned a cut to its sexual health services budget in 2024.

Its sexual health services budget in 2023/24 was £9.468m – with this figure set to drop to £9.396m in 2024/25.

According to the LGA, funding for local authorities' sexual health provision has fallen across the country over recent years.

A study by the organisation which supports councils found the government's public health grant had been cut by £880m in real terms since 2015.

LGA community wellbeing board chair Councillor David Fothergill has previously called on the government to "ensure sexual health funding is increased to levels" which match infection rises.

"Councils have been working hard to encourage more people to access sexual health services and get tested more regularly to help improve detection rates and catch infections early," he said in a January statement.

"Investment in sexual health services helps to prevent longer term illness and unwanted pregnancies, reducing pressure on our NHS and improving the health of people across our communities."