Background: The HIV epidemic in the UK disproportionately affects persons from ethnic minorities. We used the community-led STIGMASurveyUK2015 conducted among people living with HIV (PLHIV) to examine differences in the experiences of HIV-related stigma and discrimination between people from black, Asian and other minority ethnicities (BAME) and white UK born people (non-BAME).
Methods: The HIVStigmaSurveyUK2015 invited PLHIV through >120 cross-sector community organisations and 46 clinics to complete an anonymous web-based questionnaire. The inclusion of BAME people was defined by community groups. Descriptive, univariate and multivariate regression analyses were performed.
Results: Among 1,576 participants, 583 (37%) identified as BAME, including those of black ethnicity (58%), white-non UK born (19%), Asian (6%) and other ethnicities (16%). BAME mean age was 43 years (range 17-76), 53% were men, 44% women and 3% trans. 87% of black persons identified as heterosexual, 65% of white-BAME, 57% of Asian and other ethnicities as MSM vs 81% as MSM for non-BAME.
Significantly fewer BAME felt in control about the disclosure of their HIV status (82%% vs 92%
p< 0.001) and had disclosed their status to friends (64% vs 86%, aOR:2.1, 95%CI:1.6-2.) and employers/co-workers (38% vs 50%, aOR:1.5, 95%CI:1.1-2.0) than non-BAME, adjusted for sexuality and gender. 18% of BAME felt that they had no or low levels of support when disclosing to their sexual partner, family, friends, or co-workers/employers vs 10% among non-BAME (p< 0.001). Disclosure in the healthcare was high in both groups: 93% for BAME vs 97% for non-BAME. However, fewer BAME felt supported than non-BAME (79% vs 88% p< 0.05).Moreover, 40% of BAME reported being treated differently in healthcare during the last 12 months vs 29% of non-BAME (p< 0.001) and among these a higher proportion of BAME avoided care when needed compared to non-BAME
(71% vs 57% p< 0.001).
Conclusions: In the UK, PLHIV from BAME communities are particularly vulnerable to HIV-related stigma and discrimination, with less control over and support during disclosure of their status and more experiences of discrimination in healthcare. These findings call for culturally and settings targeted interventions to address HIV-related stigma and discrimination that severely affect PLHIV access to healthcare and support.