HIV and AIDS in the UK

The UK has a relatively small HIV and AIDS epidemic in comparison with some parts of the world. An estimated 91,500 people in the UK – or around 1.5 per 1000 of the UK population – are currently living with HIV.1 While this number is relatively low, it has increased dramatically since the 1990s, alongside a general rise in the prevalence of sexually transmitted infections.

back to top AIDS & HIV in the UK - the current situation

British campaign poster against HIV/AIDS (colour) A poster which was part of the early campaign by the British government to raise awareness of AIDS

Although AIDS gets less attention from the media in the UK than it did during the early history of the UK AIDS epidemic, it’s far from a problem of the past. In fact, the epidemic has expanded, with the annual number of new HIV diagnoses more than doubling between 1999 and 2003, and peaking in 2005 at almost 8,000 diagnoses.2 Annual diagnoses have slightly declined since then with 6,660 people diagnosed HIV-positive in 2010.3

The UK AIDS statistics show that of the 91,500 people living with HIV in the UK at the end of 2010, approximately 24 percent were unaware of their infection.4

Relatively low numbers of people in the UK have died from AIDS in recent years thanks to the availability of HAART (Highly Active Antiretroviral Therapy), which dramatically increases the life expectancy of people living with HIV. In 2010, around 529 HIV-infected persons died, compared to 1,723 in 1995, when antiretroviral treatment for HIV was not widely available.5 The majority of AIDS-related deaths in 2010 occurred because people were diagnosed late and therefore did not start treatment early enough. In 2010, an estimated 50 percent (3,300) of adults were diagnosed at a late stage of infection.6

Since 1996 the life expectancy of people living with HIV in the UK, on antiretroviral treatment, has increased by 15 years.7 Until recently, an average person living with HIV aged 20 years, was expected to live an additional 30 years (they would live to be 50 years). However, a recent study indicates that an average person living with HIV aged 20 is now expected to live an additional 46 years (they would live to be 66 years). This is still about 13 years less than the general UK population.8 Improvements to antiretroviral treatment was cited as the main reason for the increase.

However, this estimation of life expectancy does vary depending on certain factors, such as: sex, CD4 count, and lifestyle factors. For example, women living with HIV in the UK have a slightly higher life expectancy than men. Also, if a persons CD4 count is low when they begin antiretroviral treatment, their life expectancy is expected to be significantly lower, at least 10 years less, than if they had started treatment at the recommended CD4 count of between 200-350 cells/mm3. Factors such as smoking, alcohol and drug use and the existences of co-morbidities can also affect life expectancy, but were not measured in the study.9

Infections acquired through heterosexual sex account for the largest number of HIV diagnoses in the UK. The majority of people who acquired HIV heterosexually were infected overseas but only became aware of their status after being tested in the UK. However, this majority appears to be diminishing; The number of new HIV diagnoses among people infected overseas has decreased since 2004, whilst diagnoses among people who most likely were infected heterosexually within the United Kingdom have recently risen dramatically, from 320 in 2001 to 1,090 in 2010. By 2010, people who were infected within the UK accounted for a third of all heterosexuals newly diagnosed that year.10 Recently, new infections among gay men (and other men who have sex with men) have also risen, reaching an all time high and accounting for 45 percent of new infections in 2010.11

Despite the rising numbers of new HIV infections in the UK, public knowledge of HIV and AIDS appears to have declined. In 2000, 91 percent of people in the UK knew that HIV was transmitted through unprotected heterosexual sex; by 2010 this figure had fallen to 80 percent.12

Many UK HIV/AIDS organisations have called for improved sexual health services. The Terrence Higgins Trust, for example, released a 2007 report stating that sexual health services in England remain woefully under prioritised and under funded. It claims that despite the government’s promise of an extra £300 million for sexual health services across the United Kingdom to modernise clinics and reduce waiting times, many GUM (Genitourinary Medicine) clinics remain cramped, out-of-date and understaffed.13

“awareness of HIV and AIDS in Britain has fallen below the public radar”

In 2011 a report by the House of Lords Select Committee into HIV and AIDS in the UK noted that despite a growing epidemic and increasing numbers of people on treatment, "awareness of HIV and AIDS in Britain has fallen below the public radar".14 More resources directed towards HIV prevention, including wider access to HIV testing, were identified as key measures needed to reduce new HIV infections in the UK and effectively deal with the epidemic.

