HIV diagnoses continue to fall as UK exceeds UNAIDS target
Prevention efforts to end the HIV epidemic in the UK are working, but with 8% unaware of their infection it is still vital people seek an HIV test if at risk.
A new report published by Public Health England (PHE) showed that the UK is one of the first countries to meet the UNAIDS 90-90-90 targets, highlighting that prevention efforts are working in the UK. New estimates revealed that in 2017, 92% of people living with HIV in the UK have been diagnosed, 98% of those diagnosed were on treatment, and 97% of those on treatment were virally suppressed.
An estimated total of 102,000 people were living with HIV in the UK in 2017, with 8% (8,200) unaware of their infection. As a result of treatment, 87% of all people living with HIV have an undetectable viral load and are unable to pass on their infection to other people (this is widely known as ‘Undetectable equals Untransmissible’ or ‘U=U’).
New HIV diagnoses continued to decline in the UK, falling 17% from 5,280 in 2016 to 4,363 in 2017. The reduction in new diagnoses continues the downward trend in HIV transmission among gay and bisexual men that started in 2012.
The success in the UK can be largely attributed to a combination of HIV prevention efforts that include condom use, increased HIV testing, reductions in time to starting treatment, and potentially the availability of pre-exposure prophylaxis (PrEP).
More can be done to eliminate HIV in the UK. In 2017, 43% (1,879) of new HIV diagnoses were made at a late stage of HIV infection. While numbers of late HIV diagnoses have declined, there continue to be missed opportunities for early diagnosis that can help people with HIV live a long and healthy life. PHE continues to stress the need for the public to accept the offer of an HIV test when attending a sexual health clinic or another healthcare service.
Professor Noel Gill, Head of STI & HIV Department, at Public Health England, said:
There can be no doubt prevention efforts to end the HIV epidemic in the UK are working. Our efforts must continue apace in order to eliminate HIV. With an estimated 8,000 people still unaware of their infection, it is vital that people seek out an HIV test if they consider themselves at risk, or accept the offer of an HIV test by a healthcare professional, as early diagnosis is key to stopping transmission.
Treatment for HIV is freely available and highly effective, enabling people to live a long, healthy life. There are now a variety of ways people can protect themselves from being infected with or passing on HIV, including the use of condoms, PrEP, regular HIV testing, and prompt initiation of antiretroviral treatment.
Matt Hancock MP, Secretary of State for Health and Social Care, said:
Many of us will remember a time when an HIV positive result was effectively a death sentence. Today’s report is a poignant and powerful reminder of how far we’ve come.
Now in the UK, almost everyone with HIV is not only diagnosed and in treatment, but living long, healthy lives - and we’re one of just a handful of countries to meet these ambitious UN targets. This didn’t seem possible just a few decades ago, but thanks to the efforts of public health bodies, charities and the NHS to encourage early testing and pioneer high-quality treatment, we are pushing ahead in the fight against HIV.
Dr Olwen Williams, President of the British Association of Sexual Health and HIV (BASHH), and Professor Chloe Orkin, Chair of the British HIV Association (BHIVA) welcomed the 2017 figures and commented:
The UK today has one of the best success rates for people taking HIV treatment anywhere in the world - 98% of those diagnosed are on treatment, and 97% can’t pass HIV on because the level of the virus in their blood is undetectable. However, it is shocking that 43% of those newly diagnosed were diagnosed late, leaving them at risk of serious ill health, and risking further transmission.
There are still an estimated 8,200 people who don’t know their HIV status - a finger prick test could change not only their life, but that of their partners. Yet despite this progress HIV stigma remains, which is why we must reach the wider community with these messages, so that HIV knowledge is based on fact, not fear.
HIV testing and treatment is free and available to all. Tests are available at sexual health services, GPs, healthcare, and community settings nationwide. In many cases, the test involves a finger prick and results are ready within minutes.
Alternatively, a blood sample can be taken in the privacy of your own home, which you can send to a local laboratory and receive test results in a format that best suits your lifestyle.
On 17 November 2018 National HIV Testing Week began promoting HIV testing to gay and bisexual men and black African men and women. This campaign is run by HIV Prevention England (HPE),, which is part of Terrence Higgins Trust and funded by PHE.
Background
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Data from the report can be interrogated and analysed at Local Authority level via an online tool allowing a range of outputs to be generated.
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HIV is a virus which damages the cells in people’s immune system and weakens their ability to fight everyday infections and diseases. Without treatment, after an average of 10 to 15 years, the infection is fatal.
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Read more information about how to prevent and get tested for HIV on NHS.UK. The HIV home sampling service offers an alternative to traditional testing offered by GPs and sexual health clinics. Visit www.FreeTesting.hiv to find out more about free HIV home-sampling test kits.
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The Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets aim to eliminate AIDS by 2030 by ensuring 90% of people living with HIV are diagnosed, 90% of people diagnosed are receiving antiretroviral therapy and 90% of people on treatment are virally suppressed and unable to pass on the infection.
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People with HIV who have been on treatment and show undetectable levels of the virus for at least 6 months are unable to pass HIV on. The slogan Undetectable = Untransmissible (or U=U) has been widely used and is endorsed by PHE.
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PHE is supporting NHS England in delivering the 3-year PrEP Impact Trial, which began in October 2017. The PrEP Impact Trial in England aims to recruit 13,000 participants across 150 specialist SHS over 3 years and is open to all clinic attendees clinically assessed to be at high risk of HIV acquisition. Trial results will address outstanding questions regarding PrEP eligibility, uptake and duration of use, and impact on HIV and other STIs, to help inform future commissioning in England. As of early November 2018, over 9,800 participants had been recruited across 140 sexual health services. Results from interim analyses will be available in early 2019.
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Find out how PHE are getting PrEP to those who need it in the latest public health matters blog.
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Combination HIV prevention includes both primary prevention (focused on people who are HIV negative) as well as prevention of onward transmission. Some essential elements of combination HIV prevention include condom use, pre-exposure prophylaxis (PrEP), expanded HIV testing and prompt initiation of ART after diagnosis.