HPA 2006: over 66,000 living with HIV in the UK

The number of adults living with HIV in the United Kingdom at end of 2005 has increased by 9% from the previous year to 63,500, according to the Health Protection Agency's (HPA) annual report on HIV/AIDS and sexually transmitted infections (STIs), released today. Of these, a third – an estimated 20,100 – were unaware of their infection. The report also reveals that more gay men and other men who have sex with men (MSM) than ever were diagnosed with HIV in 2005, whereas there were fewer new diagnoses amongst heterosexual women and men who acquired their HIV in Africa.

The HPA's report, A Complex Picture estimates that more than 66,000 individuals were living with HIV in the UK at the end of 2005. This number is based on an estimated 63,500 adults aged between 15-59 (43,400 diagnosed, 20,100 undiagnosed); an additional 1,650 diagnosed HIV infections in adults aged 60 or over; and another 800 in children and adolescents aged 14 or under. Although the HPA thinks that there will be undiagnosed HIV infections amongst those over 60 and under 15, they believe the proportion of undiagnosed infections is likely to be much smaller than in those aged 15 - 59.

The HPA's Dr Valerie Delpech says that the increased numbers of people living with HIV in the UK is due to a number of factors, including “people living longer with HIV due to advances in treatment, sustained levels of newly acquired infections in gay men, further diagnoses among heterosexuals who acquired their infection in Africa, and cases being picked up earlier.”

The HPA has received reports so far suggesting that 7,450 individuals were newly diagnosed with HIV in the UK in 2005. However, this number is likely to increase as reports continue to be collated. Whereas the numbers of individuals who acquired their infection through heterosexual sex in Africa appears to be declining (2,760 in 2005, so far), the number of new diagnoses of HIV infection among gay men and other MSM (2,356 in 2005, so far) was the highest ever recorded.

The HPA report suggests that the reasons for the continuing high level of new HIV diagnoses “is due to sustained levels of newly acquired infections in men who have sex with men; further diagnoses among heterosexual men and women who acquired their infection in Africa; and earlier and increased HIV testing.”

Although new diagnoses are remaining high, the report suggests that the “annual numbers of new HIV diagnoses may be stabilising”. However another part of the report refers to “continued increases” in HIV diagnoses, suggesting that until final figures are collated, it is impossible to know whether new diagnoses are stable or increasing.

New diagnoses do not necessarily mean recent infections, however, which the HPA is currently unable to track accurately, although there are plans to do so via increased use of the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) assay, which can determine the window period of HIV infection to within 133 days.

Key findings

• In 2005 there were an estimated 63,500 adults aged between 15 and 59, living with HIV in the UK, of whom 20, 100 (32%) had not been diagnosed.
• A total of 47,517 individuals (all ages) accessed HIV-related care in the UK during 2005, a 13% increase since 2004, and the lowest annual increase since 1998.
• In 2005, a total of 7,450 individuals were newly diagnosed with HIV in the UK. This is similar to new diagnoses in 2004 (7492) and in 2003 (7283)
• In 2005, there were 2,356 new diagnoses of HIV infection among gay men and other MSM: the highest ever reported. In 2004, the number was 2,185, the highest number since 1990.
• In 2005, there were 2,760 new diagnoses of HIV infection who acquired their infection through heterosexual sex in Africa. In 2004 the number was 3,374, and in 2003 the number was 3,554.
• In 2005, where probable country of infection was reported, 84% (1149/1374) of newly diagnosed gay men probably acquired their infection in the UK compared with 15% (553/3,668) of heterosexuals.
• Of adults diagnosed with HIV in the UK in 2005, at the time of their diagnosis 34% (2498/7325) had a CD4 cell count below the BHIVA's recommended threshold for starting anti-HIV therapy (3) and 11% (837) presented with AIDS.
• HIV testing appears to have stabilised at 80% among gay men and other MSM attending sentinel GUM clinics in the UK. The biggest increase in the uptake of HIV testing was among heterosexuals outside London (from 76% in 2004 to 85% in 2005).
• In 2005, among gay men and other MSM attending sentinel GUM clinics, the prevalence of previously undiagnosed HIV infection remained stable at 3.2%. Prevalence varied from 3.8% in London, to 3.2% in Scotland and 2.5% elsewhere in the UK.
• In England and Scotland in 2005 an estimated 0.09% of all pregnant women had an undiagnosed HIV infection prior to antenatal testing. Most of these women will have been diagnosed as a result of antenatal testing.