Funding cuts announced by the government in 2010 will likely affect services for HIV and AIDS in the UK. In June 2010 it was announced that £28 million allocated for HIV/AIDS support services in the country would no longer be protected, a decision with likely knock-on effects for counselling, peer support, staff training and care services for people living with HIV in the UK.15 Charities such as the Terrence Higgins Trust and the National AIDS Trust have expressed concern that such cuts will affect local HIV organisations who rely on such funding to provide specialist social care support to HIV positive people who are not necessarily catered for by mainstream services.16 17 However, there is a broad geographical distribution of services, with more than 80 percent of people with a diagnosed HIV infection living within five kilometres of an HIV service.18

UK regions affected by HIV

In 2010 there were 5,627 new HIV diagnoses in England, 280 in Scotland, 148 in Wales and 81 in Northern Ireland.19 London is the epicentre of the UK AIDS epidemic, accounting for around half of HIV diagnoses in the UK so far. In Wales, Scotland, and Northern Ireland, HIV diagnoses have risen year on year, although there has been a slight decline in diagnoses in recent years.20

back to top HIV transmission routes in the UK

Of all HIV diagnoses to the end of December 2010, 44 percent resulted from sex between men, 45 percent from heterosexual sex, 5 percent from injecting drug use, 2 percent from mother-to-child transmission, 2 percent from blood/tissue transfer or blood factor, and 3 percent from other or undetermined routes.21

Heterosexual sex

In 2010, around 50 percent of people diagnosed in the UK were infected through heterosexual sex, making this the single biggest exposure category. Of these people around a third were probably infected in the UK.22 The high rate of HIV amongst Africans in the UK reflects the severity of the AIDS epidemic in sub-Saharan Africa. In the period 1995-2010 there have been a total of 46,863 HIV diagnoses among people of black African ethnicity in the UK, 70 percent of which were as a result of heterosexual sex.23

The increasing number of people infected with HIV through heterosexual sex means that the number of women with HIV is increasing. The male to female ratio of HIV diagnoses made before 1994 was more than 7 to 1, whereas in 2010 the ratio for new diagnoses was around 2 male to 1 female.24

'Choose safer sex' poster Choose safer sex poster

HIV/AIDS and gay men in the UK

In 2007 the Health Protection Agency (HPA) announced that the number of newly diagnosed HIV infections amongst gay men had risen for the third successive year, to an all time high.25  In 2010 sex between men accounted for an estimated 3000 new HIV diagnoses, representing 45 per cent of new diagnoses that year.26 By the end of 2009, the number of MSM living with HIV in the UK was estimated at 35,000.27 An estimated four out of five probably acquired their infection in the UK.28 However, around 9,000 MSM living with HIV in the UK are unaware that they are infected.29

Injecting drug use

The level of HIV infection caused by injecting drug use is relatively low in the UK; around 2.5 percent of all new HIV diagnoses in 2010 were attributed to injecting drug use.30 Just over a third of these infections were definitely acquired within the UK. By the end of December 2010 injecting drug use accounted for 5 percent of HIV diagnoses ever reported in the UK.31

Mother-to-child transmission of HIV in the UK

A high uptake of antenatal HIV testing and the availability of drugs to prevent mother-to-child transmission of HIV has contributed to a low number of HIV infections passed from mother to child in the UK. HIV diagnoses attributed to mother-to-child transmission totalled 51 in 2010, the majority of which were acquired outside of the UK. There has been a total of 1,964 UK diagnoses of HIV in people who acquired the virus from their mothers.32

View UK statistics by transmission route and gender.

HIV infected blood/tissue transfer

Blood safety measures within the UK have minimised the risk of transmission through infected blood transfusions/tissue to such a degree that there have been no reports of HIV infection being acquired in this way, in the UK, since 2002.33 The last recorded incident of HIV transmission through infected blood donated in the UK was in a female blood transfusion recipient in 2003.34

To minimise the risk of receiving infected blood whilst donors are in the window period, the UK has certain restrictions on who can donate. Individuals that have ever been a sex worker or have ever injected drugs are banned from donating blood for life. Other behaviours that are considered to be high risk result in an individual being deferred from donating blood rather than having a lifetime ban.  For example, individuals that have had sex with somebody who has been sexually active in a high-prevalence country, with a sex worker or with an injecting drug user, cannot donate blood for twelve months afterwards.35 Until 2011, men who have sex with men (MSM) were permanently excluded from donating blood in the UK. The blood donation criterion was changed in England, Scotland and Wales on 7th November 2011, bringing the donation criteria for MSM in line with other high-risk groups with a twelve-month deferral period.

