England has an important population of people living with the Human Immunodeficiency Virus (HIV) in comparison with the rest of the United Kingdom (UK) ( 89,400 people out of 101,200). This epidemic is concentrated to a large extend among key populations such as men who have sex with men (MSM), drug users and black African populations.Despite the UK has had an important progress in antiretroviral treatment coverage in the past decades, late diagnosis is still one of the main challenges to fight against the infection. Another concerning point is the decreasing knowledge against HIV and some Sexually Transmitted Infections (STIs). HIV prevention programming in the UK is mainly run by HIV Prevention England (HPE) which is coordinated by the Terrence Higgins Trust and focuses primarily on the needs of men who have sex with men and black Africans.In order to reduce new cases of HIV, the UK government recommends MSM that have unprotected sex to be tested for the infection once per year, or every three months if they have sex with casual or new partners.
In 2016, new HIV diagnoses among MSM fell for the first time since the epidemic began. London had the highest success rate, where new diagnoses fell by 42% in centres like the Dean Street´s clinic, which is considered the largest HIV clinic in Europe. Specialists attributed this success to the availability of Pre-exposure prophylaxis (PrEP) as well as to increased testing and earlier provision of treatment. Pre-exposure prophylaxis (PrEP) is a daily course of antiretroviral drugs (ARVs) that can protect HIV-negative people from HIV. In 2017 the National Health System commenced a three year trial where the PrEP is provided to an estimated 10,000 people. This major NHS-England funded intervention will assess the full additional potential of PrEP, by gathering clinical evidence on optimal targeting, uptake and implementation on a large scale.
In order to reduce the HIV transmission amongst people who inject drugs, the UK achieved the recommendation of the World Health Organization. The Needle and syringe programmes (NSPs) coordinated the distribution of 200 to each consumer every year.Learning about safer sex is vital. In March 2017, it was announced that Relationships and Sex Education (RSE) will be compulsory in England from 2019. The program aims to provide personal, social, health and economic education. The government’s decision to make RSE statutory is a step forward towards helping pupils develop healthy and supportive relationships.Additionally, public awareness campaigns that warn people of the risks of unprotected sex and recommend safer sex behaviours are an essential part of STIs prevention programs.
In 2011, the UK government launched a new initiative called, ‘National HIV Testing Week’ that aimed to increase HIV awareness and testing among key affected populations in England. A recent survey, shown a successful increase in the number of orders of HIV self-testing kits since then. Furthermore, to guarantee all people affected by HIV achieve viral suppression and untransmittable levels of HIV, the NHS in England have implemented a new policy of treatment for HIV immediately after diagnosis is made. This follows the World health Organization (WHO) guidelines that highlight the need to initiate the antiretroviral treatment (ART) as soon as HIV is diagnosed, regardless of CD4 count. Although the UK has improved the provision of antiretroviral treatment in the past 10 year, there are still gaps in HIV prevention and education. To facilitate even more the access to testing services, in order to prevent new infections, is indispensable. Consequently, significant efforts to increase HIV and STI knowledge across the country through both public campaigns and education in schools are needed.
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