The United Kingdom (UK) has a relatively small HIV epidemic, with an estimated 101,200 people living with HIV in 2015. This equates to an HIV prevalence of 1.6 per 1,000 people aged 15 and over.1 In the same year, 6,095 people were newly diagnosed with HIV and 594 people died of AIDS-related illnesses. 

Despite testing and treatment being free and universally available in the UK, around 13,500 people are unaware of their HIV infection.

In 2015, 96% of people living with HIV were receiving antiretroviral treatment (ART).3However, late diagnosis of HIV remains a key challenge in this country, despite declining rates.

Although the figure for undiagnosed cases has fallen by 11% since the estimate of 24% in 2014, it still means that around 13,500 people are unaware of their infection, despite testing and treatment for HIV being free and universally available in the UK.

The annual number of new diagnoses – 6,095 people – represents a notably high rate of 11.3 per 100,000 people. Western Europe’s average is 6.3 per 100,000.

The epidemic in the UK mainly affects men who have sex with men and black African women. But in its 2016 report, Public Health England emphasised the diversity of people living with HIV in the UK. In 2015, for the first time since the 1990s, the proportion of people diagnosed with HIV who were born in the UK (52%) exceeded the proportion born abroad (48%). Since the 1980s, men who have sex with men have remained the group most at risk of HIV in the UK. In 2014, the most recent data available, an estimated 45,000 men who have sex with men were living with HIV. This means roughly 1 in 20 men who have sex with men aged 15 to 44 are living with the virus. The prevalence rate is 4.9% nationally among this group, rising to 9% in London.

The number of men who have sex with men newly diagnosed with HIV continues to rise, from 2,860 in 2010, to 3,320 in 2015.

In 2014, men who have sex with men aged between 25 and 44 years old accounted for two-thirds of new diagnoses. 6% were over 55 at the time of their diagnosis. Over half (51%) of these new diagnoses were made in London. Four out of five men who have sex with men newly diagnosed with HIV were white (81%), 2% were black African, 2% black Caribbean and 14% described as other/mixed race.8

Increases in HIV diagnoses can be partly explained by increased HIV testing as well as ongoing HIV transmission. 14% of men who have sex with men living with HIV in the UK are believed to be unaware of their infection. Those living in London have a lower rate of late diagnosis (23%) than those who live outside of the capital (36%).

Heterosexual men, women, and black Africans

In 2014, an estimated 21,300 heterosexual men and 32,700 heterosexual women were living with HIV in the UK. Of this number, 55% of men and 62% of women were of black African ethnicity (much higher than the percentage of black Africans in the UK population). Indeed, the number of black Africans living with HIV continues to rise.

In 2015, there were 2,360 new HIV diagnoses as a result of heterosexual sex – 1,350 among heterosexual women and 1,010 among heterosexual men. This is about half the diagnoses made ten years ago when this figure stood at 4,340. The fall is largely due to changing migration patterns, with fewer people born in sub-Saharan Africa being diagnosed with HIV in the UK.

Of the 88,769 people accessing HIV treatment in the UK in 2015, 41,945 were men and women who had acquired HIV through heterosexual sex and 41,016 were men who had acquired HIV through homosexual sex.

Of those who acquired HIV via heterosexual sex, 16,291 men and 25,654 women were accessing care. Among this group, 60% of people were black African, 24% white, 4% black Caribbean, 4% Asian and 3% of other black ethnicity.

Just over half (51%) of the heterosexual men and 60% of the heterosexual women living with HIV were aged 25 to 44. As with other groups in the UK, the proportion of heterosexual people diagnosed at an older age has increased. The median age of HIV diagnosis for heterosexuals has risen from 34 in 2005 to 40 in 2014. 24% of all heterosexual men and 18% of heterosexual women living with HIV were unaware of their HIV status. This difference is largely due to the effectiveness of the UK’s antenatal screening programme. 

Among the black African population living with HIV, roughly 16% of men and 12% of women were living with an undiagnosed infection. HIV prevalence is comparatively higher among this group. For example, nearly 18 (17.9) out of 1,000 black African heterosexual men and nearly 44 (43.7) out of 1,000 black African women were living with HIV in 2014 compared to 0.5 per 1,000 non-black African men and nearly 1 (0.7) per 1,000 non-black African women.