Intended for healthcare professionals


Race, ethnicity, and sexual health

BMJ 1997; 314 doi: (Published 14 June 1997) Cite this as: BMJ 1997;314:1703

Can sexual health programmes be directed without stereotyping

  1. Kevin Fenton, Lecturera,
  2. Anne M Johnson, Professor of epidemiologya,
  3. Angus Nicoll, Consultant epidemiologistb
  1. a Department of Sexually Transmitted Diseases, UCL Medical School, Mortimer Market Centre, London WC1E 6AU
  2. b PHLS Communicable Disease Surveillance Centre, London NW9 5EQ

    Studying and interpreting the relation between race, ethnicity, and health often invites debate and controversy. Research in this area is rapidly expanding, driven by a desire to explore variations in health and to understand the aetiology of diseases. However, concerns have been raised about the ways in which race and ethnicity are defined and used in epidemiological research. Some have questioned the motives behind research in ethnicity; with hindsight, it is often unclear who, besides the researcher, benefits from the results. Methodological errors in some studies, chief of which is non-adjustment for confounding by socioeconomic variables, have led to erroneous conclusions or to findings of limited generalisability. To this end, guidelines for improving the use of ethnicity in research and mechanisms to avoid common pitfalls have been published.1 2

    In this week's BMJ, Raj Bhopal takes a critical look at research in race and ethnicity (p 1751).3 He challenges researchers to “move from repetitive demonstration of disease variations” towards “assessing needs and inequality, and guiding practical action.” Alongside this article are a series of papers that demonstrate or comment on ethnic differences in the incidence of sexually transmitted diseases, including HIV infection and AIDS.4 5 6 7 The studies also highlight the difficulties in carrying out such research. But to what extent has Bhopal's challenge been met by researchers and practitioners in sexual health? How should these findings impact on the provision of services to reduce inequity?

    Surveillance data for HIV infection and AIDS and other sexually transmitted diseases show variations in incidence across ethnic groups.8 9 10 In the United States, higher rates of sexually transmitted diseases have been …

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