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HIV & AIDS in the UK Risk groups
Men who have sex with men
Heterosexuals
Injecting Drug Users
Blood and blood factor recipients
Children born to HIV infected mothers
By 1985, when heat treatment of blood products to
inactivate the virus was implemented, most haemophilia patients with
HIV had had their infections diagnosed. Since then, three routes of
infection - sex between men, heterosexual sex and injecting drug use
- have been the main determinants of HIV infections in the UK.
Up until 1998, men who have sex with men formed the
main exposure category for new HIV diagnoses. However, in 1999,
heterosexually acquired HIV became the largest category, and has
continued to be so ever since. The proportion of HIV infections
acquired through injecting drug use has been much smaller in the UK
than in many other European countries.
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Men who have sex with men remain the group at
greatest risk of getting infected with HIV in the UK. Throughout the
1990s, there were modest falls in the number of new HIV diagnoses
among this group, except in 1996 when highly active antiretroviral
therapy first became widely available and the advantages of early
diagnosis became clearer. Since 1999, the figures have steadily
risen again to more than 1,800 per year. The primary cause of
transmission is high risk sexual behaviour, and there are
indications of rises in such behaviour in recent years. However, the
introduction of clinician reporting is also likely to have
contributed to recent trends.
As the end of March 2005, 33,669 men who have sex
with men have been diagnosed with HIV. It has been estimated that,
at the end of 2003, just under half of all people living with HIV in
the UK were men who had sex with men.
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The number of heterosexually acquired HIV infections
diagnosed in the UK has risen hugely over the last 15 years. In
1999, for the first time, the rate of heterosexually acquired HIV
diagnoses overtook the rate of diagnoses in men who have sex with
men. During 2004, there were 3,627 reports of heterosexually
acquired HIV, and a total of 26,653 had been reported by the end of
March 2005.
Many of the new diagnoses are in people who probably
acquired HIV in other countries. However, the number of infections
probably acquired in the UK from heterosexual sex with a
heterosexually-infected partner has soared from 139 in 1998 to 377
in 2004.
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Injecting drug use has played a smaller part in the
HIV epidemic in the UK than it has in many other developed
countries. During 2004, a reported 106 people were diagnosed with
HIV probably acquired through injecting drug use. By the end of
March 2005, reports showed that 4,246 people had acquired HIV by
this route.
In this exposure category there have been
differences within the UK. Scotland experienced rapid HIV spread
through injecting drug users in the early 1980s, which was not the
case in the rest of the Kingdom. Probably as a result of the
introduction of harm reduction measures such as needle exchange
programmes in the mid-1980s, localised epidemics on the scale of
Scotland have not occurred elsewhere in the UK.
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Production of the clotting factor concentrates, used
mainly for treating patients with haemophilia, involves the pooling
of plasma from several thousand blood donations. Before the
introduction of inactivation processes in 1985, a single donation
infectious for HIV could contaminate a batch of concentrate used to
treat many patients. There have been no recorded transmissions of
HIV in the UK through concentrate use since the introduction of
inactivation.
As soon as it was realised that HIV could be
transmitted through blood, members of the groups recognised to be at
higher risk were asked not to donate. Since October 1985, when
suitable tests became available, all blood donations have been
screened for HIV antibodies. In total, 1,792 people had been
reported as infected through treatment blood/tissue transfer or
blood factor by the end of March 2005.
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Surveillance of children recognised as born to
HIV-infected women relies on confidential voluntary reports from
paediatricians and obstetricians. A total of 5,531 children born to
HIV infected mothers had been reported by the end of March 2005. Of
these, 1,257 have contracted AIDS or have tested positive for HIV.
Women who are unaware of their infection status are
unable to benefit from interventions, which can reduce the risk of
mother to child transmission to under 5%.
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