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Questions

• Is HIV/AIDS in the UK less of a problem now than it used to be?
• Who is most affected by HIV/AIDS in the UK?
• Do a lot of people in the UK become infected with HIV through injecting drug use?
• How are gay men in the UK affected by AIDS?
• How many children are born to HIV infected mothers in the UK?
• Which areas in the UK are most affected by HIV?
• How many people diagnosed with HIV in the UK were born in another country?
• Is free NHS treatment for HIV available to everyone residing in the UK?
• If a HIV+ woman in the UK is pregnant, is she always guaranteed access to the drugs which will prevent her baby being born HIV+?
• Does 'health tourism' really occur?
• Who is receiving care and drug treatment for HIV in the UK?
• How much does it cost to treat people with HIV in the UK?
• Why do people still die from AIDS in the UK?
• When was the first case of AIDS in the UK?
• Where can I find statistics about HIV & AIDS in the UK?

Is HIV/AIDS in the UK less of a problem now than it used to be?

No. The annual number of newly diagnosed HIV infections in the UK rose steadily throughout the Eighties, wavered between 2,500 and 3,000 during most of the Nineties, and began to increase dramatically in 1999. In 2005, the annual number of newly diagnosed infections peaked at 7,692 – nearly double the figure recorded in 2000. Estimates for 2006 and 2007 are not much lower.¹ While the prevalence of HIV in the UK is relatively low compared to that of many other countries, it is rising, alongside a general rise in the prevalence of sexually transmitted infections.

It is true that the annual number of HIV infections that progress to AIDS has dropped dramatically since 1996. This is due to the introduction of HAART (Highly Active Antiretroviral Therapy), a form of AIDS treatment that has significantly extended the average life expectancy of people living with HIV in the UK. However, individuals undergoing HAART have to take medication every day for the rest of their lives, and sometimes suffer severe side effects. It has also been found that resistance to antiretroviral treatment can occur, and since HAART is a relatively new form of treatment it is not known how long an individual can continue to benefit from it.

The problem of AIDS in the UK gets much less attention from the public and the media than it did during the Eighties and early Nineties. This leads many people to assume that AIDS is no longer a problem in this country; in reality, the increasing prevalence of HIV in the UK proves that this is simply not true.

Read more HIV and AIDS statistics.

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Who is most affected by HIV/AIDS in the UK?

Sex:

At the end of 2006, an estimated 73,000 adults were living with HIV. Of the estimated 36,400 heterosexually-infected adults, some 21,600 (59%) were women.² The male to female ratio of HIV diagnoses made before 1989 was more than 10 to 1, whereas in 2005 the ratio for new diagnoses was around 3 male to 2 female.³

Age group:

People in the age group 25-34 years have accounted for 43% of all HIV diagnoses in the UK, as of the end of 2007.⁴

Ethnicity:

In 2006, 7,276 reported HIV diagnoses were made in the UK. Among the 6,514 people whose ethnicity is known, 42% were white, 46% black-African, 3% black-Caribbean and 8% of other or mixed race.⁵

Transmission route:

As of the end of 2007, 45% of diagnosed HIV infections resulted from sex between men, 42% from heterosexual sex, 5% from injecting drug use, 2% from mother-to-child transmission, 2% from blood/tissue transfer or blood factor, and 4% from other or undetermined routes.

Each year until 1999, there were more new HIV diagnoses in men who have sex with men than in any other group. Since then, heterosexual contact has been the major route of infection in the UK, peaking at 64% of new diagnoses in 2003, and accounting for 54% in 2006.⁶

AVERT.org has more about the groups most affected by HIV and AIDS in the UK in our UK HIV and AIDS statistics summary

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Do a lot of people in the UK become infected with HIV through injecting drug use?

No, the level of HIV infection caused by injecting drug use is relatively low in the UK. By the end of 2007, around 5% of all HIV infections reported since HIV first emerged in the UK had occurred as a result of injecting drug use, compared to 87% that resulted from sex.⁷

A lot of early media coverage of AIDS in the UK focused on injecting drug users (IDUs). During the early Eighties 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.

