Largest ever annual number of new HIV diagnoses in MSM

United Kingdom data for 2010 as at end December 2010

Recently published data (New HIV Diagnoses National Tables 2011 Part 2 (PDF, 464 KB) and table below) show that in 2010, an estimated 6,750 people (4,590 men and 2,160 women) were first diagnosed with HIV in the United Kingdom, after adjusting the observed number of 6,136 diagnoses for reporting delay. This represents a rate of 15.7 new diagnoses per 100,000 population aged from 15 to 59 years (21.4 per 100,000 men and 10.1 per 100,000 women).

The 2010 total was a slight increase on the number of new diagnoses seen in 2009, following a four year decline from the peak of 7,837 diagnoses reported in 2005. Half of all those diagnosed in 2010 (50%; 3,350) probably acquired their infection through heterosexual contact and 46% (3,080) through sex between men (MSM) (data adjusted for undetermined risk) [see Figure].

**Table Adjusted numbers of new HIV diagnoses by probable route of exposure and year of diagnosis (2001-2010)**
				2001	2002	2003	2004	2005	2006	2007	2008	2009	2010 ²
Probable exposure category ¹	Sex between men		Adjusted	1810	1980	2160	2440	2650	2650	2890	2770	2780	3080
	Sex between men		Observed	1786	1952	2125	2406	2611	2589	2803	2623	2534	2363
	Heterosexual contact	All	Adjusted	3030	4040	4780	4880	4830	4420	4100	4140	3520	3350
		All	Observed	2988	3985	4699	4807	4757	4329	3978	3914	3204	2549
		In the UK	Adjusted	330	520	620	750	820	890	1000	1100	1105	1150
		In the UK	Observed	320	402	477	587	654	694	726	777	749	626
		Abroad	Adjusted	2700	3520	4150	4140	4000	3530	3100	3040	2410	2200
		Abroad	Observed	2631	3519	4142	4067	3907	3385	2879	2625	2060	1442
	Injecting drug use		Adjusted	150	135	170	150	190	200	190	190	160	160
	Injecting drug use		Observed	144	131	167	150	187	199	181	182	149	111
	Other exposure categories		Adjusted	140	170	200	190	170	180	150	140	160	160
	Other exposure categories		Observed	140	164	196	188	167	178	148	130	145	113
	*Not Reported*		*Observed*	70	88	121	120	115	159	219	390	585	1,000
Total				5128	6320	7308	7671	7837	7454	7329	7239	6617	6750

1 Data are adjusted for exposure category not reported
2 Data are adjusted for reporting delay and exposure category not reported

Figure Adjusted numbers of new HIV diagnoses by probable route of exposure and year of diagnosis (2001 - 2010)

Adjusted numbers of new HIV diagnoses by probable route of exposure and year of diagnosis (2001 – 2010)

The estimated number of new diagnoses among MSM reached 3,080 in 2010, the highest ever in this group. While some of this increase may be attributable to more HIV testing, data on CD4 count and age at HIV diagnosis plus data from the recent infection test algorithm suggest ongoing transmission of HIV among MSM at a high rate. The majority of MSM diagnosed with HIV infection are of white ethnicity (81%) and acquired their infection within the UK (82%).

The number of new diagnoses among those infected heterosexually within the UK has remained steady at around 1,100 per year since 2008. In contrast, the number of new diagnoses among heterosexuals infected abroad continues to fall, from 3,040 in 2008 to 2,200 in 2010. This is largely due to a decrease in diagnoses among persons from sub-Saharan Africa.

Continued low numbers of HIV diagnoses were made in injecting drug users (160) and those infected through other exposures (160), such as mother to child transmission and recipients of blood and blood products. All infections acquired through receipt of blood/tissue products diagnosed since 2002 were acquired outside of the UK, including 18 diagnosed in 2010.

In 2010, 3,780 people acquired their infection within the UK including, 2,530 MSM, 1,150 heterosexuals, 70 IDUs and 30 children infected through mother to child transmission. Moreover, infections acquired within the UK have almost doubled over the past decade from 1,950 in 2001, and in 2010 has now exceeded the proportion acquired abroad (56% vs 44%).

Five hundred and twenty-nine deaths among people with HIV infection were reported for 2010, and this is likely to increase as further reports are received. Following the steep decline in the mid-1990s due to the introduction of antiretroviral therapy, the annual number of deaths has remained constant at between 450 and 650. The current death rate is around 10 per 1,000 people living with diagnosed HIV infection aged from 15 to 59 years (this compares with an annual death rate in the general population aged 15-59 of 1.7 per 1,000 in 2009). AIDS-elated deaths in HIV infected people are contributed to by late diagnosis (CD4 < 350 cells/µl at HIV diagnosis) with 3 out of 5 of all deaths occurring in individuals who were diagnosed late. Over the past decade, the number of deaths in HIV-infected individuals aged from 30 to 39 years has decreased, and has increased in those aged 50 years and above.

The continuing high numbers of new HIV diagnoses are a major public health problem as well as an important financial burden in the United Kingdom. If the estimated 3,780 UK-acquired HIV cases in 2010 had been prevented, over £32 million annually or £1.2 billion lifetime treatment and clinical care costs would have been saved, a figure that does not include the cost of psychosocial treatment and support.

This report will be published in Health Protection Report Vol 5 No 12: 25 March 2011

Last reviewed: 23 March 2011