HIV in the UK

posted: 03/12/2010

 

The latest report on HIV in the UK has appeared from the Health Protection Agency. They found  the number of people living with HIV in the UK reached an estimated 86,500. A quarter of these people don’t know they have HIV.
 

New diagnoses among men who have sex with men stayed high (2,760); four out of five gay and bi men probably got HIV in the UK.
 

Of the people newly diagnosed in 2009, 1,130 probably acquired their infection heterosexually, within the UK, accounting for a third of heterosexuals diagnosed.
 

One in six gay and bi men, and one in sixteen heterosexuals got HIV within the previous 4-5 months before their diagnosis.
 

6,600 new people diagnosed

A total of 6,630 people were newly diagnosed as HIV-infected. This represents a fourth year-on-year decline, largely due to fewer diagnoses among people infected heterosexually abroad, mostly in Sub-Saharan Africa – there have been fewer migrants who happen to come from countries with HIV rates of HIV.
 

Older worries

Some 65,000 individuals accessed HIV care, of whom one in five were aged 50 years or over. Since 2000 there has been a three-fold increase in the number of individuals accessing care and a fourfold increase among older (greater than 50 years) individuals.

Sue Peters, regional director of the Terrence Higgins Trust in Brighton, said they are concerned at the number of older people becoming diagnosed in recent years. She pointed out that gay and bi men over 50 have lived through the worst years of HIV and men who remain HIV negative may now feel they are not going to catch it. Some men think that they do catch HIV past their 50th birthday, they are old enough for it not to cause any really serious harm.
“The same issue is with younger people who may still not be aware of the dangers of what is a life long infection. I think people sometimes feel they are immune but they aren’t and it is something that concerns us.”
 

Becoming HIV positive after the age of 50 is not recommended. The immune system becomes less able to fight serious health problems the older we get. People over 50 with HIV tend to be diagnosed late and often need to start HIV treatment immediately. Treatment for HIV becomes more complicated with older age because we often have other long-term health problems to do with being older.

Late too
Half of adults were diagnosed with HIV at a late stage of infection in 2009 (CD4 counts less than 350 within three months of diagnosis), the stage at which treatment is recommended to begin.
 

Thirty-seven English primary care trusts (PCTs) had a prevalence of diagnosed HIV greater than 2 per 1,000 population, the threshold at which expanded HIV testing should be implemented – in NW England these are Manchester, Salford and Blackpool.
 

Uptake of HIV testing was 95% in antenatal clinics and 77% among STI clinic attendees in England.
 

The quality of HIV care received is high. Based on London data, 80% of newly diagnosed patients were seen in an HIV clinic within one month of diagnosis; 90% had an undetectable viral load (less than 50) one year after starting therapy; and 93% of those in care for more than a year had a CD4 count above 200.
 

• HPA recommendations
  
• High proportions of recently acquired HIV infections among newly diagnosed gay and bi men of all age groups underscores the need for ongoing prevention efforts tailored to all ages in this group.
• The national recommendation of universal testing for all attendees of STI clinics should be audited and improved in many clinics; the existing national standard for HIV testing in STI clinics should be reviewed so as to encourage better performance.
• In high prevalence areas (greater than 2 per 1,000 people diagnosed HIV infection) the routine offer and recommendation to accept an HIV test for all adult general practice registrants and general medical admissions should be widely implemented given the recently reported success of pilot projects. The upper age limit for application of this policy should be set with regard to local circumstances.
• Roll-out of clinical outcome indicators to assess the quality of HIV care received by patients, already in place in London, should be extended to the rest of the country.

Sources

Health Protection Agency - HIV in the UK 2010, report and PowerPoint slides

Aidsmap 
 

Brighton Argus

PinkNews

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