Sexually transmitted infections in Bangladeshis resident in the UK: a case-control study

Abstract

Objective: To evaluate the prevalence of sexually transmitted infections (STIs) and mode of presentation in patients originating from Bangladesh and resident in the United Kingdom in comparison with non-Bangladeshi patients attending an inner London genitourinary medicine (GUM) clinic. Methods: A retrospective, cross sectional study with comparator group was carried out at an open access GUM clinic in east London. 104 consecutive newly attending Bangladeshi men were compared with 199 consecutive newly attending non-Bangladeshi men and 115 consecutive newly attending Bangladeshi women were compared with 218 consecutive newly attending non-Bangladeshi women. Any diagnosed sexually transmitted infections, sexual history characteristics, reasons for presentation, and referral patterns were noted. Results: Bangladeshi men (28.8% compared with 7.5%; p<0.0001) and women (42.7% compared with 12.8%; p<0.0001) were more likely to be referred by their general practitioners or other medical services. Bangladeshi men were more likely to present with sexual dysfunction (12.5% compared with 2.5%; p=0.001). The prevalence of STIs was broadly similar across the study groups; however, syphilis was significantly more common in the Bangladeshi men (10.9% compared with 4%; p=0.04) and nongonococcal urethritis (NGU) in the control men (35% compared with 20.2%; p=0.02). Bacterial vaginosis was an infrequent diagnosis in the Bangladeshi women (3.5% compared with 22.4%; p<0.0001). Conclusions: STI prevalence in Bangladeshis attending GUM services is similar to other populations although patterns of presentation and referral do show variation. Bangladeshi men are more likely to access GUM clinics for psychosexual services. The presence of STIs in Bangladeshis particularly those imported from Bangladesh provides an opportunity for HIV transmission between the United Kingdom and Bangladesh.T wenty six per cent of the population of the London borough of Tower Hamlets are of Bangladeshi origin.1 The epidemiology of STIs in the Bangladeshi population is largely unknown and to our knowledge no data exist on STI prevalence in immigrant Bangladeshi communities in the United Kingdom. Studies from Bangladesh suggest variable rates of STIs and HIV prevalence dependent on the population sampled. [2][3][4][5] This study assessed the prevalence of STIs and the mode of presentation in Bangladeshi patients in comparison with the local indigenous population attending an inner London GUM clinic. METHODSA retrospective cross sectional study was performed in 1995. One hundred and four consecutive new male and 115 consecutive new female Bangladeshis were sampled. Controls were the preceding and subsequent newly attending, nonBangladeshi patients, providing a 2:1 ratio.A standardised proforma was used to collect epidemiological data, presenting problems, sexual history, and clinical findings from the case notes. Samples for Neisseria gonorrhoeae, Chlamydia trachomatis, and non-gonococcal urethritis (NGU) were taken in men and additionally Candida albicans, Tr...

Sexual health services for South Asians in London, UK: a case–control study

“…This may indicate poorer access to GU medicine services, possibly a reflection of cultural and socioeconomic barriers to health-care access. These results confirm findings by Skinner et al 5 who found that Bangladeshi GU medicine clinic attendees were also more likely to be referred to GU medicine services than selfreferred. This is a large, well-designed study; however, there are limitations.…”

How and why do South Asians attend GUM clinics? Evidence from contrasting GUM clinics across England

“…Our results are consistent with other studies that have reported how GUM clinics are seldom the first port of call for South Asians seeking STI care, and that South Asian GUM attendees are less likely than other attendees to self-refer, instead being more likely to be referred from other medical services such as general practice or family planning 12 13. While higher referral rates may reflect higher attendance rates by South Asians at non-GUM services, others suggest that this healthcare-seeking behaviour reflects a low perception of sexual health risk among South Asians,14 their lack of awareness of GUM services15 16 and their association of GUM services with stigma, such that the anxiety of being recognised attending a clinic acts as a barrier to access 15.…”

Sexual and reproductive health of South Asians in the UK: an overview

“…Use of condoms and IUDs was higher among Asian women than white women. Ross et al 52 Saxena et al 21 Saxena et al 39 Sethi et al 33 Sinha et al 13 Skinner et al 27 …”

“…25,26 One GUM clinic study found similar rates of STIs in Bangladeshi attendees as non-Bangladeshi attendees, though this was mainly among individuals born in Bangladesh. 27 Bangladeshi men were also more likely than non-Bangladeshis to present with sexual dysfunction, and both men and women were more likely to have been referred to GUM from general practice and family planning services. Sexual dysfunction and premature ejaculation among some South Asian and Muslim men has been found elsewhere.…”