HIV continues to be a challenge in the UK and, according to the latest government report, a wider range of people need to take steps to be aware of the risks and how PrEP can help prevent HIV transmission. In particular, the report shows that women are now at increasing risk of being diagnosed and could benefit from finding out about PrEP.
The UK’s annual report on HIV, PrEP and PEP is a valuable insight into sexual health in the UK and is helping to drive progress towards the national goal of eliminating new HIV infections by 2030. The information in this report can help guide further actions to end HIV such as improved access to HIV testing, and helping more people to use effective prevention such as PrEP, PEP and condoms.
Things to be aware of
Collecting information about people’s health is always challenging, so we always need to be careful about what we learn from reports like this. The report contains information collected more than a year ago when people’s actions were still being widely influenced by the COVID-19 pandemic and Mpox.
It’s also difficult to collect all the necessary information and, for various reasons, may not always completely reflect the real-world situation. In addition, different parts of the UK collect data in different ways, so we need to be careful comparing across borders. Yet, despite this, we are still able to gain key insights about the impact of HIV care and prevention.
So what can we learn
First, the report shows that new HIV cases are increasingly being diagnosed in women. In England, there was a 6% rise in new HIV infections in 2022 compared to the previous year (from 2,313 to 2,444). The report also shows that women are still less likely to be offered HIV tests and are more likely to decline testing, suggesting that more needs to be done to ensure women are aware of the risks of HIV and how to prevent them.
Second, the uptake of PrEP continues to increase with 7.5% more (from 88,216 to 121,547) people being identified as having a clinical ‘PrEP need’ that means they could benefit from taking PrEP. This is likely due to increases in PrEP service delivery and increased PrEP awareness.
The largest group of people with a ‘PrEP need’ is still gay and bisexual men, but the largest increase this year was among heterosexual and bisexual women. In terms of age, the highest proportion of PrEP uptake was among those aged 35 to 49.
While HIV diagnoses in the UK appear to be declining among groups that were previously considered higher risk (e.g., gay and bisexual men), there is still a lot of work to do:
- There appears to be a growing need for women to be aware of HIV, seek testing and use prevention.
- In terms of prevention, PrEP uptake is increasing, especially among populations over 35. However, with 40% of HIV diagnoses happening in people under 35, younger people also need to be more aware of HIV and how to avoid it.
One potential point to review is the integration of online testing with PrEP assessment. In 2022, around 50% of HIV tests were ordered online, yet 83% of people identified as having ‘PrEP need’ were found through in-clinic consultations. As such, people taking online HIV tests may be missing the opportunity to get on PrEP. This could also explain some of the reason why younger people appear to be missing out on PrEP if they are more likely to make use of online testing.
So, even if you do use HIV self-test kits at home, speaking to your sexual health provider directly is still really important – especially if you are concerned in any way that you may be at risk to HIV.
If you’re in the UK, the NHS website can help you to find your nearest sexual health clinic. You can also find out more in the free Preptrack app, which includes information and supports you to get on top of PrEP.
Ammi Shah, Neil Mackay, Natasha Ratna, Cuong Chau, Kedeen Okumu-Camerra, Tobi Kolawole, Veronique Martin, Clare Humphreys, Alison Brown. HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2023 report. The annual official statistics data release (data to end of December 2022). October 2023, UK Health Security Agency, London