Rates Of Newly Diagnosed Hiv Increasing In Over
- Rates of newly diagnosed HIV increasing in over-50s
“HIV rises among over-50s as they neglect safe sex” is the headline from The Times.
The news is based on a European study that found more over-50s are being diagnosed with HIV compared with 12 years ago.
The study collected data on more than 360,000 people who had been newly diagnosed with HIV between 2004 and 2015 in Europe.
The researchers looked at infection rates over time according to age, route of transmission and country.
They found a number of differences between the patterns of infection and diagnosis in those aged 15 to 49 and in those aged 50 and over.
In the over-50s age group, though people remained more likely to become infected with HIV through heterosexual sex, the rate of infection in men who have sex with men and through drug injection had increased between 2004 and 2015.
But in younger adults, infection rates hadnt changed over time and men having sex with men remains the most likely route of transmission.
Older people were also more likely to be diagnosed when the disease was advanced compared with younger people.
This study highlights the need for people of all ages to be aware of the risks of HIV infection from unprotected sex.
HIV tests are free on the NHS and can be done in various places, including walk-in sexual health clinics. There are also home testing kits available.
Find out more about HIV tests and find HIV testing services near you.
Global Hiv & Aids Statistics Fact Sheet
GLOBAL HIV STATISTICS
- 28.2 million people were accessing antiretroviral therapy as of 30 June 2021.
- 37.7 million people globally were living with HIV in 2020.
- 1.5 million people became newly infected with HIV in 2020.
- 680 000 people died from AIDS-related illnesses in 2020.
- 79.3 million people have become infected with HIV since the start of the epidemic.
- 36.3 million people have died from AIDS-related illnesses since the start of the epidemic.
People living with HIV
- In 2020, there were 37.7 million people living with HIV.
- 36.0 million adults.
- 1.7 million children .
- 53% of all people living with HIV were women and girls.
People living with HIV accessing antiretroviral therapy
- As of 30 June 2021, 28.2 million people were accessing antiretroviral therapy, up from 7.8 million in 2010.
- In 2020, 73% of all people living with HIV were accessing treatment.
- 74% of adults aged 15 years and older living with HIV had access to treatment, as did 54% of children aged 014 years.
- 79% of female adults aged 15 years and older had access to treatment however, just 68% of male adults aged 15 years and older had access.
New HIV infections
AIDS-related deaths
COVID-19 and HIV
Key populations
Key Points: Hiv Diagnoses
Gay, bisexual and other men who have sex with men b are the population most affected by HIV in the U.S.:
- MSM accounted for 69% of new HIV diagnoses in the United States.c
- From 2015 through 2019 in the United States and 6 dependent areas, Black/African American MSM accounted for more than 36% and White MSM accounted for more than 30% of HIV diagnoses among MSM annually.
- In 2019, Black/African American MSM accounted for 26% of new HIV diagnoses and 37.9% of diagnoses among all MSM.
- In 2019, Hispanic/Latinod MSM made up 22% of new HIV diagnoses and 32.5% of diagnosis among all MSM.
The number of HIV diagnoses decreased among MSM overall, but trends varied by race/ethnicity. From 2015 through 2019:
- Among MSM aged 1324 years, HIV diagnoses decreased or were stable among all racial/ethnic groups.
- HIV diagnoses increased among American Indian/Alaska Native and Native Hawaiian/other Pacific Islander MSM, ages 24 and older.
Transgender people accounted for approximately 2% of new HIV diagnoses in 2019.
- From 2015 through 2019 in the United States and 6 dependent areas, the number of diagnoses of HIV infection for transgender adults and adolescents increased.
- In 2019, among transgender adults and adolescents, the largest percentage of diagnoses of HIV infections was for transgender male-to-female people.
