Abstract
Objective: To compare the risk factors for four common sexually transmitted infections (STIs) in attenders at three large urban genitourinary medicine (GUM) clinics in England.
Methods: Clinical, demographic, and behavioural data on attenders at two clinics in London and one in Sheffield were collected. Risk factors associated with first episodes of genital warts and genital herpes simplex virus (HSV), and uncomplicated gonorrhoea and chlamydia were investigated using the presence of each of these STIs as the outcome variable in separate multiple logistic regression analyses.
Results: Using data on the first attendance of the 18 238 patients attending the clinics in 1996, the risk of a gonorrhoea or chlamydia diagnosis was strongly associated with teenagers compared with those aged over 34, with black Caribbeans and black Africans compared with whites, and increased with the number of sexual partners. The risk of genital warts or HSV diagnosis was lowest in black Caribbeans and black Africans compared with whites and was not associated with the number of sexual partners. While genital warts were associated with younger age, odds ratios were much lower compared with those for the bacterial infections. Genital HSV diagnoses were not associated with age.
Conclusions: This study of GUM clinic attenders suggests a reduction in the incidence of bacterial STIs may be achievable through targeted sexual health promotion focusing particularly on black ethnic minorities, teenagers, and those with multiple sexual partnerships. Viral STIs were less clearly associated with population subgroups and a broader population based approach to sexual health promotion may be more effective in controlling these infections.
Key Words: risk factors; sexually transmitted infections; genitourinary medicine clinics; England
Full Text
The Full Text of this article is available as a PDF (116.1 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bhopal R. Is research into ethnicity and health racist, unsound, or important science? BMJ. 1997 Jun 14;314(7096):1751–1756. doi: 10.1136/bmj.314.7096.1751. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bjekić M., Vlajinac H., Sipetić S., Marinković J. Risk factors for gonorrhoea: case-control study. Genitourin Med. 1997 Dec;73(6):518–521. doi: 10.1136/sti.73.6.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Catchpole M., Connor N., Brady A., Kinghorn G., Mercey D., Band B., Thin N. Behavioural and demographic characteristics of attenders at two genitourinary medicine clinics in England. Genitourin Med. 1997 Dec;73(6):457–461. doi: 10.1136/sti.73.6.457. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper D. L., Bernstein G. S., Ivler D., Pinal Y., Nakamura R. Gonorrhea screening program in a women's hospital outpatient department: results and analysis of risk factors. J Am Vener Dis Assoc. 1976 Dec;3(2 Pt 1):71–75. [PubMed] [Google Scholar]
- Cowan F. M., Johnson A. M., Ashley R., Corey L., Mindel A. Antibody to herpes simplex virus type 2 as serological marker of sexual lifestyle in populations. BMJ. 1994 Nov 19;309(6965):1325–1329. doi: 10.1136/bmj.309.6965.1325. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans B. A., Kell P. D., Bond R. A., MacRae K. D. Racial origin, sexual lifestyle, and genital infection among women attending a genitourinary medicine clinic in London (1992). Sex Transm Infect. 1998 Feb;74(1):45–49. doi: 10.1136/sti.74.1.45. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fenton K., Johnson A. M., Nicoll A. Race, ethnicity, and sexual health. BMJ. 1997 Jun 14;314(7096):1703–1704. doi: 10.1136/bmj.314.7096.1703. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Garnett G. P., Anderson R. M. Contact tracing and the estimation of sexual mixing patterns: the epidemiology of gonococcal infections. Sex Transm Dis. 1993 Jul-Aug;20(4):181–191. doi: 10.1097/00007435-199307000-00001. [DOI] [PubMed] [Google Scholar]
- Hooykaas C., van der Velde F. W., van der Linden M. M., van Doornum G. J., Coutinho R. A. The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals. Genitourin Med. 1991 Oct;67(5):378–383. doi: 10.1136/sti.67.5.378. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hughes G., Simms I., Rogers P. A., Swan A. V., Catchpole M. New cases seen at genitourinary medicine clinics: England 1997. Commun Dis Rep CDR Suppl. 1998 Dec;8(7):S1–11. [PubMed] [Google Scholar]
- Hughes Gwenda, Catchpole M. Surveillance of sexually transmitted infections in England and Wales. Euro Surveill. 1998 Jun;3(6):61–65. doi: 10.2807/esm.03.06.00099-en. [DOI] [PubMed] [Google Scholar]
- Lacey C. J., Merrick D. W., Bensley D. C., Fairley I. Analysis of the sociodemography of gonorrhoea in Leeds, 1989-93. BMJ. 1997 Jun 14;314(7096):1715–1718. doi: 10.1136/bmj.314.7096.1715. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Low N., Daker-White G., Barlow D., Pozniak A. L. Gonorrhoea in inner London: results of a cross sectional study. BMJ. 1997 Jun 14;314(7096):1719–1723. doi: 10.1136/bmj.314.7096.1719. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Munk C., Svare E. I., Poll P., Bock J. E., Kjaer S. K. History of genital warts in 10,838 women 20 to 29 years of age from the general population. Risk factors and association with Papanicolaou smear history. Sex Transm Dis. 1997 Nov;24(10):567–572. doi: 10.1097/00007435-199711000-00003. [DOI] [PubMed] [Google Scholar]
- Nahmias A. J., Roizman B. Infection with herpes-simplex viruses 1 and 2. 1. N Engl J Med. 1973 Sep 27;289(13):667–674. doi: 10.1056/NEJM197309272891305. [DOI] [PubMed] [Google Scholar]
- Nicoll A., Catchpole M., Cliffe S., Hughes G., Simms I., Thomas D. Sexual health of teenagers in England and Wales: analysis of national data. BMJ. 1999 May 15;318(7194):1321–1322. doi: 10.1136/bmj.318.7194.1321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rietmeijer C. A., Judson F. N., Van Hensbroek M. B., Ehret J. M., Douglas J. M., Jr Unsuspected Chlamydia trachomatis infection in heterosexual men attending a sexually transmitted diseases clinic: evaluation of risk factors and screening methods. Sex Transm Dis. 1991 Jan-Mar;18(1):28–35. doi: 10.1097/00007435-199101000-00007. [DOI] [PubMed] [Google Scholar]
- Smith J. R., Murdoch J., Carrington D., Frew C. E., Dougall A. J., MacKinnon H., Baillie D., Byford D. M., Forrest C. A., Davis J. A. Prevalence of Chlamydia trachomatis infection in women having cervical smear tests. BMJ. 1991 Jan 12;302(6768):82–84. doi: 10.1136/bmj.302.6768.82. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Toomey K. E., Moran J. S., Rafferty M. P., Beckett G. A. Epidemiological considerations of sexually transmitted diseases in underserved populations. Infect Dis Clin North Am. 1993 Dec;7(4):739–752. [PubMed] [Google Scholar]
- White P. J., Garnett G. P. Use of antiviral treatment and prophylaxis is unlikely to have a major impact on the prevalence of herpes simplex virus type 2. Sex Transm Infect. 1999 Feb;75(1):49–54. doi: 10.1136/sti.75.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]