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The UK has a relatively small HIV and AIDS epidemic in comparison with some parts of the world. An estimated 98,400 people in the UK – or around 1.5 per 1000 of the UK population – are currently living with HIV. 1 While this number is relatively low, it has increased dramatically since the 1990s, alongside a general rise in the prevalence of sexually transmitted infections. For UK specific help and advice about HIV and AIDS see here.Although HIV and AIDS gets less attention from the media in the UK than it did during the early years of the UK AIDS epidemic, it’s far from an issue of the past. In fact, the epidemic has expanded, with the annual number of new HIV diagnoses nearly tripling between 1996 and 2005, when the annual rate peaked at almost 8,000 diagnoses. 2 Annual diagnoses have slightly declined since then with 6,360 people diagnosed HIV-positive in 2012. 3The UK HIV and AIDS statistics show that of the 98,400 people living with HIV in the UK at the end of 2012, approximately 22 percent were unaware of their infection. 4 This figure is declining year on year, showing the uptake of HIV testing 2012. 11 Public awareness Despite rising numbers of people infected through sexual transmission within the UK, public knowledge of HIV and AIDS appears to have declined. In 2000, 91 percent of people in the UK knew that HIV was transmitted through unprotected heterosexual sex; by 2010 this figure had fallen to 80 percent. 12 A 2011 report by the House of Lords Select Committee into HIV and AIDS in the UK noted that, "awareness of HIV and AIDS in Britain has fallen below the public radar". 13 More resources directed towards HIV prevention, including wider access to HIV testing, were identified as key measures needed to reduce new HIV infections in the UK and effectively deal with the epidemic. Despite this, since the UK's previous national strategy for HIV and sexual health came to an end in 2010, the UK remained without a renewed strategy for more than two years. 14 15 In 2012, HIV Prevention England (HPE) was formed, funded by the Department of Health and managed by Terrence Higgins Trust, which focuses on men who have sex with men (MSM) and African communities. 16 17 Since the NHS reform in April 2013, HIV services are now under the guide of local authorities, rather than regional primary care trusts (PCTs). This has caused concern for the sustainability of HIV services, and their connection to sexual health services. 18 In 2013 it was announced that healthcare workers living with HIV are now allowed to undertake certain medical procedures, from which they were previously banned. Positive governmental changes like this may go a long way towards changing negative attitudes towards people living with HIV. 19 UK regions affected by HIV In 2012 there were 5,846 new HIV diagnoses in England, 287 in Scotland, 125 in Wales and 95 in Northern Ireland. 20 London is the epicentre of the UK HIV and AIDS epidemic, accounting for roughly half of HIV diagnoses in the UK so far. 21 There is a good distribution of services around the country, with more than 80 percent of people with a diagnosed HIV infection living within five kilometres of an HIV service. 22 HIV transmission routes in the UK Of the total HIV diagnoses reported in 2012, 51 percent resulted from sex between men, 45 percent from heterosexual sex, 2 percent from injecting drug use, and less than 2 percent combined from mother-to-child transmission, blood/tissue transfer, and other or undetermined routes. 23 Transmission from sex between men became the largest transmission route in 2011, when it overtook heterosexual sex. Heterosexual sex Infections acquired through heterosexual sex accounted for 45 percent of diagnoses in 2012. 24 The number of people who acquire HIV heterosexually overseas is continuing to decline; conversely the number of infections acquired in the UK continues its dramatic rise from 27 percent in 2002, to 52 percent in 2011. 25 The increasing number of people infected with HIV through this route means that the number of women living with HIV is increasing. The male to female ratio of HIV diagnoses made before 1995 was around 6 to 1, whereas in 2011 the ratio for new diagnoses was around 2.1 males to 1.0 female. 26 Men who have sex with men (MSM) and HIV/AIDS in the UK In 2012, an estimated 40,900 MSM were living with HIV in the UK, with only 17 percent of this number aware of their status. HIV prevalence among MSM is of increasing concern in the UK. 51 percent of all new HIV diagnoses in the UK were among MSM, a 10 percent increase on 2011, and the highest number ever reported in the country. 27 In Scotland, sex between men has accounted for 71 percent of all new HIV diagnoses since 2004. 