1 in 6 Gay Men Recently Infected

posted: 26/07/2010

One in six gay men having a HIV positive test in the UK became HIV positive within the past six months. This is the first result from a new system tracking trends in recent HIV infections in the UK.
 

The Health Protection Agency devised a formula (an algorithm) and method for tracking recent HIV infections. Knowing how many people were recently infected is helpful for working out what is actually happening in the UK HIV epidemic.

The number of recent infections matters because people who are recently infected are far more infectious than at any other time.
 

Tracking recent infections
The new formula and tracking method, called either the Recent Infection Testing Algorithm (RITA) or Serological Testing Algorithm for Recent HIV Seroconversion (STARHS), measures the amounts of certain antibody markers. These amounts change depending on how long ago the HIV infection took place. Amounts below a certain level mean the infection was recent (approximately within the last six months).
 

The RITA / STARHS method is not exact enough to tell an individual when they became HIV positive, because we all vary in how our immune system responds to HIV, but the method is good enough to give rough timings, which is all we need to track what is happening with the epidemic.
The work on this tracking system began in 2008, when the Health Protection Agency rolled-out STARHS as part of the routine public health monitoring of all newly diagnosed HIV infections in the country.
 

Results
The data presented the International AIDS 2010 conference in Vienna that has just ended, came from samples of 2099 people, who broadly represent, demographically and geographically, people newly diagnosed in the UK. The samples were collected between February 2009 and May 2010.
 

Gay and bi men results

Amongst gay and bisexual men, 16.1% of diagnoses were judged to be recent – within the past six months – one in six. There wasn’t any difference between gay and bi men of different ages.
 

Heterosexual results

Among heterosexuals, 6.2% men and 6.8% women were recently infected. This is just one in sixteen heterosexuals being infected within six months of their positive test.
 

There appears to be a trend for recent infections to be more commonly identified in younger heterosexual women (probably due to antenatal testing), but the age variations were not statistically significant. Curiously, in women aged 50 or over, there was a relatively high proportion of recent infections, but this is based on a small number of cases and could be due to chance. But it fits with another recent report from the HPA at the Vienna International AIDS Conference - many long-term heterosexual relationships break up when people are in their 50s, and women, no longer needing contraception, may neglect to consider the need for safer sex - condoms - to protect against STIs such as HIV.

Recently infected heterosexuals were largely people born in the UK. Heterosexual people born in Africa tend to have infection diagnosed later, the majority becoming HIV positive before migration to the UK.
 

Source

Reference: Lattimore S et al. Surveillance of recently acquired HIV infections among newly diagnosed individuals in the UK. Eighteenth International AIDS Conference, Vienna, abstract FRAX01001, 2010.
 

Global Treatments Working

posted: 24/11/2009

The death toll from HIV across the world fell by more than 10% over the past five years, latest figures show. The World Health Organization and the Joint UN Programme on HIV/AIDS (UNAids) say that since effective treatments first became available in 1996, some 2.9 million lives have been saved.

As the number of deaths has fallen, the number of people living with HIV has risen slightly - an estimated 33.4 million people worldwide are infected with HIV, up from 33 million in 2007 because of fewer deaths.
 

New infections fall
The latest report also shows there has been a significant drop in the number of new HIV infections. The report suggests that HIV prevention programmes are having a significant impact - new HIV infections have fallen by 17% over the past eight years.
 

In sub-Saharan Africa, the epicentre of the global pandemic, the number of new infections has fallen by around 15% since 2001 - equating to about 400,000 fewer infections in 2008 alone. In the same period, infection rates were down by nearly 25% in East Asia, and by 10% in South and South East Asia. In Eastern Europe, after a dramatic increase in new infections among injecting drug users, the rate of infection has levelled off considerably.
 

UNAids executive director Michel Sidibe said although prevention programmes had helped cut new infections, they were often "off the mark". "If we do a better job of getting resources and programmes to where they will make most impact, quicker progress can be made and more lives saved," he said.

Prioritise Gay Men in UK

Deborah Jack, chief executive of National AIDS Trust, said: “The downward trend in new infections is a testament to the work of the international HIV community. It’s the result of the roll-out of treatment and increased investment in prevention initiatives.

"However today’s report shows there are gaps in prevention programmes that meet the needs of key groups, such as over 25s and gay men. We need to get smarter about HIV prevention and also sustain efforts to find new tools such as microbicides and a vaccine, if we are to seriously reduce new infections.

"Worryingly, the global decrease in new infections is not being seen in the UK. Here new diagnoses have trebled in the past ten years. HIV diagnoses among men who have sex with men in the UK rose by 74 per cent between 2000 and 2007. The UK needs to re-prioritise HIV prevention among gay men, otherwise we risk falling further behind.”
 

UNAIDS global HIV epidemic update 2009

Source

Eliminate HIV from the World?

posted: 20/02/2009

Getting rid of HIV from the world is a dream that is becoming more reasonable to have. It might sound like fantasy: HIV infection has no cure and no vaccine, after all.

Yet there is a way to completely wipe it out - at least in theory. What's more, it would take only existing medical technology to do the job.

This is the start of a long article, in the latest issue of the New Scientist , that looks at the issues, problems and solutions and how we could do it.

What would it take to rid S Africa of HIV?

The most interesting section is where they discuss how it could be done.

Researchers looked at the case for elimination in South Africa, which has the highest number of HIV cases in the world. They modelled what would happen if everyone over 15 were given annual tests, with all those who tested positive offered free antiretroviral treatment immediately, regardless of their CD4 count. They plugged in actual figures from a free treatment programme in Malawi, to take account of people who refuse treatment, or who stop because of side effects, or who change treatments because of resistance.

10 years action would see HIV start to disappear

The team found that within 10 years, the scheme would slash new HIV infections from the 1 in 50 people at present to less than 1 in 1000. Within 50 years, as people with HIV died (mainly from other causes), prevalence in the general population would fall from about 10 per cent to less than 1 per cent.

That all sounds great, but the cost of the scheme would initially be about $3.5 billion a year. That might sound prohibitive, but the key comparison to make is with the cost of alternative plans.

....

Or in the UK?

It might be easier to attempt universal treatment in a developed country. For example, the UK could, if it chose, afford to put every one of its estimated 73,000 HIV-positive residents on antiretroviral therapy. On the other hand with HIV only affecting 0.1 per cent of the UK population, so the universal testing this would need would be hard to justify.

read the full report