Gay men in the UK

In the UK, the HPA’s Unlinked Anonymous Surveys, which determine actual HIV prevalence amongst STI-clinic attendees, have unearthed a paradox. Despite the fact that 94% of people who attend GUM clinics for an STI check-up, excluding those already known to have HIV, now take an HIV test as part of their check-up, there remains a significant proportion of people with undiagnosed HIV who attend STI check-ups and go away with their HIV still undiagnosed. This figure is a minority of a minority – those remaining undiagnosed amongst the undiagnosed – but in the case of gay men it still amounts to about 1.5% of all gay men attending for STI checkups.

Furthermore, the proportion of people who remain undiagnosed is higher within the group of attendees with an acute STI. This is of particular concern given the increased risk of HIV transmission among persons with an acute STI.

Who are these people? Because this is unlinked anonymous data, we cannot directly tell. There are a number of hypotheses, and each one may contribute to the total who remain undiagnosed:

  • Some may be people who know they have HIV and are choosing to conceal the fact when they visit for an STI check-up, possibly fearing the consequences if it becomes clear they have been knowingly having unsafe sex.
  • Some clinicians and patients have mistaken beliefs about testing, believing that there is no value in testing when a sexual risk has been taken in the past six weeks. In fact, being diagnosed with an acute STI is independently associated with testing HIV-positive, regardless of whether or not there has been a recent negative test.
  • Some may be people who have previously had an HIV-negative test result – possibly quite recently – and assume they are still negative. There is evidence (see below) that incidence amongst some gay men is so high that a considerable proportion of men who tested under a year or even six months ago are positive.
  • Some – a category that may overlap with the previous one – may be avoiding an HIV test precisely because they suspect they are at especially high risk of acquiring HIV and are afraid of knowing.
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.