The number of gay and bisexual men (GBM) with newly diagnosed HIV fell to the lowest point in 20 years, according to a new report from Public Health England (PHE) published today.

The report shows there were 1,700 new HIV diagnoses in GBM in 2019 compared to 1,500 in 2000.

Overall, the number of people with a new HIV diagnoses fell by 10% (from 4,580 in 2018 to 4,139 in 2019). There was also a 34% decline from a peak of 6,312 new diagnoses in 2014.

There were 1,700 new HIV diagnoses in gay and bisexual men (GBM) in 2019 compared to around 1,600 cases in heterosexual adults. This is the lowest number of new HIV diagnoses in GBM since the year 2000 (1,500) and since 1998 in heterosexual adults (1,600).

HIV transmission in GBM has fallen by 80%; newly acquired HIV infections fell from an estimated peak of 2,700 cases in 2011 to an estimated 540 in 2019 (see background information).

While the proportion of people diagnosed late remained high at 42%, the overall number decreased from around 1,900 in 2015 to 1,300 in 2019. People diagnosed late in 2019 had an eight-fold risk of death compared to those diagnosed promptly.

The decline in HIV transmission in GBM can be directly linked to the increase in combination prevention, including:

• the use of condoms

• pre-exposure prophylaxis (PrEP)

• frequent HIV testing in a wide range of settings

• starting antiretroviral therapy (ART) as soon as possible after diagnosis

Treatment is now so effective that 97% of people receiving ART have undetectable levels of virus, which means it is impossible to pass the virus on, even if having sex without condoms. Undetectable = untransmittable (U=U).

HIV testing is vital for preventing HIV-related illness and death and to achieve the goal of ending HIV transmission in the UK by 2030. The UK continues to meet the United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 targets for the third consecutive year – however, there are opportunities to improve uptake of testing and support those testing positive to continue their treatment.

Almost 300,000 people declined to have an HIV test when they attended a specialist sexual health service. Black African heterosexual women attendees were more likely to decline a test than Black African heterosexual men (20% versus 9% declined testing) but less likely than heterosexual women and men overall (25% versus 13%). More focused conversations on HIV, testing, prevention and treatment in schools and clinical settings can help to combat high rates of declined tests.

By comparison, only 4% of GBM attending specialist sexual health services declined an HIV test – this is the group in which greatest declines in HIV transmission have been achieved.

Dr Valerie Delpech, Head of HIV Surveillance at PHE, said:

In the UK, we have made great progress towards eliminating HIV transmission by 2030. Frequent HIV testing, the offer of PrEP among those most at risk of HIV, together with prompt treatment among those diagnosed, remain key to ending HIV transmission by 2030.

Further progress can only be achieved if we also address the inequalities in reducing HIV transmission that exist around sexuality, ethnicity and geography.

The most common way of getting HIV in the UK is through sex with a person who is unaware of their HIV infection.

You can protect yourself from HIV by consistent and correct condom use with new and casual partners, by using PrEP, or if your partner is on treatment and is undetectable if they are living with HIV. Correct and consistent condom use will also stop you getting or transmitting other sexually transmitted diseases (STIs).

People can get tested through free tests available from sexual health clinics, GP surgeries, as well as through a self-sampling service or by using a self-testing kit.

Background information

Those at risk of HIV and STIs can still access services through sexual health clinics during the COVID-19 pandemic. Many clinics offer online testing, which means people can order tests using clinic websites, take them in the privacy of their own home, return by post and receive results via text, phone call or post.

New HIV diagnoses reflect diagnoses that occurred within a year. Since people can live with HIV for many years without being aware of their HIV infection, trends in diagnoses do not necessarily reflect trends in newly acquired infections. We use models to estimate newly acquired infections (infections acquired recently) for gay and bisexual men only.

The government’s landmark legislation to transform our environment has returned to Parliament today (Tuesday, 3 November) after a pause due to the coronavirus outbreak.

The Environment Bill sets out a comprehensive and world-leading vision to allow our environment to prosper for future generations and ensure that we maintain and enhance our environmental protections.

A key vehicle for delivering the bold vision set out in the 25 Year Environment Plan, the Bill will enhance wildlife, tackle air pollution, transform how we manage our resources and waste, and improve the resilience of water supplies in a changing climate to ensure we protect and restore the natural environment.

Welcoming the Environment Bill back to Parliament, Environment Minister Rebecca Pow said:

Protecting and enhancing our environment is a priority for this Government, especially as we strive to build back greener from the coronavirus pandemic.

The Environment Bill is one of the most important pieces of legislation for a generation, and it’s essential that we complete its passage into law as soon as possible so that we can continue our work to transform society and improve our air, water and nature.

Legally binding targets will be introduced for air quality, nature, water and resource and waste efficiency, and a new, independent Office for Environmental Protection (OEP) will be created to hold government and public bodies to account for their environmental credentials.

The Office’s enforcement powers will cover all climate change legislation and hold the government to account on its commitment to reach net zero emissions by 2050. By also championing nature-based solutions, the Bill demonstrates our commitment to tackle climate change.

