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Black gay men in the UK almost twice as likely to have HIV as white men, meta-analysis shows
Roger Pebody, 2012-07-30 14:00:00

A new analysis of existing studies on the sexual health of black gay men in the UK has found that despite having similar sexual risk behaviours to white gay men, they have almost twice the chance of being HIV-positive. The findings are published in a special issue of The Lancet on men who have sex with men, published last week to coincide with the 19th International AIDS Conference (AIDS 2012).

While reviewing studies on HIV infection and risk factors that affect black men who have sex with men in the United States, Greg Millet and colleagues also examined similar studies from the United Kingdom and Canada. They wished to see if the inequalities experienced by black MSM in the US were unique to that setting.

A total of 13 UK reports were identified, nine of which were based on the semi-annual Gay Men’s Sex Survey.

Putting all of these results together, the researchers found that black men had almost twice the odds of having HIV as white gay men – odds ratio 1.86 (95% confidence interval 1.58 – 2.18).

They were also more than twice as likely to have a sexually transmitted infection – odds ratio 2.66 (95% confidence interval 1.53 – 4.64).

But their individual risk behaviours were the same as for white gay men, with no statistically significant differences seen in terms of unprotected anal intercourse, unprotected sex with men of a different HIV status, number of partners, drug use and protective behaviours.

Black men were more likely to have tested for HIV (odds ratio 1.75) but less likely to be on antiretroviral therapy if diagnosed with HIV (odds ratio 0.78). The authors say that this finding is surprising, given the UK’s open access health service, but note that immigration status can act as a barrier to accessing healthcare.

A recent study based on the UKCHIC cohort has also found that black and minority ethnic gay men are 17% less likely to start antiretroviral therapy than white gay men, but that after starting treatment there are no differences in treatment outcomes.

The new meta-analysis also showed that, compared to other black people living in the UK, black gay and bisexual men have a nine-fold greater risk of HIV infection (odds ratio 9.3, 95% confidence interval 7.1 – 12.1).

Compared to the general population in the UK, black MSM have more than one hundred times the risk of having HIV (odds ratio 111.4).

The authors note that these findings resemble in many ways those of the United States – despite similar risk behaviour to their white peers, black gay and bisexual men have a markedly higher number of infections.

Source:1