Blacks/African Americans and Hispanics/Latinx continue to be severely and disproportionately affected by HIV:
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Achieving Universal Access To Antiretroviral Therapy Programs
Effective ART first introduced in 1996, led to dramatic reductions in morbidity and mortality . There has been a parallel increase in the number of pregnant women receiving ART for the prevention of mother to child transmission of HIV and significantly more women and children are receiving ART . In sub-Saharan Africa, AIDS related deaths overall have declined by 39% in the period 2005 to 2013 with dramatic declines in Rwanda , Eritrea , Ethiopia , Kenya , Botswana , Burkina Faso , Zimbabwe , Malawi , South Africa and Tanzania attributable to the rapid increase in the number of people on ART.
Most countries have progressed with scaling-up ART provision and with a commitment to increase the numbers over the next several years. In South Africa alone over 2.0 of the 6.4 million HIV positive individuals are on ART, making it one of the largest programs in the world . Similarly Botswana, Namibia and Rwanda have made remarkable progress with more than 80% coverage of eligible individuals on ART based on WHO 2010 guidelines, whilst several other countries like Zambia and Swaziland are steadily increasing ART initiation.
What Types Of Daily Prep Are Available
Currently, there are two FDA-approved formulations of PrEP. Both are prescribed as a daily pill.
- The first, which has been approved since 2012, is Truvada . It is approved for all the risk groups mentioned above.
- A newer formulation of PrEP called Descovy was approved in August 2019. It is approved only for people who engage in anal sex , because cisgender women were not included in studies to show effectiveness.
To read more about these two options, see this blog post.
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Data For Art Coverage Estimation
To estimate ART coverage of the HIV-infected people included in the samples described above, we matched the individuals who were eligible to participate in the population-based HIV surveillance to the patients in the local HIV treatment programme, using data on first name, last name, sex, birth date, and South African identification number .
Hiv Information Education And Communication
Prisoners and prison staff need to be educated about HIV and AIDS and how to prevent HIV transmission, with special reference to the likely risks of transmission within prison environments and to the needs of prisoners after release.103
Even in high-income countries, information, education and communication programmes for prisoners about HIV and other STIs are not impacting levels of new infections. Sessions that include topics beyond HIV, such as employment and housing concerns, have been shown to have high success in changing risk behaviours, and peer-based interventions have been successful, yet very few prisons implement these type of programmes.104
High levels of illiteracy among prisoners can also complicate IEC programmes. For example, 70% of prisoners in the USA have the literacy levels of a nine-year-old.105 As a result, prisoners often cannot understand the HIV prevention information they are given. This emphasises the importance of tailoring programmes to meet prisoners specific needs or they will be ineffective.
Peer education by prisoners in Ghana
A programme in Ghana recruits prisoners who are literate, have good communication skills and can maintain confidentiality as peer educators. The peer educators receive five days of training on HIV prevention, stigma and discrimination, STIs, sexual and gender-based violence and facilitation skills.
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People With Diagnosed Hiv In 44 States And The District Of Columbia 2019*
* The 44 states are AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, HI, IL, IN, IA, LA, ME, MD, MA, MI, MN, MS, MO, MT,NE, NV, NH, NM, NY, NC, ND, OH, OK, OR, RI, SC, SD, TN, TX, UT, VA, WA, WV, WI, and WY. Had 2 viral load or CD4 tests at least 3 months apart in a year. Based on most recent viral load test.
Trends Of Hiv/aids Incidence In Cameroon Central African Republic Chad And The Democratic Republic Of The Congo
The trends of crude and age-standardized HIV/AIDS incidence rates in the four countries displayed similar declining patterns . In 1990, the CAR had the highest HIV/AIDS incidence rate compared to the rest of the countries. From 19902000, CAM and Chad recorded an upward pattern in their HIV/AIDS incidence rates before decreasing until 2019. Although HIV/AIDS incidence rates have decreased in all four countries, it remains higher in the CAR compared to CAM, Chad, and the DRC with the DRC having the lowest incidence rate in 2019, as represented in .