The Environment Bill will:

• ensure the environment is at the heart of all government policy making and that both this government and future governments are held to account if they fail to uphold their environmental duties, including meeting net-zero by 2050 and new long-term legally binding targets on biodiversity, air quality, water, and resource and waste efficiency
• improve air quality – by requiring a legally-binding target to reduce concentrations of fine particulate matter (PM2.5), the pollutant of most concern for human health, and by increasing local powers to address sources of air pollution
• restore and enhance nature – through ‘biodiversity net gain’ ensuring new development enhances nature, helping to deliver thriving natural spaces for local communities. We will improve protection for our natural habitats in supporting a Nature Recovery Network by establishing Local Nature Recovery Strategies, giving communities a greater say in the protection of nature
• transform the way we manage our waste – through powers to ensure that producers take responsibility for the waste they create, introducing a consistent approach to recycling including food waste, tackling waste crime, introducing deposit return schemes and more effective litter enforcement. Powers to introduce new charges will minimise the use and impacts of single use plastics, and we will also be able to ban the export of plastic waste to developing countries
• protect precious water resources – by increasing sustainable water management through securing long-term, resilient water and wastewater services in the face of a changing climate. Powers to direct water companies to work together to meet current and future demand for water will make planning more robust

The legislation builds on this government’s decisive action to protect the environment as set out in our 25 Year Environment Plan. Our binding commitment to reach net-zero carbon emissions by 2050 and hosting the COP26 climate change conference will keep the UK at the forefront of international work on these issues.

The Bill also sets a new and ambitious domestic framework for environmental governance as we maximise the opportunities created by leaving the European Union.

Ahead of the Environment Bill’s return, a number of amendments have been tabled by the Government for consideration. These clarify how the OEP should exercise its enforcement powers so as to leave no doubt about its thresholds for action, and to protect its confidence and ability to focus on the most serious cases whilst maintaining its crucial independence.

Other amendments would enable the creation of Species Conservation Strategies and Protected Site Strategies to deal with the complex challenge of protecting and restoring species and habitats at risk, while also enabling much needed development.

Following the Bill’s completion of Committee Stage, it will be further scrutinised by the whole House of Commons at Report Stage and Third Reading, after which it will move to the House of Lords for further debate and scrutiny.

Airbus has been awarded a contract to prepare a mission to collect the most accurate measurements of energy coming into the Earth from the Sun, and light reflected off Earth’s surface, to help understand changes in balance (global warming) and mankind’s impact on the planet.

The mission will not only make measurements itself, but also improve the performance of other missions through calibration from space, becoming a new ‘gold standard’ reference for climate measurements.

The contract is backed by the UK Government and awarded as part of the European Space Agency’s TRUTHS satellite mission, which will rapidly improve our ability to track and monitor climate change from Earth Observation data. It will allow climate scientists to better compare and calibrate data from other satellites while making the reasons for climate change action more certain and enabling progress from those actions to be seen in the shortest possible time.

Earth observation satellites collect hundreds of terabytes of data per day, delivering vital intelligence about how fast glaciers flow, the size of forest fires in the Amazon, and the quality of the air that we breathe. Measurements from these satellites will arm policy makers, governments and industry with the best quality data and knowledge needed to track and better understand the impacts of climate change.

The TRUTHS mission was originally conceived in the UK by Professor Nigel Fox of the National Physical Laboratory (NPL) – a world leading centre for measurement science – to act as the first ever ‘climate and calibration laboratory in space’.

Richard Franklin, Managing Director of Airbus Defence and Space in the UK said:

Validating data on Earth’s changing climate is at the heart of this exciting mission, which will have a profound impact on future studies. It will provide the gold standard of calibration for space-based Earth observation – a kind of ‘standards laboratory in space’.

For the first time the international scientific community will be able to cross-reference their measurements and data, enabling much more accurate forecasts and analysis, from both large institutional and small commercial missions.

The TRUTHS mission will build on the UK’s status as a world-leader in tackling climate change, with Airbus now set to lead the industrial charge in helping provide this novel mission.

Many other UK companies will be part of the programme, UK science and expertise will guide its requirements and the resultant data has the potential to help revolutionise our understanding of the planet.

UK Science Minister Amanda Solloway, said:

We have to use every tool at our disposal to help understand and tackle major issues such as climate change, whether that’s locating harmful carbon emissions or tracking the effects of deforestation.

This ambitious mission to create a ‘climate laboratory’ in space – the first of its kind – will help increase the accuracy of future climate projections by arming our leading scientists with the most reliable data and insight we have ever had access to – helping us take action to tackle this here in the UK, and around the world.

TRUTHS will carry a Cryogenic Solar Absolute Radiometer (CSAR) to provide a primary calibration standard in order to benchmark measurements of both incoming solar radiation and outgoing reflected radiation with unprecedented accuracy.

The TRUTHS study and pre-developments marks a determined approach by the UK to propose and lead missions within the European Space Agency that meet UK objectives and will include key partners from the UK space industry including Teledyne e2v UK, NPL, RAL, University of Leicester, Thales Alenia Space UK, CGI IT UK, Telespazio-UK and Goonhilly Satellite Earth Station as well as important contributions from companies and institutes from the participating nations: The Czech Republic, Greece, Romania and Switzerland. The overall contract is worth approximately €16 million.

The UK has embarked on a strategy to take a leadership role and build national capacity in this domain ranging from the strong climate science expertise and the innovation and expertise in developing new satellite instrument concepts, through to the build of operational missions which provides data for science, government and the space-enabled service companies who are building commercial climate services on trusted data.

By working with the engineering experts in ESA and by collaborating with our colleagues in other countries the UK Space Agency not only aims for a new mission but one that through building and operation offer an opportunity to inspire the next generation to be involved in an exciting and stimulating career of climate and Earth Observation.