28 34 percent of newly diagnosed MSM in the UK in 2012 were diagnosed late, compromising the benefits of starting treatment early. 29 There is a great need for consistent testing at least once a year, and every 3 months if having unprotected sex with new partners among this group. 30 Drug use among MSM in the UK is also on the rise, particularly in London. This is another potential HIV transmission route within an already vulnerable population. 31 Video of We&amp;#039;re in a cock fight with HIV!! - (GMFA - the gay men&amp;#039;s health charity) Injecting drugs The prevalence of HIV infection among people who inject drugs (PWID) is relatively low in the UK - 1 in 100 PWID are living with HIV. 32 Around 2 percent of all new HIV diagnoses in 2012 were a result of injecting drugs, and more than half of those diagnoses were amongst people who were born abroad and inject drugs. 33 Although injecting drugs isn't a major cause of HIV infection in the UK, drug users are at higher risk for HIV co-infection with hepatitis. Around 90 percent of hepatitis infections in the UK are among current or former PWID. Treatments for co-infections are complicated, requiring earlier treatment in order to prevent liver damage. 34 In 2013, a study found that HIV prevalence among men who inject image and performance enhancing drugs (IPEDs) was similar to men who inject psychoactive drugs in the UK. The study pointed out that it is not the type of substance injected that causes HIV infection, it is the injecting practice itself. 35 There are calls for more targeted HIV prevention information for this group; as many as 59,000 people used steroids in England during 2013. 36 A UK based study followed 24 steroid users who were obtaining the drugs from illicit markets, meaning they could not tell exactly what drugs were in the concoction. The participants only relied on information from their peer steroid users about injecting practices. Unknown drugs and risky injecting practices mean that there is a call for harm reduction education to be increased among steroid users. 37 National Institute for Health and Care Excellence (NICE) (2014, April) 'Needle and syringe programmes PH52' - See more at: http://www.avert.org/people-inject-drugs-hiv-aids.htm#sthash.v1rsjzHb.dpuf National Institute for Health and Care Excellence (NICE) (2014, April) 'Needle and syringe programmes PH52' - See more at: http://www.avert.org/people-inject-drugs-hiv-aids.htm#sthash.v1rsjzHb.dpuf Mother-to-child transmission of HIV A high uptake of antenatal HIV testing and the availability of drugs to prevent mother-to-child transmission of HIV has contributed to a low mother to child transmission rate of just 1 percent. 38 HIV diagnoses attributed to mother-to-child transmission totalled 95 in 2011, though the majority were from infections that had actually been transmitted outside the UK. There have been nearly 2,200 UK diagnoses of HIV in people who acquired the virus from their mothers, since 1985 when the first diagnosis was reported. 39 A 2012 study found that pregnancy rates among HIV-positive women in the UK have increased. Additionally, the proportion of pregnancies that were terminated among the women taking part in the study decreased from 13 percent in 2000-01 to 3 percent in 2008-09. The investigators concluded that this increase in women choosing not to have an abortion was likely to result from increased access to prevention of mother-to-child transmission. 40 HIV infected blood/tissue transfer Blood safety measures within the UK have minimised the risk of transmission through infected blood transfusions and tissue to such a degree that there have been no reports of HIV infection being acquired in this way, in the UK, since 2002. 41 The last recorded incident of HIV transmission through infected blood donated in the UK was in a female blood transfusion recipient in 2003. 42 To minimise the risk of receiving infected blood whilst donors are in the window period, the UK has certain restrictions on who can donate. Individuals that have ever been a sex worker or have ever injected drugs are banned from donating blood for life. Other behaviours that are considered to be high-risk result in an individual being deferred from donating blood rather than having a lifetime ban. For example, individuals that have had sex with somebody who has been sexually active in a high-prevalence country, with a sex worker or with an injecting drug user, cannot donate blood for twelve months afterwards. 43 Until 2011, men who have sex with men (MSM) were permanently excluded from donating blood in the UK. The blood donation criterion was changed in England, Scotland and Wales on 7th November 2011, bringing the donation criteria for MSM in line with other high-risk groups with a twelve-month deferral period. Occupational exposure is very rare in the UK, with one definite documented case since 1997. 