Elford J, Ibrahim F, Bukutu C, Anderson J
City University London, Department of Public Health, 20 Bartholomew Close, London EC1A 7QN, UK.
Sex Transm Infect. 2008 Jun;84(3):176-8. doi: 10.1136/sti.2007.029249. Epub 2008 Feb 18.
To examine, by ethnicity, gender and sexual orientation, uptake of antiretroviral treatment among people living with HIV in London.
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)
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/mm(3) 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.
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.
按种族、性别和性取向研究伦敦艾滋病毒感染者接受抗逆转录病毒治疗的情况。
在2004年6月至2005年6月期间，1687名在伦敦东北部国民保健服务门诊接受治疗和护理的艾滋病毒感染者（回应率73%）完成了一份保密的自填问卷。询问受访者是否正在接受艾滋病毒治疗（抗逆转录病毒或联合疗法）。
总体而言，73.7%（1057/1435）的受访者表示他们正在接受艾滋病毒治疗：与男性发生性关系的白人男性（男男性行为者）为70.7%；少数族裔男男性行为者为70.9%；非洲裔黑人异性恋女性为75.0%；非洲裔黑人异性恋男性为80.8%（p<0.05）。在所有组中，接受艾滋病毒治疗与诊断时CD4细胞计数低密切相关（p<0.001）；30.1%的白人和少数族裔男男性行为者在诊断时CD4细胞计数低于200个细胞/mm³，而非洲裔黑人异性恋女性为53.1%，非洲裔黑人异性恋男性为66.3%（p<0.001）。在对诊断时的CD4细胞计数进行调整后，各组之间在接受艾滋病毒治疗方面没有显著差异：男男性行为者调整后比值比为1.00（参照组）；非洲裔黑人异性恋女性调整后比值比为1.15，95%置信区间为0.71至1.88，p = 0.6；非洲裔黑人异性恋男性调整后比值比为0.88，95%置信区间为0.43至1.80，p = 0.7。
我们的分析表明，在伦敦，一旦诊断出感染艾滋病毒，来自两个主要风险群体——男男性行为者（大多为白人男性）以及非洲裔黑人异性恋男性和女性——会根据临床需求接受艾滋病毒治疗，而不论其种族、性别或性取向。
