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Recent epidemiological data suggests that 1 in 8 men-who-have-sex-with-men (MSM) diagnosed with HIV in London during 2011 were born in Latin America.1 The recent global recession caused significant migration to the UK from South America and Spain, including people living with HIV (PLWH). In March 2015, we retrospectively evaluated a Spanish-speaking HIV service dedicated to this group at the Chelsea and Westminster Hospital NHS Trust in London, looking at the key characteristics and needs of this cohort.
Sixty-one patients were included, of whom 92% were male (90% MSM, 6% bisexual). The mean transfer age was 35, ranging from 23 to 57 years. The majority (72%) were born in Latin America, of which the largest represented group was Colombian (37%), yet 76% of the cohort had Spanish (European) nationality. Most overseas transfers of care for HIV (87%) were from Spain. The majority (85%) were employed but only 20% were registered with general practitioners. Mean transfer CD4 lymphocyte count was 565 copies/mL; 85% were on antiretroviral therapy, of whom 90% had an undetectable HIV viral load. Twenty-two per cent had a previous STI (chlamydia, gonorrhoea, syphilis or genital warts). There was a heavy burden of depression: 31% compared with the general UK HIV population rate of 26%.2 Language difficulty was prevalent (96% spoke limited or no English) and this was the main reason for declining the medications home-delivery service (56%). We noted that four of the five women referred presented with lower CD4 lymphocyte counts (<500 copies/mL). The year 2013–2014 saw an 82% rise in referrals compared with 2011–2012.
The substantial changes to current commissioning arrangements across London must ensure continued access to culturally and linguistically appropriate services for PLWH. They are essential for reducing inequalities in health outcomes affecting emerging unidentified migrant populations, as the one described here, and must remain a priority for providers.
Footnotes
Twitter Follow Ivana Paccoud at @ivanicka
Contributors MMH created the database, performed the data analysis, and is the first and submitting author. LDG participated in the Spanish-speaking HIV service. She collected data, contributed to the database and reviewed the article. MW and IP reviewed the article. CC reviewed the original data. He is a referrer to the Spanish-speaking HIV service. CC leads the Spanish-speaking HIV service. She collected data, reviewed and contributed to the article.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
Data sharing statement Patient-level data are available from the corresponding author at malikamohabeer@gmail.com.