The high STI rates amongst gay men are undoubtedly contributing to the continuing high rate of HIV transmission in the community. Having an STI makes someone much more biologically vulnerable to HIV. For some of the gay men diagnosed with both an STI and HIV, it is probable that having the STI resulted in them acquiring HIV also.
An STI can also be a predictor of future HIV acquisition for gay men. HPA data has shown than amongst gay and bisexual men attending sexual health clinics, gay men diagnosed with chlamydia were three times more likely to acquire HIV in the following year and gay men diagnosed with gonorrhoea were nearly two and half times more likely to get HIV in the following year. This is because STIs are indicators of risk behaviour which may result in HIV transmission in the future.
The STI epidemic amongst gay men also means that those with both HIV and an acute STI are significantly more infectious than they would otherwise be – so the high rate of STIs diagnosed at the same time as HIV amongst gay men is a cause for real concern. These STIs are fuelling the spread of HIV in the gay community.
Deborah Jack, Chief Executive of NAT (National AIDS Trust), comments:
‘Last year saw the highest ever number of HIV diagnoses amongst gay men. A key lesson from the HPA report is that if you don’t take STIs seriously you’re not taking HIV seriously. Most STIs may be treatable and curable but they are not just some ‘occupational hazard’ of gay life – they are inextricably connected to the spread of HIV.
‘It is vitally important that gay men test at least once a year for STIs and HIV, and every three months if they’re having unprotected sex with new or casual partners. If you’ve been diagnosed HIV positive, it’s still important to have regular and frequent STI screens.
‘HIV negative gay men diagnosed with an STI should really treat it as a ‘wake up call’. You are at serious risk of getting HIV in the near future and need to take steps to prevent that happening – such as consistent condom use and reduction in number of sexual partners.’
Other key findings from the HPA 2012 report
The number of people living with HIV in the UK hit 96,000 in 2011, with 6,280 new diagnoses that year.
In 2011, there were an estimated 3,010 new diagnoses among gay men*, surpassing the number of diagnoses among heterosexuals for the first time since 1999 and the highest annual figure since records began. This means the proportion of gay men living with HIV is one in 20.
Just under half (48%) of people diagnosed with HIV in the same period were heterosexuals (predominantly African men and women).
Among gay men, nearly a quarter (23%) were acquired recently (i.e. infected in the previous 4-6 months) which shows, worryingly, a high proportion of new infections are still taking place. This compares to 9% of heterosexual men and 8% of heterosexual women.
Among gay men, younger men were more likely to be recently infected compared to older men, with 27% of newly diagnosed gay men aged 35 or under recently infected, compared to 14% among gay men over 50
A fifth of gay men with HIV (20%) remain unaware of their infection.
Gay men are significantly less likely to be diagnosed late than heterosexuals, with 35% of gay men diagnosed late compared to while 56% of heterosexual women and 64% of heterosexual men.
In 2011, 70% of all STI clinic attendees received an HIV test, but this increased to 83% among gay men.