Explaining differences in HIV prevalence among ethnic minority and migrant MSM in Britain
J. Elford1, R. Doerner1, E. McKeown1, S. Nelson2, N. Low3, J. Anderson4
1City University, London, United Kingdom, 2Terrence Higgins Trust, Bristol, United Kingdom, 3University of Bern, Bern, Switzerland, 4Homerton Hospital NHS Foundation Trust, London, United Kingdom
Background: Differences in HIV prevalence have been reported between ethnic minority, white and migrant men who have sex with men (MSM) in Britain. It is unclear whether these differences can be explained by established risk factors for HIV. This paper compares HIV prevalence in different ethnic and migrant groups in Britain, adjusting for confounding risk factors.
Methods: In 2007-2008 a diverse national sample of MSM living in Britain was surveyed online. Men were recruited through websites as well as in bars, clubs and sexual health clinics.
Results: Of the 13163 MSM included in this analysis, 311 men described their ethnicity as Black and 565 as Asian. Approximately half these men were born in Britain. In addition the sample included 136 men born in Central or South America and 207 men born in Eastern Europe. The remaining men were white British (table 1).
|N||HIV positive||Adjusted OR*||95% confidence interval||p-value|
|Central/South American||136||23||16.9||1.56||0.95, 2.55||p=0.08|
|Eastern European||207||7||3.4||0.29||0.14, 0.64||p<0.01|
|* OR = odds ratio. Odds ratios were adjusted for age, unprotected anal intercourse, recreational drug use, HIV treatment optimism, education, employment, place of residence.|
In univariate analysis, HIV prevalence was significantly lower among Asian and Eastern European men and elevated for men from Central or South America, compared with white British men (p< 0.01). These differences remained significant after adjusting for confounding risk factors (table 1).
Conclusion: Differences in HIV prevalence between white, ethnic minority and migrant MSM in Britain can not be explained by corresponding differences in sexual behaviour or other risk factors for HIV.