Access to HIV Community Services by Vulnerable Populations: Evidence From an Enhanced HIV/AIDS Surveillance System in the United Kingdom
October 12, 2011
"In many countries including those in the UK," vulnerable populations -- including black and minority ethnic groups, men who have sex with men (MSM), and migrants -- are disproportionately affected by HIV, the study authors explained. "Community organizations in the UK are charitable, non-governmental organizations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV."
Noting that information on how these organizations contribute to the care of vulnerable groups "is relatively sparse," the researchers conducted the current study using data generated from an enhanced HIV surveillance system in North West England. They set out to determine the characteristics of patients who chose to access community services in addition to clinical services (1,375 out of 4,195 records of HIV patients in clinical services). The team examined demographic information and risk factors including residency status uniquely gathered in the region, as well as deprivation scores. Multivariate logistic regression modeling was used to predict the relative effect of patient characteristics on attendance at community services.
The highest attendance at community services was noted among those living in the most, compared with the least, deprived areas (p<0.001), "and was most evident among MSM and heterosexuals." Compared to white UK nationals, attendance was significantly higher in non-UK nationals of uncertain residency status (adjusted odds ratio=21.91, 95 percent confidence interval 10.48-45.83; p<0.001), refugees (AOR=5.75, 95 percent CI 3.3-10.03; p<0.001), migrant workers (AOR=5.48, 95 percent CI 2.22-13.51; p<0.001), and temporary visitors (AOR=3.44, 95 percent CI 1.68-7.05; p<0.001).
"Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society," the authors concluded. "Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services."
05.2011; Vol. 23; No. 5: P. 542-549; H.C.E. Madden, and others
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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
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