You are here

  • Home
  • Archive
  • Volume 94, Issue 5
  • Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a cross-sectional, self-administered questionnaire study

Article Text

Article menu

Download PDFPDF

Behaviour
Original article
Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a cross-sectional, self-administered questionnaire study
  1. Rachel Margaret Coyle1,
  2. Ada Rose Miltz1,
  3. Fiona C Lampe1,
  4. Janey Sewell1,
  5. Andrew N Phillips1,
  6. Andrew Speakman1,
  7. Jyoti Dhar2,
  8. Lorraine Sherr1,
  9. S Tariq Sadiq3,
  10. Stephen Taylor4,
  11. Daniel R Ivens5,
  12. Simon Collins6,
  13. Jonathan Elford7,
  14. Jane Anderson8,
  15. Alison Rodger1
  16. on behalf of the AURAH Study Group
  1. 1 Research Department of Infection and Population Health, University College London, Royal Free Hospital, London, UK
  2. 2 Staffordshire and Stoke on Trent Partnership NHS Trust, Leicester, UK
  3. 3 Institute for Infection and Immunity, St George’s, University of London, London, UK
  4. 4 Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UK
  5. 5 Marlborough Department of Sexual Health, Royal Free Hospital, London, UK
  6. 6 HIV i-Base, London, UK
  7. 7 School of Health Sciences, City University London, London, UK
  8. 8 Centre for the Study of Sexual Health and HIV, Homerton University Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Rachel Margaret Coyle, Research Department of Infection and Population Health, University College London, London NW3 2PF, UK; rachelcoyle{at}nhs.net

Abstract

Objectives In the UK, people of black ethnicity experience a disproportionate burden of HIV and STI. We aimed to assess the association of ethnicity with sexual behaviour and sexual health among women and heterosexual men attending genitourinary medicine (GUM) clinics in England.

Methods The Attitudes to and Understanding of Risk of Acquisition of HIV is a cross-sectional, self-administered questionnaire study of HIV negative people recruited from 20 GUM clinics in England, 2013–2014. Modified Poisson regression with robust SEs was used to calculate adjusted prevalence ratios (aPR) for the association between ethnicity and various sexual risk behaviours, adjusted for age, study region, education and relationship status.

Results Questionnaires were completed by 1146 individuals, 676 women and 470 heterosexual men. Ethnicity was recorded for 1131 (98.8%) participants: 550 (48.6%) black/mixed African, 168 (14.9%) black/mixed Caribbean, 308 (27.2%) white ethnic groups, 105 (9.3%) other ethnicity. Compared with women from white ethnic groups, black/mixed African women were less likely to report condomless sex with a non-regular partner (aPR (95% CI) 0.67 (0.51 to 0.88)), black/mixed African and black/mixed Caribbean women were less likely to report two or more new partners (0.42 (0.32 to 0.55) and 0.44 (0.29 to 0.65), respectively), and black/mixed Caribbean women were more likely to report an STI diagnosis (1.56 (1.00 to 2.42)). Compared with men from white ethnic groups, black/mixed Caribbean men were more likely to report an STI diagnosis (1.91 (1.20 to 3.04)), but did not report risk behaviours more frequently. Men and women of black/mixed Caribbean ethnicity remained more likely to report STI history after adjustment for sexual risk behaviours.

Discussion Risk behaviours were reported less frequently by women of black ethnicity; however, history of STI was more prevalent among black/mixed Caribbean women. In black/mixed Caribbean men, higher STI history was not explained by ethnic variation in reported risk behaviours. The association between STI and black/mixed Caribbean ethnicity remained after adjustment for risk behaviours.

  • ethnic groups
  • sexual behaviour
  • sexual networks
  • sexually transmitted diseases

This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/sextrans-2017-053308

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Handling editor Nicola Low

    • Contributors RMC, FCL and ARM analysed the data and wrote the manuscript. ARM and JW contributed to data handling and analysis. All authors contributed to the interpretation of the results and the final draft of the manuscript.

