The number of people infected with HIV in the UK is increasing rapidly, says a report.
HIV is a growing problem
The Health Protection Agency says that, as at September 2002, there were 49,500 people in the UK living with HIV.
This was up nearly 20% in a year - and a third of these people do not know their HIV status.
Minsiters have responded by announcing £15m funding to improve genito-urinary medicine (GUM) services.
There were 5,711 new diagnoses during the year to September.
Of these, 3,305 were heterosexually acquired and 1,691 were amongst gay and bisexual men.
When all reports for the year are received this figure is expected to rise to 6,400.
There were 1,850 cases of HIV diagnosed during 2002 that were likely to have been acquired in the UK.
Some 80% of these diagnoses were among gay and bisexual men. Among the heterosexual community, the number was 275 - up from 147 in 1998.
Heterosexual transmission of HIV is more likely to occur outside the UK.
Dr Kevin Fenton, an HPA HIV public health consultant, said: "The problems we face with HIV are not going away, despite it being a disease that is largely preventable."
Terrence Higgins Trust findings:
More than two thirds of GUM clinicians say their ability to provide services is getting worse
Only one in eight clinicians think they have enough resources to manage their current workload
Nearly 80% of clinicians said their drugs budget would be overspent by the end of the year
Almost a third of primary care trusts have done no assessment of needs around sexual health and HIV
One in six primary care trusts have no agreed process for implementing the National Strategy for Sexual Health and HIV
The HPA report also found that increases in high-risk sexual behaviour amongst gay and bisexual men have led to significant rises in the rates of other sexually transmitted infections (STIs).
For example, cases of gonorrhoea amongst gay men have almost doubled (from 1,842 in 1999, to 3,363 in 2002) and cases of syphilis have increased from 52 to 607 over the same period.
As STIs facilitate the transmission of HIV, it is possible that the rise in these may have played a significant part in the increase in HIV among gay men.
The report says that the increase in STIs is putting sexual health services under increasing pressure.
The HPA is calling for gay and bisexual men attending GUM clinics to be offered annual HIV tests.
It also wants to see moves to reduce waiting times at clinics.
Dr Fenton said: "With stigma and discrimination being the theme for this year's World AIDS Day, it is important to highlight that these are still major obstacles for people living with HIV.
"Tackling these issues is important so that more people may come forward for testing.
"The earlier people are diagnosed with HIV, the greater chance they have of living a longer and healthier life.
"Awareness of their HIV status also enables people to make informed choices about their sexual behaviour and practising safer sex."
The pressure on GUM clinics is highlighted by a separate report, also published on Monday, by the charity the Terrence Higgins Trust.
It finds that in several areas, waiting times at sexual health clinics are in excess of six weeks.
Chief executive Nick Partridge, said such long waits were unacceptable for patietns and staff.
"A fresh approach is needed - injecting cash into the existing system alone will not tackle the problem.
"We must make testing for HIV and other sexually transmitted infections easier.
"People should be able to test when and where they want, and be able to get their results much faster."
Mr James Johnson, British Medical Association chairman of council, said the HPA figures made "depressing reading".
He said: "The BMA is particularly concerned that the increasing incidence of HIV and other sexually transmitted infections is leaving GUM clinics unable to cope.
"Doctors tell us that far from offering treatment within 48 hours, as recommended by the Health Select Committee, GUM clinics are only able to offer appointments after weeks of delay.
"It is a scandal that we cannot offer more prompt treatment."
Dr George Kinghorn, of the BMA's dermatology and venereology committee, said: "We have now reached crisis point in genito-urinary medicine with many clinics having waiting times of anything up to eight weeks.
"We need to return to a position where they can see patients within 48 hours."
Health Secretary John Reid said the new money would mean clinics would be able to expand services, increase capacity and reduce waiting times.
He said: "This investment will enable the NHS to make the necessary improvements so that patients are treated in higher quality premises."
Dr Reid said an £11m boost announced earlier this year was already being targeted at services where patients face longer waiting times, and was supporting the introduction of an improved test for chlamydia.
"We are determined to reduce waiting times for sexual health services because we know that a key principle of controlling STIs is to identify infection quickly and start treatment early."