The latest HIV stats from the UK Health Security Agency (UKHSA) show 2,955 new HIV diagnoses in the UK in 2021, which represents a fall of 0.2% compared to 2020 and 33% fall from 2019.
HIV testing rates in all groups remained far lower than it was in 2019 except for gay and bisexual men where testing rates returned to pre-COVID levels in 2021.
The new data on sexually transmitted infections (STIs) shows there were 311,604 STIs diagnosed in England in 2021, which represents a rise of 0.5%. There was a 1.7% increase in gonorrhoea and 8.4% jump in syphilis, while diagnoses of chlamydia fell by 5% as changes to the National Chlamydia Screening Programme came into force with a change in scope. The greatest burden continues to be on young people, gay and bisexual men, and Black ethnic groups.
These statistics come at a time when capacity in sexual health services is being displaced by monkeypox testing and vaccination with limited capacity for HIV and STI testing, provision of HIV prevention drug PrEP and long-acting contraception.
Chief Executive Ian Green said: 'Today’s statistics show that STI and HIV testing rates are still lagging behind pre-COVID levels seen in 2019. This comes at a time when the already very limited capacity of sexual health services is being swallowed up by leading the country’s monkeypox response, which is displacing HIV and STI testing.
'The Government needs to act with urgency to properly resource the monkeypox response and mitigate the impact on wider sexual health service to avoid an increase in STIs, unwanted pregnancies and people contracting HIV. That includes a clear commitment to prioritising the nation’s sexual health and ramping up HIV testing to achieve the life-changing goal of ending new HIV cases by 2030.'
On the jump in STI rates, Ian Green said: 'Today’s STI data shows levels of syphilis and gonorrhoea remain high while testing levels aren’t back to where they were before COVID. That’s why we need the Government to set out its vision for sexual and reproductive health in its long-overdue sexual and reproductive health action plan. These latest numbers show why the Government must urgently set out what good looks like with the funding attached to achieve that vision.
'Currently we have no national goal around sexually transmitted infections despite rates of STIs being unacceptably high for years and certain groups – including young people, gay and bisexual men, people living with HIV and some ethnic minority groups – being disproportionately affected year after year.'
On HIV testing, Ian Green said: 'HIV testing rates must quickly return to pre-Covid levels and then expanded to get on track to end the Government’s goal of ending new HIV cases by 2030. But today’s data shows that this isn’t happening with levels lagging behind pre-COVID testing rates in all groups other than among gay and bisexual men. That needs to be urgently address as we won’t end HIV transmissions without achieving it across all populations and right across the country.
'Many more people are now getting tested for HIV through testing kits they order online to do at home. This is a great innovation and one we want to see available right across the country 365 days of the year. But there is inequity in who is accessing testing this way which means it’s crucial access to testing in a wide range of other settings is scaled up to overcome the digital exclusion some are currently experiencing.
'Testing for HIV whenever blood is taken in emergency departments is working. In the first 100 days of this game-changing approach in areas classed as having very high HIV prevalence, there were more than 100 HIV diagnoses made. Pilots show that those diagnosed in accident and emergency departments (A&E) are more likely to be heterosexual, female and of Black ethnicity than in the sexual health department. We need to see opt-out testing rolled out to the 30 area in the country with high HIV prevalence, including Nottingham, Liverpool and Derby.
'There was also a big impact from COVID on people living with HIV being lost to care with around 1,600 more people falling out of the system compared to 2019. The re-engagement of those who know they’re living with HIV is crucial for them staying in good health, but also a key part of work to end new HIV cases by 2030. That goal must be achieved which is why we need to see HIV clinics commissioned to find those lost to care.'