SHARE

Each year Public Health England (PHE) releases a report detailing the latest data on HIV across the United Kingdom. These are the initial findings covering New Diagnoses, Treatment and Care.

One of the biggest messages from this report was that with the continuing rise of new diagnoses, especially within MSM, and the fact that people living with HIV are living longer, is that the number of people receiving care for HIV is both growing – and we are getting older.

By the end of 2014 there were 85,489 people receiving HIV care in the United Kingdom. This is an increase of 5% over the previous year and nearly a doubling since 2005. 48% (40,834) were aged 45 or over, that’s up from 25% in 2005.

People seen for HIV cae by age group over time; 2005 - 2014 (Public Health England)
People seen for HIV care by age group over time; 2005 – 2014 (Source: Public Health England) Click to enlarge

Out of the 85,489 people living with HIV and accessing care in the UK  there were 57,347 men (67%) and 28,142 (33%) women. Out of the the total number 48% (40,842) had acquired HIV through heterosexual sex,  and 45% (38,432) through men having sex with men.

Amongst the heterosexual population the ethnic breakdown was: 60% Black African, 24% White, 4% Black Caribbean, 3% Black (other), 2% Indian/Pakistani/Bangladeshi and 2% Asian (other).

However amongst the MSM population the story was somewhat different with the make up being: 86% White, and the next most common single ethnic group being 2% for Black Caribbean.

The numbers of people who acquired HIV through either sharing injecting equipment (PWID) or from vertical transmission (mother to child) both remained at 2%.

Number of adults seen for HIV care over time by key prevention groups; 2005-2014 (Source: Public Health England)
Number of adults seen for HIV care over time by key prevention groups; 2005-2014 (Source: Public Health England) Click to enlarge

Moving on to treatment coverage, the number and proportion of people living with HIV and receiving treatment has continued to increase with 91% (76,462) receiving treatment in 2014 which is a considerable increase from the 84% (57,867) in 2010.

Out of the 91% of those in care and on treatment, 95% were virally suppressed – or undetectable. This puts the UK in good standing to meet the UNAIDS’ ambitious 90/90/90 targets.

People are also starting treatment earlier. In 2013 26% of the 5,370 people who started treatment did so with a CD4 count of 500 cells/mm3 or higher, this is more than double the 10% who did the same in 2009. These figures show how both clinicians and people living with HIV have embraced study and trial data that continues to show that Treatment As Prevention (TAsP) is successful at preventing onwards transmission to HIV negative partners (see: PARTNER study), as well as leading to better long-term health for the person taking the treatment – compared to those who start with a CD4 count below 350 (see: START Study).

Number of adults starting ART by CD4 count at initiation; UK 2009-13 (Source: Public Health England)
Number of adults starting ART by CD4 count at initiation; UK 2009-13 (Source: Public Health England) Click to enlarge

New diagnoses were up on 2013 figures, but not by much. In 2013 6,000 people given a HIV diagnosis, this rose to 6,151 in 2014 – an increase of 2.5%. That 6,151 was broken down into: 4,611 men and 1,540 women. An estimated 3,360 men acquired HIV through sex with other men, whilst 2,490 people acquired HIV through heterosexual sex.

The number of those diagnosed this year through shared use of injecting equipment remained low and stable at 131 (2%).

The majority of people diagnosed with HIV in 2014 were aged between 25 and 44, although the proportion of people over the age of 45 acquiring HIV has almost doubled from 16% in 2005 to 30% in 2014.

New HIV diagnoses by exposure group over time; 2005-2014 (Source: Public Health England) Click to enlarge
New HIV diagnoses by exposure group over time; 2005-2014 (Source: Public Health England)   Click to enlarge

The number of people receiving a late HIV diagnosis (diagnosed with a CD4 count of below 350) has declined from 56% (3,596/6,365) in 2005 to 40% (1,975/4,877) in 2014. The median CD4 count at diagnosis has increased from 308 cells/mm3 to 414. Public Health England recognises that whilst these drops are substantial and encouraging that there’s a lot of work needed to expand HIV testing and diagnosis.

People living with HIV can now expect a normal life-span if they are diagnosed promptly, but a late diagnosis can bring with it a ten-fold risk of death in the year following diagnosis – compared those who are diagnosed promptly.

In 2014 346 people were diagnosed with AIDS, or Late Stage HIV as is the more common term these days, and 613 people with HIV were reported to have died – most of who were diagnosed late.

New HIV diagnoses, AIDS and Deaths over time; 1999-2014 (Source: Public Health England) Click to enlarge
New HIV diagnoses, AIDS and Deaths over time; 1999-2014 (Source: Public Health England)   Click to enlarge

The take home from this report is: we’re all living longer with HIV, Treatment As Prevention (TAsP) is working, but we’ve got a lot of work to do with both prevention, and diagnosing people earlier on in their initial infection.

 

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