Impact of the HIV epidemic in sub-Saharan Africa on the pattern of HIV in the UK

OBJECTIVE: To describe the epidemiology of HIV infection acquired in Africa and among African communities in the United Kingdom. DESIGN: Descriptive analysis using national HIV and AIDS surveillance data, routine voluntary confidential HIV reporting and unlinked anonymous seroprevalence surveys in the United Kingdom to the end of December 2001. RESULTS: Of all reported HIV infections diagnosed in the United Kingdom by the end of 2001, 21% (9993 of 48,226) were probably acquired in Africa and 90% of these infections were heterosexually acquired. Numbers of diagnoses of HIV infection acquired in Africa have been increasing rapidly, with rises in infections from southeastern and southern Africa predominating recently. Among those living with diagnosed HIV infection in 2000, 23% (4883 of 21,291) were described as black African, 81% of whom lived in London. The proportion living in London has declined over successive prevalence surveys. CONCLUSIONS: Infections acquired in Africa and among Africans are making an increasing contribution to HIV infection in the United Kingdom. Migration, diagnosis of long-standing infection and incident cases are all potential influences, but they are difficult to measure. Improvement in early diagnosis of HIV continues to be an important component of intervention to prevent onward vertical and sexual transmission and to promote access to treatment and care.