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Home News centre National Press Releases 2013 Press Releases ›  New research explores driving forces behind HIV epidemic in men who have sex with men in the UK

New research explores driving forces behind HIV epidemic in men who have sex with men in the UK

18 February 2013

New HIV infections rose in men who have sex with men (MSM) between 1990 and 2010 in the UK, driven by a 26 per cent increase in the proportion having condomless sex, according to new research by the Health Protection Agency and UCL. However, the findings suggest the increase in new infections would have been 68 per cent greater without the introduction of antiretrovirals (ART) in the same period, and 400 per cent greater if MSM condom use had ceased entirely from 2000 onwards. Published in PLOS ONE, the study received funding from the National Institute for Health Research.

Professor Andrew Phillips, lead investigator at UCL, said: “We created a model reconstructing the HIV epidemic in men who have sex with men in the UK. In doing so, we were able to explore the interplay between HIV testing rates, antiretroviral treatment and sexual behaviour on HIV transmission and incidence. By better understanding the driving forces behind the trends we’ve seen in the past, it will allow us to make informed choices to reduce new HIV infections in the future.”

Dr Valerie Delpech, head of HIV surveillance at the HPA, said: “Our research provides important evidence to support current UK public health recommendations on expanded HIV testing and higher levels of ART coverage, to reduce new infections among men who have sex with men. However, we see it is also vital condom use education continues as not only does this have a strong limiting effect on the HIV epidemic, but only a modest increase in unprotected sex is enough to erode the benefits of other interventions”.

Estimated HIV incidence rose from 0.30 per 100 person years (1990-1997) to 0.53 (2006-2010), associated with increased condomless sex following the introduction of effective ART. However, exploring other scenarios, the research found incidence would have reduced during this period if HIV testing levels had been higher (25 per cent lower incidence), if ART had been prescribed at diagnosis (32 per cent lower incidence) or these interventions had been combined (62 per cent lower incidence). Effective ART therapy reduces the infectivity of HIV positive individuals, lowering transmission risk.

Dr Delpech, HPA, continued: “Everyone should use a condom when having sex with new or casual partners, until all partners have had a sexual health screen. We also encourage men who have sex with men to get an HIV and STI screen at least annually, and every three months if having condomless sex with new or casual partners – and clinicians to take every opportunity to recommend HIV testing to this group. Through combining earlier and more frequent HIV testing, programmes that reduce unsafe sexual behaviour and higher levels of ART coverage for those requiring it, we could substantially reduce HIV transmission in this group.”


Notes to editors

  1. The paper is now published in PLOS one, the full version is available as open access on [external link]. Phillips AN, Cambiano V, Nakagawa F, Brown AE, Lampe F, et al. (2013) Increased HIV Incidence in Men Who Have Sex with Men Despite High Levels of ART-Induced Viral Suppression: Analysis of an Extensively Documented Epidemic. PLOS ONE 8(2): e55312. doi:10.1371/journal.pone.0055312
  2. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email Out of hours: 0208 200 4400.
  3. This paper and associated press release present independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0608-10142). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
  4. About the National Institute for Health Research. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website ( [external link]).


Last reviewed: 18 February 2013