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Sex Transm Infect doi:10.1136/sti.2007.029249

Uptake of antiretroviral treatment among people living with HIV in London: ethnicity, gender and sexual orientation

  1. Jonathan Elford (j.elford{at}city.ac.uk)
  1. City University, United Kingdom
    1. Fowzia - Ibrahim, - (f.ibrahim{at}city.ac.uk)
    1. City University London, United Kingdom
      1. Cecilia - Bukutu, - (c.bukutu{at}city.ac.uk)
      1. City University London, United Kingdom
        1. Jane Anderson (jane.anderson{at}homerton.nhs.uk)
        1. Homerton University Hospital NHS Foundation Trust, United Kingdom
          • Published Online First 18 February 2008

          Abstract

          Objective: To examine, by ethnicity, gender and sexual orientation, uptake of antiretroviral treatment among people living with HIV in London.

          Methods: Between June 2004-June 2005, 1687 people living with HIV (73% response) receiving treatment and care in north east London National Health Service (NHS) outpatient clinics completed a confidential, self-administered questionnaire. Respondents were asked whether they were currently taking HIV treatments (antiretroviral or combination therapy)

          Results: Overall, 73.7% (1057/1435) of respondents said they were currently taking HIV treatments; white gay men 70.7%, ethnic minority gay men 70.9%, black African heterosexual women 75.0%, black African heterosexual men 80.8% (p<0.05). In all groups, taking HIV treatments was strongly associated with having a low CD4 count at diagnosis (p<0.001); 30.1% of white and ethnic minority gay men had a CD4 count less than 200 cells/mm3 at diagnosis compared with 53.1% of the black African heterosexual women and 66.3% of the black African heterosexual men (p<0.001). After adjusting for CD4 count at diagnosis, no significant differences in uptake of HIV treatments remained between the groups; gay men adjusted odds ratio (aOR) 1.00 (reference group); black African heterosexual women aOR 1.15, 95% confidence interval (CI) 0.71, 1.88, p=0.6; black African heterosexual men aOR 0.88, 95% CI 0.43, 1.80, p=0.7.

          Conclusion: Our analysis suggests that in London, once HIV infection is diagnosed, people from the two main risk groups - gay men (mostly white) and black African heterosexual men and women - receive HIV treatment according to clinical need regardless of their ethnicity, gender or sexual orientation.

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