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UK rates of HIV transmission continue to plummet

Estimated number of undiagnosed HIV infections has also halved, in just four years, as UK exceeds all UNAIDS targets

Louise Prime

Friday, 17 January 2020

The estimated number of people in the UK living with undiagnosed human immunodeficiency virus (HIV) infection has halved in just four years, official figures reveal. Public Health England (PHE) also said yesterday in its latest annual report that the rate of HIV transmission continues to fall, and has plummeted particularly among men who have sex with men.

PHE said that fewer people than ever now remain unaware of their HIV status, as a result of several factors including increasing levels of HIV testing in a wide range of settings, preventive activity such as condom use, starting antiretroviral activity (ART) as soon as possible if found to be positive, and the availability of Pre-exposure Prophylaxis (PrEP) for people who are HIV negative.

PHE announced yesterday that between 2014 and 2018 (the latest year with available figures), the estimated number of HIV transmissions in gay, bisexual and other men who have sex with men plummeted by 73%, from 2,300 to 800. Over the same period, the estimated number of men who have sex with men, and who are living with undiagnosed HIV infection, almost halved from 7,000 to 3,000.

Despite these successes, PHE warned, in order to meet the goal of completely eliminating HIV transmission by 2030 we need to sustain prevention efforts, and expand them further to reach everybody who is at risk. Although testing has greatly increased over the past decade, there were still an estimated 7,500 people in the UK unaware that they have HIV infection. Furthermore, two in five people diagnosed with HIV in 2018 were already at a late stage; the risk of death within a year of diagnosis ten times higher for people diagnosed with late-stage infection, compared with those diagnosed early who start treatment immediately. It said: “If you are living with HIV or you are at high risk of acquiring HIV, then knowing your HIV status is vital.”

PHE head of STIs and HIV Dr Noel Gill commented: “We are well on our way to reaching the goal of eliminating HIV transmission by 2030, with the rapid fall in HIV transmission continuing in 2018, and nearly all of those diagnosed receiving treatment that prevents onward transmission.

“Testing is a key part of the UK’s success, if you have HIV you can benefit from life-saving treatments that also prevent further transmission of the virus. Certain groups of people are at higher HIV risk and are advised to have regular tests, including men and women who have had unprotected sex with new or casual partners from countries where HIV is common, who should test every year, and men who have sex with men.

“The UK is one of the few countries in the world to have reached and exceeded all UNAIDS 90:90:90 targets. Of the 103,800 people living with HIV in the UK in 2018, 93% were diagnosed, 97% of people diagnosed were receiving treatment and 97% of people receiving treatment were virally suppressed.”

Dame Inga Beale, chair of the HIV Commission, added: “The latest HIV statistics show real progress is being made in the fight against HIV, but also highlight the significant challenges that remain if we’re to achieve the ambitious goal of ending transmissions by 2030.

“To make good on that commitment we must look at what’s working well and how these successes can be further capitalised on, as well as thoroughly investigating how to tackle persistently high rates of late diagnosis and ensure the decline in new diagnoses is felt across all groups impacted by the epidemic. Progress that leaves some people behind is not progress at all.”

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