UK Health Security Agency, London, UK.
Liverpool John Moores University, Liverpool, UK.
HIV Med. 2022 Oct;23(9):978-989. doi: 10.1111/hiv.13297. Epub 2022 Mar 30.
People who inject drugs are at high risk of blood-borne infections. We describe the epidemiology of HIV among people who inject drugs in England, Wales, and Northern Ireland (EW&NI) since 1981.
National HIV surveillance data were used to describe trends in diagnoses (1981-2019), prevalence (1990-2019), and behaviours (1990-2019) among people who inject drugs aged ≥15 years in EW&NI. HIV care and treatment uptake were assessed among those attending in 2019.
Over the past four decades, the prevalence of HIV among people who inject drugs in EW&NI remained low (range: 0.64%-1.81%). Overall, 4978 people who inject drugs were diagnosed with HIV (3.2% of cases). Diagnoses peaked at 234 in 1987, decreasing to 78 in 2019; the majority were among white men born in the UK/Europe (90%), though the epidemic diversified over time. Late diagnosis (CD4 <350 cells/µl) was common (2010-2019: 52% [429/832]). Of those who last attended for HIV care in 2019, 97% (1503/1550) were receiving HIV treatment and 90% (1375/1520) had a suppressed viral load (<200 copies/ml). HIV testing uptake has steadily increased among people who inject drugs (32% since 1990). However, in 2019, 18% (246/1404) of those currently injecting reported never testing. The proportion of people currently injecting reporting sharing needles/syringes decreased from 1999 to 2012, before increasing to 20% (288/1426) in 2019, with sharing of any injecting equipment at 37% (523/1429).
The HIV epidemic among people who inject drugs in EW&NI has remained relatively contained compared with in other countries, most likely because of the prompt implementation of an effective national harm reduction programme. However, risk behaviours and varied access to preventive interventions among people who inject drugs indicate the potential for HIV outbreaks.
注射毒品的人有很高的感染血源性传染病的风险。我们描述了自 1981 年以来英格兰、威尔士和北爱尔兰（EW&NI）注射毒品人群中 HIV 的流行情况。
使用国家 HIV 监测数据描述了 EW&NI 中年龄≥15 岁的注射毒品者的诊断（1981-2019 年）、流行率（1990-2019 年）和行为（1990-2019 年）的趋势。2019 年评估了那些参加 HIV 护理和治疗的人的情况。
在过去的四十年里，EW&NI 中注射毒品人群中 HIV 的流行率仍然很低（范围：0.64%-1.81%）。共有 4978 名注射毒品者被诊断患有 HIV（占病例的 3.2%）。诊断数在 1987 年达到峰值 234 例，然后下降到 2019 年的 78 例；大多数是在英国/欧洲出生的白人男性（90%），尽管随着时间的推移，疫情逐渐多样化。晚期诊断（CD4 <350 个细胞/µl）很常见（2010-2019 年：52%[429/832]）。在 2019 年最后一次接受 HIV 护理的人中，97%（1503/1550）正在接受 HIV 治疗，90%（1375/1520）的病毒载量得到抑制（<200 拷贝/ml）。注射毒品者的 HIV 检测率稳步上升（自 1990 年以来上升了 32%）。然而，在 2019 年，18%（246/1404）的目前正在注射毒品的人报告从未接受过检测。目前正在注射毒品的人报告共用针头/注射器的比例从 1999 年到 2012 年下降，然后在 2019 年增加到 20%（288/1426），任何注射设备的共用比例为 37%（523/1429）。
与其他国家相比，EW&NI 中注射毒品人群中的 HIV 疫情相对得到控制，这很可能是因为迅速实施了有效的国家减少伤害方案。然而，注射毒品者的风险行为和获得预防干预措施的情况各不相同，表明 HIV 有可能爆发。
