Sexual Health & Blood-Borne Viruses
Sexual Health
Inequalities in sexual health exist with some people experiencing a higher risk of things such as STIs and unintended pregnancies (Public Health Scotland, 2023). People more likely to be affected include:
- people living in deprived areas
- people with learning disabilities
- people involved in commercial sexual exploitation
- people in prison
- looked-after and accommodated children and young people
- lesbian, gay, bisexual and transgender people
Teenage pregnancies
27.1 teenagers per 1,000 women were pregnant in Scotland (2022). This is an increase since 2021 and was mostly driven by pregnancies in those aged between 17 and 19. While the rate of under 18 pregnancies in Midlothian has been persistently higher than the other 3 local authority areas in Lothian between 2018/20 and 2020/22, the rate has been decreasing during this period.
Note: This includes all pregnancies in women aged under 18. The rate is calculated using the female population aged 15-17 for 3-year periods. For pregnancies in women aged under 16 the female population aged 13-15 is used.
Termination of pregnancy
In Scotland the termination of pregnancy rate increased steadily from 2013 to 2020 with a sharper increase from 2021 to 2024. The rate in Midlothian has consistently been higher than the Scottish rate and has mirrored this upward trend.
10.3 per 1,000 - rate of women aged 15-44 who had a termination in Midlothian who have had one or more previous termination of pregnancy (2024). This is the second highest rate in Scotland.
Sexually Transmitted Infections (STIs)
In Scotland in 2023, there was a 6% increase in gonorrhoea (5,999 diagnoses in total) compared to 2022. The highest rate was reported in NHS Lothian: 38 per 100,000 population (Public Health Scotland, 2024). Data is not available at a Midlothian level.
117 people from Midlothian attended the Healthy Respect+ service in Chalmers Sexual Health Centre in Edinburgh (2022, Healthy Respect+ unpublished data). 38 people lived in Dalkeith, which was almost double the number of people from Penicuik (20).
207 people attended Healthy Respect+ sexual health clinic in Dalkeith for people aged 13-18 (2022). Most people who attended resided in Central or East Midlothian, very few people travelled from West Midlothian.
Snapshot data for August 2023 show:
- 90% of attendees were female
- 68% attended regarding an STI
- 32% attended regarding contraception, of which 14% were for long-acting reversible contraception (Healthy Respect+ unpublished data).
Blood-Borne Viruses
Hepatitis C
160 people were newly identified as Hepatitis C antibody positive in Lothian (2022, Public Health Scotland, 2023).
704 people live in Lothian with chronic HCV (estimated, Public Health Scotland, 2023). The majority of these are likely to have been infected some years ago, but there is evidence of ongoing transmission in Lothian, particularly among people who use drugs.
2,470 people live with treated and untreated chronic Hepatitis C in Lothian (estimated)
HIV
1,694 people aged 15+ years had been diagnosed and were living with HIV in Lothian (2023). NHS Lothian reported the greatest population prevalence with 220.6 per 100,000 population. This compares with an overall prevalence in Scotland of 136.3 per 100,000.
16 people were newly diagnosed with HIV in 2023 (NHS Lothian) (Out of a Scotland total of 126). The number of new cases of HIV infection in Lothian has been falling since 2005. However, the prevalence of people with HIV is increasing due to decreased deaths, antiretroviral therapies and new cases being diagnosed.
Since the HIV PrEP programme began in Scotland in July 2017, NHS Lothian has reported the second highest number and proportion of first-time attendees (29%, 3,289/11,413). Between 1 July and 31 December 2023, the majority of HIV PrEP recipients attended clinics in NHS Lothian (31.4%, 401/1277), NHS Greater Glasgow and Clyde (24.6%, 314/1277) and NHS Grampian(11.7%, 149/1277). The number of individuals in Scotland prescribed HIV prEP for the first time in 2023 – 2024 was 1,277. In total there have been 13,886 individuals prescribed HIV prEP for the first time since the program began.
- Page updated: February 2026