Occupational exposure is very rare in the UK, with one definite documented case since 1997.36   Medical settings have procedures in place in case of a ‘sharps injury’, which can involve PEP if there is a danger that the health care worker has been exposed to HIV infected blood.

back to top HIV and Africans in the UK

Africans in the UK are affected by HIV and AIDS to a far greater extent than other broadly defined ethnic groups, representing 29 percent of new diagnoses in the UK during 2010.37 In 2009 HIV prevalence among black Africans was 4 percent, compared to 1 percent among the white population.38 Between 1995 and 2008, people of black African ethnicity accounted for 42 percent of the UK’s total HIV diagnoses, of which the overwhelming majority were attributed to heterosexual sex.39 Around 90 percent of the 23,288 black Africans who received HIV care in the UK in 2009 reported that they were infected during heterosexual sex and most acquired their infection in Africa.40

HIV diagnoses among black Africans and black Caribbeans often occur at a late stage of infection - when antiretroviral treatment is less likely to work as effectively. In 2007 over 40 percent of late diagnoses were among black Africans and 27 percent were among black Caribbeans, highlighting the need for increased HIV testing in this population.41

back to top HIV/AIDS prevention in the UK

Men who have sex with men (MSM)

Gay men are currently the focus of a number of HIV prevention campaigns in the UK. An important nationally coordinated campaign is CHAPS, which is funded by the Department of Health and run by a partnership of organisations, led by the Terrence Higgins Trust (THT).

Another broad campaign is The London Gay Men’s HIV Prevention Partnership (LGMHPP) – a collaborative prevention effort implemented by AIDS-related organisations and funded by most London health authorities. Interventions include condom distribution, using media to promote prevention messages, newsletters and booklets, counselling and group work.

Despite campaigns to raise HIV awareness, there is evidence to suggest prevention efforts are insufficient. A study released in 2007 found that 18 percent of HIV-negative gay men had had unprotected anal intercourse with more than one partner during the previous year. Worryingly, this figure rose to 37 percent for gay men who were HIV-positive.42

In 2011 HIV organisations in London expressed 'disappointment' and 'concern' over 20 percent cuts to their funding for HIV prevention services in the capital city. It is believed that the reduced funding will particularly affect high-risk groups such as MSM.43 44

Africans in the UK

UK AIDS awareness poster UK AIDS awareness poster

The National African HIV Prevention Programme (NAHIP) is a country-wide prevention campaign funded by the Department of Health. It is managed by the African HIV Policy Network and collaborates with a number of smaller organisations that aim to prevent HIV among African people in the UK.

Among NAHIP’s most prominent initiatives are the ‘Do It Right – Africans Making Healthy Choices’ campaign which provides information on sexual health, condoms, and where to access help. Its website features a series of soap opera-styled videos encouraging viewers to think about HIV, condom negotiation and testing.45 The ‘Beyond Condoms’ campaign promotes debate among African communities about a wide range of issues regarding sexual health and ‘building a safer sex culture’. The campaign’s literature targets different religious groups and is available in five different languages.46

It is important that any prevention work targeting African communities in the UK be supported by parallel activities that aim to reduce the problem of HIV-associated stigma and discrimination.47 A 2006 study found that fear of discrimination is stopping some people of African origin from accessing HIV testing services for fear of community reaction if their result were to be positive.48 Encouraging HIV testing uptake is a key part of preventing onward transmission of HIV in all communities. If people know their status they are less likely to pass the virus to others.

Public health bodies are encouraged to deliver information about HIV, to overcome stigma and to promote the benefits of knowing your status among black African communities.49 This can be achieved by distributing promotional materials among black African communities, particularly those that have high incidence of HIV and high HIV prevalence.

