HIV prevalence in UK: latest data

Last Friday the Department of Health published a report detailing the latest figures on HIV and hepatitis prevalence in the UK.

The estimate of the number of adults aged 15-59 currently living with HIV in the UK has increased to 33,000. This represents a 10% increase on the estimate at the end of 1998. One third of people living with HIV remain unaware of their condition.

Across England, HIV prevalence in pregnant women is about 1 in 350. This is the highest level ever recorded. Among women in London seeking a pregnancy termination the rate rises to 1 in 100.

There has been a substantial improvement in the detection of HIV among pregnant women. As a result, in 2000, fewer babies in the UK were born with HIV than in previous years. This is in spite of the fact that the prevalence of HIV among pregnant women in England and Scotland has risen. The majority of women tend to be born abroad, usually in Central and East Africa).

Improving the detection of HIV among HIV-positive women has meant that last year infection was prevented in 75 babies. In inner London the national target to diagnose 80% of HIV-positive women has been reached two years ahead of schedule (82% of HIV-positive women were identified prior to giving birth, and other areas such as Birmingham and Brighton where prevalence is lower have also made good progress).

In a recent letter to the British Medical Journal, Dr Gillian Dean from the Royal Sussex County Hospital illustrated that uptake of antenatal screening for HIV can be high outside London too. In Brighton and Hove since antenatal testing began, 98% of women offered antenatal HIV testing have taken up the offer. Over a quarter of HIV-positive pregnant women live outside London.

Among heterosexuals, the prevalence of HIV is significantly higher among those born abroad. Among London GUM clinic attendees during 1999/2000, one in 33 men and one in 16 women born in sub-Saharan Africa was HIV-positive. This compares to one in 232 men and one in 459 women who were born in the UK.

More heterosexuals are getting their infection diagnosed. In 1996 in London only 31% (66 of 215) had their infection diagnosed during their clinic attendance this had risen to 40% in 2000. However, only 20% of heterosexuals attending a GUM clinic for STI screening were offered an HIV test. Extending the offer of an HIV test to heterosexuals attending GUM clinics with an acute STI needs to be improved.

In 2000 the HIV prevalence among injection drug users (IVDUs) attending specialist agencies in London was one in 27 for men and one in 34 or women. Outside London one in 544 male IVDUs and one in 331 female IVDUs were HIV-positive. Encouragingly, no-one who began injecting in the last three years was found to be HIV-positive. However the data indicate a continuing low level of HIV transmission through injecting drug use in the UK.

Consistent with all previous years the prevalence of HIV in 2000 was highest among gay and bisexual men. HIV prevalence among GUM clinic attendees had increased from 6.7% in 1999 to 11% in 2000. The overall prevalence outside London decreased from 4.6% in 1993 to 2.0% in 2000. Information about the prevalence of previously undiagnosed HIV infection indicates the underlying transmission rate.

The current syphilis outbreaks in the UK are likely to increase the number of samples collected by the Unlinked Anonymous Survey and any future change in HIV prevalence will require careful interpretation. Where HIV status was known, HIV prevalence among men diagnosed with syphilis between January 2000 and the end of March 2001 was 49%.