Advocates warn that alarming numbers of straight men and women don't realize they've been infected with HIV until the virus has already begun to cause lasting damage.
Nearly half—49 percent—of women who were diagnosed with HIV in England in 2015 didn't realize they had HIV until later on in the progress of the virus. Fifty-five percent of straight men who were diagnosed with HIV last year were also diagnosed late. Overall, 40 percent of all people diagnosed with HIV in the UK last year received late diagnoses, indicating a continued need for education and more awareness about the realities of contracting and living with HIV.
Clinicians define late-stage HIV diagnoses as when the virus has begun to compromise the individual's immune system. In technical terms, this means your CD4 count (the number of white blood cells that fight infection) drops below 350. In normal adults, this figure should be around 500 and 1,500; drop below 200, and you're at risk of serious illness, even death. It can take three years for your body to reach this point—hugely increasing the risk that you'll pass the infection on to others.
The Terrence Higgins Trust compiled the data using statistics from the UK healthcare authorities. They found that heterosexual men are most likely to discount the possibility they have HIV and defer testing, with 55 percent of late stage diagnoses occurring in straight guys. The second most likely group to receive a late diagnosis was black African people (49 percent), followed by heterosexual women.
It's important to emphasize that gay and bisexual men are still overwhelmingly most at risk from HIV, and more likely to be infected with the virus. In 2015, 3,320 of the 6,095 new diagnoses in the UK came from gay and bisexual men, making up around half of all cases.
One factor responsible for late-stage diagnoses may be the common misperception of HIV as a gay disease. "A common theme we see with late diagnoses is that people think it won't happen to them," explains Simone Howard of the Terrence Higgins Trust. "Heterosexual people might not feel as at risk as other people—they think they're more likely to get chlamydia or herpes, which are more widely spoken about."
Misperceptions of HIV as something that only affects gay men are damaging for everyone. In the UK, activists are fighting to make the potentially life-saving HIV prevention drug PrEP available to those in high-risk groups, such as sex workers, members of the African community and gay and bisexual men. But homophobic media stigmatization of the drug has contributed to a decision not to prescribe it on the NHS—despite overwhelming evidence as to its effectiveness.
The bigger picture is that around a quarter of the people who currently have HIV in the UK don't know they have it, according to NHS data. These people may unintentionally infect other people they come into contact with, all the while not knowing their immune systems are suffering potentially lasting damage. While advance in modern medicine mean that people with HIV can live long and healthy lives, it's critical that the infection is detected early in order for treatment to be effective. "Fail to receive early treatment for the virus, and you can become seriously ill," Howard says.
Today's figures indicate a profound need to redouble efforts to educate people about HIV. "Lack of knowledge and understanding of how the virus is transmitted is the main thing driving late transmission," Howard explains. She highlights the need for comprehensive education in schools as well as at universities, where young people are more likely to become sexually active.
"It's about educating people at a young age, making sure it's spoken about in schools, colleges, and universities."
If you're based in the UK, find out where you can be tested for HIV as part of National HIV Testing Week here.