Interventions Supporting Engagement with Sexual Healthcare among People of Black Ethnicity: A Systematic Review of Behaviour Change Techniques

Rebecca Clarke, Gemma Heath*, Jonathan Ross, Claire Farrow

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


BACKGROUND: Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated. METHOD: Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised. RESULTS: Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators' demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s). DISCUSSION: Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups.

Original languageEnglish
Article numberSh23074
JournalSexual Health
Issue number1
Publication statusPublished - 2 Jan 2024

Bibliographical note

Copyright © 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an accepted manuscript of an article published in Sexual Health. The published version is available at:


  • Black minority ethnic groups
  • STI testing
  • behaviour change
  • intervention
  • public health
  • sexual health
  • sexually transmitted infection
  • systematic review


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