Health Protection Agency reports highest number of HIV diagnoses ever among gay and bisexual men in 2011

Keith Alcorn
Published: 23 October 2012

HIV being diagnosed more frequently in under-30s

New figures from the Health Protection Agency released today show that although the total number of HIV diagnoses in the United Kingdom fell in 2011, new HIV diagnoses among gay and bisexual men have never been higher, rising by 4.5% compared to 2010.

The total number of HIV diagnoses attributed to sex between men was 3010 in 2011, while 2990 were attributed to heterosexual contact. This is the first time since 1999 that new HIV diagnoses in gay and bisexual men have exceeded the number attributed to heterosexual contact. The total number of new diagnoses in 2011 (6280) represented a decline of 20% compared to the 2005 peak (7914), but the number of new diagnoses linked to sex between men was higher than any previous year.

The HPA continues to report that approximately one in five infections diagnosed in the UK among men who have sex with men had been acquired outside the UK (a consistent trend over the past decade).

Among heterosexuals an improved method of pinpointing the approximate year of infection has revealed that almost half (48%) of infections diagnosed in heterosexuals born abroad were acquired in the UK.

Of all people diagnosed with HIV last year 1527 were born in sub-Saharan Africa, compared with 3291 in 2003 and 3245 in 2004, the peak years for HIV diagnosis among Africans resident in the UK. This change has been driven largely by a very substantial decline in HIV diagnoses among people of East African origin. Diagnoses among the Black-Caribbean group are also running at half the level reported in 2003 (147, compared to 312 in 2003, the peak year for HIV diagnoses among this ethnic group in the UK).

In contrast there has been a steady increase in HIV diagnoses among people from the European region (up from 258 in 2003 to 639 in 2011).

There has also been a shift in the age at which gay and bisexual men are being diagnosed with HIV. Whereas in 2003 almost half of new diagnoses occurred in men aged 30-39 (953 out of 2152), and less than a quarter in men aged 20-29 (515), an almost equal number of men aged 20-29 (861) and men aged 30-39 (926) were diagnosed with HIV in 2011. 

The changing pattern of age at HIV diagnosis in the UK among gay and bisexual men

(% of total diagnosed by age)

 

2002

2003

2010

2011

20-29

24%

24%

29%

31%

30-39

46%

44%

32%

33%

40-49

18%

21%

25%

23%

50-59

7%

7%

7%

7%

Whether this shift is attributable to higher uptake of HIV testing, leading to diagnosis earlier in the course of HIV infection (for which raised median CD4 cell counts at diagnosis among gay and bisexual men provide some evidence), or whether this represents an increase in the rate of infection among younger men, is unclear and requires further analysis.

More men in their 40s and 50s were diagnosed with HIV in 2011 compared to 2003, and the proportion of men diagnosed in their 40s has risen substantially over the past decade.

In contrast, distribution of HIV diagnoses across age bands has not changed substantially in heterosexual men and women; both men and women continue to be more likely to be diagnosed in their 30s than in their 20s.

The number of people diagnosed with AIDS fell to 457 in 2011, compared to 819 as recently as 2008 and 1035 in 2004. AIDS-associated deaths also showed a downward trend, falling to 504 reported deaths in 2011 compared to 606 in 2008. 

E-atlas

Health Protection Agency , HIV/STI Department

London, United Kingdom

National centre for epidemiological surveillance of HIV/AIDS; publishes “Health Protection Report” weekly.

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