However, while they account for a small proportion of people living with HIV in the UK, the prevalence of HIV among IDUs has risen significantly in recent years, from one in 110 in 2002 to one in 50 in 2006.⁸ Risk behaviour is high amongst this group: in a 2007 survey, half of IDUs reported that they had shared needles or other injecting equipment. Campaigners currently argue that needle exchange provision in the UK is patchy and should to be improved.⁹

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How are gay men in the UK affected by HIV and AIDS?

HIV is transmitted more easily through sex between men than it is through heterosexual sex. For this reason and others – such as infrequent condom usage and high rates of partner change amongst some of this population – gay men and other men who have sex with men (MSM) in the UK face a proportionately higher risk of HIV infection than other groups, even though heterosexuals now account for a greater number of new diagnoses.

In 2006, 2,417 new HIV infections were diagnosed amongst gay men and other MSM in the UK. This was around one third of all new HIV infections diagnosed with known exposure risk. The annual number of MSM diagnosed with HIV doubled between 1996 and 2005. In the same period, the number of new diagnoses among heterosexuals increased almost five-fold.¹⁰

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How many children are born to HIV infected mothers in the UK?

A reported 804 HIV-infected children have been born in the UK to infected mothers as of the end of 2007. This includes 22 reported births of infected babies during 2006. Including children born in other countries, there have been 1,643 UK diagnoses of HIV in people who acquired the virus from their mothers.¹¹

In 1999 the UK Government introduced routine antenatal testing, whereby all pregnant women are offered screening for HIV and other conditions as part of routine procedure. The use of antiretroviral treatment can greatly reduce the chances of a HIV positive mother’s baby becoming infected, and since 1996 the increased use of such treatment has caused the rate of mother-to-child transmission to fall substantially.¹²

See the tables in our UK women and children statistics page.

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Which areas in the UK are most affected by HIV?

As of the end of 2007, there have been 86,040 HIV diagnoses in England, 5,217 in Scotland, 1,446 in Wales and 528 in Northern Ireland.¹³

London has a higher prevalence of HIV than any other area in the UK; around 53% of all UK diagnoses up to the end of 2007 have occurred in the capital. South-East London has been particularly affected, with the prevalence of HIV approaching 1% in some boroughs. In 2006, 46% of those accessing treatment and care services in the UK were London residents.¹⁴

Outside of London, the areas with the highest prevalence of HIV are Edinburgh, Manchester, the East Midlands and South East England.¹⁵

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How many people diagnosed with HIV in the UK were born in another country?

The countries of origin of people diagnosed with HIV in the UK are not known exactly. This data is not published. We do know the presumed countries of infection for people with heterosexually-acquired HIV diagnosed in the UK, which are shown in the table below. This does not necessarily mean that these people come from these countries - just that they were infected in them. The list includes not only high-prevalence African countries, but also popular holiday destinations.¹⁶

Rank	1992	1997	2002
1	Uganda	UK	Zimbabwe
2	UK	Uganda	UK
3	Zambia	Zimbabwe	S.Africa
4	Kenya	Zambia	Uganda
5	Zimbabwe	Kenya	Zambia
6	DR Congo	Nigeria	Nigeria
7	Tanzania	DR Congo	Kenya
8	Malawi	Thailand	Jamaica
9	Spain	Malawi	Malawi
10	USA	S.Africa	DR Congo

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Is free NHS treatment for HIV available to everyone residing in the UK?

No. According to the latest Government legislation, NHS treatment for HIV is free to everyone who is living in the UK legally. This means that people who are living in the UK without due authority, such as illegal immigrants and failed asylum seekers, must pay for any HIV treatment that they receive.

This measure was put in place to tackle ‘health tourism’, the process whereby people migrate from one country to another in order to take advantage of better healthcare services. Yet denial of treatment to many of the people in these situations, especially if they are then deported to countries where none is available, can effectively be a death sentence. A lot of medical professionals have argued that it is unethical to stop a person living with HIV from accessing treatment on the basis of their immigration status.

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If a HIV+ woman in the UK is pregnant, is she always guaranteed access to the drugs that will prevent her baby being born HIV+?

