Human Immunodeficiency Virus (HIV)

HIV (human immunodeficiency virus) is a virus that damages the cells in your immune system and weakens your ability to fight everyday infections and disease. Early diagnosis and treatment of infection are critical to reduce the likelihood of infecting others and of developing serious and life-threatening medical conditions. Treatment has transformed HIV from a fatal infection into a chronic. Now, if diagnosed early and with the right treatment, people with HIV can expect to live a normal life.[1] Late HIV diagnosis is associated with poorer health outcomes, including premature death.

Office for Health Improvement and Disparities' (OHID) 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. OHID has also produced a recent report 'Spotlight on sexually transmitted infections in the North West' (2021 data). 

This section summarises data around uptake of HIV testing, prevalence of HIV and late diagnosis.

 

Key findings for Lancashire-12

Prevalence of diagnosed HIV infection

The NICE HIV testing guidelines define high HIV prevalence local authorities as those with a diagnosed HIV prevalence of between 2 and 5 per 1,000 and extremely high prevalence local authorities as those with a diagnosed HIV prevalence of 5 or more per 1,000 people aged 15 to 59 years.

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.

The following key findings are based on 2021 data.

• Across Lancashire-12 there are an estimated 688 people, aged 15 to 59 years, diagnosed with HIV infection (based on people accessing HIV care at an NHS service).
• In Blackburn with Darwen there are an estimated 93 people and in Blackpool 348 people, aged 15 to 59 years, diagnosed with HIV infection.
• In Lancashire-12 (0.99 per 1,000 population) the prevalence of diagnosed HIV infection is below 2 cases per 1,000 and below the England rate (2.32).
• In Blackburn with Darwen (1.02) the diagnosed HIV prevalence is also below 2 cases per 1,000 and in Blackpool (4.40) it is above 2 cases per 1,000; Blackpool meets the NICE HIV testing guidelines' criteria of a high HIV prevalence local authority.
• The recent trend shows that in Lancashire-12 the prevalence of diagnosed HIV infection remains unchanged.
• HIV testing coverage* in Lancashire-12 (52.2%) is better than the England rate (45.4%), however, the recent trend shows this coverage to be decreasing and getting worse in Lancashire-12.

* the number of persons tested for HIV out of those people considered eligible for a HIV test when attending specialist sexual health services.

Late diagnosis

Late diagnosis is the most important predictor of morbidity and mortality among those with HIV infection. Late diagnosis is the most important predictor of morbidity and mortality among those with HIV infection. Among those diagnosed in England, those diagnosed late in 2019 had more than a 7-fold increased risk of death within a year of diagnosis compared to those diagnosed promptly, and this indicator is essential to evaluate the success of expanded HIV testing. [2]

The following key findings are based on 2019-21 data.

• In Lancashire-12 (39.0%), Blackburn with Darwen (44.4%) and Blackpool (32.0%) the proportion of persons (aged 15+ years) presenting at a late stage with HIV (first diagnosed with HIV in the UK) is similar to the England rate (42.1%).

For county and unitary data and further information please see below. 

[1] Towards Zero: the HIV Action Plan for England - 2022 to 2025

[2] OHID, Sexual and Reproductive Health Profiles

Page updated November 2023