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 and June 2005, 1687 people living with HIV (73% response) receiving treatment and care in North East London National Health Service 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 men who have sex with men (MSM) 70.7%; ethnic minority MSM 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 cell count at diagnosis (p<0.001); 30.1% of white and ethnic minority MSM had a CD4 cell 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 cell count at diagnosis, no significant differences in uptake of HIV treatments remained between the groups: MSM AOR 1.00 (reference group); black African heterosexual women AOR 1.15, 95% CI 0.71 to 1.88, p = 0.6; black African heterosexual men AOR 0.88, 95% CI 0.43 to 1.80, p = 0.7.

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