Sexual and Reproductive Health

The impact of COVID-19

There have been dramatic changes in how sexual and reproductive health services have been delivered due to the COVID-19 response. Partners across the sector have worked, and are continuing to work hard, to understand the impact of these changes to inform recovery and renewal plans.

The impact of COVID-19 restrictions, including attendances at sexual health clinics and wider health services in relation to sexual health, is reflected in the figures for 2020 below where stated, though new figures for 2021, generally show an upturn in relation to accessibility of services and diagnosis (3). We know that the pandemic necessitated and accelerated the use of phone and video consultations and the increase in postal kits for sexually transmitted infection (STI) testing. We also recognise how important face to face services are in order to facilitate identification of issues such as reinforcing behavioural messages, and reducing health inequalities for people who do not have access to digital services:

Local data relating to sexual health in Cheshire West and Chester

• There has been a gradual increase in the number of women using Long Acting Reversible Contraception (LARC) since 2015. In 2019 62.6 women per 1000 were using LARC, trending above the North West and England average. However, the impact of COVID-19 meant that in 2020 this had dropped to 39 per 1000
• The rate of new Sexually Transmitted Infection (STIs) diagnoses (excluding chlamydia in 15- to 24-year-olds, for which there is a national screening programme) has fluctuated, reaching a peak in 2018. There was a significant reduction in 2020, most likely caused by the impact of the pandemic. However, data for 2021 shows STIs to be on the rise, at 300 per 100,000 in Cheshire West and Chester, though still below the North West (322 per 100,000) and England (394 per 100,000)
• The most common sexually transmitted infections diagnosed in Cheshire West and Chester are chlamydia and gonorrhoea, though the number of gonorrhoea infections in Cheshire West and Chester (41 per 100,000) is still significantly lower than the North West (67 per 100,000) and England averages (90 per 100,000).
• The chlamydia diagnostic rate in Cheshire West and Chester has seen an increase in 2021 to 293 per 100,000, above the North West rate of 265 per 100,000 and England 282 per 100,000. This is the same as the pre pandemic 2019 rate for Cheshire West and Chester.
• The number of those aged 15-24 screened for chlamydia in 2021 is 17,6 percent, above the 2019 figure and above the 2021 rates for the North West and England.

• The prevalence of HIV (Human Immunodeficiency Virus) has remained similar over the past five years with the most recent diagnosed prevalence rate at 1.28 per 1,000 aged 15-59 years in 2021. This meets the national target of less than two per 1,000.
• Of those who do receive a diagnosis of HIV in Cheshire West and Chester (2019-2021) 50 percent are diagnosed at a late stage of infection which is higher than England (43.4 percent).

• Since 1998, national and local conception rates in females aged under 18 have reduced. The latest data (2020) records a rate of 12.7 conceptions per 1,000 females under the age of 18.
• Emergency Hormonal Contraception is available free of charge to all women from accredited Pharmacists in Cheshire West and Chester. Between April 2016 and March 2017 2,995 consultations were carried out, of which 53 per cent were with women aged under 25.

Our vision

To improve the sexual and reproductive health and wellbeing of people living in Cheshire West and Chester by adopting a whole system approach and continually improving education, prevention, testing, treatment and support services.

Our aim

Our aim is for Cheshire West and Chester to be a place where everyone can lead a healthy and fulfilling life. We want our residents to know that their borough is a place where people can make positive and informed choices that result in sexually fulfilled lives, are treated with dignity and respect in a manner that is non-judgemental to ensure they get the help, support and information they need.