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.’

  • Chlamydia trachomatis: In 2023, there were 13,400 diagnoses of chlamydia in Scotland. 55% of chlamydia diagnoses were observed in women (7,392). The majority (72%) of diagnoses in women were in those aged less than 25 years compared to 48% in men.
  • Gonorrhoea: In 2023, there were 5,999 diagnoses of gonorrhoea in Scotland. This is higher than in 2022 and represents a 6% increase. Most diagnoses were observed in men (64%: 3,843) and are consistently higher than in women across the ten-year period. Most diagnoses (73%) in women were in those aged less than 25 years compared to 39% in men. This trend is consistent with previous years where most gonorrhoea diagnoses are reported in younger women, while in men, diagnoses tend be more prevalent in older age groups
  • Infectious syphilis: 369 diagnoses were reported to HPS in 2019, a 20% decrease from 2018 (455). The majority of diagnoses were recorded among men who have sex with men (MSM) (86%). 
  • Human immunodeficiency virus (HIV): In 2023, a total of 385 reports of HIV diagnoses were recorded in Scotland. This includes 126 first time diagnoses (decreasing from 226 first time diagnoses in 2017). In 2023, 206 of the 385 diagnoses reported (54%) were heterosexually acquired, followed by 103 (27%) among gay, bisexual and other men who have sex with men and 9 (2%) in people who inject drugs.
  • Pre-Exposure Prophylaxis (PrEP): Of the 3,354 individuals prescribed PrEP at least once over the two-year period (2017-2019), almost all were male (99%, 3,317) and, of these, 98% (3,266/3,317) were men who have sex with men (MSM). Those aged 20-29 at their first prescription made up the largest proportion of patients (41%) with almost a third aged 50 or above (28%). Around a quarter (27%: 910 individuals) of those prescribed PrEP, attended sexual health services for the first time, or the first time in the previous decade, indicating that a proportion of non-attending individuals at high risk of sexual acquisition of HIV have engaged with services since its implementation. 
  • The Long Acting Reversible Contraception (LARC) prescribing rate decreased from 51.8 to 48.4 per 1,000 women between 2022/23 and 2023/24. This is lower than rates before the Covid-19 pandemic. The intrauterine system (IUS) replaced the contraceptive implant as the most common type of LARC prescribed with rates of 21.3 per 1,000 women, a fall from 21.9 in 2022/23. The rate for contraceptive implants fell from 23.9 in 2022/23 to 20.5 and the rates for IUD increased from 6.1 to 6.6. The rate for contraceptive injections increased slightly from 23.9 in 2022/23 to 24.1 in 2023/24.
  • Sexual wellbeing: 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. 10% of men and 5% of women had sex without a condom with more than one partner in the previous year.
  • Non-volitional sex: 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.
  • Attitudes towards non-heterosexual relationships: 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%. 

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

Sections on teenage pregnancy and terminations can now be found under Pregnancy, births and maternity.

 

Section updates:

  • This last major update of this section was completed in December 2024.