No. There are certain 'notifiable diseases', for which a person will always receive treatment in the UK regardless of their legal status, in order to prevent the rapid spread of epidemics. HIV, however is not on the notifiable diseases list. If a woman has no legal right to be in the UK – if she has overstayed a visa or is an illegal immigrant – then she will only receive medication to stop her baby being born HIV+ if doctors decide it is an 'emergency'. In some hospitals doctors will see this as an emergency, and in others they will not. Doctors are being urged to follow official guidelines, which means in some circumstances not administering drugs to prevent mother-to-child transmission of HIV.

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Does 'health tourism' really occur?

Yes. Health tourism has always existed, as a result of inequalities between the health services of different areas and different countries. This means that people sometimes have to travel to find better or cheaper treatment. Some people may come to the UK for treatment, others may leave the UK and go elsewhere for treatment. HIV is no different from any other disease in this respect.

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Who is receiving care and drug treatment for HIV in the UK?

According to SOPHID data, there were 52,083 HIV-positive people seen for care in the UK in 2006. Of these, at least 34,151 were accessing antiretroviral therapy, which in 96% of cases involved at least three different drugs.¹⁷

In 2006, 51% of those receiving care in the UK had acquired their infection through heterosexual contact, and 43% were men who have sex with men. Black Africans comprised 38% of those receiving care, and 52% were white.¹⁸

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How much does it cost to treat people with HIV in the UK?

The cost of managing a patient with HIV is around £16,000 per year.¹⁹ The total cost of treatment and care in 2002-03 was estimated to be £345 million.²⁰

In 2000 it was estimated that the average lifetime treatment cost for an HIV-positive person was between £135,000 and £181,000. Each HIV infection prevented saves between £500,000 and £1 million over a lifetime.²¹

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Why do people still die from AIDS in the UK?

Most people diagnosed with HIV in the UK are given HAART, and this often keeps them healthy for years. However, in many people the virus eventually become resistant to one or more class of drug that they are taking, which can lead to treatment failure. In some instances, those who are infected with a drug resistant strain of HIV go on to infect others with this strain. In 2004 an estimated 9% of newly diagnosed HIV-positive people, who had never received antiretroviral drugs before, were diagnosed with a drug resistant strain of HIV.²²

Another reason why people are still dying of AIDS is because many are being diagnosed with HIV at a late stage of infection. In 2005 more than one third of adults diagnosed with HIV had a CD4 count lower than 200 cells per mm3 (the recommended threshold for starting treatment) at the time of diagnosis. At this stage treatment is much less likely to work, and death often results. For instance, amongst men who have sex with men in the UK, it has been found that HIV-positive people diagnosed late are almost ten times more likely to die within a year of diagnosis than those diagnosed at an earlier stage.

Almost half of heterosexual men diagnosed in 2005 were diagnosed late, and 19% had AIDS at the time of diagnosis. The proportion of late diagnoses was lower amongst women (probably because many women are tested for HIV whilst receiving antenatal care during pregnancy) and amongst men who have sex with men (probably due to increased awareness and more frequent attendance for sexual health care). Late diagnosis is alarmingly common amongst all groups though, highlighting the need for greater awareness and for people to access testing services as soon as possible if they think they may have been exposed to HIV. ²³

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When was the first case of AIDS in the UK?

The first recognised case of AIDS in the UK was recorded in December 1981, when doctors at Brompton Hospital in London reported the case of a 49 year-old homosexual man who had died ten days after being referred to them. He was suffering from PCP, a rare AIDS-related infection that almost always occurs in individuals with severely weakened immune systems. Doctors believed that this condition might be linked to similar cases that had been occurring amongst gay men in the US, a theory which was given credence by the fact that the patient had been travelling to the US annually to visit gay friends.²⁴

AVERT.org has more about the emergence of AIDS in the UK on our History of AIDS in the UK pages.

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Where can I find statistics about HIV & AIDS in the UK?

AVERT.org has a UK HIV & AIDS Statistics Summary page that provides statistics about the UK, including discussions of annual trends and individual risk groups.

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WHERE NEXT ?

AVERT.org has more about:

• HIV and AIDS in the UK
• Overview of AIDS in the UK
• HIV & AIDS in America
• STD Statistics for the UK