Substantial rise in HIV prevalence seen in England, Wales and N.I. last year

Last year saw a 33% increase in the prevalence of heterosexually-acquired diagnosed HIV infection in England, Wales and Northern Ireland, and a 11% increase in diagnosed HIV infection amongst gay/bisexual men.

The former increase may be explained by the recent increase in African immigration from Sub-Saharan Africa, whilst the latter increase may be due partially to increased uptake of HIV testing within the gay community.

2002 also saw the largest ever rise in the number of HIV-infected people attending HIV clinics in England, Wales and Northern Ireland, with a 20% increase over 2001, bringing the total number of people being seen for care to over 30,000.

The results of the latest SOPHID (Survey of Prevalent HIV Infections Diagnosed) data were reported at the Health Protection Agency’s First Scientific Conference held at the University of Warwick, reflecting the changing face of HIV in the United Kingdom.

According to the 2002 data, 14,326 (47%) of those attending HIV clinics in England, Wales and Northern Ireland were (predominantly white) gay or bisexual men, with 12,841 (42%) being men or women who acquired HIV heterosexually, of which two-thirds were of black African ethnicity.

It is predicted that in 2003, for the first time, the number of people living with HIV who acquired HIV infection heterosexually will outnumber those who acquired HIV through gay sex, and that by 2005 out of almost 50,000 people predicted to be living with HIV, 54% will be heterosexually-acquired and 38% acquired through gay sex.

Between 1997 and 2002, the number of people infected by injection drug user (IDU) and other routes - such as mother-to-infant transmission - has remained relatively constant at 10-13% of the total HIV clinic population and is expected to remain so in the future.

Officially, HIV is also no longer solely a London-based issue, with two others areas in the UK - notably the South East and North West - now reporting an HIV prevalence of more than 30 per 100,000. Whilst the epidemic is still primarily a gay one in Brighton and Blackpool (where around 90% of people living with HIV in these major gay resorts are gay/bisexual men), clinics in Greater Manchester and Merseyside as well as London and the Home Counties are now seeing almost equal numbers of heterosexuals and gay/bisexual men.

The area around London - the Home Counties and London suburbs collectively termed by HPA researchers as “the London fringe” - has seen the largest increase of heterosexually-acquired HIV infections in recent years. Between 1997 and 2002, the London fringe saw a 557% increase, compared with a 186% increase in London and 306% in the rest of England, Wales and Northern Ireland.

Since 75% of heterosexually-acquired infections on the London fringe were amongst black Africans the researchers suggest that these numbers could be driven by the large number of black Africans living in areas like Luton and Slough. The SOPHID data does not collect information about the country of origin, however, so it is hard to know how many are UK- or Sub-Saharan African-born. It is also possible, however, that this London fringe increase could also be due to economic reasons: London boroughs may simply be too expensive, and black African communities with high HIV prevalence may be moving out of central London.

The SOPHID data only includes people who are aware of their HIV infection and are currently being seen for treatment. Given that an estimated 33% of people living with HIV in the UK are unaware of their status, it is important to remember these numbers do not reflect the total number of people actually living with HIV in the UK.

The full SOPHID report for 2002 is now available at the Health Protection Agency website.