Injecting drug users

A lot of early media coverage of AIDS in the UK focused on injecting drug users. During the early 1980s it was a big problem, particularly in Scotland where areas such as Edinburgh and Dundee had a very high prevalence of HIV among IDUs. In 1986 needle exchanges began to operate all across the UK, providing clean needles and giving drug users access to information and support. These schemes were largely effective, and helped to substantially reduce the prevalence of HIV among IDUs during the 1990s. From 1990 to 1996 prevalence among this group fell from nearly 6 percent to 0.6 percent, rising slightly around 2003 and remaining fairly stable since.50

Needle exchange symbol on window of Boots, a UK-based pharmacy. Needle exchange symbol on window of Boots, a UK-based pharmacy.

Needle exchange services are run by hospitals, pharmacies, drug agencies and other organisations. While over 90 percent of current and former drug users in England, Wales and Northern Ireland have used a needle exchange service, campaigners argue that needle exchange provision in the UK is patchy, out of hours provision is poor and there are disparities in the availability of equipment.51 Risk taking among this group remains high. In 2007, 23 percent of injecting drug users in England, Wales and Northern Ireland reported sharing needles or syringes during the four weeks prior to a survey, down from around a third in the early part of the decade.52

Doctors in the UK are permitted to prescribe methadone as a substitute for injected heroin. Through methadone substitution, users can also be helped to end their dependency on drugs.

HIV/AIDS education and awareness

HIV education is a vital component of HIV prevention strategies. Educating people about HIV can help them to protect themselves and others, and can reduce the fear and stigma surrounding HIV and AIDS.

A 2010 UK survey of peoples’ attitudes to and knowledge of HIV conducted by the National AIDS Trust found that levels of understanding about HIV transmission in the UK have fallen significantly since the year 2000. It was found that in 2010, only a third of the British public could correctly identify all true and false HIV transmission routes.53 It was also noted that there had been an increase in the proportion of people who incorrectly believe HIV can be transmitted through spitting and kissing.

The over 50 age group has also been overlooked by those providing HIV and AIDS education in the UK. In the ten year period 2000-2010, new HIV diagnoses almost tripled among the over 50s; in 2010 around 1 in 8 new diagnoses were among those over 50.54

Deborah Jack, Chief Executive of the National AIDS Trust, emphasises the need to educate the general UK public about HIV:

“Ignorance about HIV increases vulnerability to infection and also contributes to stigma and discrimination. The Government must re-invest in educating the public about HIV.”55

HIV education in schools is one way to target young people with HIV prevention. In England and Wales, the government encourages secondary schools to teach pupils about HIV/AIDS as part of Sex and Relationships Education (SRE), although it is not a statutory subject on the national curriculum. Ofsted – an official body that regulates schools in England – reported in 2007 that:

Schools gave insufficient emphasis to teaching about HIV/AIDS. Despite the fact that it remains a significant health problem, pupils appear to be less concerned about HIV/AIDS than in the past.”56

In Northern Ireland and Scotland, HIV/AIDS is not a compulsory part of school education either.

The Terrence Higgins Trust, amongst other organisations, believes that sex and relationships education should be a core part of the National Curriculum in the UK:

“The lack of good sex education means many young people are leaving school ignorant about HIV and safer sex...It’s time to get our facts straight.”Nick Partridge, Chief Executive, THT57

In 2009 it seemed as if this was set to change. In response to recommendations following an independent review, it was announced that Personal, Social, Health and Economic (PSHE) education would be made compulsory at primary and secondary schools in the UK from 2011.58 This was to ensure that all young people in the UK would be provided with some sex and relationships education before they leave school. However, in 2010 this part of the Children, Schools and Families bill was omitted and as a result, PSHE education is not a statutory part of national curriculum.59

Prevention of mother-to-child transmission

The UK has been very successful at preventing mother-to-child transmission of HIV. All expectant mothers are offered an HIV test and uptake in 2008 was 95 percent resulting in at least 90 percent of infections being identified before delivery.60 Women who are identified as HIV-positive are offered antiretroviral treatment to prevent transmission to their unborn baby. As such, only 0.7 percent of children born to HIV infected mothers in 2010 became infected with the virus, compared to 14 percent a decade earlier.61

back to top HIV testing in the UK

According to British guidelines, HIV testing should be offered at genitourinary medicine (GUM) clinics as part of routine STD screening, regardless of symptoms of disease or risk factors of infection. The guidelines state that everybody taking an HIV test should have a pre-test discussion, and be offered counselling if requested, or if there is a high risk of a positive result.62

