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

Background: Improving access to sexual healthcare is a priority in the UK, especially for ethnic minorities. Though South Asians in the UK report low levels of sexual ill health, few data exist regarding their use of genitourinary medicine (GUM) services. Objectives: To describe reasons for attendance at GUM clinics among individuals of South Asian origin relative to patients of other ethnicities. Methods: 4600 new attendees (5% South Asian; n=226) at seven sociodemographically and geographically contrasting GUM clinics across England completed a questionnaire between October 2004 and March 2005, which were linked to routine clinical data. Results: South Asians were more likely than other groups to be signposted to the GUM clinic by another health service-for example, in women 14% versus 8% respectively (p=0.005) reported doing so from a family planning clinic. These women also reported that they would be less likely to go to the clinic if their symptoms resolved spontaneously compared with other women (51% vs 31%, p=0.024). However, relative to other clinic attendees, no differences in the proportions of South Asians who had acute STI(s) diagnosed at clinic were noted. Furthermore, South Asian men were more likely to report as their reason for attendance that they wanted an HIV test (23.4% vs 14.8%, p=0.005). Conclusion: Despite having similar STI care needs to attendees from other ethnic groups, South Asians, especially women, may be reluctant to seek care from GUM clinics, especially if their symptoms resolve. Sexual health services need to develop locally-delivered and culturally-appropriate initiatives to improve care pathways.