Latest data on UK epidemic: increases in people accessing care and in heterosexually acquired HIV

The Public Health Laboratory Service (PHLS) released preliminary data last week showing a 14% increase in the number of people with HIV accessing care in England, Wales and Northern Ireland during 1999.

In 1999 a total of 19,179 people were reported as having been seen for care. This compares to 16,891 in 1998.

Among those accessing care, patients recorded as having acquired HIV through sex between men rose by 11% (from 9637 to 10,650), through heterosexual sex by 25% (from 4392 to 5506), through injecting drug use by 5% (from 890 to 936).

The survey also identifies an increase in the number of patients using HAART. Though the figures are likely to represent an underestimate, since data on use of treatment are not available for all patients, 11,969 patients received antiretroviral drug therapy in 1999. In the previous year the figure had been 9,943.

For those patients for whom information on treatment was reported, the proportion taking HAART rose from 62% in 1998 to 68% in 1999 - an increase of 10% in the overall numbers on HAART. The proportion of patients reported to be receiving three or more drugs rose from 85% in 1998 to 93% in 1999.

Data collected during the first half of 2000 show a total of 1246 new HIV diagnoses up to the end of June this year. Of those, for whom the route of transmission has already been established, 53% (565) are recorded as having acquired HIV heterosexually, and 44% (463) as having acquired HIV through sex between men.

The PHLS has suggested that the rise in the proportion of heterosexually acquired infection may reflect a rising number of infections being recognised as a result of symptomatic disease, diagnoses in individuals without symptoms being made as a result of the growing awareness of the potential benefits of treatment, and the widening of antenatal testing.

Most of the 1341 people whose infection was attributed to heterosexual sex were recorded as ‘probably acquired abroad’, with around two thirds having acquired HIV in sub-Saharan Africa.

In 1999 there were 403 HIV infected children, and 117 children were born to HIV-positive women but were still of indeterminate HIV status when last reported in the UK. It is highly likely that most of the indeterminate infants will not have been infected. Eighty per cent of these children live in London or the South East.

Figures for recent years in all exposure categories are likely to rise as further reports are received. That said, the increase in heterosexually acquired infections appears to be a sustained trend.