Suchergebnisse

BACKGROUND: Women using primary care vary in need for sexually transmitted infections (STIs) testing and contraception. Psychosocial correlates of these needs may be useful for targeting services. We undertook a systematic review to identify psychosocial correlates of STI acquisition, unplanned pregnancy (UP), abortion and risky sexual behaviours in general population samples of women of reproductive age. METHODS: We searched bibliographic databases for probability surveys of women aged 16-44years in the European Union, USA, Canada, Australia, UK or New Zealand undertaken January 1994-January 2014. RESULTS: Eleven papers were included. Unplanned pregnancy was associated with smoking, depression, being single and sexual debut <16years. Abortion was associated with lack of closeness to parents, leaving home at an early age, and relationship break-up. Multiple partnerships were associated with intensity of marijuana and alcohol use, and smoking. STI diagnosis was associated with relationship break-up and younger partners. Non-use of contraception was associated with smoking, obesity, relationship status, sedentary lifestyles, fatalistic pregnancy attitudes and lower alcohol use. Condom non-use was higher (at first sex) with partners 5+years older and lower (at last sex) in less stable partnerships. CONCLUSION: Psychosocial variables, particularly relationship status and smoking, may help identify women in primary care for STI testing and contraception advice and supply.

International audience ; There has been a large influx of Central and East European (CEE) migrants to the UK following the expansion of the European Union. This paper examines the factors associated with GUM clinic attendance and STI diagnosis among CEE migrants in London. We conducted a survey of sexual behaviour among CEE migrants attending two central London GUM clinics (n=299) and community venues in London (n=2276). Routinely-collected clinic data were also analysed. CEE migrants made up 2.9% of male and 7.0% of female attendees at the clinics. Half of the women attending sessions for female sex workers were from CEE countries and paying for sex was widely reported by men. Women were more likely than men to have attended a GUM clinic in the UK (7.6% vs 4.5%, p=0.002). GUM survey respondents were more likely than community survey respondents to report one or more new sexual partners in the past year (women: 67.9% vs 28.3%, p<0.001; men: 75.6% vs 45.1%, p<0.001) and homosexual partnership(s) in the past five years (men: 54.3% vs 1.8%, p<0.001); but were less likely to report assortative heterosexual mixing (women: 25.9% vs 74.2%, p<0.001; men: 56.5% vs 76.3%, p<0.001). CEE patients make up a notable proportion of patients attending two central London GUM clinics. Higher numbers of sexual partners, homosexual partnerships and sexual mixing with people from outside the country of origin are associated with GUM clinic attendance. Heterosexual CEE men report behaviours associated with HIV/STI acquisition but appear to be under-utilizing GUM services.

Introduction: Hard-to-reach and minority groups are often at higher risk for adverse sexual health outcomes. While such groups are therefore of
interest to sexual health researchers, it can be difficult to locate and recruit sufficient sample sizes using probability sampling methods. This study
aims to establish whether web-panel surveys can provide a viable less resource intensive means of boosting sample sizes of two hard-to-reach
groups (people of Black African ethnicity, and gay men) for a sexual health survey, and the extent of any bias.
Methods: Results from a national probability sample survey (Natsal-3, administered using a computer-assisted personal interview (CAPI) and selfinterview
(CASI) with 15,162 participants), which included 211 black African participants and 83 gay men, were compared with results from a webpanel
survey (using identical questions) of 529 black Africans and 592 gay men. Web-panel survey results for socio-demographics were
compared with external benchmarks, and for sexual behaviours and attitudes reported in Natsal-3. Odds ratios (ORs) were used to examine
differences between variables and the average absolute OR, along with the number of estimates for which the web-panel survey differed
significantly from the benchmarks, were used to summarise survey performance.
Results: At least 18% of estimates differed significantly between surveys for gay and black African men, and 28% for black African women. For
black African women average absolute ORs were: 1.6 for attitudinal questions asked in CAPI, 1.5 for attitudinal CASI questions, 3.2 for behaviour
questions asked in CAPI and for 1.7 for behaviour CASI. For black African men average absolute ORs were: 1.5 for attitudinal questions asked in
CAPI, 1.8 for attitudinal CASI questions, 2.5 for behavioural questions asked in CAPI and 1.6 for behavioural questions asked in CASI=1.6. For
gay men, average absolute ORs were: 2.2 for attitudinal questions asked in CAPI, 2.8 for attitudinal CASI questions, 1.8 for behavioural questions
asked in CAPI to 1.6 for behavioural questions asked in CASI.
Discussion: Web-panel surveys may be able to sample hard-to-reach groups but may not be able to replace probability-sample surveys where
accurate population-level estimates of sensitive sexual behaviours are required. Differences between web and CASI responses, where mode
effects may be similar, suggest web-panel survey selection bias.

