HIV, sexual risk and ethnicity among gay and bisexual men in England: survey evidence for persisting health inequalities
HIV, sexual risk and ethnicity among gay and bisexual men in England: survey evidence for persisting health inequalities
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DOI：
10.1136/sextrans-2016-052800
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发表时间：
2017-11-01
影响因子：
3.6
通讯作者：
Weatherburn, Peter
中科院分区：
文献类型：
--
作者：
Hickson, Ford;Melendez-Torres, G. J.;Weatherburn, Peter
目的在进行类似观察13年后，研究同性恋和双性恋男性（GBM）大样本中艾滋病毒检测和性行为的种族差异，评估国家艾滋病毒预防反应并为规划重点提供信息。方法2014年夏季与社区健康促进者和同性恋网络服务机构合作设计和招募的横断面便捷自填在线调查；与2001年类似设计的调查结果比较。结果我们招募了15 388名居住在英国的GBM，他们自我报告如下：18.5%来自少数民族；9.0%的艾滋病毒检测呈阳性（2001年分别为17.0%和5.4%）。与英国白人相比，亚洲男性报告诊断出艾滋病毒的可能性不再低，但这样做的概率相同（2001年OR=0.32, 95% CI 0.13至0.79；2014年OR=1.04, 95% CI 0.71至1.54）；与其他白人组（2001年OR=1.54, 95% CI 1.23至1.93；2014年OR=1.62, 95% CI 1.10至2.36）相比，黑人男性仍然更有可能报告诊断出艾滋病毒（2001年OR=2.06, 95% CI 1.56至3.29）。2014年报告的艾滋病毒诊断总体年发病率为1.1%。在过去的12个月里，黑人男性比英国白人更有可能报告被诊断患有艾滋病毒（调整后的优势比（AOR） 2.57, 95% CI 1.22至5.39）。在过去的一年里，没有哪个少数民族报告有安全套无保护肛交（CUAI）的可能性更高或更低，但亚洲人、黑人和所有其他群体的男性比英国白人报告有不止一个非稳定伴侣的CUAI的可能性更高。在英国的GBM中，与英国白人相比，黑人男性和其他白人男性的艾滋病毒感染率仍然更高。来自亚洲背景的保护作用似乎不再适用。性危险行为可能是造成这些差异的部分原因。
Objectives To examine ethnic group differences in HIV testing and sexual behaviours among a large sample of gay and bisexual men (GBM), 13 years after similar observations were made, assess national HIV prevention responses and inform planning priorities.Methods Cross-sectional convenience self-completion online survey in summer 2014, designed and recruited in collaboration with community-based health promoters and gay internet services; comparison with earlier findings reporting on similarly designed survey in 2001.Results We recruited 15 388 GBM living in England who self-reported as follows: 18.5% from ethnic minorities; 9.0% tested HIV positive (cf. 17.0% and 5.4% in 2001). Compared with the white British, Asian men were no longer less likely to report diagnosed HIV but had an equal probability of doing so (2001 OR=0.32, 95% CI 0.13 to 0.79; 2014 OR=1.04, 95% CI 0.71 to 1.54); black men remained significantly more likely to report diagnosed HIV (2001 OR=2.06, 95% CI 1.56 to 3.29; 2014 OR=1.62, 95% CI 1.10 to 2.36) as did men in the other white group (2001 OR=1.54, 95% CI 1.23 to 1.93; 2014 OR=1.31, 95% CI 1.10 to 1.55). Overall annual incidence of reported HIV diagnoses in 2014 was 1.1%. Black men were significantly more likely to report diagnosis with HIV in the last 12 months than the white British (adjusted odds ratios (AOR) 2.57, 95% CI 1.22 to 5.39). No minority ethnic group was more or less likely to report condom unprotected anal intercourse (CUAI) in the last year but men in the Asian, black and all others groups were more likely than the white British to report CUAI with more than one non-steady partners.nonsteadyConclusions Among GBM in England, HIV prevalence continues to be higher among black men and other white men compared with the white British. The protective effect of being from an Asian background appears no longer to pertain. Sexual risk behaviours may account for some of these differences.