Public Health England has published its latest HIV data today, showing 4,139 new HIV diagnoses in 2019, which represents a 10% drop in a year.

There was an 18% drop in new diagnoses among gay and bisexual men, with heterosexuals lagging behind with a 6% fall. There has been a fall of 47% among gay and bisexual men in five years.

4,139 new diagnoses is a welcome 10% decline but there are still worrying high rates of late diagnosis with more than four in 10 people who receive a diagnosis being diagnosed late (42%).

Since this data, funding for HIV prevention pill PrEP has been allocated in England – but ongoing delays in provision and awareness raising among groups beyond gay and bisexual men means its impact continues to be limited. 

The stats show:

• 4,139 new diagnoses, 10% down on last year and 34% down in five years.
• Stubborn levels of late diagnosis at 42% – especially in Black Africans (47%) and older people (56% among those aged 50-64).
• Gay and bisexual men drop a further 18%, making a 47% decline in five years. This is largely attributed to the knowledge and take-up of PrEP and fast initiation of treatment after diagnosis, which stops HIV from being passed on. 

Ian Green, Chief Executive at Terrence Higgins Trust, said:

‘Gay and bisexual men have been hugely impacted by HIV since the very start of the epidemic. The sharp fall in diagnoses among this group since 2015 – including an 18% drop in 2019 – is a testament to what we can achieve when we utilise everything we have in the fight against HIV, including prevention pill PrEP and the fast initiation of HIV treatment for those diagnosed to stop the virus being passed on.

‘But the progress for gay and bisexual men could be even greater and the 18% drop in this group in 2019 makes the delayed roll-out of PrEP across the country even more frustrating. Because, despite the Government handing £11.2m to local authorities in the first week of October, only a small number of clinics and in a smaller number of local authorities are delivering the promised uncapped PrEP provision. Terrence Higgins Trust is still hearing story after story of people being turned away from clinics with no PrEP and no way of accessing this effective HIV prevention drug.

‘The new data shows a worrying disparity in progress for groups outside of gay and bisexual men, which needs to be urgently tackled if we’re to end HIV transmissions within a decade. The 6% drop in new HIV diagnoses among heterosexuals is three times lower than the one for gay and bisexual men, which clearly underlines the shocking lack of awareness of PrEP in the community at large and highlights how wrong it is that PrEP is only available in sexual health clinics. However, it’s encouraging to see a 15% drop in new diagnoses among Black African people as one of the groups most impacted by HIV in the UK, but rates of late diagnosis remain much too high.

‘If the Government, NHS England and local public health commissioners want to see 2019 levels of reduction for gay and bisexual men across all groups, PrEP needs to far better known and be available in GP surgeries, gender clinics, pharmacies and as part of maternity care. In a year when so much focus has been on inequality and the Black Lives Matter movement, today’s HIV statistics show that some communities are being left behind in the fight against HIV. PrEP works for everyone – regardless of gender, sexuality, geography or ethnicity – but you can’t access something you don’t know about.’

On COVID-19, Green said:

‘These statistics don’t include the impact of this year’s first COVID-19 lockdown, where we know fewer people were meeting for sex – presenting a never-before-seen opportunity to break the chain of HIV infection. During that period we worked with 56 Dean Street to encourage those who hadn’t had sex for a month or more to get tested for HIV and utilise all the tests being offered online.

‘We hope that we will see the impact of this in next year’s data, but abstinence isn’t how we’re going to stop HIV and we have all that we need in condoms, testing, PrEP and HIV treatment to meet the Government’s goal of ending new HIV cases by 2030. It’s about making them truly accessible to all groups affected by HIV.’

On late diagnosis, Green said:

‘It’s unacceptable that 42% of new diagnoses are made late with Black African men and the over-50s some of the most likely to be diagnosed once damage to the immune system has already begun. Late diagnosis is bad for individuals, leads to unnecessary new transmissions and is expensive for the NHS. It is vital the Government ramps up HIV testing, has a plan to fight HIV-related stigma and learns from its mistakes – every late diagnosis is a story of missed opportunity.’

On next steps, Green said:

‘The medical progress in the fight against HIV has been incredible but stigma remains a huge barrier standing in the way of ending transmissions once and for all. That’s why work to update the public’s knowledge of HIV and the effectiveness of PrEP is just as important as access to condoms and HIV self tests on the high street shelves.

‘We’re determined to play a key role in ending HIV transmissions in the UK by 2030 at the latest. The HIV Commission, founded by Terrence Higgins Trust, National AIDS Trust and Elton John AIDS Foundation, is due to publish its recommendations for reaching that all important goal.’

On the need for better education, Green said:

‘We also need to get the basics right and that starts with teaching young people about HIV in schools. As Relationships and Sex Education becomes compulsory in all schools in England from summer 2021, it must start as it means to go on with information on PrEP and how HIV treatments stops the virus from being passed on. Some schools are already doing this, but as with everything relating to sexual health, it needs to be consistent with parity across the country.’