UK Health Protection Agency (HPA) recommends universal HIV testing in the high incidence regions of the UK

The number of people living with HIV in the UK reached an estimated 91,500 in 2010, with a quarter of those unaware of their infection, according to Health Protection Agency (HPA) figures published just ahead of World AIDS Day on 1 December.

The report also showed how in 2010, one in five people visiting an STI clinic did not accept an HIV test. This comes as the HPA calls for universal testing for HIV, so that no one leaves an STI clinic without knowing their HIV status.

The HPA is concerned that over half of people diagnosed in 2010 came forward for testing after the point at which treatment for their infection should ideally have begun. Late diagnosis is associated with an increased risk of AIDS and death. Among the 680 people with HIV who died in 2010, two thirds were people who had been diagnosed late. The HPA report recommends that in areas where prevalence of HIV is high, there should be universal testing for the infection in all new GP registrants and patients admitted to hospital so as to reduce late diagnosis.

The HPA’s annual ‘HIV in the UK’ report found 6,660 people were newly diagnosed with HIV in the UK. The report confirmed that infections probably acquired within the UK almost doubled in the last decade from 1,950 in 2001 to 3,640 in 2010 and exceed those acquired abroad – 3,020. This rise is mostly due to infections acquired among men who have sex with men, who remain the group most at risk of HIV infection in the UK.

In 2010, over 3,000 gay men were diagnosed with HIV – the highest ever annual number. One in 20 gay men are now infected with HIV nationally with one in 12 in London.

Dr Valerie Delpech, consultant epidemiologist and head of HIV surveillance at the HPA, said: “HIV is an infection which can nowadays be treated and those diagnosed promptly can expect to experience similar life expectancy as an individual without the infection. However, we are very concerned that a large number of people in the UK are unaware of their HIV status and are diagnosed late.

“We want to see increased access to HIV testing routinely offered in clinical settings such as new registrants at GPs and hospital general admissions, in areas of the country where rates of HIV infection are high. We are also urging sexual health clinics to ensure that HIV testing is offered as part of a universal sexual health screen at every new attendance.

“Research by the HPA has shown that routine and universal testing is feasible to undertake and acceptable to patients. Increased testing and greater access will help reduce the number of people who are unaware of their HIV status and increase the chances of early diagnosis, when treatment is more successful.”

Dr Delpech added: “Thanks to the development of anti-retroviral treatments and universal access to world class health care through the NHS, HIV is a manageable illness for the vast majority of people affected in this country. But an HIV diagnosis means a lifetime of medication and the costs of providing specialist HIV treatment and care are substantial and accelerating, so avoiding the infection altogether is essential for controlling the epidemic in the UK.

“If you are having sex, using condoms with any new or concurrent partners is the best way to prevent HIV. We encourage all people to take up the offer of an HIV test in whatever health care setting.”