Treatment outcomes among different ethnic groups similar for UK gay men

via Aidsmap, by Michael Carter

HIV treatment outcomes among gay men in the UK are similar across ethnic groups, investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

The study showed that gay men from black and minority ethnic (BME) populations were approximately 17% less likely to initiate antiretroviral therapy than white gay men. However, after starting treatment there were no differences by ethnicity in treatment outcomes.

“The provision through the NHS [National Health Service] of publicly funded HIV care with universal access has resulted in equitable utilisation and outcomes of HIV care across different ethnic MSM [men who have sex with men] groups,” comment the investigators. “Nevertheless we have shown that there are disparities in the uptake of cART [combination antiretroviral therapy] and the reasons for this warrant further study.”

Gay men remain one of the groups most affected by HIV in the UK. Prevalence of the infection differs significantly according to ethnicity and is higher among BME gay men compared to white gay men.

US research showed that differences in health insurance status meant that MSM from minority racial populations were less likely to access healthcare compared to white MSM.

In the UK, however, the NHS provides universal and equitable access to healthcare. Despite this, there is some evidence suggesting that BME patients are more likely to report dissatisfaction with their care and longer waiting times for appointments.

Investigators from the UK Collaborative HIV Cohort (UK CHIC) therefore analysed differences in retention in HIV care, uptake of antiretroviral therapy and HIV treatment outcomes between MSM according to ethnicity.

The study involved 16406 gay male patients who received care between 1996 and 2008. The analysis of HIV treatment utilisation was restricted to individuals who were seen after 2000. Examination of treatment outcomes was restricted to the subgroups of individuals who received care after 2007.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Is Homophobia a Factor in the HIV Racial Gap?

from Reuters, by Amy Norton

Among gay men in the United States, blacks are more likely than whites to believe that homosexuality is "wrong" - and these feelings might be contributing to the black men's higher risk of HIV infection, researchers suggest.

According to the U.S. Centers for Disease Control and Prevention, in 2006 African-Americans accounted for nearly half (45%) of new infections in the 50 states and the District of Columbia. Also, according to recent estimates, they account for a disproportionate 24 percent of reported HIV cases among gay and bisexual men in the U.S. The reasons are not clear. Studies have not found a higher rate of risky sexual behavior among black men versus white men -- but a range of factors are likely at work.

The current study was an attempt to look at one possible social factor: the stigma attached to homosexuality.

Using data from a U.S. health survey conducted periodically since 1972, the researchers found that, in general, African-Americans were more likely than whites to report a negative attitude toward homosexuality.

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Strategies and ethical considerations for the recruitment of young men who have sex with men: challenges of a vaccination trial in Mexico

Via PubMed.gov by Gutiérrez-Luna A, Angeles-Llerenas A, Wirtz VJ, Del Río AA, Zamilpa-Mejía L, Aranda-Flores C, Viramontes JL, Lazcano-Ponce E.

BACKGROUND:The importance of recruiting and retaining study participants from minority groups is well recognized; however, there are no established rules for recruitment as its success depends on the setting and population.

PURPOSE: To describe and analyze recruitment strategies, ethical considerations, and recruitment outcomes from a study to evaluate the efficacy the Human Papilloma Virus vaccine in young men who have sex with men (MSM).

METHODS: The recruitment settings were university and community sites in the state of Morelos, Mexico. Eligibility requirement were men between 18 and 23 years old, who were free of anal-genital lesions as confirmed by clinical exploration, HIV negative, with no history of sexual relations with female partners and with fewer than five male lifetime sexual partners. Recruitment goals were 25 study participants in a four and a half month period. In addition to traditional recruitment strategies (flyers and media advertising, specific training of the recruitment team and adequate choice of recruitment sites)-engagement of local leaders in the MSM community formed a crucial part of the strategy. Special consideration was given to confidentiality and respect for study participants and a Bill of Participant Rights was developed as an explicit commitment to respect and acceptance.

RESULTS: In total 723 MSM were initially contacted, 243 filled out the recruitment questionnaire, of which 151 met the criteria to be invited to the clinical examination. After clinical examination and interviews with the recruitment team, 131 fulfilled the inclusion criteria, of whom 73 were enrolled in the study - nearly triple the recruitment goal. Among the initial recruitment strategies (application of the screening questionnaire) attending meetings with MSM activist organizations was the most successful (326), followed by recruitment at bars and dance clubs (107).

LIMITATIONS: The recruitment strategies should be formally evaluated for their effectiveness to identify those which are most successful. In addition, future studies should consider the evaluation of study participants' perceptions of the recruitment strategies.

CONCLUSIONS: Recruiting MSM in a developing country such as Mexico presented multiple challenges. We recommend that future studies actively engage the local MSM community and pay special attention to designing recruitment strategies that guarantee the confidentiality of and respect for participants.

For the full study, please click here.

UN human rights head decries "perpetuation of prejudice"

In a valedictory speech to the United Nations Human Rights Council today, Louise Arbour has challenged the continued oppression of women and sexual minorities.

She is to step down later this month as the UN's High Commissioner for Human Rights.

"A failure to understand or accommodate diversity has inevitably led to an erosion of the rights of minorities and vulnerable people within a country, and those of individuals who move across borders, including refugees or migrants," she told the 47-member council.

"Fears and mutual suspicions, engendered by the security environment that has prevailed in the past few years, have exposed minorities to additional risks and abuse.

"The perpetuation of prejudices continue to deny equal rights and dignity to millions worldwide on the basis of nothing more innocuous than their sexual identity or orientation, or their ancestry, in the case of caste discrimination.

"Whether these are explicitly articulated grounds of prohibited discrimination or not, it remains that they are immutable personal attributes, or, as in the case of religious adherence, they are personal choices that could only be forcibly abandoned at an unconscionable personal cost.

Read the rest here.