title: HIV, sexual risk and ethnicity among gay and bisexual men in England: survey evidence for persisting health inequalities.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Sigma Research, Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Ford
authors.initials: F
authors.lastname: Hickson
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Melendez-Torres
authors.affiliation: Sigma Research, Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Reid
authors.affiliation: Sigma Research, Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Weatherburn
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000208:ethnology / Q000523:psychology; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006306:Health Surveys; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology; D006801:Humans; D008297:Male; D012747:Sexual Partners
keywords: ETHNICITY; GAY MEN; HIV; SEXUAL BEHAVIOUR