HIV risk factors common in Central and Eastern European gay men who have migrated to the UK

Gay men from Central and Eastern Europe who have migrated to the UK are at risk of HIV and other sexually transmitted infections, investigators report in the online edition of Sexually Transmitted Infections.

Approximately a quarter of men reported unprotected anal sex with a casual partner of a different or unknown HIV status, and 15% of men reported having been paid for sex.

“Our findings suggest that CEE [Central and Eastern European] MSM [men who have sex with men] report comparable levels of risk to those in the general MSM population in London and the UK,” comment the investigators, “interventions aimed at MSM should be accessible to CEE MSM.”

The study was undertaken in 2009 and followed the expansion of the European Union on 2004 to include ten new member states in Central and Eastern Europe.

Investigators wished to establish a clear understanding of sexual risk behaviour and use of health services by gay and other men who have sex with men who had migrated to the UK with men from these regions.

Using the internet cruising sites gaydar and gayromeo, the investigators recruited 691 men from Central and Eastern Europe who were living in the UK. These individuals completed in-depth on-line questionnaires.

The men had a mean age of 29 years, most were working and 54% had a degree. The majority (83%) had lived in the UK for over a year and resided in London (80%).

There was a high prevalence of HIV risk behaviour. Overall, 22% (13% in the UK) of men reported being paid for sex, 37% said they had recently used recreational drugs, 31% had been diagnosed with a sexually transmitted infection, 62% had had ten or more sexual partners in the past year, and 23% had had unprotected anal sex that involved a risk of HIV transmission.

HIV testing rates were high with 79% stating that they had ever tested, and 64% said they had tested since arriving in the UK.

Prevalence of HIV was 5%, much lower than prevalence among UK gay men, which some studies have suggested is as high as 12% in London . Over three-quarters (78%) of men from Central and Eastern Europe with HIV were diagnosed in the UK. Similarly, the majority of diagnoses of other sexually transmitted infections were made in the UK.

The longer men lived in the UK the more likely they were to report risky sex. Levels of drug use were higher among those who had lived in the UK for at least a year (p = 0.005), and longer residence was also associated with a greater number of partners.

Factors associated with unprotected sex with casual partners of an unknown or different HIV status were being HIV-positive (p < 0.001), or untested (p = 0.001), recreational drug use (p < 0.001), and being paid for sex in the UK (p = 0.004).

“CEE MSM are at significant risk of the acquisition and transmission of HIV,” write the investigators, who emphasise the UK’s “duty of care to ensure that MSM from CEE countries are aware of their sexual health services in the UK and are able to access them.” They call for HIV prevention materials to be tailored to meet the needs of these men.