{"id":46794,"date":"2023-12-01T07:40:29","date_gmt":"2023-12-01T07:40:29","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=46794"},"modified":"2024-01-19T12:05:01","modified_gmt":"2024-01-19T12:05:01","slug":"latest-figures-published-on-hiv-in-the-uk-2023-report","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/46794","title":{"rendered":"Latest figures published on HIV in the UK: 2023 report"},"content":{"rendered":"<div>\n<div>\n<p class=\"HTBsubhead2articletitle\"><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><strong><span lang=\"EN-US\">On 6 October 2023, UKHSA published the latest annual report on HIV, together with the supporting data tables. [1, 2]<\/span><\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">This essential resource is always an impressive achievement that provides the evidence to plan services by highlighting recent trends as well as current needs.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">It includes data from 2022 on HIV testing, new diagnoses and access to ART together with other key measures including use of PrEP. Breakdowns by age, sex, gender, ethnicity, sexuality, geographic region and other related factors are included (mainly based on data for England). Results from 2022 are also compared to previous years. <\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">D<\/span><span lang=\"EN-US\">ata for Scotland<\/span><span lang=\"EN-US\"> were published by Public Health Scotland in September 2023. [3]<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Summary points are included below.<\/span><\/p>\n<h2>HIV testing<\/h2>\n<\/div>\n<div>More than 1,155,000 people had an\u00a0HIV\u00a0test at a sexual health service (SHS) in England (rather than in other settings including pregnancy). This was 10% higher than in 2021 but still 16% lower than in 2019.<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">As in 2021, half of these were home tests ordered online.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Overall, approximately half the people who were eligible to need a test in a clinic took up this offer. Uptake was higher by gay and bisexual men (74% tested, 23% not offered, 3% declined) compared to straight and bisexual women (38% tested, 40% not offered, 22% declined).<\/span><\/p>\n<h2>HIV PrEP<\/h2>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">The proportion of clinic visits from people who could benefit from\u00a0PrEP increased to 9.7% in 2022 to over 121,000.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Uptake varied by risk group: 59% of straight and bisexual women (n=2,695), 63% of heterosexual men (n=2,607) and 84% of gay and bisexual men (n=83,223).<\/span><\/p>\n<h2>HIV diagnoses<\/h2>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Overall,\u00a0HIV\u00a0diagnoses in England rose by 22% from 3,118 in 2021 to 3,805 in 2022. <\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Of these, approximately one-third (1361\/3805) were previously diagnosed outside the UK. Most were already on ART when they came to the UK, with an undetectable viral load (87%), and 96% were linked to UK care within three months.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">New first-diagnoses in England increased by 6% from 2,313 in 2021 to 2,444 in 2022.<\/span><\/p>\n<\/div>\n<div>\n<ul>\n<li class=\"HTBBODYtext\"><span lang=\"EN-US\">8% drop in gay and bisexual men to 724 in 2022, including a 3% drop in London (n=244),<\/span><\/li>\n<li class=\"HTBBODYtext\">14% increase in men and women in London identifying as straight to 325.<\/li>\n<li class=\"HTBBODYtext\">11% increase in men and women outside London identifying as straight to 651.<\/li>\n<li class=\"HTBBODYtext\">31% increase in women living outside London to 393. Of these, 77% (301) were born outside the UK.<\/li>\n<\/ul>\n<h2>Late and very late diagnosis<\/h2>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">The report notes that almost half (44%) the new diagnoses in England were late, based on having a CD4 count &lt;350 cells\/mm<sup>3<\/sup>.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">However, this 44% is based on only 865 people diagnosed in England and who had not been previously diagnosed in another country. This is because a significant percentage of other people diagnosed for the first time in the UK were originally diagnosed outside the UK and most had undetectable viral load on ART.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">The data tables report the combined figures. Table 1b shows 608\/1997 men (35%) are listed as being diagnosed late and 387\/1154 women (33%). This shows 1080\/3151 people were diagnosed with a CD4 count &lt;350 cells\/mm<sup>3<\/sup> (roughly 34%),<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">The summary report also misses out information on very late diagnosis defined as having a CD4 &lt;200 cells\/mm<sup>3<\/sup>.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Table 1a7 shows that 1081 people (34%) were diagnosed late with a CD4 &lt;350 and a further 624 people (20%) were diagnosed very late with a CD4 &lt;200 cells\/mm<sup>3<\/sup>.\u00a0<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Although this figure for late diagnosis should ideally be adjusted to exclude people diagnosed in acute infection, before the expected rebound, it isn&#8217;t clear whether this adjustment is included yet.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">No data is provided for people with more serious immunosuppression, including those with a CD4 count &lt;50 cells\/mm<sup>3<\/sup>. People in this category are at the highest risk for all opportunistic infections, including mpox where cases can be fatal, and including active CMV which requires urgent monitoring. They also have more difficulty normalising their CD4 count on ART and are likely to have more complex risk of future complications.