Blood Borne Viruses & Sexually Transmitted Infections

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BBV & STI

Surveillance Report

21 March 2017

HIV infection and AIDS: Quarterly report to 31 December 2016 (ANSWER)

Diagnosed HIV-infected persons living in Scotland Number of HIV-infected persons attending for care and treatment Proportion of attenders on treatment
5277 4575 95%

During 2016, NHS Scotland laboratories reported positive HIV-antibody test results for 285 individuals not previously recorded as HIV-positive. This represents the lowest annual figure recorded since 2003. The cumulative total of known HIV-positive individuals ever reported in Scotland is now 8648, of whom 6345 (73%) are male and 2303 (27%) are female. Allowing for known and presumed migration of infected persons, and for the 2053 (24%) known to have died, it is estimated that there are currently 5277 persons living in Scotland who have been diagnosed HIV-positive.

HIV infection in Scotland - 2016

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Of the 285 HIV-positive individuals reported in 2016, 227 (80%) are male, and 169 (59%) are aged between 25 and 44 years. Greater Glasgow & Clyde reported 101 diagnoses, 70 were reported from Lothian, 30 from Grampian and 27 from Lanarkshire. The probable route of transmission was men who have sex with men (MSM) in 139 cases, heterosexual intercourse in 94, and injecting drug use in 36. Transmission category remains unresolved for 15 individuals. Of the 270 diagnoses for which the location of exposure can be presumed, 131 (49%) occurred in Scotland.

As at 30 September 2016, 4575 HIV infected individuals were attending specialist services for monitoring and treatment. Including recently reported persons (125 – Table 5) who may not as yet have recorded an attendance, this represents 89% of the estimated number of diagnosed individuals currently living in Scotland. Across Scotland, 95% of persons attending for monitoring are receiving anti-retroviral therapy.

Continuing investigation into previously reported cases has resulted in the enhancement of several records with additional epidemiological information, while several recent reports have yet to be followed up. See Tables 2, 3 and 4 for detailed updates to totals in transmission categories, NHS boards, and other data.

More detailed information and cumulative information is included in the following tables. The HIV-positive and AIDS databases are under continual review and modification as additional information becomes available. This may result in apparent discrepancies when current and previously published tables are compared.

HPS would welcome comment and suggestions from stakeholders regarding content. Please direct any correspondence to Glenn Codere, BBV/STI Information Manager, HPS (email g.codere@nhs.net, tel 0141 300 1146).

Acknowledgements

HPS thanks collaborators and contributors to national HIV surveillance throughout Scotland for their assistance in the compilation and production of these data.

Terms and definitions

Attending/Attenders: Individuals are considered to be ‘attending’ if they have recorded at least one visit to a specialist HIV clinic for monitoring and/or care within the most recent 12-month period.

Lost to follow-up: Individuals are considered to be ‘lost to follow-up’ if a) they have not recorded an attendance at a specialist HIV clinic within the previous 12 months and b) no evidence exists of recent attendance at an NHS facility for a non-HIV related condition and c) no evidence exists of recent attendance for HIV care in an NHS setting other than a specialist HIV centre and d) no evidence exists that the patient is deceased or has left Scotland.

NHS board: Unless otherwise specified, individuals are assigned to a specific NHS board based on the patient’s postcode of residence or, where this is not known, their NHS board of referral.

Suppression of ‘small numbers’: Where there is deemed to be a risk of deductive disclosure, some small numbers (usually those below five) presented within these tables have been suppressed (represented by *).

Transmission category: Individuals are assigned to a transmission category based on a clinical assessment of their most likely method of exposure and subsequent infection.

Estimated number of diagnosed persons living in Scotland: This estimate is calculated by adding persons currently attending, persons recently reported but not yet attending, persons of Scots origin/ethnicity who are lost to follow-up, and 54% of individuals of non-Scots origin/ethnicity who are lost to follow-up. Data from the 2010/2011 HIV Action Plan (Action 6) quantitative project, the 2011 BASHH Scotland Audit (both investigating reported HIV-positive individuals lost to follow-up), and routine follow-up of cases performed by HPS indicate that approximately 46% of non-Scots who have not attended for specialist monitoring/treatment are presumed to have left Scotland.

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Vol: 51 No: 11 Year: 2017 Page:

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