Sexually transmitted infection risk exposure among black and minority ethnic youth in northwest London: findings from a study translating a sexually transmitted infection risk-reduction intervention to the UK setting.
OBJECTIVE
Young black women are disproportionately affected by sexually transmitted infections (STI) in the UK, but effective interventions to address this are lacking. The Young Brent Project explored the nature and context of sexual risk-taking in young people to inform the translation of an effective clinic-based STI reduction intervention (Project SAFE) from the USA to the UK.


METHODS
One-to-one in-depth interviews (n = 37) and group discussions (n = 10) were conducted among men and women aged 15-27 years from different ethnic backgrounds recruited from youth and genitourinary medicine clinic settings in Brent, London. The interviews explored the context within which STI-related risks were assessed, experienced and avoided, the skills needed to recognise risk and the barriers to behaviour change.


RESULTS
Concurrent sexual partnerships, mismatched perceptions and expectations, and barriers to condom use contributed to STI risk exposure and difficulties in implementing risk-reduction strategies. Women attempted to achieve monogamy, but experienced complex and fluid sexual relationships. Low risk awareness, flawed partner risk assessments, negative perceptions of condoms and lack of control hindered condom use. Whereas men made conscious decisions, women experienced persuasion, deceit and difficulty in requesting condom use, particularly with older partners.


CONCLUSIONS
Knowledge of STI and condom use skills is not enough to equip young people with the means to reduce STI risk. Interventions with young women need to place greater emphasis on: entering and maintaining healthy relationships; awareness of risks attached to different forms of concurrency and how concurrency arises; skills to redress power imbalances and building self-esteem.
Gerressu
M
M
Centre for Sexual Health and HIV Research, University College London, London, UK. mgerressu@gum.ucl.ac.uk
Elam
G
G
Shain
R
R
Bonell
C
C
Brook
G
G
Champion
J Dimmitt
JD
French
R
R
Elford
J
J
Hart
G
G
Stephenson
J
J
Imrie
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044383:Black People / Q000208:ethnology; D017691:Caribbean Region / Q000208:ethnology; D017280:Condoms / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008131:London / Q000453:epidemiology; D008297:Male; D008913:Minority Groups; D016032:Randomized Controlled Trials as Topic; D012725:Sexual Behavior / Q000208:ethnology* / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000208:ethnology* / Q000517:prevention & control; D014481:United States; D016387:Women's Health / Q000208:ethnology; D055815:Young Adult; D015022:Yugoslavia / Q000208:ethnology; D001741:Black or African American