Public Health England (PHE) has published a new report which states that HIV transmission has continued to fall across the UK.
The ‘HIV in the United Kingdom’ report states that the drop in HIV transmission has been especially large among men who have sex with men (MSM), from an estimated 2,300 transmissions in 2014, to 800 in 2018. The number of MSM living undiagnosed with HIV has almost halved since 2014, dropping from an estimated 7,000 to 3,600 in 2018.
The UK is one of the few countries in the world to have reached and exceeded all UNAIDS 90:90:90 targets. Of the 103,800 people living with HIV in the UK in 2018, 93% were diagnosed, 97% of people diagnosed were receiving treatment and 97% of people receiving treatment were virally suppressed.
Across the UK, there has been a scale-up of combination prevention, including the use of condoms, HIV testing in a wide range of settings, starting antiretroviral therapy (ART) as soon as possible if positive and the availability of pre-exposure prophylaxis (PrEP) – a drug taken by HIV-negative people before and after sex that reduces the risk of acquiring HIV – all of which appear to be effective.
Since late 2015, access to PrEP use has increased across the UK, and in Scotland in 2017, a national programme was implemented. This programme makes PrEP available via sexual health clinics to those at highest risk of sexual acquisition of HIV; in the first year of the programme 1,872 individuals were prescribed PrEP.
In Scotland, sharing of needles and syringes in the previous month fell from 15% during 2008-09 to 10% in 2017-18 among individuals attending drug treatment services. Although the prevalence of HIV remains low, outbreaks of HIV among people who inject drugs continue to occur, notably the ongoing incident in Glasgow. According to the report, around one in five people who injected in the past four weeks reported sharing of needles or syringes, a significant source of risk for bacterial infection and bloodborne virus (BBV) transmission.
The report believes that the goal of eliminating HIV transmission by 2030 across the UK depends upon sustaining prevention efforts and further expanding them to reach all at risk, and the report shows that because of increases in HIV testing, fewer people remain unaware of their HIV status.