HIV Diagnoses Burden Continues In Gay Men

Ruzanna Harutyunyan's picture
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An estimated 7,370 new HIV diagnoses were made in the United Kingdom in 2008, according to latest figures from the Health Protection Agency. A high rate of transmission remains among gay men in the UK with 38% (2,830) of all new diagnoses probably acquired through sex between men.

Although diagnoses among gay men are slightly down on 2007 (3,050), they are at their second highest level since recording began. Between 1999 and 2007 there was a 110% increase in diagnoses among gay men (1,450 cases to 3,050). It remains too early to say whether the annual number of new diagnoses among gay men has peaked or whether the 2008 decline is an artefact due to failure to fully adjust for reporting delay.

Recent years have seen considerable emphasis put on the importance of HIV testing, especially in higher risk groups like gay men and there is evidence that gay men are being tested and diagnosed earlier than previously. Blood tests at the time of diagnosis give an indication of how well individuals' immune systems are working (CD4 cell count). The average CD4 cell count at diagnosis among gay men has increased year on year from 334 in 1999 to 416 in 2008. However, around one in five gay men are still being diagnosed late, after the point at which treatment should have begun.

Late diagnosis (a CD4 cell count of <200) significantly increases chances of death within the first year of diagnosis compared with those diagnosed earlier.

Dr Barry Evans, a sexual health expert at the Health Protection Agency, said: "The number of gay men diagnosed as HIV positive each year is still high and shows that a large number of individuals are still being infected.

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"Gay men continue to be the group in the UK most at risk of acquiring HIV and latest national guidelines recommend that gay men should test annually.

"Safe sex is the best way to protect against HIV infection. Using a condom with all new or casual partners is the surest way to ensure you do not become infected with a serious sexually transmitted infection such as HIV."

The overall estimate for new diagnoses in 2008 is slightly less than 2007 (7,660), due largely to the continued fall in diagnoses of heterosexually acquired HIV infections in people from sub-Saharan Africa.

Overall, HIV diagnoses through heterosexual contact continue to decline from a peak of 5,000 cases in 2004 to 4,200 cases in 2008. Most of this fall is among cases infected abroad (3,110). Conversely, the numbers of heterosexuals being infected with HIV in the UK continues to increase. Between 2002, when surveillance was enhanced, and 2008 the estimated number of new HIV diagnoses among those infected heterosexually in the UK increased from 500 to an estimated 1,090. Heterosexuals acquiring HIV in the UK now account for 15% of all new diagnoses.

Professor Maria Zambon, Director of the Health Protection Agency's Centre for Infections, said: "People need to know that testing for HIV and all sexually transmitted infections is both free and confidential at sexual health clinics across the UK. If you have had unprotected sex with a new or casual partner you should go and get tested.

"Key to improving diagnosis of HIV and reducing risk of transmission is in enabling easier access to testing through different healthcare settings including general practice, and looking at innovative ways to target those communities most at risk including gay men and black African heterosexuals.

"Early diagnosis of HIV and other sexually transmitted infections has obvious advantages like access to treatment, improved survival and reduced transmission risk to partners."

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