One of the problems of racism and of a society sensitive to its complexities, is that sometimes it can be difficult to have a straightforward discussion of serious problems within ethnic minority communities.
It has taken people from within Britain's Afro-Caribbean community to talk bluntly about a health crisis affecting them: an epidemic of sexually transmitted diseases with infection rates in some cases 20 times those in comparable white communities.
Ben Geoghehan reported on an attempt to break down potentially deadly taboos on sexual health.
When it comes to talking about sexual
health, it takes someone as forceful as this
to try and break the ice.
We have numbers of young people getting
sexually transmitted infections much
higher than last year and the year before.
Michael Hamilton is trying to get black
people in south London to wake up to the
alarming spread of sexually transmitted
infections within their community.
Within the black community there are
secrets around this story at a very personal
level because we know that there are black
people who are dying of HIV. But those
stories are not being told, those people are
not coming out and not coming forward in
any kind of big way so that we know that
their black heterosexual people dying. So it
seems that all the way along the line, at a
personal level, at a professional level, at an
institutional level, at a political level that
we've kind of colluded not to tell this story.
It is a story these men have been recruited
to try and take onto the streets of south
London. This is an area suffering an
epidemic of several sexual diseases as at
the same time but they too have been
finding out it is a problem most people
would prefer to keep quiet about.
A lot of people haven't been willing to talk
about it. It is a stigma. People think that it
is said that to speak about these things it
must mean you have it. Or to go to the
clinic you must have it or you'll be classed
as you've had it. People don't want to get
involved in that.
People see it as I don't see why I should
talk about it because I don't have it. Or if I
do have it, then, I'm not going to go, deal
with it with they might judge me or see me
as I am a slag.
I think it's shame, embarrassment as well,
along with the things my colleague said.
With the stigma and things like that. It is
shame and embarrassment has got
something to do with it.
Mark, Jamie and Jay have joined a project
to break down the taboos surrounding
sexual health. It's a small first step to tackle a growing
national problem. The last decade has seen
an explosion in the spread of sexually
transmitted infections. But for some reason
certain diseases occur more frequently in
Afro-Caribbeans than anyone else. Their
rates for gonorrhoea and chlamydia are
higher than in whites and significantly
higher than among black Africans.
DR NICOLA LOW:
Rates of gonorrhoea and chlamydia are
about ten times higher in black Caribbeans
compared to the white population as a
whole. In the younger age groups the
disparity is much higher, going up to 20
times higher in teenagers. Over the last
five to ten years, rates of gonorrhoea and
chlamydia have doubled, but the ethnic
distribution has stayed the same. So the
disparity stays the same, but rates of
infection have about doubled since 1995.
One study has shown how big the disparity
is between the Afro-Caribbean community
in south London and other groups. In men
aged between 20 and 24 the rate of
gonorrhoea per 100,000 was 111 in the
white group. Among Afro-Caribbeans, it
was 20 times higher with 2,348. In teenage
women the rate was 222 in the white group
and 11 times higher among Afro-
Caribbeans, whose rate was 2,612. The
study also looked at chlamydia in teenage
women. It found a rate of 433 in white
women but it was ten times higher among
black Caribbeans, where the rate was
4,579. Even though there might be no
symptoms, Gonorrhoea and chlamydia are
far from harmless infections. In women,
both of them can lead to complications like
ectopic pregnancies and infertility. What
really worries health experts is the rate in
HIV. The Afro-Caribbean community has
seen a six-fold increase since 1995.
DR KEVIN FENTON:
We know that sexually transmitted
infections can and do facilitate the
transmission of HIV infection. Therefore,
if we are having population sub-groups
with very high groups of sexually
transmitted infections, this really provides
a bed for seeding and transmission of HIV.
One of the problems with this information
is this information comes from science. As
a black person, I have learnt to be wary of
science because science has been used by
racists on a number of occasions to
describe us, to make us into what racist
people want us to be. So when a white
scientist comes to me and tells me yet
something else that is negative about me,
that is negative about my community, my
instant response is to close down, shut up,
to go away, because I know as a white
scientist that what she's bringing to me is
pain. It might not even be true, because
historically what white scientists have told
me about me, have not been true.
Ethnic differences in sexual infections
were noticed soon after Caribbean
migrants began arriving in Britain. One
study from the '60s claimed gonorrhoea
rates were 19 times higher than in the
white population. Since then, scientists
appear so been reluctant to tackle the issue
for fear of being accused of racism.
DR NICOLA LOW:
It makes it difficult to come out and do
research in this area. It is not a well-funded
area and for many researchers it is too
sensitive a topic to want to tackle. There
will continue to be little research done
whilst it is still perceived that you're
portraying a racist message in saying there
are higher rates of infections amongst
certain ethnic groups. But my opinion is it
is negligent not to do that research because
it is only when we have the figures that we
can lobby people to devote resources to
The comparatively high level of some
sexual infections is something which may
have gone unnoticed for as many as 50
years. Part of the reason is it is an issue
which is so controversial, no-one has yet
been willing to address it head-on. It does
ask questions about people's sex lives, the
spread of disease and racial difference. No
wonder people consider it a taboo issue.
Scientists and people within the black
community are beginning to agree the
silence has to be broken before it is too
late. Ending the silence and trying to
understand the reasons means getting
people to talk openly about their attitudes
to sex. One of the big questions is how to
get more people to use condoms.
I am still a bit scared to say you need to
stop and put on a condom.
If they go with a woman, who asks them to
wear a condom, that means the women
sleep around, therefore they won't have
them as their girlfriend or boyfriend as the
popular myth is men are saying they'll only
go with clean women, whatever that
means. So they are not willing to wear
condoms. The minute they start wearing
condoms with a woman, that woman isn't
What my picture contains is something
about there being a lot of competition
among us black men around sexuality and
some of that competition means we front
things and because it is important to be the
We need to pull together so that can be
stopped. Now we know black people have
high rates of STIs, high rates of teenage
pregnancy, everything that is negative is
owned by black people. We need to come
together as a community and do something
Some black people feel they can't do
anything about it. Because of the racism
which they say exists within the NHS.
The NHS community is predominantly
white. They don't really see black people at
the forefront of going to the clinics, for
example. They feel uncomfortable going to
If there is no awareness and better facilities
for the clinics and for us young people in
the clinics, then people are going to have
attitudes like they are not out for us and I
am not going there because even though I
have something, what's the point in going
because they're going to disrespect me,
give me some racist looks or some
The scientists have a long way to go before
they fully understand what lies behind the
spread of disease in Afro-Caribbeans.
Newsnight has seen the latest unpublished
research for the Department of Health and
it suggests the differences in the infection
rates are partly due to the fact that Afro-
Caribbean men have different sex lives to
white men. It shows they tend to have
more sexual partners, although not alone is
sufficient to account for the disparity in
infections. Just as important is the fact that
Afro-Caribbeans mainly have sex with
DR NICOLA LOW:
If their sexual mixes patterns are largely
restricted to other members of their ethnic
group and there is a high level of infection
in that group, then infection will continue
will continue to spread.
Afro-Caribbeans will soon have more to
talk about when for the first time, the
Government publishes its own figures for
sexual infections in different ethnic groups.
They are expected to confirm the findings
of previous studies. For now, it looks as
though the taboos are being broken and a
proper discussion has begun.
This transcript was produced from the teletext subtitles that are generated live for Newsnight. It has been checked against the programme as broadcast, however Newsnight can accept no responsibility for any factual inaccuracies. We will be happy to correct serious errors.