Official figures released last week show dramatic progress in preventing HIV and slowing down the HIV epidemic in the UK. The research suggests that if current trends continue, there will be almost no HIV transmission happening in the UK by the year 2030.
New HIV diagnoses have been going down for several years. In 2018, 4453 people were diagnosed with HIV in the UK, a fall of 29% since 2014.
One thing to bear in mind is that figures for HIV diagnosis (which are the numbers we hear most often) don’t just reflect new cases of HIV transmission. Someone who is diagnosed this year may have had HIV for several years, so the numbers also reflect older infections. Changes in how frequently people are tested for HIV can affect the figures.
The true rate of new infections (which scientists call HIV incidence) is a more meaningful figure. It’s an estimate of the number of people who became HIV positive in a specific year, whether or not they got tested. It’s harder to calculate, which is why you don’t hear these figures so often.
In their latest report, Public Health England estimates that the true rate of new HIV infections in gay and bisexual men fell by 71% between 2012 and 2018. Only around 800 gay men acquired HIV in 2018. The rate has also fallen by 55% in heterosexual men and by 22% in women.
This shows that having a combination of HIV prevention methods is working. This includes condom use, regular HIV testing, HIV-positive people taking treatment, and PrEP.
The UK is already beating a set of targets that guide HIV policy around the world. One target is for at least 90% of people who have HIV to be diagnosed (in the UK the figure is 93%) and the next is for at least 90% of people with HIV to be taking treatment (here it is 97%). The third target is for over 90% of people taking treatment to have an undetectable viral load, which means that they can’t pass HIV on (our figure is 97%).
Experts believe these results are the key to the fall in HIV transmission in the UK. The prevention medication PrEP could make a big difference in the future, but not enough people are taking it yet.
Another impact of the scale-up of HIV treatment is even fewer HIV-related deaths. In fact, the official figures show that someone under the age of 60 who is diagnosed with HIV in good time is now less likely to die than other people in the general population of the same age, probably due to getting better medical care.
One in 840 people with HIV died in 2018, compared to one in 621 in the general population. This is a remarkable change from the worst years of AIDS when the annual death rate was more like one in five.