Objectives Despite being the largest ethnic minority group in England, South Asians have historically had low levels of utilisation of sexual health services (SHS) and sexually transmitted infection (STI) diagnoses, although recent data suggests this may be changing. This study aimed to investigate factors associated with a bacterial STI diagnosis among South Asians attending SHS in England.
Methods Using data from the GUMCAD STI Surveillance system, a descriptive analysis of South Asians attending SHS in England in 2019 was carried out. Factors associated with a bacterial STI diagnosis were examined using univariate and multivariable logistic regression models adjusted for age, Asian ethnic subgroup, HIV status, patient’s region of residence and Index of Multiple Deprivation quintile. Analyses were stratified by gender and sexual orientation (heterosexual male versus gay, bisexual and other men who have sex with men (GBMSM) versus women of any sexual orientation). Crude and adjusted associations were derived using binary logistic regression.
Results There were 121 842 attendances by South Asians to SHS in England in 2019. Compared with heterosexual South Asian men, GBMSM had a higher odds of being diagnosed with a bacterial STI (adjusted odds ratio (aOR) 2.32, 95% CI 2.19 to 2.44) and South Asian women had a lower odds (aOR 0.83, 95% CI 0.78 to 0.87). For women and heterosexual South Asian men, a diagnosis was associated with younger age, being of any other Asian background other than Bangladeshi, Indian or Pakistani and not being HIV positive. For heterosexual South Asian men, there was an association with increasing socioeconomic deprivation. For GBMSM, a bacterial STI diagnosis was associated with known HIV-positive status and living in London.
Conclusion People of South Asian ethnicity in England are heterogeneous with regard to their sexual health needs, which should be explored further through focused research and policy.
- Ethnic Groups
- SEXUAL HEALTH
Data availability statement
Data are available upon reasonable request. Data used is from GUMCAD which is publically accessible. Data from this analysis is included in the paper and supplemental material. Data from the sensitivity analysis can be requested.
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Handling editor Jane S Hocking
Twitter @crageshri, @juliavbailey
Contributors RD and HM are responsible for the overall content as guarantors. RD designed the study, carried out the analyses and drafted and revised the manuscript. AS reviewed the study design, supported running the analyses, advised on their interpretation and reviewed the manuscript. JB reviewed the study design, advised on data interpretation and reviewed the manuscript. HM designed the study, supervised the research and drafted and revised the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests RD has received educational grants from the British HIV Association and speaking honoraria from Gilead Sciences and ViiV Healthcare. AS, JB and HM report no competing interests.
Provenance and peer review Not commissioned; externally peer reviewed.
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