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.
 

Tell Your Living Story

posted: 01/03/2010

Terrence Higgins Trust is looking for gay men with HIV to share their stories online on their What Next? website for gay men recently diagnosed HIV positive.

The What Next? website  is looking for gay men to keep an online diary, whether you’ve been diagnosed recently or living with HIV for longer. Part of the website includes videos and diaries describing men’s personal experience. Want to share yours?

What they are looking for is the story of what you’re up to and how you’re getting on in about 500 words, once a month, and they will then post this on the What Next? website for you. You will need to agree to have your photograph on the site.

If sharing your experiences online interests you, or you would like more information, please feel free to contact Stephen Adair at Terrence Higgins Trust or call him on 020 7812 1783.
 

French Gay Men – Half Diagnosed Recently Infected?

posted: 21/12/2009

Over the last five years, half of the gay men diagnosed with HIV in France were infected in the six months before their diagnosis, researchers report in Eurosurveillance. In the UK, a study in Brighton gave a similar result in 2007, but more recent work suggests the true UK figure is much lower – about 1 in 5 gay men diagnosed were recently infected.

The French study suggests that the rate of new infections among gay men in France is very high. However it could also be due to high rates of testing among some gay men.

After many years in which only AIDS diagnoses had to be reported in France, recently there have been big improvements in the French public health HIV reporting system. Since 2003, HIV diagnosis must be reported. A test to identify recent infections is also now usually performed as well.

Recent infections tests

Testing for recent infections (known as STARHS or incidence tests) looks for antibody markers that change depending on how long ago the infection happened.

There are now around 6,500 - 7,500 people newly diagnosed with HIV every year in France. [In the UK, in 2008, 7298 people were newly diagnosed, 2,760 of them gay men.] The numbers of gay men in France diagnosed with HIV has increased from below 2,000 in 2003 to around 2,500 for each of the last three years.

Epidemiologists analysed the available data on gay men diagnosed between 2003 and 2008, although quite a lot of information is missing. Recent infection results were only available for 4,819 gay men.

The average age for gay men diagnosed was 37. Doctors judged that around 1 in 5 gay men were in the primary infection stage. The test for recent infections showed that in fact 48% of men had been infected in the previous six months. This figure remained stable between 2003 and 2008.

More frequent testers
Men who had taken at least three HIV tests in their life were four times more likely to be diagnosed with recent infection than men who were diagnosed on their first HIV test. Being diagnosed in recent infection was more common both for men with French nationality and those with higher socio-economic status.

Younger men more likely to be recently infected, older men to be diagnosed late
Moreover, recent infection was more common for younger men, with 57% of those diagnosed aged 15-29 having recent infection, compared to 30% of men aged 50 and over. In line with this, whereas 11% of all gay men were diagnosed very late (with an AIDS-defining illness) this figure rose to 27% for those men aged over 50. The numbers of men diagnosed late fell during the study.

Older men were more likely to take a test because of symptoms, but younger men usually tested because of their risk-taking.

The authors note that the high number of recent infections in gay men probably reflects both testing behaviour and HIV incidence. They plan to publish a study estimating incidence rates in 2010.

Describing their data as worrying, they comment: “Prevention campaigns remain crucial, but they do not seem sufficient to contain sexual risk behaviours among MSM in France, despite the wide availability of screening, condoms and information and the fact that MSM represent a highly educated sub-population”.

In the United Kingdom, the Health Protection Agency (HPA) is also rolling out the use of recent infection tests. Whereas a 2007 study from Brighton estimated that half of new diagnoses in gay men were recent infections, the HPA’s preliminary results for 2008 suggest it is much lower - one-in-five for gay men, and one-in-ten for heterosexuals.

Source

Reference
Semaille C et al. Recently acquired HIV infection in men who have sex with men (MSM) in France, 2003-2008. Euro Surveill 48: 5-8, 2009.