Sexual health behaviour and the choices people make are influenced by whole range of factors including social grouping, education, peer pressure and access to services/information. Report on the health of the public in Britain have shown that sexual ill health is unequally distributed across society (Department of Health 2001; Royal College of Nursing 2001). people from socially disadvantaged and marginalised groups experience the highest levels of sexually related illness. Quantitative studies form the main pool of information available in relation to sexual health and risk. They have demonstrated that in some areas of the country the infection rates for STI's are up to twelve times higher in men from black Caribbean communities (Fenton, Johnson et al. 1997; Lacey, Merrick et al. 1997; Low, Daker-White et al. 1997). At present there is very little published qualitative information on the factors affecting sexual health decisions, especially in relation to black Caribbean communities. The research study focuses on black Caribbean men. A qualitative approach is used to identify and explore the key factors influencing the health decisions and risk activities of black Caribbean men in relation to sexual health. Social construction theory provides the theoretical underpinning for this study alongside aspects of feminism, criticalist and ethnicities based approaches. The stereotype of black Caribbean men as sexually insatiable and irresponsible emerged as a key feature of the social scripts associated with their sexual behaviour. The themes 'The nature of the stereotype', 'Living with the stereotype' and 'Hearing the silences' discussed in the data chapters explore the impact of the stereotype on the sexual health decisions of black Caribbean men. The experiences highlighted through the themes expose the importance of the political, social and personal context associated with specific sexual scripts on the sexual health decisions of black Caribbean men. Of key importance in these socially determined scripts are the screaming silences contained within them. The findings are reviewed in the light of current sexual health policies to consider how sexual health services and professionals can best provide for the sexual health needs of black Caribbean men. The thesis adds to current knowledge in sexual health and ethnicities in concluding that the sexual health decisions of black Caribbean men take pace in the context of the real or imagined expectations that society has of them. Individuals sexual decisions therefore occur in light of shared and personal appraisal of socially determined relevant issues. This forms the context in which sexual scripts are given meaning and sexual decisions take place. The study compliments the established pool of quantitative data available linking issues of sexual health and ethnicity in Britain. The findings presented within the thesis reveal a range of issues to initiate further qualitative research in the area and provides a lead for British based thinking on adult sexual health decisions and ethnicity.