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February 14, 2013

Widespread Testing Fails to Reduce HIV Incidence in English and Welsh Gay Men

Despite widespread testing efforts and a 40 percent drop in the proportion of undiagnosed gay men with HIV in England and Wales, the number of new infections among this population remained unchanged between 2001 and 2010, aidsmap reports. Researchers from the U.K.’s Medical Research Council and the Health Protection Agency (HPA) reported these disappointing findings in The Lancet Infectious Diseases.

Between 2001 and 2010, the number of new annual HIV diagnoses in gay men in England and Wales increased from about 1,800 to about 2,600. The researchers used the men’s CD4 count at diagnosis to speculate when they were initially infected and projected that 2001 saw about 2,200 new infections in this population and 2010 saw about 2,300.

While areas such as San Francisco, British Columbia and some parts of South Africa have experienced a reduced incidence of infection among gay men in tandem with a rise in treatment, the proportion of gays in England and Wales with a fully suppressed viral load due to antiretrovirals appears too low to cause such an effect, the paper concludes.

The paper’s authors advise extending HIV testing efforts into more non-traditional settings and pushing gay men to screen for the virus more often. Their recommendation dovetails with the U.K. Department of Health’s recent statement calling the risk of HIV transmission “extremely low” when the positive person is on treatment and maintains an undetectable viral load and both partners have no sexually transmitted infections. (While that statement pertained specifically to heterosexuals, as the bulk of research on treatment as prevention has been in this population, it still anticipated “extremely low risk” among gay men if they meet the same criteria).

The authors of the latest study concluded that treating gay men immediately after diagnosis, regardless of CD4 count, might be necessary to control the spread of the virus. The paper urges clinicians to observe the British HIV Association’s treatment guidelines, which recommend that health providers discuss the benefits of treatment as prevention.

To read the aidsmap story, click here.

To read the study abstract, click here

Search: England, Wales, British, English, Welsh, HIV, testing, incidence, U.K., Medical Research Council, Health Protection Agency, HPA, diagnosis, San Francisco, British Columbia, South Africa, U.K. Department of Health, treatment as prevention.

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