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HIV in the United Kingdom: 2013

HIV in the United Kingdom: 2013. HIV and AIDS Reporting Section Centre for Infectious Disease Surveillance and Control (CIDSC) Public Health England London, United Kingdom. Estimated number of people living with HIV (both diagnosed and undiagnosed): UK, 2012.

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HIV in the United Kingdom: 2013

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  1. HIV in the United Kingdom: 2013 HIV and AIDS Reporting Section Centre for Infectious Disease Surveillance and Control (CIDSC) Public Health England London, United Kingdom

  2. Estimated number of people living with HIV (both diagnosed and undiagnosed): UK, 2012 HIV in the United Kingdom: 2013

  3. Annual new HIV and AIDS diagnoses and deaths: UK, 1981-2012 HIV in the United Kingdom: 2013

  4. Back-calculation estimate of HIV incidence and prevalence of undiagnosed infection among MSM: UK, 2003-2012 HIV in the United Kingdom: 2013

  5. Geographical trends of new HIV diagnoses among MSM by PHE region and country: UK, 2003-2012 HIV in the United Kingdom: 2013

  6. Geographical trends of new HIV diagnoses among people who acquired their infection heterosexually: UK, 2003-2012 HIV in the United Kingdom: 2013

  7. New HIV diagnoses among people who inject drugs by country of birth: UK, 2003-2012 HIV in the United Kingdom: 2013

  8. Attributes of late* HIV diagnosis, UK 2012 HIV in the United Kingdom: 2013

  9. Trends in late diagnosis* by exposure group: UK, 2003-2012 HIV in the United Kingdom: 2013

  10. One year mortality among adults diagnosed by CD4 count at diagnosis: UK, 2010 HIV in the United Kingdom: 2013

  11. Mortality rates among people diagnosed with HIV: UK, 2002-2012 HIV in the United Kingdom: 2013

  12. Prevalence of diagnosed HIV infection by area of residence among population aged 15-59 years: UK, 2012 HIV in the United Kingdom: 2013

  13. Trends in people diagnosed with HIV accessing care by age group: UK, 2003 – 2012 HIV in the United Kingdom: 2013

  14. Link to care: proportion* of adults with a CD4 count within 1 and 3 months of diagnosis: UK, 2011 HIV in the United Kingdom: 2013

  15. Retention in care: Proportion of adults in care in 2011 seen for care the following year: UK, 2012 HIV in the United Kingdom: 2013

  16. Treatment guidelines: proportion of adults with CD4 <350 cells/mm3 receiving ART: UK, 2012 HIV in the United Kingdom: 2013

  17. Proportion of drug naïve people with evidence of transmitted drug resistance (any class) by exposure group: UK, 2002-2010 HIV in the United Kingdom: 2013

  18. Prevalence of diagnosed HIV infection among adults aged 15-59 years by residential deprivation: England, 2012 HIV in the United Kingdom: 2013

  19. Key findings: HIV in the United Kingdom, 2012 • An estimated 98,400 (93,500-104,300) people were living with HIV by the end of 2012, with 22% (18%-27%) unaware of their infection. • The overall prevalence was 1.5 per 1,000 population (1.0 in women and 2.1 in men). • There were 490 deaths among people with an HIV infection in 2012, a continuation of the decline since the introduction of antiretroviral therapy (ART).  • People living with HIV can expect a near normal life expectancy and better clinical outcomes if they are diagnosed promptly. • Earlier treatment must be combined with a substantial increase in the frequency of HIV testing among groups most affected. Treatment as prevention’ is unlikely to be sufficient to reduce HIV transmission in the UK since it is estimated that two-thirds of HIV positive people with detectable viral loads are unaware of their infection. HIV in the United Kingdom: 2013

  20. Key findings: HIV in the United Kingdom, 2012 Men who have sex with men (MSM) • MSM remain the group most affected by HIV with 47 per 1,000 living with the infection (18% unaware). • Over the past decade, an estimated 2,400 (1,600-4,100) MSM acquired HIV infection each year. • New diagnoses among MSM continued to rise and reached an all time high of 3,250 in 2012. This reflects both an increase in HIV testing and on-going transmission. Heterosexual men and women • Black-African men and women were the second largest group affected by HIV with 38 per 1,000 living with the infection (26 in men and 51 in women). • Of the 31,800 (29,700-34,600) black-African men and women living with HIV, 23% remained unaware of their infection in 2012. • Over the past five years, an estimated 1,000 black-African men and women probably acquired HIV in the UK annually. HIV in the United Kingdom: 2013

