The turnaround in fortunes coincides with three big changes for HIV in the UK in the past decade. This makes the news of a higher number of HIV diagnoses in heterosexuals than gay men even more significant. There was a 7% fall in HIV testing by gay men in sexual health clinics in England in 2020, but HIV testing rates in heterosexuals dropped by a third. It’s worth noting that this shift is a true change in the epidemic rather than one manufactured such as that of Covid-19 lockdowns and resulting drops in testing. And, as someone who has received that life-changing HIV diagnosis, I understand the immense value of every transmission halted. Instead, it’s primarily the result of a sharp, sustained drop in diagnoses among gay and bisexual men with a 71% fall since 2014. Thankfully, this isn’t about a huge spike in HIV diagnoses among heterosexuals. Because continuing to solely target those traditionally most at risk won’t work. A change that must influence our response – and quickly – to ensure the government makes good on its commitment to ending new HIV cases by 2030.
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This is the first time in a decade that new diagnoses among heterosexuals are higher – marking a clear change in the shape of the domestic HIV epidemic. Now, 49% of new diagnoses in England are among straight people (with an almost even split between men and women), compared with 45% for gay and bisexual men.
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And that impact is being felt and changing lives.