HIV Diagnosis

Figure 1: HIV and AIDS diagnoses and deaths in HIV-infected MSM, and diagnosed MSM accessing HIV-related care, UK

In the UK, men who have sex with men (MSM) remain the behavioural group at greatest risk of acquiring HIV infection, with the number of new diagnoses increasing 63% since 1997, and 20% since 2002, with 2006 seeing the greatest number of newly diagnosed HIV infections since the start of the epidemic. Adjusting for reporting delay, there were an estimated 2,700 newly diagnosed cases of HIV in 2006 reported among MSM. MSM represented 32% (2,301/7,093) of all reports received for 2006 by the end of June 2007. Assuming that MSM account for 3.3% of the male population aged 16-44 in the UK (NATSAL), this is equivalent to 469 (1,938/413,300) new diagnoses of HIV per 100,000 MSM aged 16-44.
With the widespread availability and uptake of highly active antiretroviral therapy (HAART) there has been a dramatic increase in life expectancy and the quality of life among people with HIV. As a result, newly diagnosed cases of AIDS as well as deaths among infected MSM have remained low. In 2006 there were 169 cases of AIDS reported, of which 69% (116/169) were made at the same time as their HIV diagnosis.
Since 2001 there have been fewer than 200 deaths among HIV-infected MSM per year, with 170 deaths, reported in 2006 among HIV-infected MSM in the UK, amounting to 34% (170/497) of all deaths among HIV-infected persons in this year. This represents a decrease of 71% since 1997 (575 to 169), and to an even greater extent as a proportion of all MSM accessing care (6.2% [575/9,259] to 0.78% [169/21,694]). Mortality among HIV-infected persons has declined due to the impact of HAART although a high proportion of the deaths in recent years occurred within a year of diagnosis due to previous undetected infection with no apparent evidence of a population level increase in antiretroviral resistance or treatment failure.
In 2006, 21,694 HIV-infected MSM accessed HIV-related care in the UK, representing an annual increase of 9.6% since 2005 (19 799) and a 134% increase since 1997 (9,258). An increasing proportion of these MSM were aged 45 and above: 2006 (33%; 7 251/21,694) compared with 1997 (19%; 1,785/9,258).