Objective: To compare sexual behaviour and HIV risk behaviour between women in three clinical settings and to investigate the effect of socio-economic status and ethnic origin upon these behaviours.
Subjects and methods: A questionnaire was administered to 1,950 women attending clinics for genitourinary medicine (GUM) family planning and termination of pregnancy (TOP), all in inner London.
Results: A quarter of women attending the GUM and TOP clinics were not using any regular form of contraception. Differences in the median numbers of sexual partners in the past year (1-2) and over lifetime (4-6) between the three groups were slight. Amongst the women in all three groups: more than half (54.8-64.9%) had had a non-regular partner in the preceding twelve months; fewer than one-fifth (10.4-17.1%) reported always using condoms with their regular partners, and fewer than two-fifths (31.3-39.7%) always used them with their non-regular partners; approximately one in five women (18.6-23.9%) reported one or more major HIV risk behaviours. Some parameters of sexual behaviour were found to be influenced by socio-economic status and/or ethnic origin.
Conclusions: The behaviour of women attending these three clinics is very similar. Women attending clinics for family planning or termination of pregnancy need advice on sexually transmitted diseases and HIV infection, and women attending genitourinary medicine or termination clinics need advice on contraception. Closer integration between disciplines is required to provide a comprehensive sexual health service for women.
PIP: In England between November 1989 and February 1991, 917 new female patients at a department of genitourinary medicine (GUM), a family planning clinic (FPC), and an abortion clinic, all in inner London, completed a questionnaire so researchers could examine sexual behavior and HIV risk behavior between these women and to determine the effect of ethnic origin and socioeconomic status on these behaviors. 25.3% of GUM women and 25% of women at the abortion clinic did not use any contraception. The median numbers of sexual partners in the last 1-2 years and 4-6 years were essentially the same in all 3 groups (1.5-2.0 and 6.8-11.1, respectively). 54.8-68.9% of the women had had sexual intercourse with a nonregular sexual partner in the last 12 months. Few (10.4-17.1%) always used a condom with their regular partners. The percentage who always used a condom with nonregular partners was also low (31.3-39.7%). 18.6-23.9% of the women had at least 1 major HIV risk behavior. Age at first intercourse was younger in women of lower socioeconomic class than those of higher class (17.39 years vs. 18.04 years; p 0.0001). Whites had more lifetime sexual partners (10.34 vs. 5.18; p = 0.02) and were more likely to have practiced fellatio and anal sex (p 0.0001 and p 0.05) than did Afro-Caribbean women. Whites were more likely to have had a history of genital herpes (4.6% vs. 1%; p 0.02) and to have had sex with an IV drug user (6.9% vs. 1.5%; p = 0.005) than Afro-Caribbean women. Yet, Afro-Caribbean women were more likely to have at least 1 HIV risk behavior than Whites (29.5% vs. 21.4%; p = 0.01), almost entirely because they had had intercourse with a man from Sub-Saharan Africa. These findings suggest that staff at FPCs and abortion centers should provide women advice on sexually transmitted diseases and HIV infection and that staff at GUM clinics need to offer contraception advice. The 3 clinical disciplines must be integrated so women can receive more comprehensive sexual health services.