The HIV epidemic in Europe, including the United Kingdom, is being fuelled by the risky behaviour of young gay men, according to recent published research.
Public messages and campaigns about the dangers of unsafe sex do not appear to be getting through to men who have sex with men (MSM), the researchers said — particularly young ones. By investigating the genetic profile of the virus in more than 500 newly screened patients over nine years, scientists in Belgium identified clusters of people with the type B virus, not the one most prevalent in Africa.
Those infected are almost all white, male, gay and young, they said. These men also tend to have other sexual diseases, such as syphilis, which suggests that they are involved in unsafe sexual behaviour and are not using condoms. The research was carried out by scientists at Ghent University in Belgium and there is every indication that their findings hold true for the UK.
The Health Protection Agency, which monitors HIV numbers in the UK, warns every year of the rising rate of infection among men who have sex with men. In its last full report for 2009 it said that the rate of infection among gay men remained high, even though there had been a slight overall drop.
HIV infection can go unnoticed for years, but the agency’s report said one in five of those diagnosed had become infected within the previous six months, suggesting recent risky behaviour was to blame.
A 2008 report specifically on HIV among MSMs said there were about 32 000 living with HIV in the UK. Just less than half of all new diagnoses were among MSMs and 82% of the infections were probably acquired within the UK.
The Belgian researchers, Kristen Chalmet and colleagues from the Aids Reference Laboratory at Ghent University, found one “striking and alarming” cluster of cases. Over the nine years of the study, 57 men acquired genetically very similar viruses, they said. Eight of them did so in the past year.
“Members of this cluster are significantly younger than the rest of the population and have more chlamydia and syphilis infections,” they wrote in the open-access journal BioMed Central Infectious Diseases. Even excluding that group from the study, there was still a relationship between HIV infection and contracting syphilis, which suggested risky sexual behaviour.
The study found two main types of HIV, but their analysis found that those infected with the two types were “significantly different populations”. The vast majority of cases of infection within Belgium were sub-type B cases and those infected were most often MSMs. The non-B cases were more likely to be in heterosexuals and acquired abroad.
“We clearly demonstrate that, in spite of the existence of prevention programmes, easily available testing facilities and a supposedly broad public awareness of the infection and its possible routes of transmission, MSM still accounts for the majority of local onward transmissions,” they said.
“Continuous effort to sustain prevention programmes targeting MSMes is definitely needed.” Nick Partridge, the chief executive of British charity, the Terrence Higgins Trust, echoed the call for targeted campaigns. “More than a quarter of people with HIV in the UK are undiagnosed and they’re far more likely to pass the virus on than those who know they have it.” —