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Rates of newly diagnosed HIV increasing in over-50s

11:00pm Tuesday 26th September 2017 content supplied byNHS Choices

They analysed the data according to two age groups: younger people aged 15 to 49 and older people aged 50 or over.

What were the basic results?

Overall, between 2004 and 2015:

  • There were 312,501 new cases of HIV in people aged 15 to 49, a rate of 11.4 per 100,000 people. This rate of infection didn't change over time.
  • There were 54,102 new cases of HIV in adults over 50, a rate of 2.6 per 100,000 people. The rate of infection increased by 2.1% per year over the 12-year period.

In the UK:

  • There was an increase of 3.6% in new diagnosis rates for older people between 2004 and 2015, from 3.1 to 4.32 new cases per 100,000 people. This is higher than the European average.
  • There was a 4% reduction in new diagnosis rates for younger adults during this time.

Diagnosis by age group:

  • Older people were more likely to have a delayed diagnosis, with significantly lower CD4 counts than younger adults.

Men compared with women:

  • Over the 12-year period, the average diagnosis rate for older men increased from 3.5 to 4.8 per 100,000, while older women had an increase from 1.0 to 1.2 per 100,000.
  • Over the same period, the average rate of diagnosis increased by 1.4% in younger men and reduced by 4.8% for younger women.

Mode of transmission in 2015:

  • The most common route of infection for older adults was heterosexual contact (42.4% of cases), followed by sex between men (30.3%), "other" or unknown causes (24.6%), and injecting drugs (2.6%).
  • For younger adults, sex between men was the most common route of infection (45.1% of cases), followed by heterosexual contact (30.8%), other or unknown (19.5%), and injecting drugs (4.6%).

Changes in mode of transmission from 2004 to 2015:

  • The rate of HIV infection from heterosexual sex remained stable in older people, and decreased in younger people.
  • Infection resulting from injecting drugs increased in older people and decreased in younger people.
  • The rates of HIV infection in men who have sex with men increased in both age groups, but more so in older people at 5.8% compared with 2.3%.

How did the researchers interpret the results?

The researchers concluded that the "increasing new HIV diagnoses among older adults point towards the compelling need to heighten awareness among healthcare providers and deliver more targeted prevention interventions for this age group and the total adult population".

They were also careful to say that "no data for the reasons behind such an increase [in new HIV diagnoses in older people] have been published".

Conclusion

This was a well-conducted study and the results are likely to be reliable, though there are some limitations, including missing data.

For example, the researchers had no information on the migration status or CD4 count (an indicator for stage of the disease) for a quarter of cases.

This study found that although the overall rate of infection is higher in younger people, this has remained stable over the last 12 years while the rate of infection in older people has increased.

Some of the media stories focused on the finding that older people are most likely to have become infected through heterosexual sex.

While true, this is nothing new: the rate of infection from heterosexual sex has in fact been stable for over-50s over the study period, whereas the rates of infection in men having sex with men and drug use have both increased for this age group.

What makes further analysis of this trend difficult to interpret is the high proportion of people for whom "other" or "unknown" infection was recorded.

The finding that older people were more likely to have a delayed diagnosis highlights the importance of HIV testing for people of all ages who are at risk of infection.

What's of most concern is that the rates of infection remain high in all age groups despite public health campaigns about practising safe sex.

HIV tests are free on the NHS and can be done in various places, including walk-in sexual health clinics. There are also home testing kits available.

Find out more about HIV tests and find HIV testing services near you.

Summary

"HIV rises among over-50s as they neglect safe sex" is the headline from The Times. The news is based on a European study that found more over-50s are being diagnosed with HIV compared with 12 years ago.

Links to Headlines

HIV rates climbing among over-50s in UK and Europe, researchers warn. The Guardian, September 26 2017

Rise in new HIV cases in over-50s - study. BBC News, September 27 2017

HIV on the rise in the over-50s: Warning that reckless sexual behaviour of 'silver splitters' has led to an increase in cases. Mail Online, September 27 2017

HIV rising among over-50s as they neglect safe sex. The Times, September 27 2017

Links to Science

Tavoschi A, Gomes Dias J, Pharris A. New HIV diagnoses among adults aged 50 years or older in 31 European countries, 2004-15: an analysis of surveillance data The Lancet HIV. Published September 26 2017

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