People aged 15 to 59 years seen at HIV services in the UK, expressed as a rate per 1,000 population.Data is presented by area of residence, and exclude people diagnosed with HIV in England who are resident in Wales, Scotland, Northern Ireland or abroad.
Rationale
The geographical distribution of people seen for HIV care and treatment is not uniform across or within regions in England. Knowledge of local diagnosed HIV prevalence and identification of local risk groups can be used to help direct resources for HIV prevention and treatment.
In 2008, http://www.bhiva.org/HIV-testing-guidelines.aspx recommended that Local Authority and NHS bodies consider implementing routine HIV testing for all general medical admissions as well as new registrants in primary care where the diagnosed HIV prevalence exceeds 2 in 1,000 population aged 15 to 59 years.
In 2017, guidelines were updated by https://www.nice.org.uk/guidance/NG60 which is co-badged with Public Health England. This guidance continues to define high HIV prevalence local authorities as those with a diagnosed HIV prevalence of between 2 and 5 per 1,000 and extremely high prevalence local authorities as those with a diagnosed HIV prevalence of 5 or more per 1,000 people aged 15 to 59 years.
When this is applied to national late HIV diagnosis data, it shows that two-thirds of late HIV diagnoses occur in high-prevalence and extremely-high-prevalence local authorities. This means that if this recommendation is successfully applied in high and extremely-high-prevalence areas, it could potentially affect two-thirds of late diagnoses nationally.
Local authorities should find out their diagnosed prevalence published in UKHSA's http://fingertips.phe.org.uk/profile/sexualhealth , as well as that of surrounding areas and adapt their strategy for HIV testing using the national guidelines.
Commissioners can use these data to plan and ensure access to comprehensive and specialist local HIV care and treatment for HIV diagnosed individuals according to the http://www.medfash.org.uk/uploads/files/p17abl6hvc4p71ovpkr81ugsh60v.pdf and http://www.bhiva.org/monitoring-guidelines.aspx .
Definition of numerator
The number of people (aged 15 to 59 years) living with a diagnosed HIV infection and accessing HIV care at an NHS service in the UK and who are resident in England.
Definition of denominator
Resident population aged 15 to 59.The denominators for 2011 to 2023 are taken from the respective 2011 to 2023 Office for National Statistics (ONS) revised population estimates from the 2021 Census.
Further details on the ONS census are available from the https://www.ons.gov.uk/census .
Caveats
Data is presented by geographical area of residence. Where data on residence were unavailable, residence have been assigned to the local health area of care.
Every effort is made to ensure accuracy and completeness of the data, including web-based reporting with integrated checks on data quality. The overall data quality is high as the dataset is used for commissioning purposes and for the national allocation of funding. However, responsibility for the accuracy and completeness of data lies with the reporting service.
Data is as reported but rely on ‘record linkage’ to integrate data and ‘de-duplication’ to prevent double counting of the same individual. The data may not be representative in areas where residence information is not known for a significant proportion of people accessing HIV care.
Data supplied for previous years are updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may therefore differ from previous publications.
Values are benchmarked against set thresholds and categorised into the following groups: <2 (low), 2 to 5 (high) and≥5 (extremely high). These have been determined by developments in national testing guidelines.
The data reported in 2020 and 2021 is impacted by the reconfiguration of sexual health services during the national response to COVID-19.