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英格兰男同性恋者和双性恋男性中的艾滋病毒、性风险与种族:持续存在健康不平等现象的调查证据

HIV, sexual risk and ethnicity among gay and bisexual men in England: survey evidence for persisting health inequalities.

作者信息

Hickson Ford, Melendez-Torres G J, Reid David, Weatherburn Peter

机构信息

Sigma Research, Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

Sex Transm Infect. 2017 Nov;93(7):508-513. doi: 10.1136/sextrans-2016-052800. Epub 2017 Mar 27.


DOI:10.1136/sextrans-2016-052800
PMID:28348021
Abstract

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. CONCLUSIONS: 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.

摘要

目的:在进行过类似观察13年后,对大量男同性恋者和双性恋男性(GBM)样本中的艾滋病毒检测和性行为的种族差异进行研究,评估全国的艾滋病毒预防应对措施,并为规划重点提供依据。 方法:2014年夏季进行的横断面便利性自填式在线调查,与社区健康促进者和同性恋互联网服务机构合作设计并招募;与2001年报告的类似设计调查的早期结果进行比较。 结果:我们招募了15388名居住在英格兰的GBM,他们自我报告如下:18.5%为少数族裔;9.0%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,亚洲男性报告已确诊艾滋病毒的可能性不再较低,而是具有同等可能性(2001年比值比(OR)=0.32,95%置信区间(CI)0.13至0.79;2014年OR=1.04,95%CI 0.71至1.54);黑人男性报告已确诊艾滋病毒的可能性仍然显著更高(2001年OR=2.06,95%CI 1.56至3.29;2014年OR=1.62,95%CI 1.10至2.36),其他白人组男性也是如此(2001年OR=1.54,95%CI 1.23至1.93;2014年OR=1.31,95%CI 1.10至1.55)。2014年报告的艾滋病毒确诊总体年发病率为1.1%。黑人男性在过去12个月内报告艾滋病毒确诊的可能性显著高于英国白人(校正比值比(AOR)2.57,95%CI 1.22至5.39)。去年没有少数族裔群体报告无保护肛交(CUAI)的可能性更高或更低,但亚洲、黑人和所有其他群体的男性比英国白人更有可能报告与不止一个非固定伴侣发生CUAI。 结论:在英格兰的GBM中,与英国白人相比,黑人男性和其他白人男性中的艾滋病毒流行率仍然更高。亚洲背景的保护作用似乎不再存在。性风险行为可能是造成其中一些差异的原因。

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[3]
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[4]
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[5]
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[7]
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[8]
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