Chlamydia

Healthy Lives
Protective Measures
Chlamydia
Childrens Social Emotional and Mental Health
Parental Support
Oral Health
Poverty
Healthy People
Cultural Sensitivity
Access to Services

introduction Introduction

Chlamydia is a sexually transmitted infection (STI) and is one of the most common STIs in the UK. Is it most common in sexually active teenagers and young adults under the age of 25.

Chlamydia is a bacterial infection and is mostly passed on through unprotected sex (sex without a condom). This includes:

  • Unprotected vaginal, anal or oral sex
  • Sharing sex toys that are not washed or covered with a new condom each time they’re used
  • Genitals coming into contact with a partner’s genitals – this means chlamydia can be passed on from someone even if there’s no penetration, orgasm or ejaculation
  • Infected semen or vaginal fluid getting into eye’s

Most individuals with a chlamydia infection do not have any symptoms and therefore do not know they have it. When symptoms are experienced, they can include pain when urinating, unusual discharge and painful pelvis or testicles as well as other symptoms.1

It is recommended that all sexually active individuals take a full STI test, which includes a chlamydia test, once a year and on change of a partner. A Chlamydia test is taken using a swab of the potentially infected area or a urine test. In most cases this can be done by the individual rather than a nurse or a doctor. Chlamydia testing for those under 25 is free from various in person and online (sent in the post) venues for free in the UK.

Although most often chlamydia does not present any symptoms, there are long term health effects that can occur from a chlamydia infection. These mostly affect females and those with a cervix. These include:

  • Pelvic inflammatory disease (PID)
  • Ectopic Pregnancy
  • Infertility

why is it important to population health Why is it important to Population Health?

Women and those with a cervix are the most affected group who receive the most long term harms from a chlamydia infection if this is not treated quickly. Chlamydia infections can lead to Pelvic inflammatory Disease (PID) which can cause infertility.

Chlamydia infections are most common in sexually active teenagers and young adults under the age of 25. As well as young people, more chlamydia diagnosis are seen in those living in the most deprived areas of the UK than the least deprived.

Chlamydia infections are treated with antibiotics. There is an increasing global concern around antimicrobial resistance (AMR).

AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread and severe illness. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others. Antimicrobial resistance (AMR) threatens the effective prevention and treatment of chlamydia and other infections.

Therefore prevention such as condoms and education is an important step to reduce harms from chlamydia infections.

the derbyshire population approach The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of chlamydia within The Derbyshire Population Health Approach:

• Prevention Prevention

Preventative strategies include:

Universal education on STIs

Learning about chlamydia is covered in mandatory relationships and sex education. By the end of secondary school pupils should know:

  • The facts about reproductive health, including fertility, and the potential impact of lifestyle on fertility for men and women and menopause.
  • The facts about the full range of contraceptive choices, efficacy and options available.
  • How the different sexually transmitted infections (STIs), including HIV/AIDs, are transmitted, how risk can be reduced through safer sex (including through condom use) and the importance of and facts about testing.
  • About the prevalence of some STIs, the impact they can have on those who contract them and key facts about treatment.
  • How to get further advice, including how and where to access confidential sexual and reproductive health advice and treatment.

Condom use

Using condoms reduces the risk of acquiring sexually transmitted infections like chlamydia. Condoms are provided for free by the NHS. Those under 25 and living in Derby and Derbyshire can sign up to C-Scheme which is provided by the integrated sexual health service. The scheme gives those eligible, access to a choice of free condoms in different sizes and flavors as well as dental dams and lube. Condoms provided for free as part of C-Scheme are shared with young people requesting them through venues across the county and city including community groups, health centers, charitable organisations and schools.2

The integrated sexual health service also provides free condoms by post to anyone aged 13+. Those aged 13 – 15 require a confidential conversation with a sexual health promotion practitioner prior to processing order for condoms. Condoms can be requested online and be sent out to a postal address in Derby and Derbyshire.

Similarly to C-scheme, those aged 25+ can request C-Wallets which are provided by the integrated sexual health service for free. These can be requested by anyone not eligible for C-Scheme through venues across the county and city including community groups, health centers, charitable organisations and workplaces.

Promotion of regular chlamydia screening for those aged 25 and under

The National Chlamydia Screening Programme (NCSP) is focused on reducing harms from chlamydia infection. An opportunistic or proactive offer of chlamydia testing should be provided to young women and those with a cervix, without symptoms, by services that support them including GPs, Pharmacies, community settings and other such as Abortion services. The program aims to treat the initial infections and prevent further infections in partners, by providing test results and treatment quickly. Chlamydia is treated by a course of antibiotics which are provided for free and are available to collect from various venues in person and by post. Those who receive a positive chlamydia diagnosis are encouraged to share the details of their recent sexual partners with their local sexual health service who will advise them to also take a chlamydia test to prevent additional new transmission. This service (partner notification) is confidential.  It is recommended that those who have received a positive diagnosis of chlamydia also retest 3 -6 months after first testing positive because young adults who have previously tested positive for chlamydia are at increased risk of catching it again.3

Chlamydia screening for those with symptoms

Individuals are able to seek support for symptoms related to chlamydia infections for free from sexual health clinics. This will include STI testing and treatment if required.

