{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:20:05Z","timestamp":1783016405296,"version":"3.54.6"},"reference-count":21,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["102186\/B\/13\/Z"],"award-info":[{"award-number":["102186\/B\/13\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2024,3,25]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Women aged 16\u201324 in England have a high burden of sexual and reproductive morbidity, with particularly poor outcomes among people living in more deprived areas (including racially minoritised populations). This analysis used national data to examine the disparities within sexual and reproductive outcomes among this population and to assess whether the patterns of inequality were consistent across all outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Within this ecological study, univariable and multivariable Poisson regression analyses of neighbourhood-level data from national data sets were carried out to investigate the relationships of deprivation and ethnicity with each of six dependent variables: gonorrhoea and chlamydia testing rates, gonorrhoea and chlamydia test positivity rates, and abortion and repeat abortion rates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>When comparing Index of Multiple Deprivation (IMD) decile 1 (most deprived) and IMD decile 10 (least deprived), chlamydia (RR 0.65) and gonorrhoea (0.79) testing rates, chlamydia (0.70) and gonorrhoea (0.34) positivity rates, abortion rates (0.45) and repeat abortion rates (0.72) were consistently lower in IMD decile 10 (least deprived). Similarly, chlamydia (RR 1.24) and gonorrhoea positivity rates (1.92) and repeat abortion rates (1.31) were higher among black women than white women. Results were similar when both ethnicity and deprivation were incorporated into multivariable analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We found similar patterns of outcome inequality across a range of sexual and reproductive outcomes, despite multiple differences in the drivers of each outcome. Our analysis suggests that there are broad structural causes of inequality across sexual and reproductive health that particularly impact the health of deprived and black populations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2023-220835","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T13:25:17Z","timestamp":1712928317000},"page":"451-457","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Inequalities in sexual and reproductive outcomes among women aged 16\u201324 in England (2012\u20132019)"],"prefix":"10.1136","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4177-1832","authenticated-orcid":false,"given":"Danielle","family":"Solomon","sequence":"first","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"},{"name":"National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in Partnership with UK Health Security Agency (UKHSA), London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9105-2441","authenticated-orcid":false,"given":"Fiona","family":"Burns","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"},{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"Mohammed","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in Partnership with UK Health Security Agency (UKHSA), London, UK"},{"name":"University College London, London, UK"},{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie J","family":"Migchelsen","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline A","family":"Sabin","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"},{"name":"National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in Partnership with UK Health Security Agency (UKHSA), London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"2025100307523751000_78.7.451.1","unstructured":"Mitchell H , Allen H , Sonubi T , et al . Sexually transmitted infections and screening for chlamydia in England, 2019 Public Health England, 2020. Available: https:\/\/www.gov.uk\/government\/statistics\/sexually-transmitted-infections-stis-annual-data-tables"},{"key":"2025100307523751000_78.7.451.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62071-1"},{"key":"2025100307523751000_78.7.451.3","unstructured":"Department of Health and Social Care . Abortion statistics, England and Wales. 2019."},{"key":"2025100307523751000_78.7.451.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.05.005"},{"key":"2025100307523751000_78.7.451.5","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/01.olq.0000137898.17919.35","article-title":"Family socioeconomic status and self-reported sexually transmitted diseases among black and white American adolescents","volume":"31","author":"Newbern","year":"2004","journal-title":"Sex Transm Dis"},{"key":"2025100307523751000_78.7.451.6","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1016\/S0140-6736(13)61947-9","article-title":"Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain: findings from the national surveys of sexual attitudes and lifestyles (Natsal)","volume":"382","author":"Sonnenberg","year":"2013","journal-title":"The Lancet"},{"key":"2025100307523751000_78.7.451.7","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2020-138944"},{"key":"2025100307523751000_78.7.451.8","unstructured":"Office for Health Improvement and Disparities . Integrated sexual health service specification. 2023."},{"key":"2025100307523751000_78.7.451.9","unstructured":"Local Government Association . Derby and Derbyshire: Tackling the fragmentation of the sexual health system, 2023. Available: https:\/\/www.local.gov.uk\/case-studies\/derby-and-derbyshire-tackling-fragmentation-sexual-health-system"},{"key":"2025100307523751000_78.7.451.10","unstructured":"England PH . GUMCAD STI Surveillance System: Data specification and Technical Guidance, 2020. Available: https:\/\/www.gov.uk\/guidance\/gumcad-sti-surveillance-system"},{"key":"2025100307523751000_78.7.451.11","unstructured":"GOV.UK . CTAD Chlamydia Surveillance System, 2023. Available: https:\/\/www.gov.uk\/guidance\/ctad-chlamydia-surveillance-system"},{"key":"2025100307523751000_78.7.451.12","unstructured":"Office for National Statistics . Population estimates, Available: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates"},{"key":"2025100307523751000_78.7.451.13","unstructured":"Mclennan AD , Noble S , Noble M , et al . English Indices of Deprivation 2019 - Technical report, 2019. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/833951\/IoD2019_Technical_Report.pdf"},{"key":"2025100307523751000_78.7.451.14","unstructured":"GOV.UK . NCSP: programme overview, Available: https:\/\/www.gov.uk\/government\/publications\/ncsp-programme-overview\/ncsp-programme-overview"},{"key":"2025100307523751000_78.7.451.15","unstructured":"Public Health England . What do women say? reproductive health is a public health issue. 2017."},{"key":"2025100307523751000_78.7.451.16","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.2105\/AJPH.69.12.1242","article-title":"Repeat abortions: blaming the victims","volume":"69","author":"Howe","year":"1979","journal-title":"Am J Public Health"},{"key":"2025100307523751000_78.7.451.17","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1040341"},{"key":"2025100307523751000_78.7.451.18","doi-asserted-by":"publisher","DOI":"10.1783\/147118907781005047"},{"key":"2025100307523751000_78.7.451.19","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2011-0063"},{"key":"2025100307523751000_78.7.451.20","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jes.7500533"},{"key":"2025100307523751000_78.7.451.21","unstructured":"World Health Organisation . Sexual health and its linkages to reproductive health: an operational approach. 2017."}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2023-220835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:52:54Z","timestamp":1759503174000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2023-220835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,12]]},"references-count":21,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,6,10]]},"published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1136\/jech-2023-220835"],"URL":"https:\/\/doi.org\/10.1136\/jech-2023-220835","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,12]]}}}