    • Funding The ASTRA and AURAH studies present independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (CAPRA: RP-PG-0608-10142).

    • Disclaimer The views expressed in this report are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Ethics approval The research protocol and all versions of the study documents were approved by the Health Research Authority Research Ethics Committees (NRES Committee London-Hampstead, ref: 13/LO/0246); all relevant NHS permissions were obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Collaborators The AURAH Study Group: Ada R Miltz, Alison J Rodger, Janey Sewell, Andrew Speakman, Andrew N Phillips, Lorraine Sherr, Richard J Gilson, David Asboe, Nneka C Nwokolo, Amanda Clarke, Mark M Gompels, Sris Allan, Simon Collins, Fiona C Lampe, Christopher Scott, Sara Day, Martin Fisher, Jane Anderson, Rebecca O’Connell, Monica Lascar, Vanessa Apea, Paymaneh Farazmand, Susan Mann, Jyoti Dhar, Daniel R Ivens, Tariq Sadiq, Graham J Hart, Anne M Johnson, Alec Miners, Jonathan Elford, Nicky Perry, Michael Brady. AURAH clinic teams (in addition to study group members): Barking: Rageshri Dhairyawan, Sharmin Obeyesekera; Barts: Vanessa Apea, John Saunders; Birmingham: Stephen Taylor, Gerry Gilleran, Cathy Stretton; Brighton: Martin Fisher, Amanda Clarke, Nicky Perry, Elaney Youssef, Celia Richardson, Louise Kerr, Mark Roche, David Stacey, Sarah Kirk; Bristol: Mark Gompels, Louise Jennings, Caroline Holder, Katie-Anne Baker; Calderdale & Huddersfield: Maneh Farazmand, Matthew Robinson, Emma Street; Coventry: Sris Allan, Abayomi Shomoye; Dean Street: Nneka Nwokolo, Ali Ogilvy; Homerton: Jane Anderson, Sfiso Mguni, Rebecca Clark, Cynthia Sajani, Veronica Espa; John Hunter: David Asboe, Sara Day, Ali Ogilvy, Sarah Ladd; Kings: Susan Mann, Michael Brady, Jonathan Syred, Lisa Hamza, Lucy Campbell, Emily Wandolo, Janagan Alagarajah; Leicester: Jyoti Dhar, Linda Mashonganyika, Sally Batham; Mortimer Market: Richard Gilson, Rita Trombin, Ana Milinkovic, Clare Oakland; Newham: Rebecca O’Connell, Nyasha Makoka; Reading: Alan Tang, Ruth Wilson, Elizabeth Green, Sheila O’Connor, Sarah Kempster, Katie Keating-Fedders; Royal Free: Daniel Ivens, Nicola Tyrrell, Jemima Rogers, Silvia Belmondo, Manjit Sohal; St George’s: Tariq Sadiq, Wendy Majewska, Anne Patterson, Olanike Okolo, David Cox, Mariam Tarik, Charlotte Jackson, Jeanette Honigsbaum, Clare Boggon, Simone Ghosh, Bernard Kelly, Renee Aroney; The London: James Hand, Nyasha Makoka; West London Clinic for Sexual Health: Christopher Scott, Ali Ogilvy; Whipps Cross: Monica Lascar, Nyasha Makoka, Elias Phiri, ZandileMaseko. AURAH (core) Study Group: Alison Rodger, Fiona Lampe, Andrew Phillips, Andrew Speakman. AURAH data managers: Andrew Speakman and Ada Miltz. AURAH study nurse coordinator: Janey Sewell. CAPRA advisory board: Sir Nick Partridge, Kay Orton, Anthony Nardone, Ann Sullivan, Lorraine Sherr, Graham Hart, Simon Collins, Anne Johnson, Alec Miners, Jonathan Elford.

    • Correction notice This paper has been amended since it was published Online First. In table 1, data was transcribed incorrectly in the section ’Age in years', rows 30-39 and 40+. The figure 1 flowchart has also been updated.