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RESEARCH ARTICLE

Barriers to engagement with testing for sexually transmitted infections within a UK-based young adult Black Caribbean community: a qualitative study

Gemma Heath https://orcid.org/0000-0002-1569-5576 A * , Kiranpal Kaur A , Claire Farrow A , Jonathan D. C. Ross B and Rebecca Clarke C
+ Author Affiliations
- Author Affiliations

A School of Psychology, Aston University, Birmingham, UK.

B University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

C School of Psychological Science, University of Bristol, Bristol, UK.

* Correspondence to: g.heath1@aston.ac.uk

Handling Editor: Jacqueline Coombe

Sexual Health 21, SH23166 https://doi.org/10.1071/SH23166
Submitted: 16 September 2023  Accepted: 16 February 2024  Published: 4 March 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs) compared with other ethnic groups. The aim of this study was to explore barriers to engagement with STI testing within a UK-based young adult Black Caribbean community.

Methods

Semi-structured interviews were carried out with 14 young adults from the Black Caribbean community and six sexual healthcare professionals. Data were analysed thematically. A focus group of five young adults was conducted to refine themes.

Results

Data analysis generated three themes: (1) culturally embedded stigma; (2) historically embedded mistrust; and (3) lack of knowledge. Perceived as ‘dirty’, particularly for females, infection with STIs was stigmatised by religious conceptions of ‘purity’ and shame. This presented challenges in terms of cultural acceptability of talking about STI testing with partners, friends, and family. Legacies of colonialism, medical racism and malpractice compromised young people’s trust in medical intervention and confidentiality of data management. A lack of knowledge related to STIs and their treatment, and in how to access and perform STI tests further served as a barrier. Culturally tailored interventions targeting these factors and delivered by radio, podcasts and social media were highlighted as having potential to improve engagement with STI testing.

Discussion

Engagement with STI testing by young adults from the Black Caribbean community is impacted by historically and culturally embedded teachings, practices and beliefs inherited through generations. Targeting these factors within culturally tailored interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population.

Keywords: black and ethnic minority, interview, public health, qualitative, sexual health, sexually transmitted infections, STI testing, young adults.

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