Changes to HIV weekly

There will be no HIV weekly for the next two weeks, as we will be providing news coverage from the Conference on Retroviruses and Opportunistic Infections (CROI). As a subscriber to HIV weekly, you will automatically receive our four conference summary bulletins.

After the conference coverage, we’ll be making some changes to HIV weekly.

In common with other charities in the UK, NAM has had a difficult year financially and we have been making some changes in order to reduce costs – you can find out more about this in our recent blogpost, An update for NAM's supporters.

HIV weekly is a popular and valued resource, with a wide audience, and we recognise that there is still a need for the service it provides – giving a summary of the latest HIV research news relevant to people living with HIV in the UK; providing important context and links for further information.

However, it is not currently possible for us to continue publishing it every week, so we have made a decision to change it to a fortnightly bulletin. To reflect this change, we will also be changing the name of the bulletin, to HIV update.

As a subscriber, you don’t need to do anything to continue to receive it – in mid-March you should automatically receive the first edition of HIV update to your inbox, and every two weeks after that.

If you would like to hear from us more often, why not consider signing up to one of our other email bulletins as well? The aidsmap news bulletin, for example, will be sent on alternate weeks, giving a run-down of all the headlines. To sign up for this, or if you want to recommend our bulletins to your friends, networks or colleagues, visit www.aidsmap.com/bulletins

Thank you for your continuing support. If you have any questions or comments, please get in touch on info@nam.org.uk.

HIV treatment as prevention

An analysis of the roll-out of HIV treatment in a Canadian province over 16 years has shown the impact that antiretroviral drugs have had on new HIV infections.

It is well known that HIV treatment has benefits both for the individual taking it and also for that person’s sexual partners – as treatment suppresses viral load to undetectable levels, the risk of sexual transmission is reduced by as much as 96% when heterosexual people start treatment early and use condoms consistently.

But there are some uncertainties about the likely impact on the public health – in other words on new infections across a population. This is because a number of other factors (such as the number of people who have HIV without realising it and rates of condom use) also have an impact on new infections.

The analysis comes from British Columbia. In contrast to most other parts of Canada and the United States, HIV healthcare is provided free of charge to all there.

Between 1996 and 2012, the number of people taking treatment increased eight-fold, while the number of annual diagnoses was reduced by two-thirds. The biggest drop in diagnoses was seen in people who inject drugs, but they also fell in men who have sex with men.

The researchers estimated that for every 1% increase in the number of individuals taking treatment with a viral load below 500 copies/ml, the number of new HIV infections dropped by 1%. Similar results have already been reported from a large study in South Africa.

The study therefore shows that HIV treatment does have a real and measurable impact on new infections in the ‘real world’, even if new infections cannot be eliminated entirely.

For more information on what treatment as prevention means for individuals, you may find our factsheet HIV treatment and sexual transmission useful. NAM has also been part of a project developing a community consensus statement about HIV treatment as prevention, which launches this week.

HIV testing in the UK

Guidelines issued in 2008 concerning HIV testing in general medical and primary care settings are not being followed, a new analysis shows. Researchers pooled the results of 30 studies of the uptake of HIV testing.

Although the number of people tested in sexual health clinics has increased in recent years, doctors should offer HIV tests to patients in other circumstances – in case they have HIV without realising it.

Guidelines recommend that all patients presenting with a disease indicating possible HIV infection – for example TB or glandular fever – should be offered an HIV test. But researchers have found that this happens for only around 22% of patients.

Similarly, the 2008 guidelines recommend that GPs should offer a test to all new patients if the GP practice is in an area where a large number of people have HIV. Hospital doctors are also asked to offer HIV tests in these areas.

However the researchers found that only 30% of patients in these areas were offered a test.

Most people who were offered a test chose to be tested. And a number of people were newly diagnosed with HIV – around 1 in every 200 people tested.

If the guidelines were more closely followed by doctors, it is likely that fewer people would be diagnosed late and fewer people would pass on HIV without realising it.

You can find out more about the UK guidelines in our online resource HIV transmission & testing. Explaining HIV testing to someone? Two of our illustrated leaflets cover HIV Testing in the UK and reasons why you are Better off knowing your HIV status.