44 Medical settings have procedures in place in case of a ‘sharps injury’, which can involve PEP if there is a danger that the health care worker has been exposed to HIV infected blood. Black Africans and HIV/AIDS in the UK In 2012, black African people accounted for 34 percent of all HIV diagnoses in the UK. 45 In the same year, 19 percent of all new HIV diagnoses were among this group. An estimated 32,000 people from this group are thought living with HIV in the UK, 27 percent of which have undiagnosed infections. 46 HIV diagnoses among black Africans often occur at a late stage of infection - when antiretroviral treatment is less likely to work as effectively. In 2012, over 66 percent of black African heterosexual men, and 61 percent of black African women, were diagnosed late, highlighting the need to increase HIV testing uptake among this population. 47 Similarly, this trend of late diagnosis occurs among other ethnic groups in the UK. In 2012, 66 percent of black Caribbean heterosexual men and 47 percent of black Caribbean women had a late HIV diagnosis. 48 There have been calls for urgent testing campaigns with targeted messages for communities from sub-Saharan Africa. However, there is also resistance to this approach as it could fuel stigma and discrimination towards these groups. 49 The National AIDS Trust (NAT) recommend that sexually active black Africans in the UK have an HIV test annually. 50 To access information about how to get tested for HIV in the UK, see our help and advice page. HIV and AIDS prevention in the UK Sexual transmission For serodiscordant couples, where one person is HIV positive and the other negative, there are various HIV prevention options available in the UK, the most common being condoms. Treatment as prevention is now recommended in some circumstances. The UK, unlike some high-income countries, is yet to prescribe pre-exposure prophylaxis due to a lack of evidence of its effectiveness. 51 Men who have sex with men (MSM) 'Choose safer sex' poster 'Choose safer sex' poster Gay men are currently the focus of a number of HIV prevention campaigns in the UK. An important nationally coordinated campaign body is CHAPS, which is funded by the Department of Health and run by a partnership of organisations, led by the Terrence Higgins Trust. CHAPS produces various research-informed campaigns through interventions in the media, such as ‘smart arse, clever dick’. 52 Taking the view that people can be more influenced by what their peers do than what government and health agencies advise, the campaign allows men to see other men endorsing the positive aspects of condom use. Promoting HIV prevention at MSM community events has also been found to be successful. A study of one intervention, which offered HIV and syphilis testing to men attending Birmingham Gay Pride, found that the uptake was high. 53 The study recommended testing men for HIV at other Gay Pride celebrations in the UK. Most MSM use condoms most of the time. 54 However, there is still a need to increase overall consistency of condom use. In 2010, around a quarter of MSM had unprotected anal sex with two or more partners. 55 Risks remain even when MSM have unprotected sex with someone of the same status. This practice, known as ‘serosorting’, can put men at risk of other STIs, and if both are positive, potential reinfection with a different strain of HIV. Due to the proportion of MSM who are unaware that they are living with HIV, serosorting can also put men at risk of HIV if they both believe themselves to be negative. 56 In 2011 HIV organisations in London expressed 'disappointment' and 'concern' over 20 percent cuts to their funding for HIV prevention services in the capital city, 57 commenting, “Targeted HIV-prevention strategies are vital, especially for those most at risk, such as gay men, and without them it could lead to infection rates going up and awareness of HIV going down.” - Deborah Jack, National AIDS Trust chief executive 58 Greater MSM-targeted HIV testing and the early initiation of antiretroviral treatment have been highlighted as two key areas that could reduce the transmission of HIV. 59 The preventative benefits of early antiretroviral therapy were endorsed by the British HIV Association (BHIVA) in 2013; this is a prevention approach that has also been identified as a priority for inclusion in national HIV prevention plans. 60 However, ' treatment as prevention' will only go so far in reducing new infections without substantial gains in HIV testing to diagnose MSM currently unaware of their status. 