Epidemiology of HIV among black and minority ethnic men who have sex with men in England and Wales

Abstract

Objectives: To examine the epidemiology of HIV among black and minority ethnic (BME) men who have sex with men (MSM) in England and Wales (E&W). Methods: Ethnicity data from two national HIV/AIDS surveillance systems were reviewed (1997-2002 inclusive), providing information on new HIV diagnoses and those accessing NHS HIV treatment and care services. In addition, undiagnosed HIV prevalence among MSM attending 14 genitourinary medicine (GUM) clinics participating in the Unlinked Anonymous Prevalence Monitoring Programme and having routine syphilis serology was examined by world region of birth. Results: Between 1997 and 2002, 1040 BME MSM were newly diagnosed with HIV in E&W, representing 12% of all new diagnoses reported among MSM. Of the 1040 BME MSM, 27% were black Caribbean, 12% black African, 10% black other, 8% Indian/Pakistani/Bangladeshi, and 44% other/mixed. Where reported (n = 395), 58% of BME MSM were probably infected in the United Kingdom. An estimated 7.4% (approximate 95% CI: 4.4% to 12.5%) of BME MSM aged 16-44 in E&W were living with diagnosed HIV in 2002 compared with 3.2% (approximate 95% CI: 2.6% to 3.9%) of white MSM (p,0.001). Of Caribbean born MSM attending GUM clinics between 1997 and 2002, the proportion with undiagnosed HIV infection was 15.8% (95% CI: 11.7% to 20.8%), while among MSM born in other regions it remained below 6.0%. Conclusions: Between 1997-2002, BME MSM accounted for just over one in 10 new HIV diagnoses among MSM in E&W; more than half probably acquired their infection in the United Kingdom. In 2002, the proportion of BME MSM living with diagnosed HIV in E&W was significantly higher than white MSM. Undiagnosed HIV prevalence in Caribbean born MSM was high. These data confirm the need to remain alert to the sexual health needs and evolving epidemiology of HIV among BME MSM in E&W.

Non-condom related strategies to reduce the risk of HIV transmission: Perspectives and experiences of gay men with diagnosed HIV

“…The number of MSM with diagnosed HIV currently stands at more than 33,600 (Aghaizu et al, 2013) with a disproportionately high burden of infection among black and minority ethnic MSM (Dougan et al, 2005). The desire to have sex does not, of course, cease at diagnosis and many MSM with diagnosed HIV continue to have active sexual lives, although these are often compromised by the effects of HIV stigma and rejection by sexual partners (Bourne, Hickson, Keogh et al, 2012).…”

The State of Play in HIV Health Promotion for Black and Minority Ethnic Men Who Have Sex with Men

“…The general consensus among the major sexual health reports and articles is that MSM stands for "Men who have Sex with Men" (e.g., Dougan 2005;Elford 2010;Hickson 2004;Prost et al 2008). However in terms of operationalisation, there are three variables we have identified that are not accounted for in this classification, and also are not often addressed in reports and articles about MSM: type of sex, gender, and habitualness.…”

“…Using the ONS census categorisations to describe the ethnic populations in the UK, generally speaking, a large majority of the organisations agree that the term BME includes the aggregated Black, Mixed, Asian, Chinese, and Other ethnic groups (e.g., Dougan et al 2005;Hickson et al 2004;POST 2007;Raleigh et al 2010). It is also generally accepted that the "White British" category (comprising of English, Welsh, and Scottish) describes the ethnic majority and therefore is not included in the BME designation in each case reviewed.…”

Sexual abuse and HIV-risk behaviour among black and minority ethnic men who have sex with men in the UK

“…BME MSM face a double jeopardy in relation to sexual health. Black MSM are more likely to be diagnosed with a bacterial sexually transmitted infection (STI) compared to other ethnic groups (Dougan et al, 2005), and this group is 15 times more likely to be HIV-positive compared with the general population (Millet et al, 2012). According to recent Public Health England HIV surveillance data (Public Health England, 2015), there has been a more than 82% increase in new HIV diagnoses among MSM of "other" and mixed heritage.…”