Historically, HIV hit the gay 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 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 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 MSM having the highest number of new infections.
The continuing high rate is now taking over from heterosexuals as the number of heterosexual diagnoses acquired abroad continues to fall.
MSM 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 MSM 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. Since then there has been a very slight drop in the number of new infections to 3,320 in 2015.
This is partially due to increases in HIV testing, 2015 seeing the highest rate of testing in MSM – 92% of eligible MSM being offered an HIV test at an STI clinic and 88% receiving the test.
This has led to a significantly lower level of late diagnosis among MSM than other risk groups with 30% diagnosed late compared to 55% in heterosexual males.
MSM were the most likely of any high risk group to have been recently infected (in the previous four to six months) at diagnosis at 27%.
In order to reduce the levels of undiagnosed HIV, new diagnoses need to increase so that people can receive treatment and care.
Numbers of MSM living with HIV remain high and continue to grow significantly.
At the end of 2015, there were an estimated 47,000 MSM living with HIV of whom 12% were undiagnosed.
That means around 5,800 MSM are undiagnosed, not on treatment and potentially infectious. One in 17 MSM living in the UK are living with HIV. This goes up to 1 in 7 MSM living in London.
MSM account for:
- 46% of people living with HIV in the UK.
- 54% of all new HIV diagnoses in 2015.
In 2015, two out of three MSM who were diagnosed with HIV had probably acquired their infection in the UK.
Among MSM, the greatest number of new diagnoses (1,229) were in men aged 25-34, representing over half of MSM who were newly diagnosed with HIV in 2015.
However, there are also more older people living with HIV than ever before. This has partly to do with an ageing population living with HIV and partly to do with increasing new infections in older men.
In 2015, 11% of MSM who was newly diagnosed were aged 50 or over.