History

Early Government media campaigns were successful in raising public awareness about HIV. The measures taken by UK governments in the 1980s, including needle exchanges, condom education and harm reduction programmes, alongside strong efforts by the UK’s gay communities made sure that the UK had far lower rates of HIV than some of our European neighbours.

For people living with HIV in the UK, the development of effective anti-HIV drugs means they can stay healthier for longer. The UK government has also made public commitments to tackling HIV in developing countries.

However, since the mid-1990s public and political complacency has grown about the risks of HIV and other sexually transmitted infections (STIs) in the UK. Partly because of this the number of new cases of HIV being diagnosed began to rise. Today, gay men continue to be most at risk from HIV, but the UK is also now very much a part of the global epidemic and people from areas like sub-Saharan Africa where HIV is very common are also badly affected.

Despite a slight decline of around 3% between 2007 and 2008 in numbers of new HIV diagnoses, there are now more people than ever before living with HIV in the UK.

Who is most affected?

The two groups most affected in the UK are men who have sex with men (MSM) and migrants from regions of the world where HIV is common, such as sub-Saharan Africa.

Approximately 2,760 men who have sex with men were diagnosed in 2008, Although this is a decline of about 6% from the number of new diagnoses amongst this group in 2007, numbers of MSM with HIV remain high and gay men are still at the highest risk of HIV within the UK. In 2008, 83% of newly diagnosed MSM probably acquired HIV in the UK.

The majority of people actually diagnosed with HIV in the UK in 2008 (58 %) had been infected through heterosexual sex, Two thirds of those infected heterosexually were black African and the vast majority (87%) of these people had probably acquired HIV overseas.

However, the numbers of heterosexual HIV infections that were probably acquired here in the UK have been rising steadily in recent years. Over a quarter of heterosexual HIV infections that were diagnosed in 2008 were probably acquired in the UK. The majority of these diagnoses are likely to be amongst the British black African community.

Although needle exchange programmes have been very effective, because of the ways that HIV can be transmitted, another group that faces significant risk of contracting HIV is injecting drug users who share equipment. It is also possible for the virus to be passed from mother to baby during pregnancy but improvements to antenatal HIV testing and treatments make this increasingly rare. In the past some people also got HIV through blood products but in the UK this is now extremely rare as well.

Geography

Just over two fifths (44%) of all those living with diagnosed HIV in the UK live in London, as do 42% of the people newly diagnosed with HIV in 2008. This proportion used to be much higher, but people with HIV are now living across all areas of the UK and particularly in major towns and in North West England.

In the last ten years, the biggest increases in people living with diagnosed HIV have been in the East of England, the East Midlands and on the South Coast.

Late diagnosis

If someone is diagnosed a long time after they’ve been infected with HIV, it’s more likely that the virus will have already seriously damaged their immune system. Someone is said to have been diagnosed late if the number of particular immune cells (CD4 cells) in their bloodstream has dropped below a certain level. Late diagnosis is one of the biggest contributing factors to illness and death for people with HIV. It’s very important that HIV is diagnosed early, so people can start treatment if they need to, look after their own health and take steps to ensure they don’t pass the virus on.

In 2008, an estimated  32% of adults diagnosed with HIV were diagnosed with CD4 levels below 200, indicating their immune systems had already been badly damaged by the virus. The latest treatment guidelines recommend that people with HIV should start taking medication when their CD4 levels get to 350 or below, and by this measure 55% of those diagnosed in 2008 were diagnosed after HIV treatment should already have begun.