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Last Updated: Friday, 24 November 2006, 10:24 GMT
How must the UK tackle HIV?
By Will Nutland
Head of Health Promotion, Terrence Higgins Trust

Representation of man with HIV
HIV: A global problem
There are now over 70,000 people living with HIV in the UK, including 7,450 new HIV infections last year, and a devastating epidemic spreading in Africa, Asia and Latin America.

What can we actually do in the UK that makes a real difference?

The majority (3,691) of new cases of HIV diagnosed in the UK are among black and ethnic communities, and in most of these cases the infection was contracted abroad in high prevalence parts of the world like Africa.

A big increase in HIV infections in Africa or Asia affects us in the UK

We can't put up barriers around HIV and we can't focus all our efforts at home.

HIV is a global issue, and a big increase in HIV infections in Africa or Asia affects us in the UK.

So continued pressure to fund and support HIV treatment and prevention programmes in the worst hit countries is more important than ever and essential if we are to tackle our own epidemic in the UK.

Poor targeting

We also know that many of the hardest hit countries are still failing to target health promotion and services for those at greatest risk: gay men, sex workers and injecting drug users.

And this is the minimum that has to change if we are to make more of an impact on the global epidemic.

In the UK we must make sure that people who are coming here from areas of the world with high HIV prevalence get better and more appropriate sexual health education and HIV prevention.

They also need easily accessible, relevant testing and treatment services.

The greatest number of new infections contracted in the UK (2,400 in 2005) is still among gay men - a group who have been most affected by HIV for the last two decades.

Because of the introduction of HIV treatments over 10 years ago, people with HIV are living longer and the number of gay men with HIV has doubled in the past decade.

About one in 10 gay men now have HIV in Britain's bigger cities.

Impact of testing

There is increasing evidence that the small increases in HIV diagnoses amongst gay men under 35 in London is due to an increase in HIV testing amongst this group, rather than an increase in HIV incidence.

Young gay men grow up with very little honest sex and relationship education that is relevant to them

This is good news as reducing the level of undiagnosed HIV is one of the central planks of the UK's HIV prevention strategy.

At the same time, as the numbers of gay men living with HIV increases, there has been a tendency to reduce the amount of targeted HIV prevention and sexual health work with gay men.

The world-renowned pan-London HIV prevention programme for gay men was hit with a 10% reduction in funding this year, and many local primary care trusts (PCTs) have failed to develop adequate HIV prevention programmes.

Many PCTs used the government's 300m Choosing Health money to plug NHS deficits, rather than to improve the nation's sexual health, as the government had intended.

But why, despite many tried and tested HIV prevention campaigns, is HIV continuing to grow among gay men? We need to look deeper at the social and psychological reasons behind this.


There is still a huge amount of homophobia and bullying in schools, and young gay men grow up with very little honest sex and relationship education that is relevant to them.

If we are really going to tackle the issue of sexual risk, we have to start by tackling homophobia and sex education in schools and provide support for gay men on a much bigger scale.

Posters, leaflets and outreach work are essential - but they do not go far enough.

An open an honest society that accepts gay men is just as important as good education campaigns if we are to tackle more of the real issues that are driving HIV in the UK.

If you would like advice or information on HIV or sexual health and the services available to you, visit the Terrence Higgins Trust website, or call the Terrence Higgins Trust helpline, THT Direct on 0845 12 21 200.

27 Feb 06 |  Medical notes

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