Institute for Global Health, University College London, London, United Kingdom.
HIV & STI Department, Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, London, United Kingdom.
PLoS One. 2018 Dec 7;13(12):e0208315. doi: 10.1371/journal.pone.0208315. eCollection 2018.
In the UK, people of black Caribbean (BC) ethnicity continue to be disproportionately affected by bacterial sexually transmitted infections (STIs) and Trichomonas vaginalis (TV). We systematically reviewed evidence on the association between bacterial STIs/TV and ethnicity (BC compared to white/white British (WB)) accounting for other risk factors; and differences between these two ethnic groups in the prevalence of risk factors associated with these STIs, sexual healthcare seeking behaviours, and contextual factors influencing STI risk.
Studies presenting relevant evidence for participants aged ≥14 years and living in the UK were eligible for inclusion. A pre-defined search strategy informed by the inclusion criteria was developed. Eleven electronic databases were searched from the start date to September-October 2016. Two researchers independently screened articles, extracted data using a standardised proforma and resolved discrepancies in discussion with a third researcher. Descriptive summaries of evidence are presented. Meta-analyses were not conducted due to variation in study designs. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed.
Of 3815 abstracts identified, 15 articles reporting quantitative data were eligible and included in the review. No qualitative studies examining contextual drivers of STI risk among people of BC ethnicity were identified. Compared to the white/WB ethnic group, the greater STI/TV risk among BCs was partially explained by variations in socio-demographic factors, sexual behaviours, and recreational drug use. The prevalence of reporting early sexual debut (<16 years), concurrency, and multiple partners was higher among BC men compared to white/WB men; however, no such differences were observed for women. People of BC ethnicity were more likely to access sexual health services than those of white/WB ethnicity.
Further research is needed to explore other drivers of the sustained higher STI/TV prevalence among people of BC ethnicity. Developing holistic, tailored interventions that address STI risk and target people of BC ethnicity, especially men, could enhance STI prevention.
在英国，加勒比裔黑人（BC）人群继续受到细菌性性传播感染（STI）和阴道毛滴虫病（TV）的不成比例影响。我们系统地回顾了与种族（与白人/白种英国人（WB）相比的 BC）相关的细菌性 STI/TV 以及其他风险因素之间关联的证据；并比较了这两个群体在与这些 STI 相关的风险因素的流行率、性保健寻求行为以及影响 STI 风险的背景因素方面的差异。
本研究纳入了年龄≥14 岁且居住在英国的参与者提供相关证据的研究。根据纳入标准制定了一个预定义的搜索策略。从开始日期到 2016 年 9-10 月，在 11 个电子数据库中进行了搜索。两名研究人员使用标准化的表格独立筛选文章、提取数据，并通过与第三名研究人员讨论解决分歧。呈现证据的描述性摘要。由于研究设计的差异，未进行荟萃分析。遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。
在 3815 条摘要中，有 15 篇报告定量数据的文章符合资格并纳入了审查。未发现检查 BC 族裔人群中 STI 风险的背景驱动因素的定性研究。与白种人/WB 族裔相比，BC 族裔的 STI/TV 风险较高部分可以通过社会人口因素、性行为和使用娱乐性药物的变化来解释。与白种人/WB 男性相比，BC 男性中报告性初开年龄较早（<16 岁）、同时发生性行为和有多个性伴侣的比例更高；然而，女性则没有观察到这种差异。与白种人/WB 族裔相比，BC 族裔更有可能接受性健康服务。
需要进一步研究以探讨造成 BC 族裔持续较高 STI/TV 流行率的其他驱动因素。开发针对 BC 族裔的整体、量身定制的干预措施，以解决 STI 风险并针对该人群，特别是男性，可以增强 STI 预防。
