SIDA y VIH
Key figures
An estimated 83,000 people were living with HIV in the UK at the end of 2008, of whom more than a quarter (27%) were unaware of their infection.
In 2008, there were 7,298 new diagnoses of HIV, contributing to a cumulative total of 105,625 cases reported by the end of June 2009.
There have been 25,470 diagnoses of AIDS in the UK, and 18,787 people diagnosed with HIV have died.
Trends in HIV and AIDS statistics
When the tests for HIV antibodies became widely available in the mid 1980s, three main risk groups of HIV were identified. These were men who have sex with men, injecting drug users and people who have received treatment with blood products. Many of these people came forward for testing in the mid 1980s, after which there was a decline in the annual number of HIV diagnoses. This trend was reversed towards the end of the decade and there were between 2,500 and 2,800 diagnoses each year from 1990 to 1997.
Between 1999 and 2003 there was a steep increase in the number of HIV diagnoses. A peak of 7,975 new diagnoses was observed in 2005. During 2008, 7,298 people were diagnosed with HIV in the UK, the third successive year there has been a decrease in diagnoses, though still far higher than the pre-2003 rate. A major component of the rapid increase over the past 15 years or so has been heterosexually acquired infection. Although just 20% of heterosexual infections were, or possibly were, acquired in the UK, these are on the rise. Another significant factor has been the introduction of clinician reporting, which was only introduced for HIV diagnoses made after the beginning of 2000.
The use of HAART (Highly Active Antiretroviral Therapy) has proved effective in delaying HIV associated deaths and the onset of AIDS. This resulted in a steep decline in the number of AIDS cases reported each year between 1994 and 1998. Since then the number of cases has remained more or less constant, averaging around 750-950 per year. The annual number of deaths has hovered around 500 since 1998, having peaked at over 1,720 in 1995.
Risk groups
By 1985, when heat treatment of blood products to inactivate the virus was implemented, most haemophilia patients with HIV had had their infections diagnosed. Since then, three routes of infection - sex between men, heterosexual sex and injecting drug use - have been the main determinants of HIV infections in the UK.
Up until 1998, men who have sex with men formed the main exposure category for new HIV diagnoses. However, in 1999, heterosexually acquired HIV became the largest category, and has continued to be so ever since. The proportion of HIV infections acquired through injecting drug use has been much smaller in the UK than in many other European countries.
Africans in the UK are diagnosed with HIV at a far higher rate than other ethnic groups, having comparable number of diagnoses to white people, despite being a far smaller percentage of the overall population.
Men who have sex with men
Men who have sex with men remain the group at greatest risk of becoming infected with HIV in the UK. Throughout the 1990s, there were modest falls in the number of new HIV diagnoses among this group, except in 1996 when highly active antiretroviral therapy first became widely available and the advantages of early diagnosis became clearer. Since 1999, the figures have risen again from fewer than 1,400 to more than 2,700 per year - the highest levels ever recorded. It is likely that this trend is mainly due to an increase in HIV testing, though a rise in high risk sexual behaviour may also be a contributory factor.1
As of the end of June 2009, 45,947 men who have sex with men have been diagnosed with HIV in the UK, including those who have died. It has been estimated that, at the end of 2008, about 38% of all people living with HIV in the UK were men who had sex with men.
Heterosexuals
“The number of heterosexually acquired HIV infections diagnosed in the UK has risen hugely over the last 15 years.”
The number of heterosexually acquired HIV infections diagnosed in the UK has risen hugely over the last 15 years. In 1999, for the first time, the rate of heterosexually acquired HIV diagnoses overtook the rate of diagnoses in men who have sex with men. The peak was 4,921 in 2004, since when there has been a moderate decline. A total of 45,947 cases had been reported by the end of June 2009.
Most of the new diagnoses are in people who probably acquired HIV in other countries, particularly in Africa. However, the number of infections probably acquired from heterosexual sex within the UK has soared from 228 in 2000 to 794 in 2008.
Injecting drug users
Injecting drug use has played a smaller part in the HIV epidemic in the UK than it has in many other developed countries. During 2008, a reported 152 people were diagnosed with HIV probably acquired through injecting drug use. By the end of June 2009, 5,083 people had acquired HIV by this route.
In this exposure category there have been differences within the UK. Scotland experienced rapid HIV spread through injecting drug users in the early 1980s, which was not the case in the rest of the Kingdom. Probably as a result of the introduction of harm reduction measures such as needle exchange programmes in the mid-1980s, localised epidemics on the scale of Scotland have not occurred elsewhere in the UK.
Blood and blood factor recipients
Production of the clotting factor concentrates, used mainly for treating patients with haemophilia, involves the pooling of plasma from several thousand blood donations. Before the introduction of inactivation processes in 1985, a single HIV-infected donation could contaminate a batch of concentrate used to treat many patients. There have been no recorded transmissions of HIV in the UK through concentrate use since the introduction of inactivation.
As soon as it was realised that HIV could be transmitted through blood, members of the groups recognised to be at higher risk were asked not to donate. Since October 1985, when suitable tests became available, all blood donations have been screened for HIV antibodies.
In total, 1,928 people had been reported as infected through treatment blood/tissue transfer or blood factor by the end of June 2009, of whom 79% were diagnosed before 1993. Almost all of the recent diagnoses within this category relate to infections acquired outside the UK.
Children born to HIV-infected mothers
Surveillance of children recognised as born to HIV-infected women relies on confidential voluntary reports from paediatricians and obstetricians. A total of 9,874 children born in the UK to HIV infected mothers have been reported by the end of June 2009. Of these, 847 have been diagnosed with HIV infection. Including children born in other countries, there have been 1,826 UK diagnoses of HIV in people who acquired the virus from their mothers.
The number of children born in the UK to HIV positive mothers more than doubled from 124 in 1994 to 254 during 1999, and then quadrupled to 1,260 during 2007. However, the proportion of such babies infected with HIV has fallen sharply since the widespread introduction of antiretroviral therapy and other interventions, which can dramatically cut the chances of HIV transmission from mother to child.
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Sources
- Health Protection Agency Centre for Infections and Health Protection Scotland (2009, August). Unpublished HIV Diagnoses Surveillance Tables 01:2009
- Health Protection Agency: HIV in the United Kingdom: 2009 Report, November 2009