HIV has no cure or vaccination, yet, due to advances in treatment and our understanding, someone living with HIV can expect a comparable life expectancy as someone who is HIV-free.
Achieving the best possible health outcomes depends on early diagnosis, leading to early treatment.
There were an estimated 103,700 people living with the disease in 2014, with 1 in 6 undiagnosed. Being unaware of their diagnosis means that, without treatment, they are at risk of the disease progressing and of unknowingly passing it onto others.
With over 6,000 new HIV diagnoses every year, ensuring people get a diagnosis early is critical for improving the lives of those with HIV and for tackling the rates of the disease, which are still high among certain groups.
Gay men and men who have sex with men (MSM) make up around 1% of the UK population, yet account for an estimated 43% of those living with HIV.
Similarly, Black Africans make up 2% of the UK population, but accounted for 20% of new diagnosis in 2014. These two groups, who are most at-risk of HIV in the UK, still have low rates of regular HIV testing.
Awareness among MSM and Black Africans
A recent report (‘It Starts with Me’ Evaluation by TNS-BMRB), commissioned by Public Health England, showed that the majority of MSM and Black Africans surveyed were aware a test for HIV was available.
Worryingly, one in seven (14%) of MSM and a quarter (23%) of Black Africans surveyed had never had an HIV test.
Gay men and men who have sex with men are advised to have an HIV and sexually transmitted infections (STI) screen at least annually, and every 3 months if they’re having unprotected sex with new or casual partners. Black African men and women are advised to have an HIV test and a regular HIV and STI screen if having unprotected sex with new or casual partners.
Regular testing is an essential component of national and local HIV prevention strategies, however, prevention is also key. Condoms are a highly effective method for reducing transmission of HIV and other STIs.
In both groups surveyed as part of the TNS report condom use was high, with 58% of MSM and 60% of Black Africans reporting that they ‘always’ or ‘very often’ use a condom. However, there is still a large number that never use a condom; 23% of MSM and 30% of Black Africans surveyed.
The report also showed that 6% of MSM and 12% of Black Africans did not know where to get tested. Signposting and raising awareness locally of testing availability can be targeted for reaching higher-risk communities.
As well as local sexual health services, PHE and a number of local authorities across the country fund an HIV home-sampling service. This service allows those at higher-risk of HIV to order a self-sampling kit and take their own sample in the privacy of their own home, returning the sample to a laboratory for testing.
As part of the wider PHE-funded HIV prevention programme, HIV Prevention England, a consortium led by Terrence Higgins Trust, delivers a nationally co-ordinated programme of HIV prevention work with UK-based black African people and with gay men/MSM.
Part of this work is the annual ‘It Starts with Me’ campaign which aims to raise awareness of HIV testing, condom use and other interventions to reduce the rates of HIV in England.
Campaigns such as this play a crucial role in raising awareness of HIV nationally, especially in key at-risk populations. An evaluation of the ‘It Starts with Me’ campaign conducted after National HIV Testing week 2015 found that among those who had seen the campaign, 29% of MSM and 21% of Black Africans reported getting tested as a result, and 19% of MSM who saw the ads reported ordering an HIV home-sampling kit.
Building on the previous years’ success, It Starts with Me will be relaunched in September with a fresh new look; seeking to engage more people with the campaign and promote its messages of condom use, risk reduction and HIV testing.