Historically, HIV hit the gay and bisexual community in the UK first and hardest. For the first 17 years of the epidemic, the highest number of new diagnoses of HIV were among gay men and bisexual men.
That changed in 1999 when the number of heterosexually acquired diagnoses overtook those among MSM.
However, this was mostly linked to heterosexuals acquiring HIV outside the UK and the majority of these infections were among black Africans who had acquired HIV in sub-Saharan Africa.
In 2011 the situation reversed again with gay and bisexual men having the highest number of new infections.
Gay and bisexual men, have been, and still are, the group at highest risk of being infected in the UK.
There has been a steady rise in the number of new diagnoses in gay and bisexual men since 2000, after a plateau in the 1990s. It reached an all-time peak in 2014 with 3,360 new diagnoses, the highest ever reported.
2016, however, has seen for the first time in three decades, since the start of the epidemic, a decline in new diagnoses among gay and bisexual men. In one year alone there has been a 21% decline since the end of 2015 (3,750 in 2015 to 2,180 in 2016). The decline was mostly contributed to five London clinics, delivering high levels of testing, particularly for men at high risk, and earlier commencement of anti-retroviral therapy (ART) at diagnosis.
This has led to a significantly lower level of late diagnosis among gay and bisexual men than other risk groups with 32% diagnosed late compared to 60% in heterosexual men.
At the end of 2016, there were an estimated 46,000 gay and bisexual men living with HIV in England of whom 13% were undiagnosed.
In 2016 there was a 21% decrease in new diagnosis compared to the previous year, with 2,810 people diagnosed. This contrasts to the steady increase observed from 2,850 in 2007 to 3,570 in 2015.
Almost half (46%) of new diagnoses in in gay and bisexual men were made in London, 1,096 people.
Within London there has been a steep decline in new HIV diagnosis since 2015 of gay and bisexual men aged:
- 15-24 years (57%, from 237 to 102)
- 25-34 years (33% from 693 to 464)
- 35-49 years (17% from 511 to 424)
Number of estimated transmissions has also decreased yearly, with a peak in 2012 to 2,800 infections compared to 1,700 in 2016.
One in seven gay and bisexual men living with HIV were from black, Asian or other minority ethic (BAME) groups.
The median age at diagnosis is 34. Three quarters of new diagnoses are people aged between 25-49, these demographics have largely been consistent over the past 10 years.