Context

In 2015 there were approximately 435,000 new diagnoses of sexually transmitted infections (STIs) in England. Most were among heterosexual people under 25 and men who have sex with men (Sexually transmitted infections and chlamydia screening in England: 2015 Public Health England). In the UK as a whole, 6,095 people were diagnosed with HIV in 2015 (National HIV surveillance data tables Public Health England). Over half of these were men who have sex with men (3,320). In the heterosexual population a disproportionate number of diagnoses were among black Africans.

Condoms can protect against many STIs including HIV, chlamydia and gonorrhoea. They offer less protection against STIs transmitted by skin-to-skin contact, such as genital herpes and warts. In the UK in 2011, the cost of treating STIs (excluding HIV) was estimated at £620 million (Unprotected nation Family Planning Association).

Cost can be a major barrier to condom use, particularly for poorer people (Barriers to condom use Sakar 2008). Social norms and religious and cultural beliefs can also prevent people from using them because of stigma or embarrassment.

Current practice

Some condom schemes only provide free or cost-price condoms. Others combine this with information or support. The C‑Card scheme is probably the most widespread UK scheme. Local authorities commission these and define who is eligible. Typically they focus on people aged 13 to 24 (see C-Card condom distribution schemes).

Policy and commissioning

This guideline will help local authorities and the NHS reduce STIs, a key objective in A framework for sexual health improvement in England (Department of Health).

Local authorities are responsible for commissioning and delivering all community and pharmacy contraceptive services. See Making it work: a guide to whole system commissioning for sexual health, reproductive health and HIV (Public Health England). NHS England commissions contraception schemes provided as an additional service under the GP contract, and sexual health services in prisons.

More information

You can also see this guideline in the NICE Pathway on preventing sexually transmitted infections and under-18 conceptions.

To find out what NICE has said on topics related to this guideline, see our web pages on HIV and AIDS, sexually transmitted infections, contraception and sexual health: general and other.

See also the evidence reviews and information about how the guideline was developed, including details of the committee.

  • Public Health England
  • National Institute for Health and Care Excellence (NICE)