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Last Updated: Thursday, 24 July, 2003, 13:55 GMT 14:55 UK
STD in Afro-Caribbean community
Crowd
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.

BEN GEOGHEGAN:
When it comes to talking about sexual health, it takes someone as forceful as this to try and break the ice.

MICHAEL HAMILTON:
We have numbers of young people getting sexually transmitted infections much higher than last year and the year before.

BEN GEOGHEGAN:
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.

MICHAEL HAMILTON:
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.

BEN GEOGHEGAN:
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.

MARK FEARON:
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.

JAMIE GRIFFITHS:
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.

JAY VETHAMONY:
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.

BEN GEOGHEGAN:
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.

BEN GEOGHEGAN:
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.

MICHAEL HAMILTON:
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.

BEN GEOGHEGAN:
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 combat it.

BEN GEOGHEGAN:
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.

ALIESHIA WELDS:
I am still a bit scared to say you need to stop and put on a condom.

ALVIN WRIGHT:
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 worth it.

MICHAEL HAMILTON:
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 alpha male.

ANDREA PALMER:
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 about it.

BEN GEOGHEGAN:
Some black people feel they can't do anything about it. Because of the racism which they say exists within the NHS.

MARK FEARON:
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 the clinics.

JAY VETHAMONY:
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 discrimination.

BEN GEOGHEGAN:
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 other Afro-Caribbeans.

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.

BEN GEOGHEGAN:
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.



WATCH AND LISTEN
Newsnight's Ben Geoghehan
reported on Britain's Afro-Caribbean community seeking answers to why it's facing an epidemic of sexually transmitted diseases



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