Human immunodeficiency virus (HIV) is a viral infection, primarily transmitted through sexual intercourse. After initial non-specific symptoms, the infected person can remain without symptoms until advanced stages of HIV infection – acquired immunodeficiency (AIDS). It is associated with significant mortality, serious morbidity and high costs of treatment and care. Early diagnosis and treatment of infection are critical to reduce the likelihood of infecting others and of developing serious and life-threatening medical conditions.
It is estimated that at the end of 2015 around 101,200 people were living with HIV in the UK. Of these, around one in seven don't know they have HIV because they have never had an HIV test or they were infected after their last test.
Anti-retroviral therapy (ART) has resulted in substantial reductions in acquired immunodeficiency syndrome (AIDS) and deaths in the UK. People diagnosed promptly with HIV and started with ART can expect near normal life expectancy.
Public Health England's Sexual and Reproductive Health Profiles contain indicators on uptake of HIV testing, late diagnoses and diagnosed prevalence. The indicator on late diagnosis is key and is also included in the Public Health Outcomes Framework.
This section summarises data for the three top tier authorities in the Lancashire-14 area around uptake of HIV tests, prevalence of HIV and late diagnosis.
Uptake of HIV tests
HIV testing is integral to the treatment and management of HIV. Knowledge of HIV status increases survival rates, improves quality of life and reduces the risk of HIV transmission. The majority of HIV tests take place in genitourinary medicine (GUM) clinics and any person presenting to a GUM clinic should be offered an HIV test regardless of symptoms and risk factors.
HIV test uptake measures the number of eligible new GUM episodes where a HIV test was accepted as a percentage of those where a HIV test was offered. An eligible new GUM episode is defined as a visit to a GUM clinic including all subsequent GUM attendances in the following six weeks. Based on data for 2015:
In 2015, in Lancashire-14 there were 944 people aged 15-59 years diagnosed with HIV infection (based on people seen at HIV care services). Prevalence of diagnosed HIV provides a local authority measure of burden of infection rather than a measure of performance, as prevalence will be affected by a combination of rates of new infections, uptake of HIV testing and increased survival due to improved treatments.
Late diagnosis is the most important predictor of morbidity and mortality among those with HIV infection. Those diagnosed late have a ten-fold risk of death compared to those who are diagnosed promptly. CD4 cells are part of the body’s immune system which defends against infection and a low count of these at diagnosis of HIV is indicative of late diagnosis. HIV late diagnosis is the percentage of adults (aged 15 or above) newly diagnosed with HIV with a CD4 count less than 350 cells per mm3 within 91 days. Based on 2013-15 data:
Page updated July 2017