MSM HIV Data
Tables and Graphs
Accessing care MSM 2008 (PDF, 44 KB)
Accessing care MSM 2008 (Excel Spreadsheet, 330 KB)
MSM 2008 Report SlideSet (PowerPoint Presentation, 5 MB)- Figure 2: Diagnosed HIV-infected MSM accessing care by age group, UK
- Figure 3: Diagnoses of selected STIs among MSM, UK
Living with HIV
In 2007, there were an estimated 32,000 men who have sex with men (MSM) living with both diagnosed and undiagnosed HIV in the UK (all ages), approximately a quarter (range 20%-32%) of whom were unaware of their positive status. The prevalence of HIV (both diagnosed and undiagnosed infections) among MSM aged 15-44 was estimated to be 8.5% (range 7.0-10.5%) within London, 3.7% (range 3.1-4.5%) elsewhere in England and Wales and 5.3% (range 4.7-6.1%) overall. MSM accounted for 42% (range 39%-45%) of all the reported HIV infections seen for care during 2007 in the 15-59 age group,
There were 23,990 MSM (all ages) seen for HIV related care in 2007, more than double those seen in 1998 (Figure 1); equivalent to 3,713 per 100,000 MSM aged 15-44. The proportion of HIV-infected MSM among all persons seen for HIV care decreased from 58% in 1998, to 42% in 2007. During the same period the median age of MSM accessing care has increased from 36 to 41 years. By 2007, 32% of all MSM seen for HIV care were aged over 45, and 17% were over 50.
Figure 1: Number of new HIV and AIDS diagnoses, numbers accessing care and deaths in HIV infected MSM, UK
There has been a large rise in newly diagnosed HIV infections among MSM each year since the turn of the century. In 2007 there were a total of 2,679 newly diagnosed HIV infections (increasing to 3160 if adjusted for missing data), representing an increase of 8% since 2006, and 74% since 2000 (Figure 1). MSM accounted for 41% (2,679/6,566) of all new HIV diagnoses reported in 2007; equivalent to 533 per 100,000 MSM aged 15-44.
The greatest numbers of new diagnoses were in men aged 35-39 accounting for 37% (988) of HIV-infected MSM diagnosed in 2007, followed closely by those aged 35-44 (33%, 890). As in previous years, where reported, the majority of HIV-infected MSM were of white ethnicity (96%, 2,234), and acquired their infection in the UK (82%). Where country of birth was reported, the majority of those MSM diagnosed with HIV were born in the UK (69%, 1,133).
Figure 2: Diagnosed HIV-infected MSM accessing care by age group, UK
The median age of HIV infected MSM accessing care increased from 36 in 1998 to 41 years and in 2007, one third of MSM accessing care were aged 45 years or older. This aging cohort affect is due to increases in both new diagnoses in older MSM and effective therapies reducing mortality.
Figure 3: Diagnoses of selected STIs among MSM, UK
STI'S
MSM are disproportionately affected by STIs, and with the exception of non-specific urethritis and gonorrhoea, newly diagnosed cases of all STIs are continuing to rise in this prevention group (Figure 3). Despite a small drop in 2007, gonorrhoea remained the second most common STI (after non-specific urethritis) in MSM in the UK with a 23% increase in cases since 2000. MSM accounted for 30% (3,868/12,933) of all men diagnosed with gonorrhoea in 2007, the majority of whom were aged 25-34 (39%; 1,499/3,868).
By the end of August 2008, a cumulative total of 672 cases of lymphogranuloma venereum (LGV) had been diagnosed in MSM in the UK. The greatest proportion of cases were aged 35-44 (45%, 302/672), and diagnosed in London (72%, 485/672). The proportion of LGV cases reporting more than 5 sexual partners within the past 3 months was 31% for those co-infected with HIV and 21% without HIV co-infection.
