Gay men and men who have sex with men

Historically, HIV has hit the gay community in the UK hardest. For the first 17 years of the epidemic, the highest number of new diagnoses of HIV were among gay men and men who have sex with men (MSM). That changed in 1999 when the number of heterosexually acquired diagnoses overtook those among MSM. However this was mostly to do with heterosexuals acquiring HIV outside the UK and the majority of these were infections were among black Africans who had acquired HIV in sub-Saharan Africa.

Nevertheless, in terms of transmission of the virus within the UK, MSM are still the group at highest risk of being infected. There has been a steady rise in the number of MSM living with HIV since 2000 reaching an all time peak in 2010 with 3,000 new diagnoses, the highest ever reported. There has been much improvement in the uptake and frequency of testing among gay and bisexual men, in 2010 82% of those MSM attending sexual health clinics received an HIV test compared to 67% in heterosexuals. This has led to a significantly lower level of late diagnoses among MSM than other risk groups with 39% diagnosed late compared to 63% in heterosexual males. MSM were the most likely of any high risk group to have had been recently infected at diagnosis at 24%.

Statistics

Despite two year-on-year decreases since 2007 in numbers of new diagnoses among MSM (down 6% in 2008, then down 0.5% in 2009), this group remains at greatest risk of HIV within the UK and the trend was reversed in 2010 with the highest number of new infections yet seen. Numbers of MSM living with HIV remain high and at the end of 2010, there were 29,800 MSM living with diagnosed HIV. Given rates of undiagnosed HIV at 26%, there could be a further 10,300 men who are not yet aware of their infection making a total of 40,100 men.

MSM account for:

• 44% of people living with HIV in the UK
• 45% of all new HIV diagnoses in 2010 were amongst MSM 
• Four out of five MSM probably acquired their infection in the UK and make up two thirds of those acquiring the infection in the UK.

Among MSM, the greatest number of new diagnoses were in men aged 25-29, representing 19% of MSM newly diagnosed with HIV in 2010. However, there are more older people living with HIV than ever before, partly to do with an ageing population living with HIV and partly to do with increasing new infections in older men. In 2010, one in ten MSM newly diagnosed was 50 or over and one in four receiving HIV care.