Ethnic variations in sexual behaviour in Great Britain and risk of sexually transmitted infections: a probability survey

Fenton, Kevin; Mercer, Catherine H; McManus, Sally; Erens, Bob; Wellings, Kaye; Macdowall, Wendy; Byron, Christos L.; Copas, Andrew; Nanchahal, Kiran; Field, Julia; Johnson, Anne M

doi:10.1016/s0140-6736(05)74813-3

Cited by 155 publications

(165 citation statements)

References 26 publications

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“…In the United Kingdom, white, black-African and black-Caribbean women have higher numbers of lifetime sexual partners, lower median age at first heterosexual intercourse and higher incidence of (non-HPV) sexually transmitted infections than women from Indian or Pakistani ethnic groups (Fenton et al, 2005). Although we observed increased infection risk among non-white ethnic groups, relatively few women described themselves thus (n ¼ 223), precluding multivariate analysis of individual groups.…”

Section: Ethnic Groupmentioning

confidence: 65%

“…Human papillomavirus population prevalence mainly depends on patterns of sexual exchange (International Agency for Research on Cancer, 2005), which vary between and within countries, by, for example, birth cohort and ethnic group Fenton et al, 2005). Most available data on HPV prevalence and associated factors are from the United States of America, and/or focus on young women; many series are highly selective and may lack generalisibility.…”

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confidence: 99%

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Lifestyle and socio-demographic factors associated with high-risk HPV infection in UK women

et al. 2007

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The world age-standardised prevalence of high-risk HPV (hrHPV) infection among 5038 UK women aged 20 -59 years, with a lowgrade smear during 1999 -2002, assessed for eligibility for TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) was 34.2%. High-risk HPV prevalence decreased with increasing age, from 61% at ages 20 -24 years to 14 -15% in those over 50 years. The age-standardised prevalence was 15.1, 30.7 and 52.7%, respectively, in women with a current normal, borderline nuclear abnormalities (BNA) and mild smear. In overall multivariate analyses, tertiary education, previous pregnancy and childbirth were associated with reduced hrHPV infection risk. Risk of infection was increased in non-white women, women not married/cohabiting, hormonal contraceptives users and current smokers. In stratified analyses, current smear status and age remained associated with hrHPV infection. Data of this type are relevant to the debate on human papillomavirus (HPV) testing in screening and development of HPV vaccination programmes.

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Section: Ethnic Groupmentioning

confidence: 65%

mentioning

confidence: 99%

Lifestyle and socio-demographic factors associated with high-risk HPV infection in UK women

et al. 2007

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“…Recruitment targets were set for 250 respondents in Luton, 250 in the West Midlands and 1000 in London based on expected HIV prevalence and sexual behaviours known from existing surveys. [5][6][7][8] Fieldwork was conducted between August and December 2004, adopting a purposive opportunistic sampling methodology in community-identified social and commercial venues, including bars, clubs, universities, churches, shops, barbers/ hairdressers and community events. Potential venues were identified and enrolled by a community consultant, local survey co-ordinator, field worker or local survey group.…”

Section: Methodsmentioning

confidence: 99%

Sexual behaviour and HIV infection in black-Africans in England: results from the Mayisha II survey of sexual attitudes and lifestyles

