HIV in the UK: From the 1980s to Today

Content warning: homophobia

HIV/AIDS and its origins in the UK

According to the National Health Service (NHS) HIV stands for ‘human immunodeficiency virus’ and is ‘a virus that damages the cells in your immune system and weakens your ability to fight everyday infections and disease.’^[1] AIDS is what HIV develops into if it remains untreated. AIDS is an acronym for acquired immunodeficiency syndrome which is ‘used to describe a number of potentially life-threatening infections and illnesses that happen when your immune system has been severely damaged by the HIV virus’.[2]

The first case of HIV was reported in the UK on December 1981.[3] With no testing for the virus at the time the patient, a 49-year-old homosexual man, was referred with Pneumocystis pneumonia (PCP) and cytomegalovirus (CMV) to London Hospital.[4] There was no known medication to suppress HIV and prevent it from developing into AIDS at the time. This meant contracting HIV during this time and up until 1996 (when highly active antiretroviral therapies (HAAT) began to take place) meant the development of AIDS and, ultimately, death.[5] Because contracting HIV was considered a death sentence during this time, the AIDS epidemic was one which particularly brought fear and paranoia both nationally and internationally.

The most affected and stigmatised

In 1984, the HIV antibody test was developed which showed the prevalence of HIV among the population. This revealed that the virus was particularly prevalent amongst the homosexual male population between the ages of 20 and 24.[6] This test also established that HIV had actually been present among homosexual men from as early as 1980.

The predominance of the virus among an already marginalized group meant that gay men were further stigmatized and suffered increased homophobia. The paranoia and shame surrounding the gay community increased significantly during the 1980s due to the association of homosexual men with HIV; ‘the syndrome later known as AIDS was first referred to as the ‘gay cancer’ or gay-related immune deficiency (GRID).’[7] Though there have been progression in its treatment and mortality rate since, ‘HIV continues to be a highly stigmatised disease.’[8]

Treatment

After 1996, the tracing of HIV and AIDS in the UK was developing to improve the treatment and care needed from service providers, which led to more people living with diagnosed HIV.[9] The introduction of HAAT meant that having HIV was not a death sentence and today drugs can be taken that could stop people who are HIV positive from passing the virus on.

HIV symptoms include a flu-like illness for 1-2 weeks, usually 2 to 6 weeks after HIV infection. [10] After this, someone with HIV may not have symptoms for years whilst the virus continues to damage their immune system. [11] Therefore, anyone who thinks they could have HIV should get tested. Once a diagnosis is determined, medication can be prescribed which prevents HIV from reproducing in the body and allows people who are HIV positive to build up their immune system.[12] Ultimately, this treatment’s goal is to make HIV undetectable by a test, meaning the person with HIV will ‘have an undetectable viral load’.[13] These progression in the treatment of HIV, and the prevention of it developing into AIDS, means that people who are HIV positive can lead a relatively normal life in regards to their physical health.

HIV today

In 2019, it was estimated that there were 105,200 people living with HIV in the UK, out of which 98,552 received HIV treatment.[14] This means just over 93% of all people with HIV were treated in 2019, an increase of 42% since 2010.[15] Around 92.5% of all HIV transmission were by sexual transmission in 2019, with around a 50% split in transmission between heterosexual sex and male to male sex.[16] This means transmissions between men who have sex with men (MSM) are now proportional to heterosexual transmissions of HIV and so there shouldn’t be any prejudice in relation to homosexual men and their likelihood of transmitting HIV, and yet there still is.

Blood Donation policies are changing to enable more MSM to donate blood. Currently in the UK, all MSM must wait 3 months after having sex before donating blood, but MSM who have ‘had the same partner for three months or more will be able to give blood from summer 2021’.[17] This would imply progressions in LGBTQ+ rights. Yet, according to the BBC, ‘if donors have had more than one sexual partner or a new partner in the last three months, they can donate as long as they have not had anal sex.’[18] This rule only applies to MSM.

If the transmission rate between MSM and heterosexual sexual interactions are equal, then why do these rules still only apply to MSM? This implies that legislation in relation to blood donation is still outdated in targeting homosexual and bisexual men, and so these changes seem to be only a guise for real acceptance and progression. Therefore, the UK still has a long way to go in reducing the stigma surrounding people who are HIV positive and dismantling homophobic legislation.

If you think you could have HIV and you are in the UK, read more about how to get tested here: https://www.nhs.uk/conditions/hiv-and-aids/

References

Coutinho, Alex, ‘Capturing the HIV/AIDS Epidemic’, The Lancet, 364.9449 (2004), 1929–30

Day, N. E., S. M. Gore, M. A. McGee, and M. South, ‘Predictions of the AIDS Epidemic in the U.K.: The Use of the Back Projection Method’, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences (1934-1990), 325.1226 (1989), 123–34

Dougan, S et al., ‘HIV in gay and bisexual men in the United Kingdom: 25 years of public health surveillance’, Epidemiology and infection, vol. 136.2 (2008), 145-56. doi:10.1017/S0950268807009120

‘HIV in the UK’, The Psychologist, https://thepsychologist.bps.org.uk/volume-26/edition-7/hiv-uk

Hunte, Ben, ‘Blood donation: Rule change means more gay and bisexual men can give blood’, BBC (14 December 2020), https://www.bbc.co.uk/news/uk-55296525

‘Men who have sex with men (MSM)’, Give Blood – https://www.blood.co.uk/who-can-give-blood/men-who-have-sex-with-men/

NAT, https://www.nat.org.uk/about-hiv/hiv-statistics

NHS, https://www.nhs.uk/conditions/hiv-and-aids/

[1] NHS – https://www.nhs.uk/conditions/hiv-and-aids/

[2] NHS

[3] Dougan, S et al., p. 145.

[4] Dougan, S et al., p. 146.

[5] Dougan, S et al., p. 146.

[6] Dougan, S et al., p. 147.

[7] ‘HIV in the UK’, The Psychologist.

[8] ‘HIV in the UK’, The Psychologist.

[9] Dougan, S et al., p. 151.