Crude incidence rate and age-standardized incidence rate of HIV/AIDS infection incidence in Cameroon , Central African Republic , Chad, and the Democratic Republic of the Congo from 1990 to 2019.
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Newer Tools To Target Hiv Prevention
Knowing your epidemic has been the basis and opportunity for countries to critically assess and match the prevention response to meet the priority needs . Whilst these have been useful as a national response and scaled up towards attaining universal access to prevention and treatment including care and support for all, these have failed to address social and economic factors and power in relationships. These relationships, together with physiological differences, determine to a great extent an individuals risk of infection and their ability to protect themselves. However, country level HIV data masks diverse, complex and heterogeneous epidemics at sub-national, regional and district level. Furthermore, as new HIV infections continue one or more sub-populations of virus emerge resulting in the spread of HIV viral variants.
The complexity and heterogeneity of local epidemics evolve with localized differences, highlighting the importance of locations and populations as the overall country level HIV prevalence may mask the true complex mosaic nature of the epidemic in relation to key risk factors and populations. As evidenced by district level prevalence and geospatial mapping of HIV South Africa, Nigeria, Mozambique, Burkina Faso and Malawi experience significant variability with hotspots clustered around truck stops, main transport routes, sex work and further complicated by migration and limited access to health care .
Hiv Rates Rising: Could New Forms Of Prep Help
- Robert Goldstein, MD, PhD, Contributor
In 2021, HIV continues to be a disease with huge national and international impact. There are over 1.2 million people in the US estimated to be living with HIV today, and approximately 1.7 million new infections occurred globally last year.
In parts of the US, HIV rates are currently climbing among underserved populations. Weve seen a recent epidemic among people without stable housing in Boston, and similar outbreaks in areas like West Virginia and Philadelphia. The COVID-19 pandemic has only exacerbated the problem because many people have had less access to testing and medical care for HIV. Now more than ever, medicines known as pre-exposure prophylaxis or PrEP could help reverse this worrisome trend by preventing people from getting HIV. And new formulations could make it easy for a much broader range of people at risk for HIV to use PrEP. Already, one is being reviewed by the FDA.
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Increased Hiv Prevention And Treatment Efforts Needed To Slow And Reverse Aids Epidemic According To New Unaids/who Report
Geneva — There is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infection — such as increased use of condoms, delay of first sexual experience and fewer sexual partners — have played a key part in these declines. The new UN report also indicates, however, that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic.
Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10% in the late 1990s to 7% in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26% in 2003 to 21% in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4% in 2001 to just under 2% in 2003.
These latest findings were published in , the annual report by the Joint United Nations Programme on HIV/AIDS and the World Health Organization . The joint report, which this year focuses on HIV prevention, was released today in advance of World AIDS Day, marked worldwide on the first of December.
Several recent developments in the Caribbean region give cause for guarded optimism — with some HIV prevalence declines evident among pregnant women, signs of increased condom use among sex workers and expansion of voluntary HIV testing and counselling.
Understanding Hiv Prevalence And Incidence
Prevalence is the proportion of a population identified as having a certain condition. The prevalence figure is determined by comparing the number of people found to have a condition with the total number of people in that population group. Prevalence is most often reported as a percentage.
Prevalence is among the HIV statistics used by public health officials and policymakers to identify the burden of human immunodeficiency virus infection in certain regions and/or population groups. The population groups may be classified by ethnicity, gender, age, sexual orientation, economic status, drug use, culture, or a combination of any of these categories.
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What Were The Basic Results
Overall, between 2004 and 2015:
- There were 312,501 new cases of HIV in people aged 15 to 49, a rate of 11.4 per 100,000 people. This rate of infection didnt change over time.
- There were 54,102 new cases of HIV in adults over 50, a rate of 2.6 per 100,000 people. The rate of infection increased by 2.1% per year over the 12-year period.
