Sexual health: key points

According to the World Health Organisation sexual health is defined as:

‘a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.’

• Rates of teenage pregnancies are at the lowest level in Scotland since reporting began in 1994, with the rate amongst those under 20 reducing from 29.6 per 1000 women in 2018 to 27.7 per 1000 women in 2019. This is a decrease of over 50% since 2007.
• Young women living in areas of highest deprivation had four times higher teenage pregnancy rates that those in the least deprived areas in 2019 (52.6 compared to 11.8 per 1,000 women).
• The proportion of teenage pregnancies resulting in termination rather than delivery has increased steadily over time, with 50.3% resulting in termination. This is the first time that terminations rates amongst those under 20 (13.9 per 1,000) were higher than delivery rates (13.8 per 1,000).
• Genital chlamydia - 17,336 diagnoses were reported to HPS in 2019. This is a 6% increase from 2018.  The majority of diagnoses (57%) were in women. However, amongst men, the highest number of diagnoses were reported in ten years. In 2019, 64% of all diagnoses were in young people aged under 25.
• In 2019, 3,776 diagnoses of gonorrhoea were reported to HPS. This is a 17% increase on the number reported in 2018. This is the largest number reported in a decade.
• In 2019, 369 cases of infectious syphilis cases were reported to HPS, a 20% decrease from 2018. The majority of diagnoses were recorded among men who have sex with men (MSM) (86%).
• In 2019, there were 326 diagnoses of HIV infection newly reported in Scotland. This includes those newly diagnosed and those previously diagnosed but newly reported in Scotland. Of those newly diagnosed (167), 40% were among men who have sex with men (MSM), 37% from heterosexual intercourse, and 16% in people who inject drugs (PWID). The number of first-ever HIV diagnoses has been decreasing steadily with the total in 2019 being the lowest reported in the past 10 years.
• PrEP: During the first two years of NHS PrEP implementation (2018-2019) 3,354 individuals were prescribed PrEP and of those 98% identified as men who have sex with men (MSM).
• The prescribing rate for new insertions of long acting reversible contraception (LARC) (an implant, intra-uterine device (IUD) or intra-uterine system (IUS)) has been significantly impacted by the COVID-19 pandemic across all NHS board areas, decreasing from 54.3 per 1,000 women in 2019/20 to 32.1 per 1,000 women in 2020/21.
• The most recent nationally representative data for Scotland (2010-12) shows, 25% of men and 15% of women in Scotland aged 16-74 years reported that they had had sex with someone of the opposite sex before they were 16 years old. Having multiple sexual partners in the previous year was reported by 15% of men and 9% of women in 2010-12, while 10% of men and 5% of women had sex without a condom with more than one partner in the previous year.
• The most recent nationally representative data for Scotland (2010-12) shows, one in five women (19%) and one in 20 men (4%) aged 16-74 years reported that someone had attempted to have sex with them against their will at least once since the age of 13 years. One in ten women (10%) and one in 50 (2%) men aged 16-74 years had experienced someone having sex with them against their will.
• Between 2000 and 2015, the proportion of adults in Scotland aged 18 years and over saying that sexual relationships between two people of the same sex are always or mostly wrong, declined from 48% to 18%. 

• In 2021 there was 13,758 terminations undertaken in Scotland (13.4 per 1,000 women aged 15 to 44), a slight reduction from 2020 (13,896 terminations; 13.5 per 1,000 women aged 15 to 44).

• While the gap between the rates of termination in the most and the least deprived areas has reversed slightly, the strong association between deprivation and the rate of termination remains in 2021, with rates almost twice as high in women from the most deprived areas in comparison to those from the least deprived areas in Scotland.

Please note: throughout these sections we have adopted terminology used within the relevant data source (e.g. women and men vs females and males).