Gay men in the UK are being urged to have an HIV test at least once a year. The recommendation comes from the UK Health Protection Agency which published figures showing continuing high levels of new HIV diagnoses amongst gay men in 2007.
There were a total of 6,840 new HIV diagnoses in the UK in 2007. Although this represented a fall of approximately 1,400 in the total number compared to 2006, new diagnoses amongst gay men were essentially unchanged at 2,630.
This is the third successive year that new HIV diagnoses amongst gay men have been above 2,600. In the early and mid-1990s approximately 1,500 gay men a year were diagnosed with HIV. But numbers increased steadily during the late 1990s, reaching a peak in 2006.
It is thought that a number of factors are contributing to the high levels of new HIV diagnoses amongst the UK’s gay men. Increased levels of HIV testing are partly responsible, as is migration, but there is also evidence of ongoing HIV transmission amongst gay men.
Approximately a third of all cases of HIV are undiagnosed in the UK and compared to some other countries, such as Australia, levels of HIV testing amongst gay men in the UK are very low. A recent survey suggested that as many as 40% of gay men in the UK have never had an HIV test..
There are public health and clinical concerns about high levels of undiagnosed HIV in the UK. Individuals with undiagnosed HIV are more likely to transmit HIV than patients in HIV care. There is also good evidence that individuals with very recent (and undiagnosed) HIV infection are responsible for between a third and half of all new HIV infections. Furthermore, late diagnosis of HIV is the cause underlying most HIV-related deaths seen in the UK today.
Prof Peter Borriello, Director of the HPA’s Centre for Infections recommended that “gay men should test for HIV at least annually. Earlier diagnosis of HIV infection will give men access to treatment, improve their survival and reduce the risk of transmission to partners. I urge all gay men to test for HIV regularly.”
The HPA’s advice to gay men to have an annual HIV test reiterates the recommendation issued by the UK’s Chief Medical Officer as long ago as 2004.
Although total numbers of new diagnoses amongst heterosexuals now exceed those seen in gay men, most HIV cases of HIV in heterosexuals are acquired overseas, mainly in Africa. Gay men account for the vast majority of HIV transmissions in the UK.
“Gay men continue to be the group most at risk of acquiring HIV within the UK”, said Dr Valerie Delpech of the Health Protection Agency, who emphasised the importance of consistent condom use as an effective method of HIV prevention. She added, “we must also shift the testing culture amongst gay men, encouraging more frequent testing particularly among individuals at greatest risk, such as those with high numbers of sexual partners and men who attend GUM services.”
The overall fall in new HIV diagnoses in 2007 compared to 2006 is due to a decline in new diagnoses amongst heterosexuals infected in Africa (down from 3250 to 2690). There was also a slight fall in the number of heterosexually acquired infections in the UK – 690 in 2007 compared to 730 in 2006. Most of these infections are in black communities and involve transmission from an individual infected outside the UK.