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

Effective interventions to address the disproportionate impact of sexually transmitted infections (STIs) among young black women in the United Kingdom are lacking, noted the investigators. Thus, 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 United States to Britain.

Men and women ages 15-27 from different ethnic backgrounds were recruited from youth and genitourinary health clinic settings in Brent, London. The investigators conducted group (n=10) and one-to-one interviews (n=37) that explored the context within which STI-related risks were assessed, experienced, and avoided; the skills needed to recognize risk; and the barriers to behavior change.

STI risk exposure and difficulties in implementing risk-reduction strategies were linked to concurrent sexual partnerships, mismatched perceptions and expectations, and barriers to condom use. Women attempted to achieve monogamy, but reported complex and fluid sexual relationships. Condom use was hindered by low risk awareness, flawed partner risk assessments, negative perceptions of condoms, and lack of control. While men made conscious decisions, women experienced persuasion, deceit and difficulty in requesting condom use, particularly with older partners.

"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," the researchers concluded.