The number of people tested for HIV and other STDs at GUM clinics (where the majority of people are tested for HIV) has risen in recent years. Almost half of sexual health screens in 2003 included an HIV test; this proportion increased to two-thirds for England, Wales and Northern Ireland in 2006. Overall, around 984,000 had an HIV test in a GUM clinic in England, Wales and Northern Ireland in 2009.63 Results from the Gay Men's Sex Survey in 2008 revealed that around two-thirds of MSM in England and Wales had taken an HIV test, a rate which, promisingly, is steadily rising year on year.64

It can be difficult to treat someone with HIV if they are diagnosed late, and in some cases late diagnosis leads to death.

A major worry is that many people infected with HIV aren’t accessing testing services soon enough. In 2009, more than half of individuals newly diagnosed with HIV were diagnosed late (CD4 count below 350 cells/mm3).65 It can be difficult to treat someone with HIV if they are diagnosed late, and in some cases late diagnosis leads to death. According to the British HIV Association (BHIVA), at least a quarter of deaths reported in HIV-positive people in the UK between 2004 and 2005 may have been avoided if HIV had been diagnosed at an earlier stage.66 Of previously undiagnosed HIV-infected heterosexual men and women attending GUM clinics in 2006, one quarter left the clinic unaware of their HIV infection.67

BHIVA, along with other experts, say that non-HIV clinicians such as General Practitioners (GPs) need to be made more aware of the importance of early diagnosis. Guidelines published in 2008 suggest offering an HIV test to all adults registering with a GP and all general medical admissions in areas with a relatively high HIV prevalence (where more than 2 in 1000 people have diagnosed HIV).68 By 2010 results from eight projects in primary care and general medical admissions showed an overall positivity rate of five per 1,000 tests conducted. Routine testing in these settings was found to be both feasible and acceptable among staff and patients.69 Dr Stephen Taylor, Consultant Physician for Sexual Health and HIV at Birmingham Heartlands Hospital, highlights the need to increase the reach of HIV testing, stating:

"Only through more effective and more widespread testing can we make earlier diagnoses, reduce undetected HIV cases and thus halt onward transmissions."70

NICE (National Institute for Health and Clinical Excellence) released guidance in 2011 which supported the new BHIVA testing guidelines but was aimed particularly at increasing access to testing among Black African and MSM communities. Included in the guidelines are recommendations to expand testing outside clinical settings by engaging community organisations, developing local strategies to increase testing, and providing rapid HIV tests.71

According to the NICE national costing model, for every new positive diagnosis of HIV 0.03 cases of onward transmission are avoided, resulting in significant cost savings.72

back to top AIDS treatment in the UK

All legal UK residents are eligible for free HIV/ AIDS treatment from the NHS. The first antiretroviral drug to treat HIV became widely available in the UK in 1987. Since then, the availability of HIV treatment in the UK has greatly reduced the number of people who die from AIDS related illnesses, and has profoundly improved the quality of life of many people living with HIV.

However, individuals taking antiretroviral treatment have to take medication every day for the rest of their lives, and sometimes suffer severe HIV drugs side effects. It has also been found that resistance to antiretroviral treatment can occur, and since HAART (taking a combination of three or more antiretrovirals) is a relatively new form of treatment it is not known how long an individual can continue to benefit from it.

The cost to treat a person living with HIV can be very expensive. For example, it costs an estimated £5485 a year to treat a 35-year old living with HIV in the UK.73 Therefore, if a person of this age lives for a further 37 years (the average life expectancy for someone aged 35, living with HIV in a developed country), the total lifetime treatment costs may be anywhere between £200,000 to £360,000.74

back to top Other issues

Stigma and discrimination: People living with HIV may face prejudice as a result of their condition, and the social stigma surrounding AIDS can stop people from discussing it. Ignorance of how HIV is transmitted can lead to discrimination against people living with HIV. More than two-thirds of people surveyed in a nation-wide survey felt there was a lot of stigma around HIV in the UK and one in three people living with HIV said they had experienced discrimination based on their status.75

George House Trust campaigners against HIV-related stigma and discrimination George House Trust campaigners against HIV-related stigma and discrimination

HIV in prisons: The last official survey into HIV prevalence in UK prisons was conducted in 1997. This survey showed an HIV prevalence higher than that in the general population, a problem driven by high-risk behaviour, including injecting drug use.76 77 Recent HPA figures for England suggest that HIV prevalence in prisons in England is more than double that than the general population.78 However, it has been noted that because of a lack of data in this area this number is probably an underestimation.79

A 2005 survey found that prisons in the UK were lacking in many of essential preventative measures necessary to lessen the risk of HIV infection and other STDs...

