Lack of sexual health knowledge amongst teenage black and minority ethnic Londoners 'cause for concern'

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Teenage black and minority ethnic (BME) schoolchildren in London have lower sexual health knowledge levels compared to their British white counterparts, according to research conducted by the Trust for the Study of Adolescence for Naz Project London. The study's authors say that this is "a major cause for concern", and that their research "illustrates the importance of sex and relationships education in schools, especially for young people from BME backgrounds."

One of the root causes of the sexual health crisis currently affecting the United Kingdom has been the poor state of sexual health education provided to teenagers as part of the national school curriculum. However, very little research has so far been carried out to identify ethnic variations in sexual health knowledge, attitudes and behaviours of teenagers.

In order to identity these variations, and to explore and to help explain why some of these ethnic variations exist, Naz Project London - a London-based BME sexual health agency - commissioned the Trust for the Study of Adolescence to undertake detailed research among students aged 15-18 in full-time education in London schools where the majority of students are from BME communities.

Glossary

chlamydia

Chlamydia is a common sexually transmitted infection, caused by bacteria called Chlamydia trachomatis. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat. Chlamydia is treated with antibiotics.

sexually transmitted diseases (STDs)

Although HIV can be sexually transmitted, the term is most often used to refer to chlamydia, gonorrhoea, syphilis, herpes, scabies, trichomonas vaginalis, etc.

Sixteen schools agreed to participate in the study, and of the 3,026 students present in schools on the data collection days, 3,007 (99%) agreed to participate. Three-quarters (74%) of the of 3,007 respondents were aged 15 or 16 years. Most (77%) were born in the UK and just over a third (36%) did not report English as their first language. In total, 80.9% reported being from BME backgrounds (i.e. anything other than white British).

Sexual experience

Males generally reported more experience of sexual intercourse than females (38% versus 24%). Black Caribbean males were most likely to have experienced sex (65%) and Asians were generally the least likely of all groups to report experience of sexual intercourse, especially Asian females (12%).

Although 11% reported that they had ever felt attracted to the 'same' or 'same and opposite' sex or were 'not sure' only 1.4% of all respondents (and 4% of those reporting ever having had sexual intercourse) reported sexual intercourse with a person of the 'same' or 'same and opposite' sex.

Almost one-in-five (18%) reported their first sexual intercourse before the age of 16, with males twice as likely as females (24% versus 13%) to report underage sex. Ethnic differences followed sexual experience trends, with 48% of Black Caribbean males reporting having had underage sex compared to none in the group of Bangladeshi females.

Sexual health knowledge

Females reported a higher overall sexual health knowledge than males (a mean of 18.5 out of 25 compared with 16.6).

The teenagers were generally more knowledgeable about pregnancy than sexually transmitted infections (STIs), with more than one-in-three (37%) unable to identify chlamydia as a STI.

"Relative to white British students," the report says, "the lower levels of sexual health knowledge among BME groups represents a major cause for concern."

In particular, knowledge gaps around sexually transmitted diseases (STIs) were greater amongst 'white other' males, black African males, Bangladeshi males, and Pakistani males and females.

Key implications

Some of the study's key implications are summarised by the report as follows:

  • There is great diversity among young people in terms of their sexual health support needs, demonstrating the importance of tailoring interventions to meet the specific needs of ethnic groups and, where appropriate, working with such groups individually.
  • There is a need to promote a greater understanding of the 'mixed messages' faced by many BME youth - the values and norms apparent in the home and the local BME community, versus the values of the wider community.
  • The greatest sexual health support needs are evident among black young people, particularly black Caribbean young men. Irrespective of sexual intercourse experience, the sexual health support needs of other groups must not be discounted.
  • Irrespective of ethnicity, this research supports the need to focus sexual health promotion among young men in particular.
  • Being the most frequent and preferred source of information on sexual matters, the content and delivery of school Sex and Relationships Education (SRE) needs to be supported by guidance and legislation to improve its 'patchy' coverage. This supports the case for SRE, within broader Personal Social and Health Education (PSHE), to be a statutory requirement for all schools. Extending SRE provision beyond the Science curriculum to PSHE is supported by this research, and this appears to be critically important for BME groups.

The summary report (a 40-page document) and full technical report (consisting of the complete report in three volumes) can be obtained from the publications team at the Trust for the Study of Adolescence. Email: publications@tsa.uk.com.

Sexual risk behaviours

Of the 31% (38% males and 24% females) who reported having sexual intercourse, lack of contraception at first sexual intercourse was most frequently reported among black African males (32%), Asian females (25%) and black African females (24%), indicating the possibility for unintended pregnancy and/or acquiring an STI.

Of those teenagers who had three or more sexual partners in their lifetime, or two or more sexual partners in the preceding six months, black African females (65%), white British females (50%), black Caribbean females (50%), and Asian females (48%) were the most likely to have not consistently used contraception methods other than condoms (i.e. to prevent pregnancy).

Following those trends, 72% of black African females, 62% of white British females and 58% black Caribbean females also reported not consistently using condoms

Twelve percent of the young women who reported being sexually active said they had been unintentionally pregnant and/or acquired an STI. Seven percent of the young men reported either getting their partner unintentionally pregnant and/or acquiring an STI.

Given the small numbers involved (39 young women and 35 young men), ethnic differences, although seen, could be due to chance. Nevertheless, the researchers found that Black females (15%) and White British females (14%) reported the highest proportions of unintentional pregnancies and/or STIs. However, black African females, at 24%, were more than twice as likely to report this risk outcome compared to black Caribbean females (10%).