HIV Infection Among Ethnic Minority and Migrant Men Who Have Sex With Men in Britain

Objective: To examine human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) from different ethnic and migrant groups living in Britain. Methods: In 2007-2008, a diverse national sample of MSM living in Britain was recruited through Web sites, in sexual health clinics, bars, clubs, and other venues. Men completed an online survey that included questions on HIV testing, HIV status, and sexual behavior. Results: Nine hundred and ninety-one ethnic minority MSM, 207 men born in Central or Eastern Europe (CEE), 136 men born in South or Central America, and 11,944 white British men were included in the analysis. Self-reported HIV seropositivity was low for men of South Asian, Chinese, and "other Asian" ethnicity (range, 0.0%-5.8%) and for men born in CEE (4.5%) but elevated for men born in South or Central America (18.7%), compared with white British men (13.1%) (P < 0.001). There were no significant differences between these groups in high-risk sexual behavior (P = 0.8). After adjusting for confounding factors in a multivariable model, substantial differences in the odds of HIV infection remained for South Asian and Chinese MSM as well as for migrants from CEE, but not for other groups, compared with white British men; for example, South Asian men, adjusted odds ratio 0.43, 95% confidence interval 0.23, 0.79, P = 0.007. Conclusion: There were marked differences in self-reported HIV seropositivity between ethnic minority, key migrant, and white British MSM in this study but not in high-risk sexual behavior. This highlights the importance of health promotion targeting MSM from all ethnic and migrant groups in Britain.