Between 2000 and 2007, diagnoses of infectious syphilis among MSM in GUM clinics increased over eleven-fold, from 130 to 1463. Enhanced surveillance in 2007 reported 1,568 diagnoses of infectious syphilis among MSM. The highest proportion of cases was seen in the 35-44 age group (37%, 518/1,439). Primary syphilis was diagnosed in 40% of cases, with secondary and early latent syphilis being seen in 30% and 24% of cases respectively. Infection was likely to have been acquired through oral sex in 25% of diagnoses.
Figure 4: HIV co-infection of new cases of syphillis, gonorrhoea and LGV reported through enhanced surveillance, among MSM by age group, England & Wales: 2007
Enhanced STI surveillance data indicate that a high proportion of MSM diagnosed with an STI also had a diagnosed HIV infection. The proportion of those co-infected varied with age group and STI, with older STI affected MSM more likely to be HIV positive (Figure 4). In 2007 32% (105/324) of gonorrhoea, 40% (556/1394) of syphilis, 78% (118/152) of LGV and 97% of hepatitis C cases reported through enhanced surveillance were also infected with HIV.
Figure 5: Proportion of MSM attending sentinel GUM clinics across the UK receiving an HIV test, by unlinked anonymous HIV test result
The proportion of MSM offered and accepting an HIV test in GU clinics across the UK has continued to rise. Of the 45,748 HIV tests offered in 2007, 86% (39,361) were accepted, increasing from 81% (26,323/32,511) in 2003. Unlinked anonymous surveillance in sentinel GU clinics show higher uptake among younger (under 25) MSM (92%) compared to those aged 25 years and over (84%). HIV test uptake was high and with little difference observed between those MSM born in the UK (87%) and abroad (84%) and similarly those attending with an acute STI (84%) and those without (86%).
Unlinked anonymous HIV testing also revealed that over the last decade HIV test uptake has consistently been lower amongst those who are HIV positive compared to those who are HIV negative (Figure 5). In 2007, HIV test uptake was 65% (228/349) amongst those who were HIV positive compared to 87% (8,512/9,814) among those who were HIV negative. This may be a true difference but may also be due to men of known HIV positive status attending alternative clinics for sexual health screens and STI treatment, and not disclosing their status.
Approximately 11% of MSM undertook an HIV test (45,748 HIV tests) at a GUM clinic during 2007. Behavioural surveillance in a range of community venues, however, suggests a much higher level of HIV testing, with 31% of MSM testing in the last 12 months in a national survey in 2006 [4], 47% of men attending London gyms in 2008 and 48% in a community survey of MSM in London in 2006 [5].
Figure 6: Prevalence of previously undiagnosed HIV amongst MSM attending sentinel GUM clinics across the UK, by age-group
Unlinked anonymous testing of residual syphilis blood samples from MSM attending sentinel GUM clinics across the UK during 2007 showed the proportion with HIV infection that was not previously diagnosed to be 3.4%. Previously undiagnosed HIV infection has remained relatively constant in clinics in London at around 4%, with those outside London showing a slight, but not significant increase from 1.6% in 1998 to 2.3% in 2007. The highest levels of undiagnosed infection were among men aged 35-44 (5%).
Of those unaware of their infection, 65% (228/349) were newly diagnosed at that visit; however, 35% (121) left the clinic undiagnosed. In 2007, 5% (112/2,427) of MSM presenting with an acute STI had a previously undiagnosed HIV infection compared to 3% (242/7,743) of men who did not present with one
Figure 7: Estimated prompt and late HIV diagnoses in MSM with associated short-term mortality, UK: 2007
In 2007, 19% (499/2,679) of MSM were diagnosed after the point at which treatment should have begun (CD4 cell count less than 200 cells per mm3), a reduction from 30% (417/1,384) seen in 1998. Between 2003 and 2007, late diagnosis (CD4
Links
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2007 HIV and STI Annual report: Testing Times
Last reviewed: 12 March 2010
