Article Text
Abstract
Background/introduction Sexually transmitted infection (STI) diagnoses are increasing in men who have sex with men (MSM) in England. While black and minority ethnic (BME) populations bear a disproportionate burden of STIs overall, it is unclear whether this inequality persists among MSM.
Aim(s)/objectives To assess the likelihood of an STI diagnosis among BME MSM relative to other MSM attending genitourinary medicine (GUM) clinics in England.
Methods We included data from the GUM clinic activity dataset (GUMCADv2), the national STI surveillance system in England. All attendances by MSM in 2014 were analysed using univariate and multivariable generalised estimating equations logistic regression. Separate models, adjusted for age, sexual orientation (homosexual/bisexual), residence (London/non-London), area-level deprivation, HIV positivity and history of HIV testing in the past year, were run for each STI.
Results BME men accounted for 5.6% of the 326,820 attendances by MSM in 2014. An STI was diagnosed at 12.5% of attendances by MSM, ranging from 11.1% in Asian non-Indian/Pakistani/Bangladeshi to 17.7% in mixed white and black African MSM. Compared to white British MSM, black Caribbean MSM were most likely to be diagnosed with chlamydia (aOR [95% CI]:1.34 [1.18–1.52]) and rectal gonorrhoea (1.31 [1.08–1.60]), while those of mixed white and black African ethnicity were most likely to be newly diagnosed with HIV (1.90 [1.14–3.17]).
Discussion/conclusion Among MSM attending GUM services, BME MSM are most likely to be diagnosed with bacterial STIs and HIV. Culturally appropriate prevention messages must be developed to address this inequality and reduce the higher burden of STIs among BME MSM.