Monitoring of the HIV Epidemic Using Routinely Collected Data: The Case of the United Kingdom.
We report on measures used to monitor the response to the UK HIV epidemic. We present analyses of routine data on HIV testing, diagnosis and care, and of CD4 back-calculation models to estimate country of HIV acquisition and incidence. Over the past decade, HIV and AIDS diagnoses and deaths declined while HIV testing coverage increased. Linkage into care, retention in care, and viral suppression was high with few socio-demographic differences. However, in 2013, incidence among MSM, and undiagnosed infection, also remained high, and more than half of heterosexuals newly diagnosed with HIV (the majority of whom were born-abroad) probably acquired HIV in the UK and were diagnosed late. HIV care following diagnosis is excellent in the UK. Improvements in testing and prevention are required to reduce undiagnosed infection, incidence and late diagnoses. Routinely collected laboratory and clinic data is a low cost, robust and timely mechanism to monitor the public health response to national HIV epidemics.
Facility of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. brian.rice@lshtm.ac.uk.
Brian D
BD
Rice
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Zheng
Z
Yin
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Alison E
AE
Brown
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Sara
S
Croxford
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Stefano
S
Conti
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Daniela
D
De Angelis
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
Valerie C
VC
Delpech
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D057210:Delayed Diagnosis; D058872:Epidemics / Q000517:prevention & control*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D006113:United Kingdom / Q000453:epidemiology
Case reporting; Epidemiology; HIV surveillance; Heterosexuals; Men who have sex with men; Monitoring; United Kingdom