61 62 Africans in the UK The National African HIV Prevention Programme (NAHIP) is a country-wide prevention campaign funded by the Department of Health. It is managed by the African HIV Policy Network and collaborates with a number of smaller organisations that aim to prevent HIV among African people in the UK. References 1. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 2. HPA (2012) ‚ ‘ United Kingdom New HIV Diagnoses to end of June 2012’ 3. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 4. Public Health England (2013) ' HIV in the United Kingdom: 2013 report<' 5. May, M. T., et al (2014) 'Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy: UK cohort study' 6. Cairns, G., NAM (2012) ' Life expectancy in older people with HIV could exceed the average - as long as ART keeps working' 7. May, M. T., et al (2014) 'Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy: UK cohort study' 8. May, M et. al (2011) ' Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study' BMJ 343:d60616 9. HPA (2012, July)‚ ‘Statistics provided to AVERT by the Health Protection Agency’ 10. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 11. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 12. NAT (2011, February 18th) ' One in five adults do not realise HIV is transmitted through sex without a condom between a man and a woman' 13. Select Committee on HIV and AIDS in the United Kingdom (2011, July) ' No vaccine, no cure: HIV and AIDS in the United Kingdom' 14. Yusef Asad (2013, 16th January) ' Why the Government Risks Letting People With HIV Down' Huffington Post 15. NAT (2012, October) ' HIV-A Strategy for Success' 16. Health Prevention England (2012) ' Who we are' 17. Department of Health (2013, March) ' A Framework for Sexual Health Improvement in England' 18. The Lancet (2014, January) ' England's HIV services face complex new environment' 19. UK Government (August 2013) ' Modernisation of HIV rules to better protect public' 20. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 21. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 22. Health Protection Agency (2011) ' HIV in the United Kingdom: 2011 report' 23. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 24. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 25. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 26. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 27. PHE (2014, April) ' Addressing Late HIV Diagnosis through Screening and Testing: An Evidence Summary' 28. Scottish Government (2014) ' HIV Prevention: Needs Assessment of Men Who Have Sex with Men (MSM)' 29. PHE (2014, April) ' Addressing Late HIV Diagnosis through Screening and Testing: An Evidence Summary' 30. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 31. The Lancet (2013, January) ' High-risk drug practices tighten grip on London gay scene' 32. Health Protection Agency (2012) ' Shooting Up - Infections among people who inject drugs in the UK 2011' 33. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 34. National AIDS Trust (2012) ' Hepatitis C and HIV Coinfection' 35. Hope. V. et al (2013) ' Prevalence of, and risk factors for, HIV, hepatitis B and C infections among men who inject image and performance enhancing drugs: a cross-sectional study' BMJ 36. National Institute for Health and Clinical Excellence (NICE) (2014) ' NICE public health guidance 52 - Needle and syringe programmes' 37. Andreas Kimergard et al (2014, June) ' Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK', BMJ 38. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 39. HPA (2012)‚ ‘ United Kingdom New HIV Diagnoses to end of June 2012’ 40. nam/aidsmap (2012) ' Pregnancy rate among HIV-positive women in the UK has increased significantly' 41. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 42. Serious Hazards of Transfusion (2003) ' Annual Report' 43. NHS Blood and Transplant (2011) ' Give Blood - Who Can't Give Blood' 44. Health Protection Agency (2008) ' Eye of the Needle' 45. NAT (2014, June) ' HIV and Black African Communities in the UK' 46. PHE (2014, April) ' Addressing Late HIV Diagnosis through Screening and Testing: An Evidence Summary' 47. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 48. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 49. NAT (2012) ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 50. NAT (2012) ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 51. aidsmap / NAM (2012) ‚ ‘ PrEP needs more study before being provided, UK physicians conclude' 52. CHAPS (2012) ‚ ‘ Smart arse, clever dick’ 53. Newton R. et al (2012, December) ‘The uptake of HIV and syphilis testing in a nurse-delivered service during Gay Pride events.’ International Journal of STD and AIDS, 23 (12) 54. CHAPS (2012) ‚ ‘ Smart arse, clever dick’ 55. CHAPS (2012) ‚ ‘ Smart arse, clever dick’ 56. HPA (2011) ‚ ‘ Sexually Transmitted Infections and Men who have Sex with Men in the UK: 2011 Report' 57. BBC News (2011, May) ' London HIV services cut as infections rise' 58. TimeOut (2011, May) ' Is London set for a new HIV epidemic?' 59. Birrell, PJ et. al (2013, February 1st) 'HIV incidence in men who have sex with men in England and Wales 2001–10: a nationwide population study' Lancet Infect Dis S1473-3099(12)70341-9 60. The British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA) (2013, January) ' Position statement on the use of antiretroviral therapy to reduce HIV transmission' 61. Phillips, N/, et al (2013) ' Increased HIV Incidence in Men Who Have Sex with Men Despite High Levels of ART-Induced Viral Suppression: Analysis of an Extensively Documented Epidemic' 62. Brown, A. E., et al (2013) ' HIV treatment as prevention among men who have sex with men in the UK: is transmission controlled by universal access to HIV treatment and care?' 63. NHS (2007) ' Do it Right website' 64. The National African HIV Prevention Programme, Beyond Condoms Campaign website, accessed 16/08/09 65. HPA (2007) ‘ Testing Times: HIV and other Sexually Transmitted Infections in the United Kingdom: 2007’ 66. Elam G et al (2006), ‘Barriers to voluntary confidential HIV testing among African men and women in England: results from the Mayisha II community-based survey of sexual attitudes and lifestyles among Africans in England’, HIV Medicine 2006; 7(Suppl. 1): 7 (abstract no. O28) 67. Hope V.D. et al, Euro Surveillance (2014) ' Two decades of successes and failures in controlling the transmission of HIV through injecting drug use in England and Wales, 1990 to 2011' 68. Hope V.D. et al (2005), 'HIV prevalence among Injecting Drug Users in England & Wales 1990 to 2003: Evidence for increased transmission in recent years' AIDS 2005:19 69. Hope V.D. et al, Euro Surveillance (2014) ' Two decades of successes and failures in controlling the transmission of HIV through injecting drug use in England and Wales, 1990 to 2011' 70. Turning point (2007), ‘ At the sharp end: a snapshot of 21st century injecting drug use’ (pdf) 71. Mathers B. M. et al (2010, March) ‚ ‘ HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage’ The Lancet 72. WHO/UNAIDS/UNICEF (2011) ‚' Global HIV/AIDS Response: Epidemic update and health sector progress towards Universal Access 2011' 73. Public Health England (2013) ' Shooting Up: Infections among people who inject drugs in the UK 2012' 74. BBC News (2012, February) ‚ ‘ Glasgow drug users warned of HIV cluster’ 75. National AIDS Trust (2013, July) ' HIV and Injecting Drug Use' 76. NAT (2011, February 18th) ' One in five adults do not realise HIV is transmitted through sex without a condom between a man and a woman' 77. HPA (2012) ‚ ‘ United Kingdom New HIV Diagnoses to end of June 2012’ 78. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 79. NAT (2008), ‘Over 90 percent of the British public do not fully understand how HIV is transmitted’ 80. Department for Education (2013, September) ' National Curriculum in England: Framework for Key Stages 1 to 4' 81. Department for Education (2013, September) ' The National Curriculum in England: Key stages 3 and 4 framework document' 82. Department for Education (2013, September) ' Guidance: Personal, Social, Health and Economic (PSHE) Education' Ofsted – the official body that regulates schools in England – reported in 2007 that: "Schools gave insufficient emphasis to teaching about HIV/AIDS. Despite the fact that it remains a significant health problem, pupils appear to be less concerned about HIV/AIDS than in the past.”Ofsted (2007, April) 'Time for change? Personal, social and health education’ 83. THT (2007) ‘Press release: Survey highlights shocking ignorance about HIV, 25 years after death of Terry Higgins’ 84. BBC News (2013) ' Poor sex education leaves pupils vulnerable - Ofsted' 85. HPA (2012) ‚ ‘ United Kingdom New HIV Diagnoses to end of June 2012’ 86. HPA (2007) ‘ Testing Times: HIV and other Sexually Transmitted Infections in the United Kingdom: 2007’ 87. