{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T12:09:54Z","timestamp":1781006994052,"version":"3.54.1"},"reference-count":27,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"unspecified","delay-in-days":69,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000724","name":"Health Foundation","doi-asserted-by":"publisher","award":["FR-000002776"],"award-info":[{"award-number":["FR-000002776"]}],"id":[{"id":"10.13039\/501100000724","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,5,7]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Co-production is an important practice for addressing health disparities and developing equitable services with underserved communities. Co-production aims to ensure that underserved communities are central to the design of services that reflect community needs. African and Caribbean heritage communities (ACHC) face heightened risks of HIV due to stigma, discrimination, social, economic and structural factors, leading to significant health inequities. Despite a national target to end new HIV transmissions by 2030, HIV remains prevalent. Common Ambition Bristol (CAB) is a co-production project aiming to increase HIV knowledge and testing. CAB\u2019s Project Delivery Group (PDG) involves ACHC community members and sexual health staff working in equal partnership to improve sexual health services for ACHC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal qualitative evaluation explored the process of CAB\u2019s co-production over time. Interviews were conducted with members of CAB\u2019s PDG at three time points. Interviews examined PDG views and experiences of the co-production process. Data were analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five themes are reported which relate to equitable power-sharing and inclusive decision-making: (1) Acknowledging power imbalances and negotiating roles, (2) Appreciating commonalities and the importance of language, (3) Benefits of sharing lived and sexual health experiences, (4) Negotiating different opinions safely and (5) Co-production: the messy middle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings underscore the potential of co-production to drive meaningful progress in health equity. Key elements of co-production which promote equitable power-sharing and effective decision-making are: (1) acknowledging and addressing unequal power structures which may affect group dynamics; (2) fostering reciprocal learning from lived experience and sexual health expertise; (3) recognising and appreciating personal and sexual health commonalities; (4) negotiating and developing ways to ensure equitable decision-making and (5) agreeing a shared language which reflects 1\u20134.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003335","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:55:16Z","timestamp":1781006116000},"page":"e003335","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Co-producing sexual health services with minoritised communities: learning from a longitudinal qualitative evaluation"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-8105","authenticated-orcid":false,"given":"Fiona","family":"Fox","sequence":"first","affiliation":[{"name":"The National Institute for Health and Care Research Applied Research Collaboration South West, Brsitol, UK"},{"name":"Population Health Sciences, Bristol Medical School, University of Bristol, Brsitol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha","family":"Namurach","sequence":"additional","affiliation":[{"name":"Public Contributor, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peninah","family":"Achieng-Kindberg","sequence":"additional","affiliation":[{"name":"African Voices Forum, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2621-9759","authenticated-orcid":false,"given":"Lindsey","family":"Harryman","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Andrews","sequence":"additional","affiliation":[{"name":"Bristol Health Partners Academic Health Science Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Wilson","sequence":"additional","affiliation":[{"name":"The Brigstowe Project, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0399-9109","authenticated-orcid":false,"given":"Nathan","family":"Speare","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6752-1304","authenticated-orcid":false,"given":"Temilola","family":"Adeniyi","sequence":"additional","affiliation":[{"name":"University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsha","family":"Doran","sequence":"additional","affiliation":[{"name":"Public Contributor, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dravie-John","sequence":"additional","affiliation":[{"name":"African Voices Forum, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momin","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Public Contributor, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7092-4960","authenticated-orcid":false,"given":"Jeremy","family":"Horwood","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School, University of Bristol, Brsitol, UK"},{"name":"NIHR Health Protection Research Unit (HPRU) in Evaluation and Behavioural Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026060904551036000_4.2.e003335.1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2023-055798"},{"key":"2026060904551036000_4.2.e003335.2","first-page":"568","article-title":"Patient and public involvement in the co-production of knowledge: Reflection on the analysis of qualitative data","volume":"35","author":"Gillard","year":"2012","journal-title":"Int J Public Adm"},{"key":"2026060904551036000_4.2.e003335.3","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1177\/1471301218789558","article-title":"Involving minority ethnic communities and diverse experts by experience in dementia research: The Caregiving HOPE Study","volume":"17","author":"Parveen","year":"2018","journal-title":"Dementia (London)"},{"key":"2026060904551036000_4.2.e003335.4","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1111\/hex.13709","article-title":"Nothing about us without us: A co-production strategy for communities, researchers and stakeholders to identify ways of improving health and reducing inequalities","volume":"26","author":"Albert","year":"2023","journal-title":"Health Expect"},{"key":"2026060904551036000_4.2.e003335.5","unstructured":"Lester MV , Shah A , Chau C , et al . HIV testing, prep, new hiv diagnoses, and care outcomes for people accessing hiv services: 2022 report. London UK Health Security Agency; 2022."