Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a cross-sectional, self-administered questionnaire study.

Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a cross-sectional, self-administered questionnaire study.
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Coyle RM, Miltz AR, Lampe FC, Sewell J, Phillips AN, Speakman A, Dhar J, Sherr L, Sadiq ST, Taylor S, Ivens DR, Collins S, Elford J, Anderson J, Rodger A, ,


Coyle RM, Miltz AR, Lampe FC, Sewell J, Phillips AN, Speakman A, Dhar J, Sherr L, Sadiq ST, Taylor S, Ivens DR, Collins S, Elford J, Anderson J, Rodger A, , (click to view)

Coyle RM, Miltz AR, Lampe FC, Sewell J, Phillips AN, Speakman A, Dhar J, Sherr L, Sadiq ST, Taylor S, Ivens DR, Collins S, Elford J, Anderson J, Rodger A, ,

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Sexually transmitted infections 2018 03 08() pii sextrans-2017-053308
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 1145 men (n=470) and women (n=676). 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.

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