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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorAICKEN, Catherine R. H.
dc.contributor.authorWAYAL, Sonali
dc.contributor.authorBLOMQUIST, Paula B.
dc.contributor.authorFABIANE, Stella M.
dc.contributor.authorGERRESSU, Makeda
dc.contributor.authorHUGHES, Gwenda
dc.contributor.authorMERCER, Catherine H.
dc.identifier.citationBMC HEALTH SERVICES RESEARCH, v.19, n.1, article ID 668, 13p, 2019
dc.description.abstractBackground In England, people of Black Caribbean (BC) ethnicity are disproportionately affected by sexually transmitted infections (STI). We examined whether differences in sexual healthcare behaviours contribute to these inequalities. Methods We purposively selected 16 sexual health clinics across England with high proportions of attendees of BC ethnicity. During May-September 2016, attendees at these clinics (of all ethnicities) completed an online survey that collected data on health service use and sexual behaviour. We individually linked these data to routinely-collected surveillance data. We then used multivariable logistic regression to compare reported behaviours among BC and White British/Irish (WBI) attendees (n = 627, n = 1411 respectively) separately for women and men, and to make comparisons by gender within these ethnic groups. Results BC women's sexual health clinic attendances were more commonly related to recent bacterial STI diagnoses, compared to WBI women's attendances (adjusted odds ratio, AOR 3.54, 95% CI 1.45-8.64, p = 0.009; no gender difference among BC attendees), while BC men were more likely than WBI men (and BC women) to report attending because of a partner's symptoms or diagnosis (AOR 1.82, 95% CI 1.14-2.90; AOR BC men compared with BC women: 4.36, 95% CI 1.42-13.34, p = 0.014). Among symptomatic attendees, BC women were less likely than WBI women to report care-seeking elsewhere before attending the sexual health clinic (AOR 0.60, 95% CI 0.38-0.97, p = 0.039). No ethnic differences, or gender differences among BC attendees, were observed in symptom duration, or reporting sex whilst symptomatic. Among those reporting previous diagnoses with or treatment for bacterial STI, no differences were observed in partner notification. Conclusions Differences in STI diagnosis rates observed between BC and WBI ethnic groups were not explained by the few ethnic differences which we identified in sexual healthcare-seeking and use. As changes take place in service delivery, prompt clinic access must be maintained - and indeed facilitated - for those at greatest risk of STI, regardless of ethnicity.eng
dc.description.sponsorshipNational Institute for Health Research Health Protection Research Units (NIHR HPRU) funding programme - NIHR HPRU in Blood Borne and Sexually Transmitted Infections at UCL
dc.description.sponsorshipPublic Health England (PHE)
dc.description.sponsorshipLondon School of Hygiene and Tropical Medicine
dc.relation.ispartofBMC Health Services Research
dc.subjectBlack Caribbeaneng
dc.subjectSexually transmitted infectionseng
dc.subjectHealth inequalitieseng
dc.subjectSexual health clinicseng
dc.subjectHealthcare behavioureng
dc.subjectHealth behavioureng
dc.subject.othergenitourinary medicine clinicseng
dc.subject.othertransmitted infectionseng
dc.subject.otherethnic variationseng
dc.subject.otherrisk behaviorseng
dc.titlePathways to, and use of, sexual healthcare among Black Caribbean sexual health clinic attendees in England: evidence from cross-sectional bio-behavioural surveyseng
dc.rights.holderCopyright BMCeng
dc.subject.wosHealth Care Sciences & Serviceseng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Catherine R. H.:UCL, Ctr Populat Res Sexual Hlth & HIV, Inst Global Hlth, Mortimer Market Ctr, London WC1E 6JB, England; London Sch Hyg & Trop Med, Natl Inst Hlth Res Hlth Protect Res Unit NIHR HPR, PHE, London, England; Univ Brighton, Sch Hlth Sci, Village Way, Brighton BN1 9PH, E Sussex, England, Sonali:UCL, Ctr Populat Res Sexual Hlth & HIV, Inst Global Hlth, Mortimer Market Ctr, London WC1E 6JB, England; London Sch Hyg & Trop Med, Natl Inst Hlth Res Hlth Protect Res Unit NIHR HPR, PHE, London, England, Paula B.:PHE, HIV & STI Dept, Ctr Infect Dis Surveillance & Control, 61 Colindale Ave, London NW9 5EQ, England; London Sch Hyg & Trop Med, Natl Inst Hlth Res Hlth Protect Res Unit NIHR HPR, PHE, London, England, Stella M.:UCL, Ctr Populat Res Sexual Hlth & HIV, Inst Global Hlth, Mortimer Market Ctr, London WC1E 6JB, England; London Sch Hyg & Trop Med, Natl Inst Hlth Res Hlth Protect Res Unit NIHR HPR, PHE, London, England, Makeda:UCL, Ctr Populat Res Sexual Hlth & HIV, Inst Global Hlth, Mortimer Market Ctr, London WC1E 6JB, England, Catherine H.:UCL, Ctr Populat Res Sexual Hlth & HIV, Inst Global Hlth, Mortimer Market Ctr, London WC1E 6JB, England; London Sch Hyg & Trop Med, Natl Inst Hlth Res Hlth Protect Res Unit NIHR HPR, PHE, London, England
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