Abstract Background Following the expansion of the European Union, there has been a large influx of Central and East European (CEE) migrants to the UK. CEE men who have sex with men (MSM) represent a small minority within this population that are none-the-less important to capture in sexual health research among the CEE migrant community. This paper examines the feasibility of recruiting CEE MSM for a survey of sexual behaviour in London using respondent driven sampling (RDS), via gay websites and in GUM clinics. Methods We sought CEE MSM to start RDS chain referral among GUM clinic attendees, our personal contacts and at gay events and venues in central London. We recruited CEE MSM (n = 485) via two popular websites for gay men in Britain (March-May 2009) and at two central London GUM clinics (n = 51) (July 2008-March 2009). Results We found seventeen men who knew other CEE MSM in London and agreed to recruit contacts into the study. These men recruited only three men into the study, none of whom recruited any further respondents, and RDS was abandoned after 7 months (July 2008-January 2009). Half of the men that we approached to participate in RDS did not know any other CEE MSM in London. Men who agreed to recruit contacts for RDS were rather more likely to have been in the UK for more than one year (94.1% vs 70.0%, p = 0.052). Men recruited through gay websites and from GUM clinics were similar. Conclusions The Internet was the most successful method for collecting data on sexual risk behaviour among CEE MSM in London. CEE MSM in London were not well networked. RDS may also have failed because they did not fully understand the procedure and/or the financial incentive was not sufficient motivation to take part.

International audience ; Since May 2004, ten Central and East European (CEE) countries have joined the European Union. While HIV rates remain low among men who have sex with men (MSM) in CEE countries, there is no research on the sexual behaviour of CEE MSM in the UK. CEE MSM living in the UK (n=691) were recruited for an online questionnaire via two popular MSM websites. The majority of men had arrived in the UK since May 2004. A previous STI diagnosis was reported by 30.7% and 4.8% reported being HIV-positive, the majority diagnosed in the UK. Unprotected anal intercourse with a casual partner of unknown or discordant HIV status was reported by 22.8%. Men who had been in the UK for longer (>5 years vs 10 partners, p<0.001) and were less likely to report their most recent partner was from their home country (14.9% vs 33.6%, p<0.001). Among migrant CEE MSM living in London, 15.4% had been paid for sex in the UK and 41.5% had taken recreational drugs in the past year. CEE MSM in the UK are at risk for acquisition and transmission of STIs and HIV through UAI with non-concordant casual partners. Sexual mixing with men from other countries, commercial sex and increased partner numbers may introduce additional risk. This has important implications for cross-border transmission of infections between the UK and CEE countries.

BACKGROUND: Since May 2004, ten Central and Eastern European (CEE) countries have joined the European Union, leading to a large influx of CEE migrants to the United Kingdom (UK). The SALLEE project (sexual attitudes and lifestyles of London's Eastern Europeans) set out to establish an understanding of the sexual lifestyles and reproductive health risks of CEE migrants. CEE nationals make up a small minority of the population resident in the UK with no sampling frame from which to select a probability sample. There is also difficulty estimating the socio-demographic and geographical distribution of the population. In addition, measuring self-reported sexual behaviour which is generally found to be problematic, may be compounded among people from a range of different cultural and linguistic backgrounds. This paper will describe the methods adopted by the SALLEE project to address these challenges. METHODS: The research was undertaken using quantitative and qualitative methods: a cross-sectional survey of CEE migrants based on three convenience samples (recruited from community venues, sexual health clinics and from the Internet) and semi-structured in-depth interviews with a purposively selected sample of CEE migrants. A detailed social mapping exercise of the CEE community was conducted prior to commencement of the survey to identify places where CEE migrants could be recruited. A total of 3,005 respondents took part in the cross-sectional survey, including 2,276 respondents in the community sample, 357 in the clinic sample and 372 in the Internet sample. 40 in-depth qualitative interviews were undertaken with a range of individuals, as determined by the interview quota matrix. DISCUSSION: The SALLEE project has benefited from using quantitative research to provide generalisable data on a range of variables and qualitative research to add in-depth understanding and interpretation. The social mapping exercise successfully located a large number of CEE migrants for the community sample and is recommended for other migrant populations, especially when little or no official data are available for this purpose. The project has collected timely data that will help us to understand the sexual lifestyles, reproductive health risks and health service needs of CEE communities in the UK.

BACKGROUND: Sexual orientation encompasses three dimensions: sexual identity, attraction and behaviour. There is increasing demand for data on sexual orientation to meet equality legislation, monitor potential inequalities and address public health needs. We present estimates of all three dimensions and their overlap in British men and women, and consider the implications for health services, research and the development and evaluation of public health interventions. METHODS: Analyses of data from Britain's third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey (15,162 people aged 16-74 years) undertaken in 2010-2012. FINDINGS: A lesbian, gay or bisexual (LGB) identity was reported by 2·5% of men and 2·4% of women, whilst 6·5% of men and 11·5% of women reported any same-sex attraction and 5·5% of men and 6·1% of women reported ever experience of same-sex sex. This equates to approximately 547,000 men and 546,000 women aged 16-74 in Britain self-identifying as LGB and 1,204,000 men and 1,389,000 women ever having experience of same-sex sex. Of those reporting same-sex sex in the past 5 years, 28% of men and 45% of women identified as heterosexual. INTERPRETATION: There is large variation in the size of sexual minority populations depending on the dimension applied, with implications for the design of epidemiological studies, targeting and monitoring of public health interventions and estimating population-based denominators. There is also substantial diversity on an individual level between identity, behaviour and attraction, adding to the complexity of delivering appropriate services and interventions.