Around a quarter Vemurafenib of heterosexuals attended a non-local service [25% (2073/8404) and 23% (3320/14747) among men and women, respectively] compared with 22% (201/916) of injecting drug users (IDUs) (χ2 for all risk groups P<0.01). Black-African and Black-Caribbean patients were less likely to attend a non-local service compared with White patients [23% (3888/16 897), 26% (367/1431) and 29% (6711/23 416), respectively; χ2P<0.01]. Older patients were more likely to attend a non-local service than younger patients [28% (5517/19 612) of 40–54-year-olds vs. 21% (375/1755) of 15–24-year-olds;

χ2P<0.01]. Patients living more than 5 km from an HIV service were more likely to use a non-local service compared with patients living within 5 km of a service [36% (3252/9010) vs. 24% (9092/37 540), respectively; χ2P<0.01], as were patients living in urban areas compared with those living in rural areas [44% (930/2130) vs. 26% (11 414/44 420), respectively; χ2P<0.01]. Adults living in the least deprived areas were twice as likely to attend non-local services as those living in the most deprived areas [42% (1185/2798) vs. 21% (4162/19 461), respectively; χ2P<0.01]. Patients prescribed ART drugs were more likely to use a non-local service compared with those not prescribed ART

drugs [28% (9243/33 117) vs. 23% (2766/12 233), respectively]. Patients who first attended PD332991 services in 2007 were less likely to attend a non-local service compared with those who attended services before 2007 [20% (1192/5962) vs. 27% (11 152/40 588), respectively; χ2P<0.01]. In a multivariable analysis, the strongest predictor of travelling to non-local care was residential deprivation. Patients ZD1839 cell line living in the least deprived areas were more than twice as likely to access non-local services compared with those living in the most deprived areas (AOR 2.6; 95% CI 1.98–2.37). Those who first attended HIV care before 2007 were 50% more likely to attend non-local sites compared with those who first attended for care in 2007 (AOR 1.48; 95%

CI 1.38–1.59). Patients living in urban areas were 23% more likely to use non-local services compared with those living in rural areas (AOR 0.77; 95% CI 0.69–0.85) (Table 2). Other predictors that retained their significance in the multivariable model included risk group, receipt of ART, age and ethnicity. Patients infected through blood/blood products were almost twice as likely to attend non-local services as MSM (AOR 1.99; 95% CI 1.61–2.45). Patients aged 40–54 years were 29% more likely to use non-local services compared with those aged 15–24 years (AOR 1.26; 95% CI 1.10–1.43). Finally, patients who received ART were 24% more likely to use non-local services compared with those not receiving ART (AOR 1.24; 95% CI 1.17–1.30) (Table 2).