Almost 50,000 have been diagnosed with HIV in the UK, according to a report published in advance of World AIDS Day by the UK Health Protection Agency (HPA).
By September 2002, 49,500 people had been diagnosed HIV-positive in the UK, with 5,711 new HIV diagnoses in 2002 representing a 20% increase in total HIV prevalence, according to the report Renewing the focus: HIV and other sexually transmitted infections in the United Kingdom in 2002.
To help combat the spread of HIV the HPA is calling for new health promotion campaigns targeted at gay men, and is recommending that gay men have an annual HIV test and that migrants to the UK be offered voluntary HIV testing and counselling.
Factors driving the increase are said by the HPA to include a possible rise in the number of new cases of HIV transmission between gay men, and continued migration of HIV-infected men and women from sub-Saharan Africa. An increase was also recorded by the HPA in the number of heterosexual cases of HIV acquired in the UK.
In 2002, 3,305 new cases of heterosexual transmission of HIV were recorded. This is almost twice the 1,691 new diagnoses involving gay men made in the same year. Since 1999 there has been an over three-fold increase in the number of heterosexual cases diagnosed each year. The HPA also points out that there appears to have been a steady, if slight, increase in the number of cases in gay men since 1999 (approximately 1,350 new cases a year to 1,650 new cases annually).
Women bore the brunt of heterosexually acquired HIV cases in 2002, accounting for 66% of all instances of heterosexual transmission (1,993 of 3,152). Since 1999 the majority of heterosexually acquired HIV cases detected in the UK were acquired in South Eastern Africa, particularly Zimbabwe, but public health officials have also detected an increasing number of cases acquired in Latin America, the Caribbean and Asia.
Of the 1,850 cases of HIV transmission which occurred in the UK in 2002, the overwhelming majority involved gay men. The annual incidence rate for gay men attending sexual health services was 3%. However there were 275 cases of heterosexual transmission in the UK, an increase of 128 on 1998. Almost all these cases involved sexual contact with an individual from a region with HIV high prevalence.
The success of HAART and the growing number of new cases of HIV transmission has meant that there has been a 101% increase in demand for HIV care since 1997. In 2002, 31,861 people received HIV care in the UK.
Demand for HIV care is heaviest in London, where 54% (17,000) of individuals receiving HIV care in 2002 lived. However, the HPA also recorded significant increases in demand for HIV services in areas bordering London.
New infections amongst injecting drug users remained steady in 2002, but the HPA noted that in individuals who had started injecting in the previous three years, the prevalence of hepatitis C virus was 14%.
Approximately a third of people with HIV in the UK are unaware that they have the infection, including 24% of HIV-positive gay men (an estimated 5,500 individuals) and 38% of heterosexual Africans (9,400 people).
Amongst the measures proposed by the HPA to slow the spread of HIV are annual HIV tests for gay men, syphilis testing for all HIV-positive gay men, the availability of voluntary HIV testing and counselling for migrants to the UK, further research into the sexual behaviour of Africans living in the UK, and reduced waiting times for sexual health services.
The HPA also notes an increase in bacterial and viral sexually transmitted infections, particularly amongst young people and gay men.
Health Protection Agency. Renewing the focus: HIV and other sexually transmitted infections in the United Kingdom in 2002. November 2003.