Sadler

McGarrigle²,

Elam³

et al. 2007

Sexually Transmitted Infections

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(48) had a diagnosed HIV infection. HIV prevalence was significantly higher in men: born in East Africa; who had had a previous STI diagnosis; or who were recruited in bars and clubs; and in women: born in East or Southern Africa; aged 25 years and over; who had had two new sexual partners in the past 12 months; or who had had a previous STI diagnosis. Conclusions: Despite about half the sample having had an HIV test at some time in the past, 9.2% of respondents had an undiagnosed HIV infection. This study supports current policy efforts to further promote HIV testing and serostatus awareness. I n the UK, individuals born in sub-Saharan Africa currently bear the brunt of the heterosexual HIV epidemic. An integral part of improving the delivery and quality of evidence-based HIV prevention interventions within the black African community is the ability to monitor levels of high-risk sexual behaviour and to measure its association with diagnosed and undiagnosed HIV infection. 4 In the absence of an ongoing behavioural surveillance programme for black Africans in the UK, ad hoc behavioural surveys including the 1999 Mayisha study 5 6 and the 2nd British National Survey of Sexual Attitudes and Lifestyles (Natsal) conducted in 2000 7 8 have provided recent estimates of risk behaviours and HIV testing in this population. Previous studies have demonstrated the feasibility and acceptability of collecting oral fluid samples in community venues for future HIV testing and linking the results to key sexual behavioural data. [9][10][11] In this study, we aim to estimate HIV prevalence and the distribution of high-risk sexual behaviours, sexual health service use, and HIV testing among black Africans aged 16 years or over living in England; and to determine the Key messages N Mayisha II is one of the largest community recruited samples of black Africans in Britain, and for the first time community sexual health survey and HIV seroprevalence data on Africans resident inside and outside London has been collected N We found evidence of substantial sexual health need: 22% of respondents reported having had a previous STI diagnosis and 47% a previous HIV test N Overall HIV prevalence was 14.0% (141/1006), and of these 66.0% of the infections identified were undiagnosed N Our findings indicate that current efforts to promote HIV testing and awareness of HIV serostatus among black Africans living in the UK should be further strengthened, and culturally competent education programmes promoting risk reduction strategies must continue 523 www.stijournal.com

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“…Not surprisingly, modelled incidence rates in subpopulations where 9 per cent or more of men are in the high-AC are more than 10 times the population average, although we have let the high-and low-activity individuals in these subpopulations have the same partner change rates as those in other subpopulations. Notably, individuals in the low-AC in such subpopulations would have an elevated risk of infection, and this may explain the contextual risk that has been observed based on various sociodemographic factors such as age and ethnicity (Fenton et al 2005), which probably influence subpopulation membership. Figure 6b revisits the Lorenz curves, where gonorrhoea is compared against an STI with a lower transmissibility, and one with higher transmissibility, as well as a parameter set depicting infections with Chlamydia trachomatis.…”

Section: Mp Explanation For Epidemiological Observations About Gonorrmentioning

confidence: 99%

A metapopulation modelling framework for gonorrhoea and other sexually transmitted infections in heterosexual populations

Chen

Ghani

Edmunds

2008

J. R. Soc. Interface.

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Gonorrhoea continues to be a public health problem in the UK, and is the second most common bacterial sexually transmitted infection (STI ) after chlamydia. In the UK, gonorrhoea is disproportionately concentrated in epidemiologically distinct subpopulations, with much higher incidence rates in young people, some ethnic minorities and inner city subpopulations. The original model of STI transmission proposed by Hethcote and Yorke explained some of these features through the concept of the 'core group'. Since then, several authors have modified the original model approach to include multiple sexual activity classes, but found this modelling approach to be inadequate when applied to low-prevalence settings such as the UK. We present a metapopulation framework for modelling gonorrhoea and other STIs. The model proposes that the epidemiology of gonorrhoea is largely driven by subpopulations with higher than average concentrations of individuals with high sexual risk activity. We show how this conceptualization of gonococcal epidemiology overcomes key limitations associated with some of the prior efforts to model gonorrhoea. We also use the model to explain several epidemiological features of gonorrhoea, such as its asymmetric distribution across subpopulations, and the contextual risk experienced by members of at-risk subpopulations. Finally, we extend the model to explain the distribution of other STIs, using chlamydia as an example of a more ubiquitous bacterial STI.

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Ethnic variations in sexual behaviour in Great Britain and risk of sexually transmitted infections: a probability survey

Cited by 155 publications

References 26 publications

Lifestyle and socio-demographic factors associated with high-risk HPV infection in UK women

Lifestyle and socio-demographic factors associated with high-risk HPV infection in UK women

Sexual behaviour and HIV infection in black-Africans in England: results from the Mayisha II survey of sexual attitudes and lifestyles

A metapopulation modelling framework for gonorrhoea and other sexually transmitted infections in heterosexual populations

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