title: Comparison of STI-related consultations among ethnic groups in the Netherlands: an epidemiologic study using electronic records from general practices.
abstract: BACKGROUND
  Currently, surveillance of sexually transmitted infections (STIs) among ethnic minorities (EM) in the Netherlands is mainly performed using data from STI centers, while the general practitioner (GP) is the most important STI care provider. We determined the frequency of STI-related episodes at the general practice among EM, and compared this with the native Dutch population.
  
  
  METHODS
  Electronic medical records from 15-to 60-year-old patients registered in a general practice network from 2002 to 2011 were linked to the population registry, to obtain (parental) country of birth. Using diagnoses and prescription codes, we investigated the number of STI-related episodes per 100,000 patient years by ethnicity. Logistic regression analyses (crude and adjusted for gender, age, and degree of urbanization) were performed for 2011 to investigate differences between EM and native Dutch.
  
  
  RESULTS
  The reporting rate of STI-related episodes increased from 2004 to 2011 among all ethnic groups, and was higher among EM than among native Dutch, except for Turkish EM. After adjustment for gender, age, and degree of urbanization, the reporting rate in 2011 was higher among Surinamese [Odds Ratio (OR) 1.99, 95 % confidence interval (CI) 1.70-2.33], Antillean/Aruban (OR 2.48, 95 % CI 2.04-3.01), and Western EM (OR 1.24, 95 % CI 1.11-1.39) compared with native Dutch, whereas it was lower among Turkish EM (OR 0.48, 95 % CI 0.37-0.61). Women consulted the GP relatively more frequently regarding STIs than men, except for Turkish and Moroccan women.
  
  
  CONCLUSIONS
  Most EM consult their GP more often for STI care than native Dutch. However, it remains unclear whether this covers the need of EM groups at higher STI risk. As a first point of contact for care, GPs can play an important role in reaching EM for (proactive) STI/HIV testing.
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Petra.Woestenberg@rivm.nl.
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Woestenberg
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Louise.van.Oeffelen@rivm.nl.
authors.forename: Aloysia A M
authors.initials: AA
authors.lastname: van Oeffelen
authors.affiliation: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. irina_stirbu@yahoo.com.
authors.forename: Irina
authors.initials: I
authors.lastname: Stirbu-Wagner
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Birgit.van.Benthem@rivm.nl.
authors.forename: Birgit H B
authors.initials: BH
authors.lastname: van Benthem
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. JvanBergen@soaaids.nl.|STI AIDS Netherlands, Amsterdam, The Netherlands. JvanBergen@soaaids.nl.|Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands. JvanBergen@soaaids.nl.
authors.forename: Jan E A M
authors.initials: JE
authors.lastname: van Bergen
authors.affiliation: Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Ingrid.van.den.Broek@rivm.nl.
authors.forename: Ingrid V F
authors.initials: IV
authors.lastname: van den Broek
mesh_terms: D000293:Adolescent; D000328:Adult; D016208:Databases, Factual; D057286:Electronic Health Records; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data; D012042:Registries; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000208:ethnology*; D055815:Young Adult