Historically, HIV has 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 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. In 2011, the situation reversed again with MSM having the highest number of new infections, the continuing high rate now taking over from heterosexuals as the number of heterosexual diagnoses acquired abroad continued 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, reaching an all time peak in 2011 with 3,010 new diagnoses, the highest ever reported. There has been much improvement in the uptake and frequency of testing among gay and bisexual men: in 2011, 84 per cent of those MSM attending sexual health clinics received an HIV test compared to 74 per cent in heterosexual men. This has led to a significantly lower level of late diagnoses among MSM than other risk groups with 39 per cent diagnosed late compared to 63 per cent in heterosexual males. MSM were the most likely of any high risk group to have had been recently infected (in previous 4-6 months) at diagnosis at 23 per cent.
Statistics
Numbers of MSM living with HIV remain high and continue to grow significantly. At the end of 2011, there were an estimated 40,100 MSM living with HIV of whom 20 per cent were undiagnosed. That means over 8,000 MSM undiagnosed, not on treatment and therefore potentially infectious. The prevalence of HIV in MSM is around one in 20 with nearly one in 12 in London.
MSM account for:
- 43 per cent of people living with HIV in the UK
- 48 per cent of all new HIV diagnoses in 2011 were among 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 (530) were in men aged 25-29, representing 19 per cent of MSM newly diagnosed with HIV in 2011. However, there are also 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 2011, one in 10 MSM newly diagnosed was 50 or over and more than one in four receiving HIV care.