On the 23rd World AIDS Day

As part of a piece in the Chelsea & Westminster GP Newsletter, Consultant Rachel Jones and Specialist Registrar Michael Rayment write of the situation in the UK:

Treatment is freely available, but is limited to those who know their HIV sero-status.  The HIV epidemic in the UK continues to grow, and the fraction of undiagnosed HIV remains frustratingly constant.  The number of people living with HIV in the UK is estimated to be 91500 in 2010. There were an estimated 6660 new HIV diagnoses in the last year alone.  In men who have sex with men, there were 3000 new diagnoses – the highest ever annual figure recorded in this risk group.  An estimated one in four of all individuals with HIV infection remains unaware of their sero-status.  Of those newly diagnosed, half were diagnosed with CD4 counts below 350 cells/μl, the current threshold for the initiation of antiretroviral therapy. Of the 680 people with HIV who died in 2010, two thirds had been diagnosed late.

and they suggest that:

The largest barrier rests with us, the healthcare providers: our own HIV testing prejudices need to be broken down.  We need to engage commissioners to develop services and strategies to tackle HIV infection in our community.  A key strength of the pilot studies to date has been the close cooperation between Sexual Health services and local primary and secondary care providers.  We would urge you to work with your local Sexual Health colleagues.  They will be keen to work with you to provide education, support, clinical expertise and guidance to keep this issue high on your local health agenda.  Please engage with us, and Getting to Zero may be a feasible and very real vision here on our own doorstep.

The Health Protection Agency (HPA) recommends ‘universal testing’ for HIV, as they publish new data on 30 years of HIV in the UK.

The British HIV Association (BHIVA), Medical Foundation for AIDS and Sexual Health (MedFASH) and the British Psychological Society launch Standards to ensure high quality support for people with HIV.

Half of the 14 million people living in poorer countries who need HIV drugs get them according to the UNAIDS World AIDS Day Report 2011 – “How to get to zero, Faster, Smarter, Better”

This is the good news. The bad news is that at this crucial time, when the end may be in sight, we also hear that the one thing that will fuel the hoped for future is being cut off:

BMA News warns that Sexual Health is under threat (again).
As councils and private companies take control of NHS sexual health services, are they unnecessarily changing an open-access system that already works wonders?
In the Report, sexual health organisations have expressed grave concerns and a number of clinicians give examples of difficulties already being experienced.

The Global fund to Fight AIDS, TB & Malaria has cut its latest round of funding. In its press release yesterday it states:

A sharply deteriorating economic situation, which is placing severe pressure on donor countries’ budgets, has prompted the Global Fund to revise its forecasts of available resources over the next two years and to take this difficult decision.