In the plan published in 2021 (HIV Action Plan for England), an 80% reduction in new diagnoses was defined as the objective for 2025. However, epidemiological surveillance data show a very significant reversal of the trend and growing inequalities between communities; and between London and other regions.
These figures show a sharp increase in new diagnoses treated in England: 6,008 in 2023, an increase of 51% compared to 2022 (3,975) and 56% (3,859) in 2019. More than half concern people whose diagnosis had been made before their arrival in England. Added to this are a few hundred cases taken care of for which the first charge virale The plasma viral load is the number of viral particles contained in a blood sample or other container (saliva, CSF, semen, etc.). For HIV, viral load is used as a marker to monitor the progression of the disease and measure the effectiveness of treatments. The level of viral load, but even more so the CD4 count, contributes to the decision to treat with antiretrovirals. indicates that they were able to be treated before their arrival in England.
The share of HIV infections diagnosed abroad in the total cases newly treated (53% in 2023) has increased significantly compared to 2022 (38%) and 2019 (27%), which represents a tripling in number by compared to 2019.
Among people diagnosed in England, the total number of new findings increases by 15% between 2022 and 2023.
The increase is 7% among MSM Man having sex with other men. lower among those who self-identify as white (in England, ethno-racial self-affiliation is used in all public statistics) than among black Africans.
Among people exposed through heterosexual intercourse and diagnosed in England, the increase is 36% for women and 30% for men, for a total number which increases from 1,047 to 1,385, mainly black African people. But an increase of 3% was also noted among people identifying themselves as white, going from 301 to 310 new diagnoses.
The increases are greater outside London (9 million inhabitants) than in London.
Late diagnoses (
Access to screening and PrEP Pre-Exposure Prophylaxis. PrEP is a strategy that allows an HIV-negative person exposed to HIV to eliminate the risk of infection, by taking, continuously or “on demand”, anti-retroviral treatment based on Truvada®.
In view of these figures, the report details all the information on screening and access to PrEP. Total screening did not return to its 2019 level in 2023: the 30% drop between 2019 and 2020 is gradually compensated to reach, in 2023, 96% of the 2019 level: 1,326,000 tests in 2019 and 1,270,000 in 2023.
In sexual health clinics “specialized” in the management of IS Sexually transmitted infections. screening increased by 21% compared to 2022 with 691,000 tests carried out in 2023. In other sexual health clinics (sexual and reproductive health), a sharp decrease occurred in 2019 and was very little compensated (- 65% between 2019 and 2023). Screening via the internet (sending of sampling kits after online request, collection at home and return of the result by telephone) has more than doubled to reach 556,000 tests in 2023. It represents, in 2023, 48% of tests carried out in clinics sexual health.
Information on screening opt out in emergency services – that is to say the systematic carrying out of screening unless opposed – put in place in 2021, will be available a little later in 2024.
The need for PrEP is assessed during referrals to sexual health clinics and PrEP is immediately offered. In total, in 2023, 10.1% of consultants are assessed as needing PrEP, 70.3% among MSM, 1.8% among heterosexual men and 0.8% among heterosexual or bisexual women. The PrEP initiation or continuation rates among those defined as needing PrEP are respectively 75.4% for MSM, 39% for heterosexual men, and 41% for women.
We can consider that there is therefore room for improvement in PrEP to limit infections in exposed people.
Référence : Hannah Kitt, Ammi Shah, Cuong Chau, Kedeen Okumu-Camerra, Shaun Bera, Victoria Schoemig, Neil Mackay, Tobi Kolawole, Natasha Ratna, Veronique Martin, Tamara Đjuretić, Alison Brown. HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2024 report. The annual official statistics data release (data to end of December 2023). October 2024, UK Health Security Agency, London
