HIV & AIDS Summary -1997 -2015 Part 3

Proportion of people newly diagnosed with HIV by PHE centre of diagnosis and exposure category: England, 2015

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The highest proportion of new diagnoses reported among men who have sex with men (MSM) was in the North West (58%, 268/466) and London (53%, 1,371/2,603). The East of England and the West Midlands had the highest proportions of people newly diagnosed who acquired HIV through heterosexual sex (49%, 197/399 and 46%, 216/473, respectively).

 

The highest proportion of new diagnoses reported among men who have sex with men (MSM) was in the North West (58%, 268/466) and London (53%, 1,371/2,603). The East of England and the West Midlands had the highest proportions of people newly diagnosed who acquired HIV through heterosexual sex (49%, 197/399 and 46%, 216/473, respectively).

 

The highest proportion of new diagnoses reported among men who have sex with men (MSM) was in the North West (58%, 268/466) and London (53%, 1,371/2,603). The East of England and the West Midlands had the highest proportions of people newly diagnosed who acquired HIV through heterosexual sex (49%, 197/399 and 46%, 216/473, respectively).

The highest proportion of new diagnoses reported among men who have sex with men (MSM) was in the North West (58%, 268/466) and London (53%, 1,371/2,603). The East of England and the West Midlands had the highest proportions of people newly diagnosed who acquired HIV through heterosexual sex (49%, 197/399 and 46%, 216/473, respectively).

In 2015, the proportion of people newly diagnosed with HIV who were white accounted for 53% of new HIV diagnoses across all PHE centres, ranging from 46% in London (1,208/2,603) to 76% in the South West (196/259).

Over the last decade, the proportion and number of adults diagnosed late has declined from 56% (4,159/7,439) in 2006 to 39% (2,363/6,095) in 2015, and across all exposure categories. This decline was steepest among men who have sex with men (MSM), with 42% (1,128/2,670) in 2006 compared to 30% (995/3,320) in 2015. Among heterosexual men and women combined the proportion diagnosed late reduced from 65% to 51%, with the number more than halving from 2,817 to 1,211 over the decade. Overall levels remain unacceptably high, with 39% diagnosed late in 2015.

Over the past decade the number of people diagnosed with HIV at a late stage of infection has decreased from 4,159 in 2006 to 2,363 in 2015. The largest decline was seen among heterosexual women, from 1,749 in 2006 to 665 in 2015. This reflects the decline in overall number of diagnoses among heterosexual men and women due to changing migration patterns.

Over the decade, the proportion  of people diagnosed at a late stage of infection has reduced (improved) in London, from 56% in 2006 to 32% in 2010. In comparison, centres outside of London have shown a slower rate of improvement, from 56% in 2006 to 44% in 2015.

The proportion of people who are diagnosed with a CD4 count < 350 cells/mm3  within three months of diagnosis differs across and within each demographic. The data from 2015 shows that women and older age groups (aged 40+)  were more likely to be diagnosed at a late stage compared to men, and younger age groups (aged 15-39). 57% of adults aged 50 years and over and 44% aged 40-49 were diagnosed late compared to 30% aged 15-39. Persons of black and other ethnicities were more likely to diagnosed at a late stage (52% and 40% respectively) compared to persons of white ethnicity (34%).Furthermore, 55% of heterosexual women and 49% of heterosexual men were diagnosed at a late stage compared to 30% of men who have sex with men.

 

Number of people who accessed HIV care by country of care: United Kingdom, 2006 – 2015people-wanting-hiv-care-2006-2015 HIV & AIDS Summary -1997 -2015 Part 3

 

In England, the number of people accessing care has increased from 47,472 in 2006 to 81,062 in 2015. The number of people living with HIV and accessing care in Northern Ireland, Scotland and Wales has increased at a much slower rate and the numbers remain relatively low.

 

Number of people who accessed HIV care by age group:
United Kingdom, 2006 – 2015

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The number of people seen for HIV care has steadily increased over the past decade from 51,448 in 2006 to 88,769  in 2015. The age distribution of people seen for HIV care is changing, with older age groups increasing both in number and proportion. In 2015, just over one third (34%) of adults (aged 15 years or older) seen for HIV care in the UK were aged 50 years or older, compared with 21% in 2010, and 14% in 2006. This rise is due to effective treatment, with few HIV-related deaths, resulting in longer lives for those living with HIV. In addition, a number of people newly diagnosed and accessing care for the first time in 2015 were aged 50 years or older.

Throughout the decade the two largest groups of people who accessed HIV care remained white MSM and black African heterosexuals. There has also been an increase in both white heterosexuals (which has almost doubled from 5,302 in 2006 to 10,417 in 2015) and non-white MSM (2,600 in 2006 to 5,589 in 2015). These figures reflect the increasing diversity of people living with HIV in the UK.

In 2015, the highest proportion of those accessing care who had acquired their HIV through sex between men were living in the North West and South West (55%; 4,361/7,935 and 54%; 2,114/3,937 respectively). In contrast, the East of England and East Midlands had the highest proportions of residents accessing HIV care who had acquired their HIV through heterosexual sex (67%; 4,123/6,192 and 65%; 2,625/4,055 respectively) and the lowest proportions of acquisition through sex between men (31%; 1,946/6,192 and 33%; 1,329/4,055, respectively).

In 2015, there was substantial variation between PHE centres in the ethnicity of residents who accessed care. In 2015, 74% (2,995/4,072) of those accessing care in the South West were white, compared with 45% (1,929/4,266) in the East Midlands. While black Africans comprised 33% (26,388/79,927) of residents who accessed care in England overall, this ranged from 18% (745/4,072) in the South West to 45% (2,907/6,396) in the East of England.

In 2015, London had the highest proportion of residents living with diagnosed HIV, accounting for 41% (35,972/88,064) of all people who accessed care. This was a 52% increase from the number of people who accessed care in London in 2006. Northern Ireland had the largest increase in the number of people who accessed care over the last ten years, which increased from 318 in 2016 to 934 in 2015 (294% increase), however, numbers remain low compared to regions in England. There were also substantial increases in those accessing care in the East Midlands (96% increase) and the North West (83% increase).

People do not always access HIV care in the region in which they live. Where information was available, 11% (4,376/40,261) of those accessing HIV services in London in 2015 were non-London residents.

The number and proportion of people receiving ART has increased over the past decade. Among those with a CD4 cell count <350 cells/mm3, 76% (12,598/16,557) were receiving ART in 2006 compared to 96% (12,637/13,110) in 2015. Similar improvements in treatment coverage for all individuals have been observed in the past decade with 95% (83,931/88,769) of people seen for HIV care in 2015 receiving ART, compared with 72% (36,904/51,449) in 2006.

Diagnosed HIV prevalence (per 1,000 population aged 15-59 years): England, 2015

 

2.26 Overall prevalence rate:

(2.24-2.27) per 1,000

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In 2015, 17% of English local authorities had a diagnosed HIV prevalence between 2 and 5 per 1,000, whilst 6% had a prevalence greater than 5 per 1,000. All 33 local authorities in London had a prevalence greater than 2 per 1,000 and 55% had a prevalence greater than 5 per 1,000. Outside London, the five local authorities with the highest prevalence were: Brighton and Hove, Manchester, Salford, Luton and Leicester.