“Many prisoners did not have appropriate access to condoms, disinfecting tablets, clean needles or healthcare information and so were not able to protect themselves from HIV if injecting drugs or having unprotected sex whilst in prison”.

The government announced plans to provide disinfectant tablets to prisoners which can be used to sterilise needles in 2005, and steps were taken to introduce disinfecting tablets into HIV in October 2007.80 However, some campaigners argue that this does not go far enough and that needle exchanges, as well as a variety of other harm reduction methods, should be introduced to prisons.81  

More up-to-date data is needed on the prevalence of HIV within prisons, and the extent and nature of HIV prevention, testing and treatment services. This can then be used to determine gaps in provision and ensure that steps can be taken to reduce new HIV infections in prisons and provide care and treatment for those already infected. AVERT.org has more information about prisons, prisoners and HIV/AIDS.

Criminal transmission of HIV: There have been several high profile cases in the UK of individuals being prosecuted for reckless transmission of HIV because they have failed to tell sexual partners about their condition. These cases generated a lot of debate about how the law should deal with this issue, and in 2008 the Crown Prosecution service released guidelines to clarify the law in England and Wales (the law is different in Scotland). As of 2008 reckless HIV transmission is only punishable in court in England and Wales if HIV is actually passed on and if the defendant is aware of their HIV status.82 In 2010 the Association of Chief Police Officers (ACPO) issued guidance to help police officers deal with cases of reckless transmission of HIV in a fair and sensitive way that respects the rights of people living with HIV.83 The prosecution of the reckless transmission of HIV remains contentious; a number of HIV organisations maintain that promoting knowledge of status and safer sex are more effective in preventing transmission than prosecuting those who have transmitted the virus.84 85

back to top The way forward

The recent history of AIDS in the UK has been marked by a number of important changes. As the situation continues to shift, government responses need to reflect these changes to minimise the future impact of AIDS in the UK.

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An interview with Lord Fowler over a report into HIV and AIDS in the UK

High costs of treatment, thousands of new HIV diagnoses every year, and persistently high levels of stigma and discrimination are some of the challenges that remain. A 2011 House of Lords Select Committee report into HIV and and AIDS in the UK concluded that...

“Not enough is being done to respond to a steadily growing risk to public health. There are potentially huge cost implications in both the short- and long-term in failing to deal effectively with the epidemic. At a time when public health in the United Kingdom is subject to major reform, the Government should ensure that HIV and AIDS is a key public health priority. ”86

Many campaigns feel that there needs to be a greater focus on, and an improvement in, the services aimed at the two groups most affected by HIV in the UK: gay men, and people of African ethnicity. HIV infection in the UK is not limited to these groups though, and with sexually transmitted infections becoming more widespread amongst the population as a whole, it’s clear that unsafe sexual practices are common in the UK. Sexual health services in general need to be improved, and the declining awareness of HIV amongst the general public needs to be addressed. If such steps aren’t taken, it’s likely that the UK epidemic will continue to expand in coming years.

