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Editor,—In their cross sectional study of patients attending 11 clinics in London, Low et al1 report the incidence of both gonorrhoea and chlamydial infection to be higher in black Caribbeans and black “other” ethnic groups than in black Africans. Neither the authors nor the writers of the accompanying editorial2 refer to similar findings in black men attending one of the clinics contributing to their study, which we published in 1999.3
We compared black African men with black Caribbean men and found that Caribbean men were less likely to be married (odds ratio (OR) = 0.03) and to have non-regular partners (OR = 0.09) but more likely to be from blue collar (OR = 250) or white collar (OR = 25) class and to be smokers (OR = 50). Caribbeans were more likely to have daily vaginal intercourse (OR = 33), begin intercourse before 16 years of age (OR = 50), and have gonorrhoea and/or chlamydial infection (OR = 12.5).
Among Caribbean men, the risk factors for gonorrhoea were being teenaged (OR = 9.5) and commencing intercourse before 16 years of age (OR = 3.3) and for chlamydial infection having had multiple partners (OR = 10.5).
Our conclusion was that the problem should be addressed by the setting up of more ethnically acceptable clinical services before the appearance of HIV infection.
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