N. Low et al., Inequalities in rates of gonorrhoea and chlamydia between black ethnic groups in south east London: cross sectional study, SEX TRANS I, 77(1), 2001, pp. 15-20
Objectives: To examine differences in population based rates of gonorrhoea
and chlamydia between black ethnic groups in Lambeth, Southwark and Lewisha
m Health Authority.
Methods: Episodes of gonorrhoea or chlamydia recorded among attenders at 11
genitourinary clinics in south and central London from 1 January 1994 to 3
1 December 1995 were retrieved. Complete: data on chlamydia were only avail
able fur women. Ethnic group was assigned according to census categories-wh
ite, black Caribbean, black African, black other, Asian, or other. We calcu
lated yearly incidence rates for episodes of gonorrhoea and chlamydia in re
sidents of Lambeth, Southwark and Lewisham Health Authority. Random effects
Poisson regression models were used to examine associations between infect
ion rates and age, ethnic group, and material deprivation.
Results: During the study period there were 1994 episodes of gonorrhoea in
men and women and 1376 episodes of chlamydia in women with complete data. F
or both infections rates among individuals from black Caribbean and black o
ther ethnic groups were markedly higher than among black Africans. In men,
the gonorrhoea rate among black Caribbean 20-24 year olds was 2348 (95% CI
1965 to 2831) episodes per 100 000 compared with 931 (95% CI 690 to 1288) i
n black African men and 111 (95% CI 100 to 124) per 100 000 in white men of
the same age. Among women gonorrhoea rates were highest in black Caribbean
15-19 year olds (2612, 95% CI 2161 to 3190 per 100 000). In contrast, rate
s in black African women of the same age (331, 95% CI 154 to 846 per 100 00
0) were similar to those of white women (222, 95% CI 163 to 312). Chlamydia
rates were also highest in black Caribbean 15-19 year old women (4579, 95%
CI 3966 to 5314 per 100 000), compared with 1286 (95% CI 907 to 1888) in b
lack African and 433 (95% CI 349 to 544) per 100 000 white women. Controlli
ng for material deprivation and age only attenuated differences in rates be
tween ethnic groups slightly.
Conclusions: There are marked differences in rates of gonorrhoea and chlamy
dia between different black ethnic groups, with higher rates in black Carib
beans than black Africans. This study supports the hypothesis that assortat
ive sexual mixing patterns can restrict epidemics of sexually transmitted i
nfections within ethnic groups. Differences in disease occurrence between b
lack ethnic groups should be explored before combining data, even when numb
ers of episodes are small.