Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
Young people under the age of 25 (aged 13-24)1, 2 due to being more likely to engage in risk-taking behaviours, stigma around seeking advice, economic challenges and vulnerabilities.
Gender
Women (particularly those aged 16 to 24) bear disproportionately high burden of sexual and reproductive morbidity3 due to biological factors including pregnancy and complications of STIs; and social, cultural and economic factors.
Socioeconomic status
Those from lower socioeconomic groups, particularly women living the most deprived areas and those among racially minoritised populations3. This is due to limited access to services & barriers, health literacy, stigma and misinformation, higher exposure to risk factors and the wider determinants of health.
Qualifications
Individuals with lower levels of educational attainment as education is a key determinant of sexual health4 due to lower health literacy, reduced access to services, stigma and misinformation, social determinants and earlier sexual activity and risk-taking behaviours.
Mental health
Individuals with mental health conditions, particularly severe or long-term, are at significantly higher risk4, 5 due to impact of mental health on decision-making, medication side effects, stigma and discrimination, barriers accessing services and higher rates of abuse and exploitation.
Ethnicity
Black ethnic groups, particularly Black Caribbean and Black African populations are at most risk3 due to systemic inequalities in healthcare access, socioeconomic disadvantages, stigma and cultural barriers, higher exposure to risk factors and underrepresentation in health campaigns.
Prisoners
Prisoners are at significantly higher risk, experiencing disproportionately high rates of STIs, blood-borne viruses and sexual health-related vulnerabilities6. This is due to limited access to sexual health services, higher prevalence of risk factors, disruption of care, stigma and lack of privacy and limited education & prevention.
Sexual orientation
Sexual minority groups, particularly gay and bisexual men, report higher rates of STIs7. Research highlights challenges in LGBTQ+ individuals accessing sexual health services5. Due to barriers accessing healthcare, higher rates of mental health issues, increased behavioural risk, lack of inclusive sexual health education and underrepresentation in health data and services.
Vulnerable children
Vulnerable children are more likely to experience poor health outcomes, including sexual health8. Due to adverse childhood experiences, exposure to abuse and exploitation, poor access to education and support, mental health challenges and systemic barriers.