title: Ethnic variations in sexual behaviour in Great Britain and risk of sexually transmitted infections: a probability survey.
abstract: BACKGROUND
  Ethnic variations in the rate of diagnosed sexually transmitted infections (STIs) have been reported in many developed countries. We used data from the second British National Survey of Sexual Attitudes and Lifestyles (Natsal 2000) to investigate the frequency of high-risk sexual behaviours and adverse sexual health outcomes in five ethnic groups in Great Britain.
  
  
  METHODS
  We did a stratified probability sample survey of 11161 men and women aged 16-44 years, resident in Great Britain, using computer-assisted interviews. Additional sampling enabled us to do more detailed analyses for 949 black Caribbean, black African, Indian, and Pakistani respondents. We used logistic regression to assess reporting of STI diagnoses in the past 5 years, after controlling for demographic and behavioural variables.
  
  
  RESULTS
  We noted striking variations in number of sexual partnerships by ethnic group and between men and women. Reported numbers of sexual partnerships in a lifetime were highest in black Caribbean (median 9 [IQR 4-20]) and black African (9 [3-20]) men, and in white (5 [2-9]) and black Caribbean (4 [2-7]) women. Indian and Pakistani men and women reported fewer sexual partnerships, later first intercourse, and substantially lower prevalence of diagnosed STIs than did other groups. We recorded a significant association between ethnic origin and reported STIs in the past 5 years with increased risk in sexually active black Caribbean (OR 2.74 [95% CI 1.22-6.15]) and black African (2.95 [1.45-5.99]) men compared with white men, and black Caribbean (2.41 [1.35-4.28]) women compared with white women. Odds ratios changed little after controlling for age, number of sexual partnerships, homosexual and overseas partnerships, and condom use at last sexual intercourse.
  
  
  CONCLUSIONS
  Individual sexual behaviour is a key determinant of STI transmission risk, but alone does not explain the varying risk across ethnic groups. Our findings suggest a need for targeted and culturally competent prevention interventions.
authors.affiliation: Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, University College London, London, UK. Kevin.fenton@hpa.org.uk
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Fenton
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.forename: Sally
authors.initials: S
authors.lastname: McManus
authors.forename: Bob
authors.initials: B
authors.lastname: Erens
authors.forename: Kaye
authors.initials: K
authors.lastname: Wellings
authors.forename: Wendy
authors.initials: W
authors.lastname: Macdowall
authors.forename: Christos L
authors.initials: CL
authors.lastname: Byron
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Copas
authors.forename: Kiran
authors.initials: K
authors.lastname: Nanchahal
authors.forename: Julia
authors.initials: J
authors.lastname: Field
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D017691:Caribbean Region / Q000208:ethnology; D003625:Data Collection; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D010154:Pakistan / Q000208:ethnology; D021841:Safe Sex; D012725:Sexual Behavior / Q000208:ethnology*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology*; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology