Recent figures released by Public Health England (PHE) show that Brighton has some of the highest rates of sexually transmitted infections (STIs) in the country.
Numbers were particularly high for HIV, gonorrhoea and syphilis, with Brighton recording the highest rates of infection for these diseases outside London.
But why are rates in Brighton so high, and what can we do about it? To find out, I spoke to Stephen Nicholson, Brighton and Hove Council’s Public Health Programme Manager for sexual health and substance misuse.
“Rates of STIs in Brighton are much higher than we would like, particularly for syphilis and gonorrhoea,” Stephen says. “Our rates are more in line with London than other cities around the country.
“Partly its to do with demographics – STI rates are higher among men who have sex with men (MSM), 15-24 year olds and some ethnic minorities. Brighton is home to lots of people who fall into these groups, which tend to be more vulnerable.”
It’s not solely to do with who lives in Brighton though, Stephen tells me; it’s also about how we live.
“Brighton is a party town – there’s lots of opportunities for casual sex and sex with new people and not everyone is able to protect themselves. Perhaps after a night out people don’t have condoms to hand. I think we can all agree that sexual arousal is an intense emotion – we’re not really thinking clearly and rationally in the heat of the moment when we’re about to have sex. In the throes of sex sometimes its hard to think about being prepared and protected.”
“Drugs and alcohol can also affect judgement. As an example, the phenomenon of “chemsex”, sex on drugs, is particularly popular among MSM because certain drugs are disinhibitors and can facilitate more adventurous sex. Also, as another example, students getting drunk in halls, away from home for the first time, might not be in the best frame of mind to be thinking about safe sex. This has an impact on STI rates.”
I ask Stephen if he thinks there’s a perception that STIs are not that serious, which might lead people to be a bit careless.
“I think that’s definitely the case, yes. I speak to some people, and they see getting an STI almost as an occupational hazard. Getting them doesn’t really matter because it’s so easy to get tested and get treatment. It’s true that many STIs are easy to test for and treat now, but this isn’t the whole picture. Many STIs can go undetected and be quite nasty. Some can cause problems around fertility, for example.
“The stigma surrounding STIs has reduced in recent years, which is a really good thing. They’re now seen as a disease like any other, which is how it should be, but that doesn’t mean they’re not worth taking seriously.”
Stephen is keen to emphasize that Brighton has excellent sexual health services, but also mentions that public health budget cuts have made it hard to scale up campaigns to prevent the transmission of STIs in the city.
“We’re lucky because access to sexual health services in Brighton is very good. We have three clinics and a primary care base, and often you can get tested and treated in the same day. The clinics have long opening hours and it’s really easy to book appointments.
“We test a lot of people for STIs in Brighton, far more than the national average, and there is a lot going on in terms of community and voluntary organisations targeting schools and colleges.
“Whilst we’re doing everything we can to educate people and provide them with the resources they need, government public health budget cuts have made things more difficult. The release of the government’s new sexual health strategy has been delayed because of coronavirus, but we’re hoping that when it comes out, we might receive some more weapons and funding that will help us battle the spread of STIs.”
I finish by asking Stephen how often we should all be getting tested for STIs.
“After having sex without a condom or every time after you’ve had sex with a new or casual partner,” he replies. “I’d also advise everyone books themselves in for a sexual health check up at least once a year.”
For more information about STIs and how to access help in Brighton and Hove, visit brightonsexualhealth.com.