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HIV in the UK – 30 years on…. Since 1981: 122,000 HIV diagnoses 27,500 AIDS diagnoses 20,500 deaths In 2011: 6280 new diagnoses 73,700 in HIV care 96,000 (90,800-102,500) living with HIV 24% (18%-30%) undiagnosed Overall prevalence: 1.5 per 1,000 population .
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HIV in the UK – 30 years on… Since 1981: • 122,000 HIV diagnoses • 27,500 AIDS diagnoses • 20,500 deaths In 2011: • 6280 new diagnoses • 73,700 in HIV care • 96,000 (90,800-102,500) living with HIV • 24% (18%-30%) undiagnosed • Overall prevalence: 1.5 per 1,000 population
HIV Incidence in MSM: Counter factual scenarios (a) (b) (c) (d) (e) • ART never introduces • No condom use • ART at diagnosis from 2000 • Increased testing rates • Higher testing and ART at diagnosis Phillips A.N., Cambiano V, Nakagawa F et al (2013). Increased HIV Incidence in Men Who Have Sex with Men Despite High Levels of ART-Induced Viral Suppression: Analysis of an Extensively Documented Epidemic. PLoS ONE 8(2): e55312. doi:10.1371/journal.pone.0055312
Aging • Average age at diagnosis is 35 • In 2008 1/6 over 50 – > 50s fastest growing group • Life expectancy predicted now near normal with Rx • HIV associated with other comorbidities esp metabolic/cardiovascular • Move to Chronic Disease Management
Health Inequality • MSM and Black Africans over-represented • Different approach needed to address their needs • Poorest areas have the highest prevalence • Need to tackle socioeconomic issues and stigma Prevalence of diagnosed HIV infection by region of residence among population aged 15-59 years: United Kingdom, 2011 London >2 1-2 <1