Uptake of antiretroviral treatment among people living with HIV in London: ethnicity, gender and sexual orientation.
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/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.


CONCLUSIONS
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.
Elford
J
J
City University London, Department of Public Health, 20 Bartholomew Close, London EC1A 7QN, UK. j.elford@city.ac.uk
Ibrahim
F
F
Bukutu
C
C
Anderson
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People / Q000706:statistics & numerical data*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D019529:Sexuality / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*