• Population Population

Although education around Chlamydia and other STIs is universally available in education settings, there is an increasing amount of young people that are not educated through mainstream schools. Also, as stated in the Relationship and Sex Education (RSE) guidance, parents can withdraw their child from aspects of RSE that involves sex education (which would include teaching about STIs) up until three terms before their 16th birthday. Therefore, efforts are made to ensure that targeted educational support is provided to these young people. These include working with community groups, charities, faith groups and organisations that provide support to young people not in mainstream education and providing targeted educational sessions on the topic of STIs. These sessions should be sensitive to different cultural and socio economic contexts.

Access to practical sexual health support such as Chlamydia testing and condoms will vary across the population of young people in Derby and Derbyshire due to various different factors. Therefore the delivery of practical support is shared amongst those supporting young peoples health and wellbeing- offering support in a wide range of settings. These include Public Health nurses in schools, pharmacies, General Practice, peripheral sexual health clinics, voluntary sector organisations, outreach and use of a roaming sexual health service van.

• Evidence Evidence

Barrier Methods

Using barrier methods of contraception that reduce the transmission of STIs from one partner to another such as condoms are effective in preventing chalmydia. In order to ensure these are available and accessible the National Institute for Health and Care Excellence (NICE) recommends that services:

“Provide a range of condom distribution schemes (also known as condom schemes) to meet the needs of different local populations, based on needs assessment, consultation and sexually transmitted infection (STI) rates. Target those most at risk.

Provide condom schemes as part of existing services that are likely to be used by those most at risk. This could include services provided by the voluntary sector (such as advice projects and youth projects), school health services and primary healthcare (including GP surgeries and community pharmacies).”4

Testing

For anyone whose partner is known to be infected, or who has symptoms of chlamydia infection, they are recommended to take a chlamydia test.

Chlamydia infections often have no symptoms yet can cause long term harm to women and those with a cervix if untreated. Therefore the National Chlamydia Screening Programme (NCSP) recommends that all sexually active women under the age of 25 get tested after having sex with a new partner as well as annually.

To ensure that this happens, it is recommended that all sexually active women under the age of 25 accessing a sexual and reproductive health service (including online), any service offering contraception, termination of pregnancy service, GP or pharmacy should be offered a chlamydia test. Local areas should also consider offering appropriate outreach programmes in line with local need.5

Detection Rate

The chlamydia detection rate among under 25 year old females and those with a cervix is a measure of control of chlamydia infection. Identifying (detecting) and treating more infections means individuals will have reduced risk of long term harm.

The UK Health Security Agency (UKHSA) recommends that local authorities should be working towards achieving a detection rate of at least 3,250 per 100,000 female population aged 15 to 24. Modelling suggests that achieving this level of detection is likely to result in a reduction of chlamydia prevalence by 2% in any population.

• Causes Causes

The causes of avoidable harms from chlamydia infections are:

  • Lack of education and awareness of preventative methods and support services
  • Risk taking behaviours such as condomless sex with casual partners
  • Accessibility of sexual health support including concerns around stigma, confidentiality and ease of access due to location

Understanding the behavioural, social, and economic factors contributing to the spread of chlamydia is crucial for developing targeted interventions. This involves addressing stigma around accessing sexual health service for condoms and STI testing, enhancing public awareness of behaviors that increase sexual risk, ensuring accessibility of services that provide sexual health support and normalizing the use of sexual health services generally.

• Collaboration Collaboration

To carry out the interventions based on the evidence for reducing the long term harms from Chlamydia, a whole system approach is needed. Prevention and awareness of sexual risk should be embedded into support provided by those supporting young people including those working in schools, health services and community leaders.

To effectively lead and support actions based on supporting young people’s sexual health, Derbyshire Public Health hosts the Young Person’s Relationship and Sexual Health Partnership. The partnership consists of partners working in Derbyshire and Derby City who support young people to have good sexual health outcomes. The partnership works within local 3 year strategy outlining what actions will be taken to maintain and improve outcomes.

No one organisation is responsible for ensuring chlamydia testing is offered widely and accessibly to those most likely to acquire an infection. Therefore, a collaborative approach is needed between those supporting under 25s sexual health to ensure this is happening effectively. For this specific aim, Derbyshire Public Health lead on a partnership of those organisations that offer opportunistic testing and take action on strategies to improve the uptake of opportunistic test, ensure quick treatment, strengthen partner notification and promote retesting after treatment.


latest derbyshire data Latest Derbyshire Data


Trend Data


Derbyshire Quilt


Prevalence Maps of Derbyshire

The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.