Back to top ^^

• Following the introduction of the National Chlamydia Screening Programme, 18% of young people (15-24 years) in London were tested in 2008/09. This exceeds the England average of 16% and the target of 17% set by the Department of Health. However, screening rates varied between London PCTs, ranging from 7% in Westminster to 36% in Lambeth.⁵
• The percentage of people offered an appointment at a London GUM clinic within 48 hours has increased steadily from 69% in 2005 to 99.9% in 2009 (data to September). The percentage of patients seen within 48 hours was 89% in 2009.^2,6 Maintaining and improving on performance remains a priority for PCTs with targets of 100% of patients to be offered an appointment within 48 hours and 95% to be seen within 48 hours.
• There has been an increase in uptake of HIV testing among people attending GUM clinics in London, from 67% in 2003 to 81% in 2008.³ Rates were high regardless of sex and sexual orientation. These figures exceed targets set by the National strategy for sexual health and HIV.²

• There were 127,651 babies born in London in 2008. The Total Fertility Rate in 2008 gives an average of 1.95 children per woman in London, which is marginally lower than England’s rate of 1.97 children per woman.⁷
• London has a high rate of teenage pregnancy. In 2008, there were over 5,500 conceptions in females aged under 18 in London. The rate was 45 teenage conceptions per 1000 females (aged 15-17), which was higher than the England average of 40. However, there is wide variation between London boroughs, with teenage pregnancy rates ranging from 23 per 1,000 females (aged 15-17) in Harrow to 72 per 1,000 in Lambeth in 2008. The percentage of teenage pregnancies in London leading to abortion in 2008 was 61%.⁸
• London’s high level of abortions reveals a need to ensure that access to contraception is maximised.² In 2008, the age-standardised abortion rate in London was 27 per 1,000 women (aged 15-44), representing 48,679 legal abortions. London’s rate was higher than England’s, which was 18 abortions per 1,000 women.⁹

• Some risky sexual behaviours, such as having multiple sexual partners and unprotected sex, are more common in London compared to other regions of Britain. The average number of heterosexual sex partners in the previous five years was higher in both men (4.5 partners) and women (2.7 partners) in London than elsewhere in Britain (3.7 and 2.3 partners respectively). The proportion of men who had a homosexual partner in the previous five years was also higher in London (5.5%) compared with the rest of Britain (2.1%). These findings are from the National Survey of Sexual Attitudes and Lifestyles (NATSAL), which was last undertaken in 2000, and may not reflect current attitudes and behaviours.¹⁰
• NATSAL national results show that Black Caribbean and Black African men report the highest number of lifetime sexual partners of all ethnic groups. Just over a quarter and a third respectively had concurrent partners.¹⁰ Although London data are not available at an ethnic group level, the capital has a larger black minority ethnic population than the rest of England.
• According to the Bass Line Survey 2008/09¹¹, one in eight Africans in London are known to be HIV positive and almost two in five have never been tested. About one third of Africans reported having more than one sexual intercourse partner in the previous year and almost one in five said they never used a condom.
• In 2007, 21% of London’s gay men had never had an HIV test. In the previous year, 28% of gay men had unprotected anal sex with a partner who was serodiscordant or of unknown HIV status. In response to the statement “I would sometimes rather risk HIV transmission than use a condom,” 12% of gay men either agreed or strongly agreed.¹²

Targets for chlamydia screening coverage, Genitourinary Medicine (GUM) waiting times, reducing gonorrhoea and reducing teenage conceptions are specified in the public health white paper Choosing health and Delivering choosing health. Public Service Agreements include: reduction in the under-18 conception rate by 50% by 2010, 100% of patients attending genitourinary medicine clinics to be offered an appointment within 48 hours by 2008, a decrease in rates of new diagnoses of gonorrhoea by 2008 and increase in the percentage of people aged 15 to 24 accepting chlamydia screening.

The Social Exclusion Unit’s report on Teenage pregnancy outlines the government’s strategy to better support teenage parents and their families, including a national campaign, coordinated action between organisations and better prevention.

The National chlamydia screening programme was established in 2003 to control and prevent chlamydia among young people under 25, the highest risk group for infection in England.

The NHS in London have developed and updated the London Sexual Health Strategic Framework (2009) which sets out 5 standards to improve sexual health in London. This Framework was endorsed by PCT Chief Executives and is included in NHS London's Operating Framework to guide PCTs' Strategic Commissioning Plans for 2010-11. The standards include commissioning to improve sexual health outcomes with performance indicators, such as reducing late diagnosis of HIV in order to prevent onward transmission and to reduce mortality and morbidity linked with late diagnosis. You can access the Framework and other London guidance on the London Sexual Health Programme website.

• British HIV Association
• Brook Advisory Centres
• Department of Health
• East Midlands Public Health Observatory (EMPHO)
• Health Protection Agency (HPA)
• Sigma Research
• South West Public Health Observatory (SWPHO)
• Terrence Higgins Trust