Sociodemographic variations in healthcare service use among people with HIV in the UK.

Abstract

People with HIV on effective treatment can expect a normal life expectancy, though they may experience increased prevalence of other chronic health conditions. We assessed among people with HIV, non-HIV health care usage and variation by sociodemographic and lifestyle factors. Positive Voices 2022 is a national UK questionnaire study of people with HIV (April 2022-March 2023). Participants self-reported on use of a range of health services. Associations of sociodemographic and lifestyle factors with five specific services were assessed using modified Poisson regression. Prevalence ratios(aPRs) adjusted for age, demographic group and year of HIV diagnosis and 95% confidence intervals [95%CIs] are given. Among 4451 people with healthcare use data, 79.0% attended their GP service in the past year, and 54.9%, 46.2%, 21.0%, and 10.0% attended dental, sexual health, accident and emergency (A&E) and mental health services, respectively. Use varied across sociodemographic groups. Older people were less likely to use mental health and sexual health services, but more likely to use GP and dentists. Black African men, other heterosexual men and Black African women were significantly less likely to use mental health services: aPR 0.19 95%CI[0.09-0.43], aPR 0.49 95%CI[0.31-0.78] and aPR 0.48 95%CI[0.34-0.68] respectively, compared to gay/bisexual/other men-who-have-sex-with-men. Participants without money for basic needs were much more likely to use mental health services (aPR 3.41, 95%CI[2.54-4.59] versus enough money) and A&E (aPR 2.00, 95%CI[1.65-2.45]), but less likely to use dentists (aPR 0.84 95%CI[0.73-0.96]). Obesity, smoking and comorbidities were also associated with higher use of A&E and mental health services. Healthcare service use among people with HIV varies across sociodemographic groups. Results suggest the need for interventions and policies to improve physical and mental health and access to timely care among people with socioeconomic disadvantage and to enable greater access to mental health services for Black African people.