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Table 1a7 also includes that 4% of diagnoses (n=155) had symptoms of opportunistic infection that made these advanced HIV disease (the new WHO recommended term for the historical diagnosis of AIDS).<\/span><\/p>\n<h2>HIV-related deaths<\/h2>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">During 2022, there were 603 deaths in 473 men and 130 women: 22 aged &lt;35,\u00ad 120 aged 35 to 49, 338 aged 50-69, 123 aged &gt;70.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Of these, 261\/603 were gay men, 143 straight men and 100 straight women.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Breakdowns are provided by sex for ethnicity, age, probable route of infection, country of birth and broad demographics of the epidemic in the UK.<\/span><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><span lang=\"EN-US\">Key points from Scotland (December 2022) include:<\/span><\/p>\n<\/div>\n<div>\n<ul>\n<li class=\"HTBBODYindent\"><span lang=\"EN-US\">An estimated 6,600 people were living with HIV in Scotland, of whom 6,150 (93%) had been diagnosed.<\/span><\/li>\n<li class=\"HTBBODYindent\">Of those engaged with HIV services, 98% were on ART and 93% of those had undetectable viral load.<\/li>\n<li class=\"HTBBODYindent\">A continued decline in recently acquired HIV (within the previous 3-4 months).<\/li>\n<li class=\"HTBBODYindent\">In 2022, 24 of 108 (22%) first ever diagnoses were made at a late stage of infection, 16 (67%) of which were very late stage, with advanced HIV disease.<\/li>\n<\/ul>\n<\/div>\n<div>\n<h3 class=\"HTBBODYindent\">comment<\/h3>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><strong><span lang=\"EN-US\">These annual data sets and accompanying reports are always important and further analyses are still ongoing, including on mortality.<\/span><\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><strong><span lang=\"EN-US\">The impact of COVID, and to a lesser extent mpox, on social behaviour, testing and access to services still affects these figures, limiting the interpretation of trends.<\/span><\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><strong><span lang=\"EN-US\">A further report, not yet released will report on progress towards the 2025 target goals. [4]<\/span><\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><strong><span lang=\"EN-US\">This includes <\/span>the commitment <span lang=\"EN-US\">to achieving zero new\u00a0HIV infections,\u00a0zero cases of advanced HIV and\u00a0HIV-related deaths in England by 2030.<\/span><\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBBODYtext\"><strong><span lang=\"EN-US\">Late diagnosis still accounts for a significant proportion of new diagnoses.<\/span><\/strong><\/p>\n<\/div>\n<div>\n<p class=\"HTBreferences\"><span lang=\"EN-US\">References<\/span><\/p>\n<\/div>\n<div>\n<ol>\n<li class=\"HTBreferences\"><span lang=\"EN-US\">UKHSA. <\/span>HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2023 report<span lang=\"EN-US\">. Publication number GOV-15487<br \/>\n<\/span><a href=\"https:\/\/www.gov.uk\/government\/statistics\/hiv-annual-data-tables\/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2023-report\">https:\/\/www.gov.uk\/government\/statistics\/hiv-annual-data-tables\/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2023-report<\/a><\/li>\n<li class=\"HTBreferences\">HIV: annual data tables<span lang=\"EN-US\"> (October 2023).<br \/>\n<\/span><a href=\"https:\/\/www.gov.uk\/government\/statistics\/hiv-annual-data-tables\">https:\/\/www.gov.uk\/government\/statistics\/hiv-annual-data-tables<\/a><\/li>\n<li class=\"HTBreferences\">Public Health Scotland. HIV in Scotland: update to 31 December 2022.<br \/>\n<a href=\"https:\/\/publichealthscotland.scot\/publications\/hiv-in-scotland\/hiv-in-scotland-update-to-31-december-202\">https:\/\/publichealthscotland.scot\/publications\/hiv-in-scotland\/hiv-in-scotland-update-to-31-december-202<\/a>2 (webpage)<br \/>\n<a href=\"https:\/\/publichealthscotland.scot\/media\/22243\/hiv-infection-in-scotland-update-to-31-december-2022-finalised-main-report-2023_09_26.pdf\" rel=\"noopener\">https:\/\/publichealthscotland.scot\/media\/22243\/hiv-infection-in-scotland-update-to-31-december-2022-finalised-main-report-2023_09_26.pdf<\/a> (full report PDF)<\/li>\n<li class=\"HTBreferences\">UKHSA. Towards Zero: the HIV Action Plan for England &#8211; 2022 to 2025. (1 December 2021).<br \/>\n<a href=\"https:\/\/www.gov.uk\/government\/publications\/towards-zero-the-hiv-action-plan-for-england-2022-to-2025\">https:\/\/www.gov.uk\/government\/publications\/towards-zero-the-hiv-action-plan-for-england-2022-to-2025<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base On 6 October 2023, UKHSA published the latest annual report on HIV, together with the supporting data tables. [1, 2] This essential resource is always an impressive achievement that provides the evidence to plan services by &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9,10],"tags":[],"class_list":["post-46794","post","type-post","status-publish","format-standard","hentry","category-special-reports","category-transmission-and-prevention"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/46794","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=46794"}],"version-history":[{"count":30,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/46794\/revisions"}],"predecessor-version":[{"id":47079,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/46794\/revisions\/47079"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=46794"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=46794"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=46794"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}