HIV in England Today
HIV (Human Immunodeficiency Virus) is a virus that gradually destroys an infected person's immune system, reducing their ability to fight off infection and increasing their susceptibility to certain cancers. HIV can only be transmitted from an infected person to an uninfected person through the direct transfer of blood, semen, vaginal fluid, pre-ejaculate or breast milk. It cannot be passed on through normal social contact such as kissing or shaking hands. As of 2008, there are 56,433 people diagnosed with HIV in England. According to the Health Protection Agency, an estimated further 15,800 people in the country have HIV but are not yet diagnosed. There were 6727 new diagnoses of HIV in England in 2008 alone.
The two groups most affected by HIV in the UK are men who have sex with men (MSM) and migrants from regions of the world where HIV is common, such as sub-Saharan Africa. Such groups are referred to as “high risk groups”. Other groups at a higher risk of contracting HIV are intravenus drug users and sex workers.
It’s been nearly 30 years since the first case of HIV in the UK, and the implications of being diagnosed with the virus have changed a lot in that time. There is still no vaccine against HIV and no cure, but treatments now enable people to live long and productive lives, if diagnosed at the right time. Since 1997 effective treatments have become available which help people with HIV stay healthy for longer, and increasing numbers of people with HIV are living into retirement and old age.
Late Diagnosis
Whilst people who are diagnosed promptly are often able to live long and healthy lives, with the help of treatment, those who are diagnosed late may not be so lucky. If HIV is left untreated, it will destroy a type of white blood cell called CD4 T-cells, which play an important role in the immune system. A normal CD4 count is anything from 600 upwards. People who have a CD4 count of 200 or under when they are diagnosed are considered to have been diagnosed “late”.
Late diagnosis means that a person’s immune system has already been damaged, and this can make it harder to treat the virus, and can shorten their life expectancy significantly. They are also more likely to be putting others at risk because they do not know they are infected. Of those who are diagnosed with HIV, 31% are diagnosed late. In 2005, being diagnosed too late for effective treatment was the single biggest factor associated with HIV-related death.
HIV testing
The British Association for Sexual Health and HIV, the British HIV Association and the British Infection Society have produced joint guidelines for HIV testing in the UK. These guidelines state that in order to reduce late diagnoses of HIV, people should be offered tests in a wider range of settings than is currently the case. They also state that people from high risk groups should be routinely offered a test, and that people with specific ‘indicator’ conditions should also be tested as a matter of routine.
Click here to read the guidelines for yourself on the BHIVA site.
Your PCT
We’re asking you to write to your Primary Care Trust (your local NHS) to make sure that reducing the late diagnosis of HIV is a priority for them. PCTs can work to reduce late diagnoses in your area by testing high risk groups routinely, as well as testing people who have had unprotected sex (for example people visiting GUM clinics), looking out for signs of primary infection (the ‘flu-like symptoms which appear a short time after contracting the virus), and testing people with illnesses that are associated with HIV infection such as tuberculosis, lymphoma and hepatitis B and C.
We have customised these letters according to your local HIV prevalence (the number of people in every 1000 who have been diagnosed with the virus) and the percentage of people diagnosed late. By sending this letter you’ll be showing the PCT that you are concerned about late diagnosis of HIV, and encouraging them to work towards reducing late diagnoses of the virus by testing the right people at the right time.