In the UK:
- There was an increase of 3.6% in new diagnosis rates for older people between 2004 and 2015, from 3.1 to 4.32 new cases per 100,000 people. This is higher than the European average.
- There was a 4% reduction in new diagnosis rates for younger adults during this time.
Diagnosis by age group:
- Older people were more likely to have a delayed diagnosis, with significantly lower CD4 counts than younger adults.
Men compared with women:
- Over the 12-year period, the average diagnosis rate for older men increased from 3.5 to 4.8 per 100,000, while older women had an increase from 1.0 to 1.2 per 100,000.
- Over the same period, the average rate of diagnosis increased by 1.4% in younger men and reduced by 4.8% for younger women.
Mode of transmission in 2015:
- The most common route of infection for older adults was heterosexual contact , followed by sex between men , “other” or unknown causes , and injecting drugs .
- For younger adults, sex between men was the most common route of infection , followed by heterosexual contact , other or unknown , and injecting drugs .
Changes in mode of transmission from 2004 to 2015:
What Did The Research Involve
The researchers collated data from 31 countries on new cases of HIV diagnosed between January 2004 and December 2015.
The data was anonymised, but included:
- date of diagnosis
- country of birth
- country of diagnosis
- stage of disease according to CD4 count, with late diagnosis defined as less than 350 cells/µL and advanced disease as less than 200 cells/µL
They analysed the data according to two age groups: younger people aged 15 to 49 and older people aged 50 or over.
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Us Prevalence And Incidence
From a global perspective, while the prevalence and incidence of HIV can vary from country to country, there is typically an association between disease burden and how effectively a country is managing the epidemic within its borders.
For example, while the estimated 1.2 million infections in the United States may pale in comparison to numbers seen in some areas of the world, the prevalence and incidence of the disease paint a starkly different picture. When compared to most other developed countries, the United States has the highest prevalence and incidence .
It is hoped that recent developments in policy and advancements in preventative medications may reduce the prevalence and incidence of HIV infection within the United States. However, low rates of care and retention among the most vulnerable populations, such as African Americans and MSM, could continue to fuel new infections.
Impact Of Hiv Treatment
The report recognizes that access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and better lives because they are on antiretroviral treatment and an estimated 250,000 to 350,000 deaths were averted this year because of expanded access to HIV treatment.
“We can now see the clear benefit of scaling up HIV treatment and prevention together and not as isolated interventions,” said WHO Director-General Dr LEE Jong-wook. “Treatment availability provides a powerful incentive for governments to support, and individuals to seek out, HIV prevention information and voluntary counselling and testing. Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable.”
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Hiv Infection Rates Not Decreasing Fast Enough: Unaids
Infection rates of HIV are not slowing fast enough to reach the goal of eradicating AIDS by 2030, a report by the United Nations group to fight the disease said Monday.
Published two days ahead of World AIDS Day, the report by the Joint United Nations Programme on HIV/AIDS said shortcomings in the pandemic response can also be seen in the fight against the decades-old disease.
“Many of these missing pieces to fight HIV are also allowing the COVID-19 pandemic to continue and leaving us dangerously unprepared for pandemics of the future,” said UNAIDS executive director Winnie Byanyima.
In June, UNAIDS set new targets to reach by 2025: bringing HIV services to 95 percent of those who need them reducing annual HIV infections to fewer than 370,000 and reducing AIDS-related deaths to fewer than 250,000 by 2025.
But the report said the world is off-track to meet those goals.
“UNAIDS data show that the curves of HIV infections and AIDS-related deaths are not bending fast enough to end the pandemic,” it said.
The report highlighted five urgent Global AIDS Strategy priorities it said should be funded and implemented globally “for pandemic prevention, preparedness and response”.
They include access to preventative equipment like condoms and clean needles, as well as support for community-based health services.
A new analysis suggests countries may be under-reporting the size of at-risk populations and highlights the need for better data, it said.
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