  21. Key findings: HIV in the United Kingdom, 2012 HIV testing • The proportion of people diagnosed late has declined over the past decade from 58% to 47%.  Among MSM, the proportion of late diagnoses reduced from 42% to 34%, while among heterosexuals the proportion diagnosed late reduced from 65% to 58%. • Almost half of MSM newly diagnosed with HIV between 2010 and 2012, had their diagnosis made at their first HIV test at that sexual health clinic: a strong indicator that many MSM who require an HIV test have yet to seek one. • The number of HIV tests performed in sexual health clinics in England increased to 900,000 in 2012.  However, significant improvements in test coverage are necessary since 29% clinic attendees did not have a test. • Overall, 64 of 326 (20%) local authorities across England had a prevalence of diagnosed HIV infection of ≥2 per 1,000 population aged 15-59 years, the threshold for expansion of testing policies beyond the routine.  Further efforts are needed to commission HIV testing in these areas. HIV in the United Kingdom: 2013

  22. Key findings: HIV in the United Kingdom, 2012 Co-infection with other sexually transmitted infections • In 2012, when newly diagnosed with HIV, 29% of MSM had a concurrent acute STI (chlamydia, gonorrhoea and/or syphilis), compared to 11% of heterosexual men and 9% of women.  Quality of HIV care • A total of 77,610 people (770 children and 76,840 adults) received HIV care in 2012, a 5% increase on the previous year. One in four adults living with diagnosed HIV were aged over 50 years. • Nearly all (97%) 6,360 people diagnosed in 2012 were linked to HIV care within three months of diagnosis. Integration into care was prompt across all population groups regardless of age, gender, ethnicity, sexual orientation, sex and area of residence. • In 2012, the annual retention rate and treatment coverage among all persons seen for HIV care were high at 95% and 89% respectively. In England, key clinical indicators are monitored locally through the HIV Clinical Dashboard to maintain high standards of HIV care. HIV in the United Kingdom: 2013

  23. HIV testing and safer sexual behaviour to reduce risk: • Early diagnosis of HIV enables better treatment outcomes and reduces the risk of onward transmission. Have an HIV test if you think you may have been at risk. Get tested regularly for HIV if you are one of those most-at-risk: • Men who have sex with menhave an HIV and STI screen at least annually, and every three months if having unprotected sex with new or casual partners. • Black-African men and womenhave an HIV test, and a regular HIV and STI screen if having unprotected sex with new or casual partners. • Always use a condom correctly and consistently, and until all partners have had a sexual health screen. • Reduce the number of sexual partners and avoid overlapping sexual relationships. • Unprotected sex with partners believed to be of the same HIV status (sero-sorting) is unsafe. For the HIV positive, there is a high risk of acquiring other STIs and hepatitis C. For the HIV negative there is a high risk of HIV transmission (as a fifth of HIV positive MSM are unaware of their infection) as well as acquiring STIs. HIV in the United Kingdom: 2013

  24. How to get an HIV test: • Ask your GP for an HIV test – nowadays there is no need for lengthy discussion about the test, it just involves having blood taken, or even a finger prick • Go to an open access sexual health clinic, some clinics in large cities are offering ‘fast-track’ HIV testing (http://www.aidsmap.com/hiv-test-finder) • Ask on-line for a self-sampling kit (http://www.tht.org.uk/sexual-health/HIV-STIs/HIV-AIDS/HIV-postal-test) HIV in the United Kingdom: 2013

  25. Acknowledgements • We gratefully acknowledge the continuing collaboration of clinicians, microbiologists, immunologists, public health practitioners, occupational health doctors and nurses and other colleagues who contribute to the surveillance of HIV and STIs in the UK. • Also members of the UK Collaborative Group for HIV and STI surveillance (listed in surveillance report) HIV in the United Kingdom: 2013

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