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 88. HPA (2011) ‚ ‘ Sexually Transmitted Infections and Men who have Sex with Men in the UK: 2011 Report' 89. Sigma Research (2010, October) 'Tactical dangers: Findings from the United Kingdom Gay Men's Sex Survey 2008' 90. Flowers. P. et al (2013, February) ' Has testing been normalized? An analysis of changes in barriers to HIV testing among men who have sex with men between 2000 and 2010 in Scotland, UK' 91. Public Health England (2013) ' HIV in the United Kingdom: 2013 report' 92. National AIDS Trust (2012) ‚ ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 93. BHIVA (2006), 2005-6 Full results of mortality audit 94. Department of Health (2013, August) ' Modernisation of HIV rules to better protect public' 95. BBC News (2014, 6 April) ' UK law passes sales of HIV home tests before they exist' 96. National AIDS Trust (2012) ‚ ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 97. BHIVA (2008) ‚ ‘ Letter from Dr Mary Armitage, Immediate Past Clinical Vice President, Royal College of Physicians (RCP)’ 98. BHIVA/BASHH/BIS (2008) 'UK National guidelines for HIV testing 2008' 99. National AIDS Trust (2012) ‚ ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 100. HPA (2010) 'Time to test for HIV: Expanded healthcare and community HIV testing in England - Interim report' 101. BBC News (2011, 7th January) 'Doctors are "reluctant" to test routinely for HIV' 102. NICE (2011) PH33 Increasing the uptake of HIV testing among black Africans in England: guidance 103. NICE (2011) ' PH33 Increasing the uptake of HIV testing among black Africans in England: costing report' 104. Department of Health (2012, 1st October) ' HIV Treatment for Overseas Visitors' 105. NICE (2011) ' Increasing the uptake of HIV testing among men who have sex with men' 106. NICE (2011) ' Increasing the uptake of HIV testing among men who have sex with men' 107. The British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA) (2013, January) 'Position statement on the use of antiretroviral therapy to reduce HIV transmission' 108. National AIDS Trust (2011) ‚ ‘ The impact of social care support for people living with HIV: the results of NAT’s snapshot survey of healthcare professionals’ 109. NAT (2010, June 14th) ' NAT Concerned by end of Protected Grant for Care of People with HIV' 110. PinkNews (2010, June 14th) ' HIV charities 'very concerned by threat to local funding' 111. National AIDS Trust (2011) ‚ ‘ The impact of social care support for people living with HIV: the results of NAT’s snapshot survey of healthcare professionals’ 112. National AIDS Trust (2011) ‘ The impact of social care support for people living with HIV: the results of NAT’s snapshot survey of healthcare professionals’ 113. HIV InSite (2006) ' Coping with Stress' 114. Positively UK (2014) ' The Impact of the Welfare Reforms on People Living with HIV in England' 115. Terrence Higgins Trust (2014, February) ' HIV and Poverty' 116. NAT (2011, February 18th) ' One in five adults do not realise HIV is transmitted through sex without a condom between a man and a woman' 117. Select Committee on HIV and AIDS in the United Kingdom (2011, July) ' No vaccine, no cure: HIV and AIDS in the United Kingdom' 118. Select Committee on HIV and AIDS in the United Kingdom (2011, July) ' No vaccine, no cure: HIV and AIDS in the United Kingdom' 119. Weild A et al (1998), 'The prevalence of HIV and associated risk factors in prisoners in England and Wales in 1997: results of a national survey', International Conference on AIDS' 120. Prison Reform Trust/National AIDS Trust (2005), 'HIV and hepatitis in UK prisons: addressing prisoners' healthcare needs'. Elkins T. 121. HM Prison Service (2007, October) ' Reintroduction of disinfecting tablets' 122. National AIDS Trust (2011, May), ' Tackling Blood-Borne Viruses in Prisons: A framework for best practice in the UK' 123. CPS (2008) ‘Policy for prosecuting cases involving the intentional or reckless sexual transmission of infection’ 124. National Aids Trust (2012, May) ' Criminal Prosecutions' 125. National Aids Trust (2010, July 15th) ' New guidance for Police Investigating Criminal Transmission of HIV' ! 126. Terrence Higgins Trust, ' Thinking on Prosecutions' 127. NAT ' Why NAT opposes prosecution for reckless HIV transmission' 128. National AIDS Trust/ Terrence Higgins Trust (October, 2012) ' Will I have to pay?' 129. UK Border Agency (2012) ' Healthcare needs and pregnancy dispersal guidance' 130. National AIDS Trust (2009) ' Detention, removal and people living with HIV' (pdf) 131. Medical Justice (2011) ' Detained and Denied: The clinical care of immigration detainees living with HIV' 132. Rice,B et al (2013) ' Decreasing incidence of tuberculosis among heterosexuals living with diagnosed HIV in England and Wales' 133. Laura Anderson et al (2014) ' Transmission of multidrug-resistant tuberculosis in the UK: a cross-sectional molecular and epidemiological study of clustering and contact tracing,' The Lancet 134. National AIDS Trust (2012)‚ ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 135. National AIDS Trust (2012)‚ ‘ HIV Testing Action Plan to reduce late HIV diagnosis in the UK' 136. Select Committee on HIV and AIDS in the United Kingdom (2011, July) ' No vaccine, no cure: HIV and AIDS in the United Kingdom' - See more at: http://www.avert.org/hiv-aids-uk.htm#sthash.S4Y4DtoC.dpuf