References back to top

  1. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  2. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of June 2010'
  3. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  4. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  5. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of December 2010'
  6. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  7. May, M et. al (2011) 'Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study' BMJ 343:d60616
  8. May, M et. al (2011) 'Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study' BMJ 343:d60616
  9. May, M et. al (2011) 'Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study' BMJ 343:d60616
  10. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  11. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  12. NAT (2011, February 18th) 'One in five adults do not realise HIV is transmitted through sex without a condom between a man and a woman'
  13. THT (2007) ‘Disturbing symptoms 5’
  14. Select Committee on HIV and AIDS in the United Kingdom (2011, July) 'No vaccine, no cure: HIV and AIDS in the United Kingdom'
  15. Communities and Local Government (2010, June 10th) 'Ringfences removed from local government funding streams'
  16. NAT (2010, June 14th) 'NAT Concerned by end of Protected Grant for Care of People with HIV'
  17. PinkNews (2010, June 14th) 'HIV charities 'very concerned by threat to local funding'
  18. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  19. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of December 2010'
  20. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of December 2010'
  21. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of December 2010'
  22. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  23. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of December 2010'
  24. Health Protection Agency (2010) 'United Kingdom HIV New Diagnoses to End of December 2010'
  25. Health Protection Agency (2007) ‘New figures show rise in HIV diagnoses amongst gay men in UK’, press release
  26. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
  27. NICE (2011) 'Increasing the uptake of HIV testing among men who have sex with men'
  28. Health Protection Agency (2010) 'HIV in the United Kingdom: 2010 report'
  29. NICE (2011) 'Increasing the uptake of HIV testing among men who have sex with men'
  30. Health Protection Agency (2011) 'HIV in the United Kingdom: 2011 report'
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  35. NHS Blood and Transplant (2011) 'Give Blood - Who Can't Give Blood'
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  42. Dodds J P et al (2007), ‘A tale of three cities: persisting high HIV prevalence, risk behaviour and undiagnosed infection in community samples of men who have sex with men’, Sexually Transmitted Infections
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  45. Do it Right website, accessed 16/08/09
  46. The National African HIV Prevention Programme, Beyond Condoms Campaign website, accessed 16/08/09
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  48. Elam G et al (2006), ‘Barriers to voluntary confidential HIV testing among African men and women in England: results from the Mayisha II community-based survey of sexual attitudes and lifestyles among Africans in England’, HIV Medicine 2006; 7(Suppl. 1): 7 (abstract no. O28)
  49. NICE (2011) 'Increasing the uptake of HIV testing among black Africans in England'
  50. Hope V.D. et al (2005), 'HIV prevalence among Injecting Drug Users in England & Wales 1990 to 2003: Evidence for increased transmission in recent years' AIDS 2005:19
  51. Turning point (2007), ‘At the sharp end: a snapshot of 21st century injecting drug use’
  52. HPA (2008), 'Health Protection Agency 2008, ‘Surveillance Update: 2008 Supplementary data tables of the Unlinked Anonymous Prevalence Monitoring Programme: data to the end of 2007’
  53. NAT (2011, February 18th) 'One in five adults do not realise HIV is transmitted through sex without a condom between a man and a woman'
  54. Health Protection Agency (2011) 'United Kingdom New HIV Diagnoses to end of December 2010' Table No. 6
  55. NAT (2008), ‘Over 90 percent of the British public do not fully understand how HIV is transmitted’
  56. Ofsted (2007, April), 'Time for change? Personal, social and health education’
  57. THT (2007) ‘Press release: Survey highlights shocking ignorance about HIV, 25 years after death of Terry Higgins’
  58. Department for Children, Schools and Families (2009, 5th November), 'Ed Balls confirms all young people to learn Personal Social Health and Economic education'.
  59. PSHE Association (2010, May) 'The new primary curriculum and PSHE education - Statutory status in relation to the Children, Schools and Families Act 2010' [PDF]
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  61. Health Protection Agency (2010) 'United Kingdom new HIV diagnoses to end of December 2010'
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  63. Health Protection Agency (2010) 'HIV in the United Kingdom: 2010 report'
  64. Sigma Research (2010, October) 'Tactical dangers: Findings from the United Kingdom Gay Men's Sex Survey 2008'
  65. NICE (2011) 'Increasing the uptake of HIV testing among men who have sex with men'
  66. BHIVA (2006), 2005-6 Full results of mortality audit
  67. HPA (2007) ‘Testing Times: HIV and other Sexually Transmitted Infections in the United Kingdom: 2007’
  68. BHIVA/BASHH/BIS (2008) 'UK National guidelines for HIV testing 2008'
  69. HPA (2010) 'Time to test for HIV: Expanded healthcare and community HIV testing in England - Interim report'
  70. BBC News (2011, 7th January) 'Doctors are "reluctant" to test routinely for HIV'
  71. NICE (2011) PH33 Increasing the uptake of HIV testing among black Africans in England: guidance
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