Introduction STI diagnosis rates vary considerably by ethnicity in England and persist after adjusting for confounding factors including deprivation and sexual behaviour. We examine the extent to which partner notification (PN) experiences differ by ethnicity as a possible contributing factor to this health inequality.
Method 3986 patients attending 17ethnically-diverse sexual health clinics in England, between May and September 2016, self-completed an online survey, which included questions onsociodemographics, sexual behaviour, and PN experience. Prior to survey analyses, these data were linked to clinic data on STI diagnosis/es and services received at their clinic visit. Age-adjusted ORs (AORs) were calculated for the 6main ethnic minority groups in England(Black Caribbean, Black African, Asian, Mixed, and White other, and other) relative to White British patients (36% of the sample).
Results Overall, 25% of men and 20% of women reported STI diagnosis/es(past year), but this was higher among those of mixed ethnicity, Black Caribbeans and ‘White others’, (AORs:1.47, 1.40,1.27respectively). Of patients reporting STI diagnoses, 75% said that clinic staff advised them to inform their partners to test for STIs, while 60% of patientsdid actuallynotify all their partners. Reporting of both of these PN measures was higher among Black Caribbeans(AORs:2.05 and 1.92, respectively) and those of mixed ethnicity (AORs:1.92 and 1.59, respectively). Of those who had not informed all their partners, 69% of women and 55% of men reported condomless last sex, with this significantly higher for women (only) of Black Caribbean or mixed ethnicity (AOR:2.52 and 5.81, respectively). Partner numbers were larger for those who had not informed all partners: 40% reported 5+ (past year) vs. 31% of those who had; this did not vary significantly by ethnicity.The 3 mostcommonly reportedreasons for not informing partners were: not having their contact details (66%), embarrassment (57%), and not being concerned about notifying casual/one-off partners (54%).
Conclusion Overall, engagement with PN is relatively high and inequalities in PN experience do not appearto explain disproportionate STI risk in some ethnic groups. However, among those who did not notify all their partners STI risk behaviour was more commonly reported,suggesting efforts toimprove PN should be maintained. The development of strategies for empowering black Caribbean and mixed-ethnicity women to negotiate safer sex and condom use is a priority.
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