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Abstract

Men who have sex with men (MSM) remain the group at highest risk of acquiring HIV in the UK. The aim of this thesis is to examine the changing patterns of HIV incidence and prevalence among MSM in the UK, making use of national HIV surveillance data.

This is a PhD-by-publication thesis, comprising seven peer-reviewed papers and four inter-related commentaries which explore the challenged of using HIV surveillance data to undertake epidemiological research in this area.

Chapter 2 explores the evolution of HIV surveillance among MSM in the UK over the past 25 years, and how this has responded to changes in HIV epidemiology and the availability of new data.

Chapter 3 examines time trends and geographic differences in diagnosed HIV among MSM in the UK. Specifically, the chapter investigates whether the recent increase in HIV diagnoses among MSM reflects an increase in HIV incidence or an increase in the uptake of HIV testing. A lack of detailed information on the 'at risk' population - the number of MSM living in the UK - constrains such analyses, however.

Chapter 4 explores an emerging area of research among MSM ethnicity and migration. Using data from several large surveillance databases, the chapter describes the epidemiology of HIV among ethnic minority and migrant MSM and makes recommendations for improving the utility of ethnicity data on MSM.

Finally, Chapter 5 examines another emerging area of research -- co-infection of HIV positive MSM with other sexually transmitted infections (STI) such as syphilis, gonorrhoea or hepatitis C. The chapter also explores sexual networks of MSM, and particularly HIV positive MSM.

In conclusion, this work highlights the increasing complexity of HIV epidemiology among MSM in the UK, and underscores the value of making full use of national HIV surveillance data. MSM continue to be disproportionately affected by HIV in the UK, emphasising the importance of continued surveillance, research, and prevention within this population.

Publication Type:	Thesis (Doctoral)
Subjects:	H Social Sciences > HT Communities. Classes. Races R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	Doctoral Theses School of Health & Psychological Sciences School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses

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