[via aidsmap]
The Health Protection Agency (HPA) in the UK has issued a bleak report on the state of the nation’s sexual health. Titled, Testing Times it notes an increase in HIV prevalence, a high incidence of syphilis and increases in new cases of herpes and genital warts.
Continuing high rates of HIV diagnoses in gay men and increases in diagnoses of many sexually transmitted infections in this population prompt the report’s authors to write, “current prevent efforts directed towards…MSM [men who have sex with men] are not succeeding adequately.” The report also calls for a review of HIV prevention campaigns targeted at gay men to make sure that they “are based upon proven interventions and authoritative recommendations”.
The report did find that more people attending sexual health clinics are being offered and accepting an HIV test, but an estimated third of all HIV infections in the UK are still undiagnosed.
Gay men, HIV and sexually transmitted infections
HPA figures suggest that 2,700 gay men were newly diagnosed with HIV in 2006, a total similar to the highest ever annual number of new diagnoses recorded in 2005.
Annual incidence of HIV amongst gay men attending sexual health services in 2006 was just over 2%. Almost three-quarters of new HIV diagnoses in gay men in 2006 were located in those aged 25 – 44.
Investigators estimate that there are 31,000 gay men living with HIV (diagnosed and undiagnosed) in the UK, and that almost 9% of gay men in London are HIV-positive, with the HIV prevalence amongst gay men elsewhere in the UK being 5%.
New diagnoses of gonorrhoea also increased amongst gay men, from just under 4,000 cases in 2004 to 4,524 cases in 2006, a 13% increase.
In all gay men accounted for 58% of all syphilis cases diagnosed in 2006. However, there was a small fall in the number of new syphilis cases amongst gay men in 2006 (1,417) compared to 2005 (1,438 cases).
Transmission of lymphogranuloma venereum (LGV) amongst gay men continued in 2006. But the number of cases diagnosed per quarter fell to an average of 32 compared to a peak of 45 per quarter in 2005.
Gay men living with HIV were particularly likely to be diagnosed with a sexually transmitted infection. Over a third of syphilis cases were in HIV-positive gay men, as were 75% of LGV cases and approximately 20% of all gonorrhoea diagnoses.
There has been a move to offer gay men ‘opt-out’ HIV tests as part of a sexual health screen to help cut the rate of undiagnosed HIV. But the investigators found there was no real difference in the proportion of gay men accepting HIV tests at ‘op-out’ and ‘opt-in clinics (87% vs. 83%). Anonymous blood testing showed that 47% of gay men with undiagnosed HIV who attended a sexual health clinic left the clinic without being tested for HIV, suggesting that those most likely to be HIV-positive are disproportionately likely to turn down the offer of an HIV test when they attend a sexual health clinic.
Late diagnosis of HIV continued to be a problem, with 20% of gay men diagnosed with HIV in 2006 having a CD4 cell count below 200 cells/mm3. However the median CD4 cell count at diagnosis in gay men has remained stable since 2003, at around 400 cells/mm3.
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