},{"key":"2026060904551036000_4.2.e003335.6","unstructured":"National Institute for Health and Care Excellence (NICE) . Reducing sexually transmitted infections: nice guideline \\[ng221]. 2023. Available: https:\/\/www.nice.org.uk\/guidance\/ng221"},{"key":"2026060904551036000_4.2.e003335.7","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1080\/01900692.2021.1912089","article-title":"Too Vulnerable to Involve? Challenges of Engaging Vulnerable Groups in the Co-production of Public Services through Research","volume":"44","author":"Amann","year":"2021","journal-title":"International Journal of Public Administration"},{"key":"2026060904551036000_4.2.e003335.8","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12864"},{"key":"2026060904551036000_4.2.e003335.9","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.socscimed.2015.04.019","article-title":"Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare","volume":"135","author":"de Freitas","year":"2015","journal-title":"Soc Sci Med"},{"key":"2026060904551036000_4.2.e003335.10","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s40900-023-00512-8","article-title":"Create to Collaborate: using creative activity and participatory performance in online workshops to build collaborative research relationships","volume":"9","author":"Malpass","year":"2023","journal-title":"Res Involv Engagem"},{"key":"2026060904551036000_4.2.e003335.11","unstructured":"Islam S , Albert A , Haklay M , et al . Co-Production in ActEarly: Nothing about Us without Us. Bradford: Bradford Institute for Health Research & University College London, 2022."},{"key":"2026060904551036000_4.2.e003335.12","unstructured":"Black South West Network & University of Bristol . The charter for co-production through an anti-racist lens. 2024. Available: https:\/\/www.blacksouthwestnetwork.org\/case-studies-and-features\/the-charter-on-co-production"},{"key":"2026060904551036000_4.2.e003335.13","unstructured":"UNAIDS . The gap report. 2014. Available: https:\/\/www.unaids.org\/en\/resources\/documents\/2014\/JC2686\\_WAD2014report"},{"key":"2026060904551036000_4.2.e003335.14","unstructured":"Bristol City Council . Bristol JSNA Health and Wellbeing Profile 2022\/23. Bristol: Bristol City Council, 2022."},{"key":"2026060904551036000_4.2.e003335.15","unstructured":"Bristol City Council . HIV health needs assessment. Bristol Public Health City Council; 2020."},{"key":"2026060904551036000_4.2.e003335.16","unstructured":"Altinoluk-Davis FCJ . Bristol hiv health needs assessment. Bristol Bristol City Council; 2023."},{"key":"2026060904551036000_4.2.e003335.17","unstructured":"Fast track cities - bristol one city. 2023. Available: https:\/\/www.bristolonecity.com\/fast-track-cities\/"},{"key":"2026060904551036000_4.2.e003335.18","unstructured":"National Institute for Health Research (NIHR) . Guidance on co-producing a research project. 2021. Available: https:\/\/www.learningforinvolvement.org.uk\/wp-content\/uploads\/2021\/04\/NIHR-Guidance-on-co-producing-a-research-project-April-2021.pdf"},{"key":"2026060904551036000_4.2.e003335.19","unstructured":"Eisenstadt N . Evaluating co-production. 2015. Available: https:\/\/knowyourbristol.blogs.bristol.ac.uk\/2015\/07\/24\/evaluating-co-production\/"},{"key":"2026060904551036000_4.2.e003335.20","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2026060904551036000_4.2.e003335.21","unstructured":"Boydell K , Gladstone BM , Volpe T , et al . The production and dissemination of knowledge: A scoping review of arts-based health research. Forum Qual Soc Res 2012;13."},{"key":"2026060904551036000_4.2.e003335.22","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2024-056259"},{"key":"2026060904551036000_4.2.e003335.23","doi-asserted-by":"crossref","DOI":"10.1186\/s40900-023-00512-8","article-title":"Create to Collaborate: using creative activity and participatory performance in online workshops to build collaborative research relationships","volume":"9","author":"Malpass","year":"2023","journal-title":"Res Involv Engagem"},{"key":"2026060904551036000_4.2.e003335.24","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1177\/0261018317747444","article-title":"Power dynamics and collaborative mechanisms in co-production and co-design processes","volume":"38","author":"Farr","year":"2018","journal-title":"Crit Soc Policy"},{"key":"2026060904551036000_4.2.e003335.25","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1057\/s41599-021-00782-1","article-title":"Co-producing knowledge in health and social care research: reflections on the challenges and ways to enable more equal relationships","volume":"8","author":"Farr","year":"2021","journal-title":"Humanit Soc Sci Commun"},{"key":"2026060904551036000_4.2.e003335.26","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1177\/14687941211065163","article-title":"Trust and temporality in participatory research","volume":"23","author":"Armstrong","year":"2023","journal-title":"Qual Res"},{"key":"2026060904551036000_4.2.e003335.27","unstructured":"Co-producing health & care services toolkit: learning from common ambition bristol. 2025."}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:55:27Z","timestamp":1781006127000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,9]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjph-2025-003335"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003335","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}