New UK HIV diagnoses in 2003: near-complete numbers confirm record increase

Near-complete numbers of new HIV UK diagnoses for 2003 were released the Health Protection Agency (HPA) last week, and reveal that with over 90% of reports in, there were a record 6606 new HIV diagnoses last year. This confirms the HPA’s earlier estimate of over 7000 new HIV diagnoses in 2003 once all reports are in. In addition, in the first half of 2004, 1680 new diagnoses of HIV infection were reported, bringing the cumulative total of HIV diagnoses in the UK to 64,678 since surveillance began in 1982.

The demographics of new HIV UK infections is a story of two parallel sex-driven epidemics; one gay/bisexual and one heterosexual.

Sex between men

Although only 26% of new HIV infections were diagnosed in men who have sex with men (MSM), they remain the group most at risk of acquiring HIV within the UK. This coincides with an increase in the reporting of riskier behaviours and other sexually transmitted infections (STIs), including syphilis and gonorrhoea. For new diagnoses among MSM made in 2003, where probable country of infection was known (950 of 1,735), 84% (796) were probably infected within the UK.

Sex between men and women

Since 1999, the number of HIV infections diagnosed in heterosexual men and women has exceeded those in MSM. Although the increase in heterosexually-acquired HIV diagnoses has been substantial, the majority of these infections were acquired abroad. For diagnoses in heterosexual men and women made in 2003, 81% (2727/3359) were infected in African countries, and 8.7% (291/3359) in other parts of the world other than the UK and Africa. Numbers of individuals infected through heterosexual contact within the UK, without evidence of a ‘high risk’ partner, have been increasing gradually, and in 2003 represented 10% (341/3359) of new diagnoses in heterosexual men and women where probable country of infection was known.

Women

In 2001, the number of HIV infections diagnosed in heterosexual women exceeded MSM for the first time. In 2003, almost two-thirds of new heterosexually-acquired HIV diagnoses (2465) were made in women.

Injecting drug users

Diagnoses among injecting drug users (IDU) remained relatively low, with 107 new diagnoses reported in 2003.

Other routes

Infections transmitted through blood transfusion or from mother to child are for the most part acquired outside the UK. Follow-up to ascertain the probable route of infection is still ongoing for 12% (786) of diagnoses from 2003.

London-focused

London remains the focus of HIV in the UK, with 2973 (45%) of new diagnoses in 2003 being made there. A further 20% of diagnoses were in the regions adjacent to London. However, all English regions have seen increases in new diagnoses each year since 1999 including areas that previously saw relatively few HIV cases, such as the North East, Yorkshire and Humberside, Eastern England, driven by the UK Government’s dispersal policy for asylum seekers from London and the southeast to the rest of the UK which began in April 2000. In each of these English regions, and Wales and Northern Ireland, new diagnoses more than doubled between 1999 and 2003.