A new national report from Public Health England (PHE) shows that in four local authorities in the West Midlands region; Coventry, Birmingham, Sandwell and Wolverhampton, there are at least 2 people per 1,000 aged 15-59 years who have been diagnosed with HIV. At this threshold, national guidelines recommend that HIV testing should be offered routinely to everyone admitted to hospital and people registering with a GP surgery in these areas
The national report has been published in the run up to National HIV Testing Week (22-29 November 2013). Regional figures show there are currently 5,115 people in the West Midlands region known to be living with HIV and accessing treatment. Of those, 1,542 live in Birmingham.
The report shows that 20 per cent (21,900) of people living with HIV in the UK (98,400) are unaware of their infection and need to get tested. In 2012 around half (47 per cent) of the 6,360 people newly diagnosed with HIV were identified late; which means the patient is often already quite ill and treatment is both less effective and more expensive.
Between 2011 and 2012 a small decline in the proportion of people living with HIV unaware was seen (25 per cent to 22 per cent), but this needs to be accelerated as early HIV diagnosis and timely treatment can nowadays mean a near-normal lifespan. This is why National HIV Testing Week is so important, raising awareness of the benefits of testing and encouraging the people most at risk; men who have sex with men (MSM) and black Africans, to get tested. New HIV diagnoses among men who have sex with men (MSM) also reached an all-time high, with 3,250 cases in 2012.
Professor Harsh Duggal, HIV and STI lead consultant for PHE West Midlands, said: “National HIV Testing Week is a great opportunity to alert people to the benefits of testing - for individuals and for the UK's public health. PHE is urging members of the public, clinicians, commissioners and community leaders to support and engage with the campaign.”
Paul Sanderson, PHE West Midlands Health and Wellbeing Programme lead, said: “PHE is committed to working closely with those local areas with the highest prevalence of HIV, to ensure adults admitted to local hospitals and those registering with a local GP are offered a routine HIV test. Efforts such as these are crucial to reducing numbers of undiagnosed HIV patients. We are also asking local authorities to redouble their efforts to target communities most affected by the virus. In addition, PHE is exploring ways to support GPs to spot the signs and symptoms of HIV infection early, to reduce the number of people being diagnosed late.
“In the UK, people who are unaware of their infection are likely to be those most at risk of transmitting HIV to others. We must increase the speed at which we're reducing the number of undiagnosed HIV infections by encouraging earlier and more frequent HIV testing, especially by those most at-risk. Earlier diagnosis will help reduce new HIV infections across the UK.
“Around half of men who have sex with men recently diagnosed with HIV received their diagnosis the first time they tested, which is a strong indication that many men who should be testing are not. National HIV Testing Week gives people a great opportunity to get tested.”
National guidelines recommend that HIV testing should be offered routinely to everyone admitted to hospital and people registering with a GP surgery in areas of the country with HIV prevalence greater than 2 per 1000 people. Introducing additional ways to get tested, such as home-sampling services, is also encouraging more people to test.
HIV testing and safer sexual behaviour to reduce risk:
Early diagnosis of HIV enables better treatment outcomes and reduces the risk of onward transmission. Have an HIV test if you think you may have been at risk. Get tested regularly for HIV if you are one of those most-at-risk:
- Men who have sex with men are advised to have an HIV and STI screen at least annually, and every three months if having unprotected sex with new or casual partners.
- Black-African men and women are advised to have an HIV test, and a regular HIV and STI screen if having unprotected sex with new or casual partners.
Always use a condom correctly and consistently, and until all partners have had a sexual health screen.
Reduce the number of sexual partners and avoid overlapping sexual relationships.
Unprotected sex with partners believed to be of the same HIV status (serosorting) is unsafe. For the HIV positive, there is a high risk of acquiring other STIs and hepatitis. For the HIV negative there is a high risk of HIV transmission (a fifth of HIV positive MSM are unaware of their infection) as well as acquiring STIs and hepatitis.
How to get an HIV test:
Ask your GP for an HIV test - nowadays there is no need for lengthy discussion about the test, it just involves having blood taken, or even a finger prick
Go to an open access sexual health clinic. Some clinics in large cities are offering 'fast-track' HIV testing (http://www.aidsmap.com/hiv-test-finder)
Ask on-line for a self-sampling kit (http://www.tht.org.uk/sexual-health/HIV-STIs/HIV-AIDS/HIV-postal-test)
Note to Editors
The full 'HIV in the UK' 2013 report will be available at: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/HIVAndSTIs/publications#2013
Additional key findings from the report include:
- In 2012, 6,360 people (4,560 men and 1,800 women) were newly diagnosed with HIV in the UK.
- The overall HIV prevalence in 2012 was 1.5 per 1,000 of population. MSM remain the group most affected by HIV, with 47 per 1,000 living with the infection. Black African men and women were the second largest group affected by HIV with 38 per 1,000 living with the infection.
- Heterosexual transmission accounted for 45% of all those diagnosed with new HIV infections in 2012 (2,880). MSM accounted for 51% (3,250) of new diagnoses.
- The proportion of people with a late diagnosis of HIV (CD4 cell count <350 cells/mm3) declined over the last decade, from 58% (3,150) to 47% (2,990).
- 88% of people with HIV for whom treatment was indicated were receiving antiretroviral therapy (ART) in 2011.
- 87% of people receiving HIV care have a fully supressed HIV viral load, meaning they are unlikely to be infectious.
More information on National HIV Testing Week can be found at: http://www.hivpreventionengland.org.uk/Campaigns-Current/National-HIV-Testing-Week
HIV statistic of 5,115 people living with HIV and accessing treatment in the West Midlands is from PHE Survey of Prevalent HIV Infections Diagnosed (SOPHID): http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317139919515