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Public Health England (PHE) compares the performance of the United Kingdom to the UNAIDS 90/90/90 goal of 72.9% of people living with HIV being diagnosed, Viral suppression and viral repression by 2020. The United Kingdom has already reached the UNAIDS 95/95/95 target of 85.7% of people who are virally suppressed – about 87% HIV-positive people in the country have undetectable viral load. While "only" 92% of people with HIV are diagnosed, 98% of those diagnosed are treated and 97% of those in care are suppressed by the virus.
In 2017, new diagnoses among all people fell by 17% over the previous year. In homosexual men, they went from 3,390 at the peak of 2015 to 2330 in 2017, a decrease of 32%, as reported in Aidsmap. Diagnoses decreased compared to 2016 in all regions of the United Kingdom, with a particularly sharp decline in Wales. Northern Ireland is an exception, but numbers are low and this region has also experienced a significant decline in the number of diagnoses recorded since 2011.
Diagnoses decreased among all sexuality, sex and ethnicity groups, not just among white gay men. There are two groups among which a fall in diagnoses is new. One is heterosexual white – the diagnoses in men have dropped by 31% and in women by 16% compared to 2016. The other is composed of black men and homosexuals belonging to an ethnic minority, for whom the diagnoses did not fall before. Last year, they fell by 57% among black men, by 22% among Asian men (where they had increased significantly) and by 36% among other mixed ethnic / ethnic groups. The diagnoses also fell among the heterosexuals of African and Caribbean ethnicity born in the United Kingdom.
The number of people diagnosed late, with a CD4 count of less than 350 cells / mm3, also fell. This decline was most marked among Black African women and men (82% and 79% respectively since 2008). However, as noted above, these absolute decreases are largely attributable to a decrease in the number of diagnoses; 52% of African heterosexual women and 69% of men are diagnosed late, compared to 52% of white heterosexuals and 33% of homosexuals. A quarter of those diagnosed late are diagnosed with CD4 less than the limit of 200 cells / mm defined by AIDS.3.
The decline in the actual number of new infections – incidence is probably even more impressive than the decline in diagnoses. This is estimated with data from 47% of newly diagnosed individuals who undergo a referral test (RITA), which detects infections contracted within the last six months, as well as a retroactive calculation of CD4, which calculates the date of infection from the average number of CD4 decline.
PHE estimates that there were probably about 1,200 new infections among homosexual and bisexual men (between 600 and 2100 uncertainties), which represents a 56% reduction from the peak of 2700 recorded in 2012. Only 286 men tested with RITA have shown signs of infection during the last six months.
The proportion of HIV-positive people who recently became infected reached a peak of 36% in 2014, but has since declined. This is indirectly revealed by the relationship between new infections and new diagnoses. In 2012-2015, the majority of homosexual men's diagnoses were for recent infections, with a ratio of 0.8 new infections per diagnosis, but it has now fallen to 0.5.
In other words, the multiplication of tests initially revealed many recent infections, but with the new increase in testing and viral suppression, the proportion of recent diagnosed infections has now decreased. More and more diagnosed infections are chronic infections that people have been living for many years.
The EPS do not provide impact estimates for the other groups because fewer people are tested with RITA and the uncertainty is greater.
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